https://ideawaza.com/api.php?action=feedcontributions&feedformat=atom&user=82.114.0.0%2F16 2026-09-30T20:48:35Z User contributions MediaWiki 1.46.0 https://ideawaza.com/index.php?title=Archive:Dysphagia_examination&diff=38346 2008-07-07T08:40:18Z

<p>82.114.74.98: </p> <hr /> <div>Dysphagia: <br /> == Difficulty swallowing with a sensation of food sticking<br /> <br /> ==ID==<br /> Specifically note the age of the patient as cancer risk increases with age<br /> <br /> ==Questions to ask==<br /> <br /> 1. Do you have difficulty moving food from your mouth to your throat? (oropharyngeal dysphagia)<br /> OR does food get stuck in your throat(known as globus hystericus)? (esophageal dysphagia?)<br /> <br /> 2. Does food stick immediately (oropharyngeal dysphagia) OR does food stick after swallowing (esophageal dysphagia)?<br /> <br /> 3. Do you have difficulty with solid foods only (mechanical obstruction) OR solids and liquid foods (neuromuscular disorder)?<br /> <br /> 4. IS your swallowing difficulty intermittent or has it been progressive?<br /> *intermittent<br /> **esophageal ring/web<br /> **diffuse esophageal spasm<br /> *Progressive<br /> **esophageal stricture<br /> **esophageal cancer<br /> **scleroderma (excessive deposits of collagen)<br /> **achalasia (absence of contraction in the lower half of the esophagus)<br /> <br /> 5. Any recent ingestion of caustic substances or foreign body?<br /> <br /> 6. Provoking factors?<br /> <br /> 7. Relieving factors?<br /> <br /> <br /> ==Review of Systems==<br /> <br /> ===General===<br /> *weight loss<br /> *appetite<br /> *night sweats<br /> *fever<br /> *fatigue<br /> <br /> ===Respiratory===<br /> *coughing<br /> *aspiration - suggests oropharyngeal dysphagia<br /> *halitosis - suggests Zenker's diverticulum<br /> <br /> ===Cardiovascular===<br /> * Chest pain - suggests esophageal spasm or esophageal cancer<br /> **chest pain in esophageal spasm mimics angina as it radiates to back ears neck and jaw<br /> <br /> ===GI===<br /> *coughing or choking<br /> **suggests oropharyngeal dysphagia<br /> *regurgitation from nose<br /> **suggests oropharyngeal dysphagia<br /> *regurgitation suggests esophageal stricture or achalasia<br /> **regurgitation is defined as the effortless return of small amounts of gastric or esophageal content into the mouth<br /> *heartburn - suggests esophageal stricture or scleroderma<br /> *odynophagia (pain on swallowing)<br /> *hematemesis<br /> *hoarseness - suggests recurrent laryngeal compression<br /> *slurred speech - muscle incoordination<br /> *dysarthria - soft palate weakness<br /> *hiccups - lower esophageal lesion<br /> <br /> ==PMHx==<br /> *Any previous dysphagia <br /> *scleroderma<br /> *cancer<br /> *radiation treatemnt<br /> <br /> ==Family history==<br /> *Japanese<br /> *cancer<br /> *scleroderma<br /> *achalasia<br /> <br /> ==Social==<br /> *alcohol <br /> *smoking<br /> <br /> ==PSHx==<br /> ==Meds==<br /> ==Allergies==<br /> <br /> <br /> ==Physical exam==<br /> *oral cavity<br /> **dentition, lesions, masses<br /> *cranial nerve exam<br /> **look for evidence of bulmar/pseudobulbar palsy (dysarthria, dysphonia, ptosis, tongue atrophy)<br /> *cervical lymph nodes<br /> *masses palpable in neck area<br /> *thyroid gland<br /> *skin changes - evidence of connective tissue disease<br /> <br /> ==Tests==<br /> *barium swallow<br /> *videofluoroscopy<br /> *upper endoscopy<br /> *fiberoptic nasopharyngeal laryngoscopy<br /> *esophageal manometry<br /> <br /> ==Other OSCE modules==<br /> {{OSCE2}}<br /> [[Category:OSCE]]<br /> [[Category:Gastroenterology]][[Category: Clinical Skills]]</div>

82.114.74.98 https://ideawaza.com/index.php?title=Archive:Dysphagia_examination&diff=38345 2008-07-07T08:38:36Z

<p>82.114.74.98: </p> <hr /> <div>Dysphagia: D<br /> == ifficult ==<br /> ooy swallowing with a sensation of food sticking<br /> <br /> ==ID==<br /> Specifically note the age of the patient as cancer risk increases with age<br /> <br /> ==Questions to ask==<br /> <br /> 1. Do you have difficulty moving food from your mouth to your throat? (oropharyngeal dysphagia)<br /> OR does food get stuck in your throat(known as globus hystericus)? (esophageal dysphagia?)<br /> <br /> 2. Does food stick immediately (oropharyngeal dysphagia) OR does food stick after swallowing (esophageal dysphagia)?<br /> <br /> 3. Do you have difficulty with solid foods only (mechanical obstruction) OR solids and liquid foods (neuromuscular disorder)?<br /> <br /> 4. IS your swallowing difficulty intermittent or has it been progressive?<br /> *intermittent<br /> **esophageal ring/web<br /> **diffuse esophageal spasm<br /> *Progressive<br /> **esophageal stricture<br /> **esophageal cancer<br /> **scleroderma (excessive deposits of collagen)<br /> **achalasia (absence of contraction in the lower half of the esophagus)<br /> <br /> 5. Any recent ingestion of caustic substances or foreign body?<br /> <br /> 6. Provoking factors?<br /> <br /> 7. Relieving factors?<br /> <br /> <br /> ==Review of Systems==<br /> <br /> ===General===<br /> *weight loss<br /> *appetite<br /> *night sweats<br /> *fever<br /> *fatigue<br /> <br /> ===Respiratory===<br /> *coughing<br /> *aspiration - suggests oropharyngeal dysphagia<br /> *halitosis - suggests Zenker's diverticulum<br /> <br /> ===Cardiovascular===<br /> * Chest pain - suggests esophageal spasm or esophageal cancer<br /> **chest pain in esophageal spasm mimics angina as it radiates to back ears neck and jaw<br /> <br /> ===GI===<br /> *coughing or choking<br /> **suggests oropharyngeal dysphagia<br /> *regurgitation from nose<br /> **suggests oropharyngeal dysphagia<br /> *regurgitation suggests esophageal stricture or achalasia<br /> **regurgitation is defined as the effortless return of small amounts of gastric or esophageal content into the mouth<br /> *heartburn - suggests esophageal stricture or scleroderma<br /> *odynophagia (pain on swallowing)<br /> *hematemesis<br /> *hoarseness - suggests recurrent laryngeal compression<br /> *slurred speech - muscle incoordination<br /> *dysarthria - soft palate weakness<br /> *hiccups - lower esophageal lesion<br /> <br /> ==PMHx==<br /> *Any previous dysphagia <br /> *scleroderma<br /> *cancer<br /> *radiation treatemnt<br /> <br /> ==Family history==<br /> *Japanese<br /> *cancer<br /> *scleroderma<br /> *achalasia<br /> <br /> ==Social==<br /> *alcohol <br /> *smoking<br /> <br /> ==PSHx==<br /> ==Meds==<br /> ==Allergies==<br /> <br /> <br /> ==Physical exam==<br /> *oral cavity<br /> **dentition, lesions, masses<br /> *cranial nerve exam<br /> **look for evidence of bulmar/pseudobulbar palsy (dysarthria, dysphonia, ptosis, tongue atrophy)<br /> *cervical lymph nodes<br /> *masses palpable in neck area<br /> *thyroid gland<br /> *skin changes - evidence of connective tissue disease<br /> <br /> ==Tests==<br /> *barium swallow<br /> *videofluoroscopy<br /> *upper endoscopy<br /> *fiberoptic nasopharyngeal laryngoscopy<br /> *esophageal manometry<br /> <br /> ==Other OSCE modules==<br /> {{OSCE2}}<br /> [[Category:OSCE]]<br /> [[Category:Gastroenterology]][[Category: Clinical Skills]]</div>

82.114.74.98