Dysphagia following stroke

1. What are the three phases of swallowing?
2. What is required for the pharyngeal phase of swallowing?
3. What is chin tuck?
4. What % of patients have silent aspiration not detected by bedside swallow? How can this be diagnosed?
5. When does recovery of swallowing function usually occur in brainstem strokes?
6. What is nasal speech?

Answers:
1. Oral, pharyngeal, esophageal.
2. Tongue elevation, soft palate elevation, laryngeal elevation, coordination of pharyngeal constriction and cricopharyngeal relaxation.
3. Compensatory technique that prevents entry of liquid into the larynx.
4. 40-60% have silent aspiration that can be diagnosed by video fluoro study.
5. First three weeks post-stroke.
6. Hypernasality caused by partial or complete failure of soft palate to close off the nasal cavity from the oral cavity.