2022-
2023
Samenvatting Dysphagia
LA FASE 3 LOGOPEDIE (DOCENT: MELISSA KONINGS)
WRITTEN BY DEMI VERHOEVEN
,LECTURE 1: General framework and introduction
1. Frames of reference: ICF and EBP
2. Goalsetting: Smart and smarter
3. Definition and classification
a. What is dyspaghia
b. Classification: by age, by stage, by etiology
4. Prevalence
5. Consequences of dysphagia
a. Medical consequences
b. Psychosocial consequences
6. Team approach
7. Setting
8. Concept and keywords
9. Anatomy
LECTURE 2: physiology & pathophysiology
1. Anatomy and physiology: introduction
a. Structures: chambers and sphincters
b. Scheme transport: negative and positive pressure
2. Physiology of deglutition: phases + cranial nerves
a. Cranial nerves
b. 4 phases
i. Preparatory phase:
a. What is happening?
b. Function of structures
c. Importance of saliva
d. Neural control: preparatory phase and
cranial nerves
ii. Oral phase:
a. What is happening?
b. Function of structures
c. Neural control: preparatory phase & cranial
nerves
iii. Pharyngeal phase:
a. What is happening?
b. Airway protection
c. Transport pharynx
d. Opening UES
e. Neural control: scheme + explanation
iv. Esophageal phase:
a. What is happening?
b. Neural control
3. Pathophysiology
c. Successful swallow
d. Pathophysiology: preparatory and oral phase
e. Pathophysiology: pharyngeal phase
f. Pathophysiology: esophageal phase
g. Examples by etiology:
, i. Neurologic disorders: hemispheric stroke, brainstem
stroke, dementia, PD
ii. Structural: congenital/acquired
iii. Structural: therapy
iv. Iatrogenic
v. Presbyphagia
LECTURE 3: assessment: non-instrumental
1. Assessment: introduction
a. Sheme diagnostic process
b. Dysphagic symptoms
c. Population at risk
2. Screening
a. Introduction
b. Performed by + content + what’s a good screening?
c. A lot of choice: some examples
i. Water swallow test: e.g. Yale swallow protocol, Timed
test
ii. VVST
iii. TOR-BSST
d. Details water swallow test: Yale swallow protocol (Leder,
2014)
e. Details water swallow test: Timed test (Nathadwarawaka,
1992)
f. Screening not possible with only instruments
g. Difference between screening and CSE
3. Anamnesis & file study
a. Medical history and swallowing complaint
i. Introduction
ii. Past medical history: examples
iii. Chief complaint
b. Swallowing history
i. Method and schedule of eating or feeding
ii. Diet
1. FOIS (outcomescale, but you can use it to
describe a diet)
iii. Onset, description and variability of problem
1. Onset
2. Description in detail: context, cough or choke,
weight loss, localization/characterization, social or
emotional impact, variability of problem
iv. Compensations
4. Clinical swallow evaluation
a. Indications
b. Limitations
c. Basic terms
d. (head neck) physical examination
i. Indications
ii. Limitations
, iii. Examinations
1. Position
2. Examination of the face
3. Examination of the nose
4. Examination of the lips
5. Examination of the oral cavity
6. Examination of the oropharynx
7. Examination of the hypopharynx -> Only
possible with instruments
8. Palpation of the neck
9. Palpation of the larynx
e. General clinical observation
i. Overall conditioning, incl. cognition or
alertness/endurance
ii. Body tone, size, posture or positioning
iii. Airway
iv. Following instructions
v. Self-feeding potential?
f. Motor and sensory function -> cranial nerves
i. Oral phase:
1. Structures
2. Sensation
3. Reflexes and responses/nonvolitional
movements
4. Motor function: volitional movements + CN: jaw,
lips, tongue, velum
5. Oral sensorimotor integrity
6. Secretions
7. Articulation
8. Resonance
ii. Pharyngeal phase and larynx
1. Vocal quality or changes
2. Pitch control or range.
3. Breathing
4. Volitional cough or throat clear
5. Saliva swallow and laryngeal management
6. Liquid/food swallow -> voice quality,
cough/throat clear?
g. Functional observation swallow
i. Test swallow
ii. Possible signs
iii. Test criteria
iv. Standardized tests
1. MASA (Mann, 2002)
2. MISA (Lambert et al; 2003)
LECTURE 4: Assessment: instrumental
1. Assessment: introduction
a. CSE has limitations
2023
Samenvatting Dysphagia
LA FASE 3 LOGOPEDIE (DOCENT: MELISSA KONINGS)
WRITTEN BY DEMI VERHOEVEN
,LECTURE 1: General framework and introduction
1. Frames of reference: ICF and EBP
2. Goalsetting: Smart and smarter
3. Definition and classification
a. What is dyspaghia
b. Classification: by age, by stage, by etiology
4. Prevalence
5. Consequences of dysphagia
a. Medical consequences
b. Psychosocial consequences
6. Team approach
7. Setting
8. Concept and keywords
9. Anatomy
LECTURE 2: physiology & pathophysiology
1. Anatomy and physiology: introduction
a. Structures: chambers and sphincters
b. Scheme transport: negative and positive pressure
2. Physiology of deglutition: phases + cranial nerves
a. Cranial nerves
b. 4 phases
i. Preparatory phase:
a. What is happening?
b. Function of structures
c. Importance of saliva
d. Neural control: preparatory phase and
cranial nerves
ii. Oral phase:
a. What is happening?
b. Function of structures
c. Neural control: preparatory phase & cranial
nerves
iii. Pharyngeal phase:
a. What is happening?
b. Airway protection
c. Transport pharynx
d. Opening UES
e. Neural control: scheme + explanation
iv. Esophageal phase:
a. What is happening?
b. Neural control
3. Pathophysiology
c. Successful swallow
d. Pathophysiology: preparatory and oral phase
e. Pathophysiology: pharyngeal phase
f. Pathophysiology: esophageal phase
g. Examples by etiology:
, i. Neurologic disorders: hemispheric stroke, brainstem
stroke, dementia, PD
ii. Structural: congenital/acquired
iii. Structural: therapy
iv. Iatrogenic
v. Presbyphagia
LECTURE 3: assessment: non-instrumental
1. Assessment: introduction
a. Sheme diagnostic process
b. Dysphagic symptoms
c. Population at risk
2. Screening
a. Introduction
b. Performed by + content + what’s a good screening?
c. A lot of choice: some examples
i. Water swallow test: e.g. Yale swallow protocol, Timed
test
ii. VVST
iii. TOR-BSST
d. Details water swallow test: Yale swallow protocol (Leder,
2014)
e. Details water swallow test: Timed test (Nathadwarawaka,
1992)
f. Screening not possible with only instruments
g. Difference between screening and CSE
3. Anamnesis & file study
a. Medical history and swallowing complaint
i. Introduction
ii. Past medical history: examples
iii. Chief complaint
b. Swallowing history
i. Method and schedule of eating or feeding
ii. Diet
1. FOIS (outcomescale, but you can use it to
describe a diet)
iii. Onset, description and variability of problem
1. Onset
2. Description in detail: context, cough or choke,
weight loss, localization/characterization, social or
emotional impact, variability of problem
iv. Compensations
4. Clinical swallow evaluation
a. Indications
b. Limitations
c. Basic terms
d. (head neck) physical examination
i. Indications
ii. Limitations
, iii. Examinations
1. Position
2. Examination of the face
3. Examination of the nose
4. Examination of the lips
5. Examination of the oral cavity
6. Examination of the oropharynx
7. Examination of the hypopharynx -> Only
possible with instruments
8. Palpation of the neck
9. Palpation of the larynx
e. General clinical observation
i. Overall conditioning, incl. cognition or
alertness/endurance
ii. Body tone, size, posture or positioning
iii. Airway
iv. Following instructions
v. Self-feeding potential?
f. Motor and sensory function -> cranial nerves
i. Oral phase:
1. Structures
2. Sensation
3. Reflexes and responses/nonvolitional
movements
4. Motor function: volitional movements + CN: jaw,
lips, tongue, velum
5. Oral sensorimotor integrity
6. Secretions
7. Articulation
8. Resonance
ii. Pharyngeal phase and larynx
1. Vocal quality or changes
2. Pitch control or range.
3. Breathing
4. Volitional cough or throat clear
5. Saliva swallow and laryngeal management
6. Liquid/food swallow -> voice quality,
cough/throat clear?
g. Functional observation swallow
i. Test swallow
ii. Possible signs
iii. Test criteria
iv. Standardized tests
1. MASA (Mann, 2002)
2. MISA (Lambert et al; 2003)
LECTURE 4: Assessment: instrumental
1. Assessment: introduction
a. CSE has limitations
