RESPIRATORY SYSTEMS
- Overview of systems - anatomy/physiology
- Breathing/Swallowing coordination
- The apneic signal
- The relationship of coordination to aspiration
- Laryngeal Chemical Responses (LCRs)
- Reflexive cough
GASTROESOPHAGEAL SYSTEMS
- esophageal function
- Barriers to reflux
- Saliva swallows
- Digestive acids
- Reflux mechanisms
- Relationship to feeding disorders
- GERD signs and symptoms u
- When does GER become GERD?
- Reflux, feeding and swallowing behaviors
- Relationship to dysphagia
GI/RESPIRATORY RELATIONSHIPS
- Pressure relationships and their effect u
- Asthma/gastroesophageal reflux connection
- Laryngopharyngeal Reflux (LPR)
ASPIRATION
- Pulmonary Clearance Mechanisms
- Aspiration in infancy
- How much is too much?
- Predictors of pneumonia in various populations
- Aspiration and oral hygiene
RESPIRATORY DISEASE PROCESSES
- Infant Respiratory Distress Syndrome (IRDS)
- Bronchopulmonary Dysplasia (BPD)
- Respiratory Synctial Virus (RSV)
- Congenital Heart defects
- Obstructive Sleep Apnea (OSA) and dysphagia
- Congestive Heart Failure (CHF)
- Obstructive Conditions
- Restrictive Conditions
- Pneumonia vs Pneumonitis
- Community Acquired Pneumonia
- Healthcare Acquired Pneumonia
- Aspiration Pneumonia
AIRWAY MANAGEMENT
- Non-invasive positive pressure ventilation
- High flow nasal cannula
- Intubation
- Post-extubation dysphagia
- Tracheostomies
- Physiological changes associated with tracheotomy
ASPIRATION ASSESSMENT
- Clinical assessment – what are we looking for?
- Cognitive assessment
- Pitch elevation
- Serial swallows
- Oral mechanism
- Respiratory factors
- Cough
- Respiratory muscle strength
- Instrumental assessment
- Modified Barium Swallow studies
- Fiberoptic Endoscopic Evaluation of Swallowing
- 3 ounce water tests
- Understanding lab values
ASPIRATION MANAGEMENT
- Diet modifications
- Implications of dietary changes
- Compliance issues
- Thick liquids
- Complicating factors associated with thickening
- Water protocols
- Compensatory strategies
- Sensory interventions
- Principles of exercise physiology
- Lingual strengthening
- Effortful swallow
- Mendolsohn maneuver
- Masako maneuver
- Shaker head lift
- Chin tuck against resistance
- Head extension exercise
- Jaw opening exercise
- Tongue pull back
- Effortful pitch glide
- Expiratory muscle strength training
REFLUX ASSESSMENT
- Upper GI studies
- Ph Monitoring
- Esophagoscopy
- Scintigraphy
REFLUX MANAGEMENT
- Lifestyle modifications
- Positioning
- Diet modifications
- Medications
- Effects of acid suppression
- Surgical interventions
- New directions in reflux management
- Endoscopic procedures
- Melatonin
- Acupuncture
- Magnetic Sphincter Augmentation