presented by Ianessa Humbert
This course, with Dr. Ianessa Humbert, offers an in depth assessment of six important swallowing events: triggering the swallow, posterior lingual propulsion, velar elevation, pharyngeal constriction and elevation, laryngeal vestibule closure, and upper esophageal sphincter opening. For each swallowing event, normal and abnormal movements and/or sensation are described, and probing strategies are discussed (i.e. modifying the event with bolus volume, head position, swallowing maneuvers). The information presented is based in research literature, including full citations for further review. This course shows each swallowing event using a combination of representative video fluoroscopic studies and anatomical animations of each abnormal swallowing event.
Dr Humbert is an Assistant Professor in the Department of Physical Medicine and Rehabilitation at Johns Hopkins University in Baltimore, MD. She is an accomplished researcher, having studied the effects of electrical stimulation on hyo-laryngeal movement in healthy and dysphagic adults. Dr. Humbert's current research focuses on swallowing neurophysiology and motor learning in normal and abnormal swallowing.
In this chapter, the participant will be introduced to theories of swallowing, including Kahrilas' theory of swallowing in two parts. The clinical relevance of probing a swallowing event will also be discussed.
In this chapter, the first event of the swallow, the triggering event, will be described and discussed. The participant will learn to describe the sensory and motor components of triggering the swallow, describe normal variation in onset of swallow triggering, and discuss the impact of bolus type, cueing, and thermal stimulation on the swallow triggering.
This chapter introduces the participant to the posterior lingual propulsion event. The participant will learn basic sensory and motor components of the posterior lingual prolusion event, identify the primary force behind bolus movement, and describe abnormal posterior lingual propulsion.
In this chapter, Dr. Humbert discusses the process of velar elevation and velo-pharyngeal closure. The participant will learn the basic sensory and motor components of the process, describe abnormal velar elevation, and identify specific tasks that modify velar elevation.
This chapter explores the swallowing event of pharyngeal contraction. The participant will be given the tools to differentiate between longitudinal pharyngeal muscles and pharyngeal constrictor muscles, describe the timing and range of motion of ht pharynx during swallowing, and identify tasks that modify pharyngeal constriction.
In this chapter, the process of laryngeal vestibule closure will be discussed. Participants will identify events that contribute to abnormal laryngeal vestibule closure, describe the motor and sensory components of laryngeal vestibule closure, and identify tasks that can be used to modify laryngeal vestibule closure.
In the final chapter of this course, the event of the upper esophageal sphincter (UES) opening will be described. After viewing this chapter, participants will be able to describe the relationship between UES pressures and bolus flow, list the neuromuscular and biomechanical components of UES opening, and identify tasks that modify UES pressures and opening.
Dr. Humbert sits down with Dr. Robert Miller to discuss the current research surrounding the events of swallowing.