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45 Cards in this Set
- Front
- Back
Four Phases of Swallowing
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Oral Prepatory Phase
Oral Phase Pharyngeal Phase |
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Oral Prepatory Phase
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First phase
Food is chewed and mixed with saliva |
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Oral Phase
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Secondary Phase
voluntary movement of bolus from front of the oral cavity to the back |
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Pharyngeal Phase
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Third Phase
Directed into esophagous |
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Esophageal Phase
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Final Phase
Food enters through esophageal sphincter |
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Four basic functions of GI tract
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motility, secretion, digestion, absorption
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Dysphagia Diet 1 (NDD-1)
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"Dysphagia Pureed"
Pudding-like consistency (no lumps) NOT ALLOWED: Fruit yogurt, jello, Peanut Butter, scrambled, fried or hard cooked eggs |
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Dysphagia Diet 2 (NDD-2)
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"Dysphagia Mechincally Altered"
Moist and Soft textured; tender ground or finely diced meats, soft vegs, and fruit FOOD NOT ALLOWED: Bread, dry cake, rice cheese cubes, corn and peas |
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Dysphagia Mixed
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Customed Pureed (NDD-1)
that allows some mechincally altered NDD-2 items |
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Mechanical Soft
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Alternative diet
Allows bread, cake and rice with NDD-2 Diet. |
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Dysphagia Diet (NDD-3)
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"Dysphagia Advanced"
Includesmost regular foods except very hard, sticky or crunchy items. NOT ALLOWED: Hard fruit and vg, corn skins, nuts and seeds |
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National Dysphagia Diet Task Force Viscosity listings
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Spoon-thick
Honey-like Nectar-like Thin Liquids (all liquids, deserts, and jello) |
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GERD
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Gastroesophageal reflux disease
Chronic of recurrent gastric pain due to reflux of gastric secretions into the lower esophagous Incompetence of LES sphincter |
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Factors lowering LES pressure (GERD)
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Increased secretion of gastrin, estrogen, progesterone
Hiatal hernia Cigarette smoking Use of medications |
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Symptoms of GERD
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Dysphagia
Heartburn Increased salivation Belching Pain radiating to back, neck, or jaw Aspiration Ulceration Barrett’s esophagus |
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Barrett's esophagus
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a compliation of severe chronic GERD invovling changes in the cells of the tissue that line the bottom of the esophagus; thse esophageal cells become irritated when the contents of the stomach back up , and there is a small but definite incraesed risk of cancer of the esophagus
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Conditions that increase the likelihood of reflux
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Ascites
Delayed gastric emptying eating large meals Lying flat after eating Obesity Pregnancy Wearing clothes that fit tightly |
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Substances that lower LES pressure
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alcohol
caffeine cigarettes garlic high fat foods onions peppermint / spearmint progesterone |
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Foods that relax LES
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peppermint / spearmint
alcohol chocolate coffee fried foods |
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Foods that increase gastric secretion
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alcohol
pepper coffee |
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Peptic Ulcer Disease
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ulcerations of the gastric mucosa that penetrate submucosa
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Pivotal Factor of PUD
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h.pylori|
92% of duodenal ulcers 70% of gastric ulcers |
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PUD: Symptoms
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epigastric pain relieved or worsened by abdominal pain, burning sensation
Presence of blood in the stool or vomit |
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PUD: Nutrition Interventions
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Restrict only those foods known to increase acid secretion
Black and red pepper, caffeine, coffee, alcohol, individually non-tolerated foods Consider timing and size of meal Do not lie down after meals Small, frequent meals |
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PUD: Symptoms
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epigastric pain relieved or worsened by abdominal pain, burning sensation
Presence of blood in the stool or vomit |
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hemorrhage
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bleeding
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PUD: Nutrition Interventions
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Restrict only those foods known to increase acid secretion
Black and red pepper, caffeine, coffee, alcohol, individually non-tolerated foods Consider timing and size of meal Do not lie down after meals Small, frequent meals |
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hemorrhage
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bleeding
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perforation
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a break in the integrity of the tissue
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perforation
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a break in the integrity of the tissue
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obstruction
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blockage
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obstruction
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blockage
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vagotomy
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severing the vagus nerve
results in decreased acid production and decreased response to gastrin |
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vagotomy
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severing the vagus nerve
results in decreased acid production and decreased response to gastrin |
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Gastric Surgery - Nutrition Implications
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Reduced capacity
Changes in gastric emptying & transit time Components of digestion altered or lost Decreased oral intake, maldigestion, malabsorption |
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Gastric Surgery - Nutrition Implications
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Reduced capacity
Changes in gastric emptying & transit time Components of digestion altered or lost Decreased oral intake, maldigestion, malabsorption |
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Dumping Syndrome
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symptoms occurring with rapid passage of large amounts of food into the small intestine
Increased osmolar load enters small intestine too quickly from stomach Release of hormones, enzymes, other secretions altered Food “dumps” into small intestine |
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Dumping Syndrome
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symptoms occurring with rapid passage of large amounts of food into the small intestine
Increased osmolar load enters small intestine too quickly from stomach Release of hormones, enzymes, other secretions altered Food “dumps” into small intestine |
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Gastric Dumping - Early Dumping
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10-20 min.; diarrhea, dizziness, weakness, tachycardia
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Gastric Dumping - Early Dumping
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10-20 min.; diarrhea, dizziness, weakness, tachycardia
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Gastric Dumping - Intermediate Dumping
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20-30 min.; fermentation of bacteria produces gas, abdominal pain, etc.
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Gastric Dumping - Intermediate Dumping
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20-30 min.; fermentation of bacteria produces gas, abdominal pain, etc.
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Gastric Dumping - Late Dumping
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1-3 hrs.; hypoglycemia
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Gastric Surgery - Nutrition
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“Anti-dumping” diet
Slightly higher in protein & fat Avoid simple sugars & lactose Calcium & vitamin D Liquid between meals Small, frequent meals Lie down after meals Assess for weight loss, malabsorption, and steatorrhea |
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Anti-Dumping Diet
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Slightly higher in protien and fat simple sugars avoided.
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