Swallowing Disorder (Dysphagia): Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height; further:
    • Inspection (viewing).
      • Skin, mucous membranes, oral/pharyngeal cavity, and skull [due topossible external causes: Foreign body, brain injury, unspecified, nerve injury, unspecified, postoperative changes, unspecified, chemical burns, injury, chemical, thermal, etc.].
    • Palpation (palpation) of the abdomen (abdomen) (tenderness?, tapping pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing tapping pain?) [see under differential diagnoses]
    • Digital rectal examination (DRU): examination of the rectum (rectum) and adjacent organs with the finger by palpation.
  • ENT medical examination – including inspection of the larynx [due todifferential diagnoses: epiglottitis (inflammation of the epiglottis), pharyngitis (pharyngitis), retropharyngeal abscess – collection of pus located between the posterior pharyngeal wall and the spine].
  • Orthopedic examination [due todifferential diagnoses: see under musculoskeletal system and connective tissue]
  • Neurological examination – including reflex testing, evidence of muscle atrophy, etc. [due todifferential diagnoses: see under nervous system]
  • Psychiatric examination [due todifferential diagnoses: dementia, unspecified]
  • Dental examination [due todental and periodontal status/findings of the entire periodontium]

The Working Group on Dysphagia of the German Geriatrics Society (DGG) has presented its Dysphagia Screening Tool Geriatrics (DSTG): Dysphagia Screening Tool Geriatrics: DSTGFurthermore, training material on the use of the Dysphagia Screening Tool Geriatrics is available: Training on the use of the Dysphagia Screening Tool Geriatrics.

Square brackets [ ] indicate possible pathological (pathological) physical findings.