Dysphagia-2001-11-slides

Dysphagia-2001-11-slides - Dysphagia Evaluation and...

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Dysphagia Evaluation and Management Shashidhar Reddy, MD Matthew W. Ryan, MD November 21, 2001
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Physiology of Swallowing The act of swallowing involves three phases: Oral, Pharyngeal, and Esophageal. Swallowing takes about 8-10 seconds Before swallowing begins, Oral Preparation of the bolus must occur.
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Physiology of Swallowing: Oral Phase Pharyngeal Phase
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Physiology of Swallowing Pharyngeal and Esophageal Phase:
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Evaluation of Dysphagia History Review of Systems Physical Exam Imaging Studies
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History Duration dietary changes, weight loss Odynophagia Solids or Liquids Level of sensation of dysphagia Past surgery to head and neck, trauma, ingestion of caustic substances Associated symptoms such as with GERD, voice changes, nasal leakage, otalgia
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Review of Systems: Ask about common systemic processes associated with dysphagia: Tobacco/Alcohol Medications – antihistamines, anticholinergics, antidepressants, antihypertensives Osteoarthritis Systemic neuromuscular disorders Auto-Immune disorders Psychiatric state
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Physical Exam: General: body habitus, mental status, drooling, wheezing, dyspnea, voice quality Cranial nerves Inspection of the tongue and palate for strength/symmetry Laryngeal Examination: pooled secretions, vocal fold movement, interaretynoid area
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Imaging Studies Should be chosen to suit the patient’s symptoms and to confirm a finding.
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Dysphagia-2001-11-slides - Dysphagia Evaluation and...

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