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Normal swallow, alterations to normal swallow (1) - Coggle Diagram

- - - - Oral stage- Older, healthy: longer oral stage of swallow. Might need 2-3 swallows. Also produce extra hyoid gestures-tongue pumping
      - Residue: small increase in amt of oral, pharyngeal residue
      - Trigger of pharyngeal stage: younger is triggered sooner, when bolus passes anterior faucial arches. Older is triggered later-by the time at which base of tongue crosses lower rim of mandible. More fatigured/sick: risky behaviour of it going that low, increase chance of sth going down wrong way, causing aspiration
  - - - Self feeding more natural, portions each time can be controlled, may improve for some. BUT may still have problems wrt impulsivity. Need to finish first bolus before putting in next one
    - - Cup
        
        Sequential sipping: VP closed, lip maintain seal, tongue repeated propulsions, tongue base, pharyngeal wall contact on each bolus tail, UES open repeatedly. Longer airway closure lasting 5-10 secs
        
        Issues: controlling size, amt of bolus taken in at a time. Think if person has enough cortical control. Also ppl tip head back to get remaining contents- DANGEROUS! Need head to be central, not tilting backwards. Then fnally poor limb, hand control can lead to spillage
      - Straw
        
        CAN HELP-but only if they dont have dysphagia, changes way of getting bolus into mouth. Helps ppl who are having issues getting bolus into mouth or to back of mouth (post lingual surgery).
        
        CAUTION-can also make things worse for some. Can be problem if X protect airway when sucking fluids in/ not coordinated w inhalation. Some too weak to suck up fluids. Solution: dysphagia straws-ball bearing to keep liquid in straw
        
        Analogy: thick milkshake
        
        Middle to back of mouth, might suck far too much into mouth if not controlled