Dysphagia

, Volume 10, Issue 1, pp 27–31

Using cervical auscultation in the clinical dysphagia examination in long-term care

  • Pamela M. Zenner
  • Diane S. Losinski
  • Russell H. Mills
Article

Abstract

The ability of the clinical dysphagia examination to identify patients who aspirate and to determine specialized diet management has been suspect. In long-term care, however, the clinical examination can be the only assessment procedure available to clinicians. Cervical auscultation with stethoscope was incorporated into the clinical examination for dysphagia in an attempt to enhance the clinical examination's ability to detect aspiration and to determine specialized diet management in long-term care. Comparison of the clinical examination's results with results from videofluoroscopy revealed significant agreement in both areas. Results support the use of cervical ausculatation as a highly sensitive and specific method of dysphagia assessment in long-term care.

Key words

Dysphagia, evaluation Auscultation Long-term care Deglutition Deglutition disorders 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Linden P, Siebens A: Dysphagia: predicting laryngeal penetration. Arch Phys Med Rehabit 64:281–284, 1983Google Scholar
  2. 2.
    Splaingard M, Hutchins B, Sulton L, Chaudhuri G: Aspiration in rehabilitation patients: videofluorscopy vs bedside clinical assessment. Arch Phys Med Rehabil 69:637–640, 1988Google Scholar
  3. 3.
    Sorin R, Somers S, Austin W, Bester S: The influence of videofluoroscopy on the management of the dysphagic patient. Dysphagia 2:127–135, 1988Google Scholar
  4. 4.
    Zerilli KS, Stefans VA, DiPietro MA: Protocol for the use of videofluoroscopy in pediatric swallowing dysfunction. Am J Occup Ther 44:441–445, 1990Google Scholar
  5. 5.
    Miller RM: Evaluation of swallowing disorders In: Groher ME (ed.): Dysphagia Diagnosis and Management. Stoneham: Butterworth Publishers, 1984, pp 85–110Google Scholar
  6. 6.
    Logemann JA: Evaluation and Treatment of Swallowing Disorders. San Diego: College-Hill Press, 1983, p 120Google Scholar
  7. 7.
    Bosma JF: Sensorimotor examination of the mouth and pharynx. In: Kawamura Y (ed.): Frontiers of Oral Physiology. Basel: Karger, 1976, pp 78–107Google Scholar
  8. 8.
    Loudon R, Murphy RLH: State of the art: lung sounds. Am Rev Respir Dis 130:663–673, 1984Google Scholar
  9. 9.
    Hamlet S, Penney DG, Formolo J: Stethoscope acoustics and cervical auscultation of swallowing. Dysphagia 9:63–68, 1994Google Scholar
  10. 10.
    Abella M, Formolo J, Penney DG: Comparison of the acoustic properties of six popular stethoscopes. J Acoust Soc Am 91:2224–2228, 1992Google Scholar
  11. 11.
    Hamlet SL, Nelson RJ, Patterson RL: Interpreting the sounds of swallowing: fluid flow through the cricopharyngeus. Ann Otol Phinol Laryngol 99:749–752, 1990Google Scholar
  12. 12.
    Hamlet SL, Patterson RL, Fleming SM, Jones LA: Sounds of swallowing following total laryngectomy. Dysphagia 7:160–165, 1992Google Scholar
  13. 13.
    Logan WJ, Kavanagh JF, Wornall AW: Sonic correlates of human deglutition. J Appl Physiol 23:279–284, 1967Google Scholar
  14. 14.
    Mackowiak RC, Brenman HS, Friedman MHF: Acoustic profile of deglutition. Proc Soc Exper Biol Med 125:1149–1152, 1967Google Scholar
  15. 15.
    Nishino T, Yonezawa T, Honda Y: Effects of swallowing on the pattern of continuous respiration in human adults. Am Rev Respir Dis 132:1219–1222, 1985Google Scholar
  16. 16.
    Selley WG, Flack FC, Brooks WA: Respiratory patterns associated with swallowing, part 1. The normal adult pattern and changes with age. Age Ageing 18:168–172, 1989Google Scholar
  17. 17.
    Martin BJ: The Influence of Deglutition on Respiration. Ann Arbor MI: University Microfilms International, Northwestern University dissertation, 1991Google Scholar
  18. 18.
    Selley WG, Flack FC, Brooks WA: Respiratory patterns associated with swallowing, part 2. Neurologically impaired dysphagic patients. Age Ageing 18:173–176, 1989Google Scholar
  19. 19.
    Langmore S: Coordination between swallow and respiration in dysphagic patients. Paper presented at Norwestern University conference, October 1991Google Scholar
  20. 20.
    Vice FL, Heinz JM, Giuriati G, Hood M, Bosma JF: Cervical auscultation of suckle feeding in newborn infants. Dev Med Child Neurol 32:760–768, 1990Google Scholar
  21. 21.
    Logemann JA: Manual for the Videofluorographic Study of Swallowing, San Diego: College-Hill Press, 1986Google Scholar
  22. 22.
    Cook IJ, Dodds WJ, Dantas RO, Kern MK, Massey BT, Shaker R, Hogan WJ: Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing. Dysphagia 4:8–15, 1989Google Scholar
  23. 23.
    Baldessarini RJ, Finklestein S, Arana GW: The predictive power of diagnostic tests and the effect of prevalence of illness. Arch Gen Psychiatry 40:569–573, 1983Google Scholar
  24. 24.
    Cohen J: A coefficient of agreement for nominal scales. Educ Psychol Measurement 20(1):37–46, 1960Google Scholar
  25. 25.
    Robbins J, Hamilton JW, Lof GL, Kempster GB: Oropharyngeal swallowing in normal adults of different ages. Gastroenterology 103:823–829, 1992Google Scholar

Copyright information

© Springer-Verlag New York Inc 1995

Authors and Affiliations

  • Pamela M. Zenner
    • 1
  • Diane S. Losinski
    • 2
  • Russell H. Mills
    • 3
  1. 1.Audiology and Speech Pathology ServiceVA Medical CenterSt. CloudUSA
  2. 2.Rehabilitation Medicine ServiceVA Medical CenterSt. CloudUSA
  3. 3.Audiology and Speech Pathology ServiceVA Medical CenterMurfreesboroUSA
  4. 4.VA Medical CenterSt. CloudUSA

Personalised recommendations