STAGES OF SWALLOWING

NORMAL SWALLOW REQUIRES

• 6 cranial nerves
• 48 muscles
• Salivary glands
• Cartilaginous structurs
• Book calls it "rapid interplay"

4 PHASES

• Oral preparatory
• Oral
• Pharyngeal
• Esophageal

ORAL PREP

• Seeing, smelling, reaching for item
• Bringing to mouth, putting in mouth
• Lips close to make a seal
• Tongue and cheeks move item to prep for swallow
• Temp, taste and texture receptors of the tongue aid

ORAL PHASE

• bolus or object prepared by tongue
• Bolus is propelled by tongue
• Reaches back of mouth

PHARYNGEAL

• Bolus passes over tongue into pharynx
• Nose entrance seals
• Hyoid & larynx elevate upward
• Vocal folds close, epiglottis tilts downward
• cricopharyngeal sphincter opens

ESOPHAGEAL

• Bolus passes into esophagus
• Bolus propelled into stomach

WHY THIS IS IMPORTANT

DYSPHAGIA

DYSPHAGIA

• Often seen in elders
• Neurological -CVA
• Neuromuscular- Parkinson's
• Dementia
• Cancer, diabetes, RA

OCCUPATIONAL THERAPY

• Intervention to solve swallowing problem
• Promote self feeding
• Establish therapeutic relationship with elder
• Attention on every detail of mealtime
• Proper positioning techniques/ assisted devices