TAILIEUCHUNG - Chapter 038. Dysphagia (Part 3)

Oropharyngeal motor dysphagia results from impairment of the voluntary effort required in bolus preparation or neuromuscular disorders affecting bolus preparation, initiation of the swallowing reflex, timely passage of food through the pharynx, and prevention of entry of food into the nasal and the laryngeal opening. Paralysis of the suprahyoid muscles leads to loss of opening of the UES and severe dysphagia. Because each side of the pharynx is innervated by ipsilateral nerves, a unilateral lesion of motor neurons leads to unilateral pharyngeal paralysis. Neuromuscular disorders causing dysphagia are listed in Table 38-1. They include a variety of cortical and suprabulbar. | Chapter 038. Dysphagia Part 3 Oropharyngeal motor dysphagia results from impairment of the voluntary effort required in bolus preparation or neuromuscular disorders affecting bolus preparation initiation of the swallowing reflex timely passage of food through the pharynx and prevention of entry of food into the nasal and the laryngeal opening. Paralysis of the suprahyoid muscles leads to loss of opening of the UES and severe dysphagia. Because each side of the pharynx is innervated by ipsilateral nerves a unilateral lesion of motor neurons leads to unilateral pharyngeal paralysis. Neuromuscular disorders causing dysphagia are listed in Table 38-1. They include a variety of cortical and suprabulbar disorders lesions of the cranial nerves in their nuclei in the brain stem or their course to the muscles defects of neurotransmission at the motor end plates and muscular diseases. Some of these disorders also involve laryngeal muscles and vocal cords causing hoarseness. Since the oropharyngeal phase of swallowing lasts no more than a second rapid-sequence videofluoroscopy is necessary to permit detection and analysis of abnormalities of oral and pharyngeal function. However such studies can only be performed in a fully conscious and cooperative patient. A videofluoroscopic swallowing study VFSS using barium of different consistencies may reveal difficulties in the oral phase of swallowing. The pharynx is examined to detect stasis of barium in the valleculae and pyriform sinuses and regurgitation of barium into the nose and tracheobronchial tree. Pharyngeal contraction waves and opening of UES with a swallow are carefully monitored. Manometric studies may demonstrate reduced amplitude of pharyngeal contractions and reduced UES pressure without further fall in pressure on swallowing see Fig. 286-3 . General treatment consists of maneuvers to reduce pharyngeal stasis and to enhance airway protection under the direction of a trained swallow therapist. Feeding by a .

• Y học thường thức
• Dysphagia
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu học ngành y
• Harrisons Internal Medicine
• BMC Anesthesiology
• Cardiac care unit
• Developed dysphagia
• Predicting dysphagia
• Critically ill patients
• Cardiac surgery
• Document Dysphagia
• Introduction and key points
• Disease burden and epidemiology
• Causes of dysphagia
• Clinical diagnosis
• Treatment options
• Useful web sites and guidelines
• BMC Cancer
• Pharyngeal cancer
• Dysphagia optimised intensity modulated radiotherapy
• Pharyngeal constrictor muscle
• Supraglottic larynx
• BMC Musculoskeletal Disorders
• Occipitocervical fusion
• Postoperative dysphagia
• Pharyngeal inlet angle
• Narrowest oropharyngeal airway space
• Oesophageal cancer
• Curative treatment
• Dysphagia swallowing rehabilitation
• Swallow exercises
• báo cáo khoa học
• báo cáo y học
• công trình nghiên cứu về y học
• tài liệu về y học
• cách trình bày báo cáo
• enhanced computerized
• tomographic (CECT)
• dysphagia showing
• needle aspirate
• mycobacterial lymphadenitis
• Nontuberculous
• equally affected
• Constitutional
• fibrosis and calcification
• medical books
• pharmacology
• epidemiologic
• Obstetrics
• anatomy
• Preventing Morbidity
• Multidisciplinary Care