By Michael E. Groher PhD, Michael A. Crary PhD F-ASHA
Get the entire details you must hopefully deal with dysphagia in expert perform with Dysphagia: medical administration in Adults and youngsters, 2d Edition! This logically prepared, evidence-based source displays the most recent developments in dysphagia in an approachable and effortless demeanour that will help you grasp the medical evaluate and diagnostic decision-making procedures. New assurance of the most recent insights and learn in addition to elevated info on youngster and baby swallowing may also help arrange you for the stipulations you’ll face within the scientific environment. Plus, the lifelike case situations and exact assessment questions threaded through the publication can help you enhance the medical reasoning abilities wanted for pro luck.
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Extra info for Dysphagia: Clinical Management in Adults and Children, 2e
Efficient movement is accomplished by the strength of the neuromuscular contraction exerted on the bolus and on the forces of gravity. Efficient bolus movement is accomplished when coordinated neuromuscular contractions and relaxations create zones of high pressure on the bolus and zones of negative pressure below the level of the bolus. Some parts of the swallowing chain, such as the esophagus, remain under negative pressure because of their location. Creating zones of high and low pressure is largely accomplished by the coordination and strength of the swallowing valves: lips, velum, airway closure, and the PES opening and closing.
Examples of volitional behaviors might include the need to eat faster, the need to expectorate an unwanted bolus, or perhaps the need to talk and masticate simultaneously. Investigations of these multiple pathways and centers have been conducted in human beings and animals with various laboratory techniques, including functional magnetic resonance imaging, electrical stimulation, ablation of suspected control centers, positron emission tomography, and transcranial magnetic stimulation. A complete understanding of the interrelations among centers during varying volitional and nonvolitional swallowing tasks remains speculative.
The combined action of the tongue’s contact to the velum and posterior pharyngeal wall and sealing the nasopharynx contribute to the maintenance of positive pressure on the bolus as it moves toward zones of negative pressure in the hypopharynx. By the tongue’s connections to the hyoid bone, and the hyoid bone’s connections to the thyroid and cricoid cartilages, the larynx is pulled up and forward, resting under the tongue base that now partially covers the opening to the airway. 12 concluded that the geniohyoid muscle was most active in the anterior displacement of the hyoid bone, whereas the mylohyoid was most responsible for superior movement.
Dysphagia: Clinical Management in Adults and Children, 2e by Michael E. Groher PhD, Michael A. Crary PhD F-ASHA