Hi. Welcome to our series on geriatric nursing.
Now, in this whole series, we're looking at age-related
changes in health.
In this specific video, we're going to talk about
which that's just another really big word for mouth and
Now, you might wonder why we're really hitting this issue.
Why is this such a big deal? Well, we're going to use these
that we've used throughout the series to help you understand
why as a nurse,
it's really important that you have expertise in this area.
So take a look at Jose and Enrique. Right? They're young.
They're happy. They're handsome.
Right now, they're not having any oropharyngeal or
Keep in mind, Jose is the one who experiences normal changes
And Enrique is our example of someone who has those extra
added medical problems. Right?
He has what we call co-morbidities. So he's had a lot of
major life and health events.
So you're going to see the difference. Jose is what happens
with just normal aging.
Enrique is what happens when you have those comorbidities.
Now, when you're in practice, you are going to see all kinds
and especially all kinds of senior clients.
And when it comes to assessing their mouth,
you are going to see things that you may not have visualized
Now, some of them will look like Jose.
Look, he looks like he's posing for a toothpaste commercial.
It's bright, white, smiling. Yeah, those teeth look
He's taking good care of his teeth, and he's not had any
major health issues.
But then we have his friend Enrique and even he knows he's
had some challenges in this area.
So as we all grow old, our oral hygiene and condition don't
just affect how we look or our smile,
but it can also affect our vital abilities like swallowing.
Now, Jose knows when he goes out to dinner with Enrique,
he might have more excitement than he counted on.
Like this example when they went out to a Chinese restaurant
and he had eaten some rice.
So even something as pleasant as two friends being together
can become something that could be dangerous.
Now, don't worry. You see there that Enrique is clearly
He's got that panicked look on this face and his friend is
This story ends fine. He was able to dislodge that, and he
went right along.
So don't even worry about that.
But what I want you to do is walk with me now as we explore
that can be seen in our oropharyngeal system as we age
and as we identify some care strategies that you need to
to help to promote successful aging in older adults
and keeping in mind these age-related changes.
Now, here we have who? Right, that's Jose.
So we're going to start off with just normal changes of
Now, we've got a lot of colors there but this is really a
great reminder for you.
Let's go through this review. So start at the top. You'll
see that is his nasal cavity. Right?
Now, remember, we have him on a side view.
So I'm looking at you directly on. He's looking at us, we
have him on a side view.
So you see of the nasal cavity. Got that? Right. We've
labelled it for you,
and you're following with us. Now, I want you to look at
On the left, you'll see the parotid gland. On the right,
you've got the sublingual gland.
Now, there's one more gland in between the parotid gland and
the sublingual gland.
Can you remember what that's called? Right. It's the sub
below mandibular gland.
Okay. Cool. We've got the glands in. We've got the nasal
And let's look at his teeth. So you see his teeth right
His tongue and we already labelled the sublingual gland.
So working from top to bottom on that side,
we have the nasal cavity, his teeth, his tongue, and then
the sublingual gland.
Now, when you swallow like I just did, we're going to show
you where that food goes.
But I want you to have these structures in mind.
So you may need to pause the video for just a minute and
make sure you're very clear.
Now, look as we're moving down. You see the pharynx. Right?
Then, there's a submandibular gland, and then it leads to
So when Enrique was choking. Right?
When they had that little traumatic event in the restaurant,
where was the food stuck? Well, if he couldn't breathe,
it was likely stuck in his esophagus and was making it
difficult for him to get air in.
Okay. So, now, you've go the pathway. This is everything
that we're looking at.
We gave you a quick review, you're welcome,
because we know that everyone needs a review when you're
particularly, as much as you are learning in nursing school.
Now, we're going to go down and look at the rest of the GI
So as you saw the esophagus went right on down, and there is
Now, food's going to go from the stomach, right?
Into the duodenum, the small intestine, then the large
and out through the colon and the rectum, and the anus.
So that's how the food is going to move through.
So you see, now, we have those labels up there for you. You
see the stomach.
And then you see the duodenum.
And then we have the small intestine, the large intestine,
and the anus. Okay.
That's the travel of food from your mouth to your exit
That's where it goes. But there's a couple other things we
want you to keep in mind.
Now, what are some structures that we haven't identified
I want to leave them blank for you and see if you can fill
Okay. How many did you get? Did you find the liver?
Yeah. We've got a great picture there. Now, what's tucked
underneath the liver?
It's your pancreas. Excellent. Remember, they're all
connected in that hepatobiliary system.
Now, there's one tiny little organ. What do we call that?
Well, it's really not an organ.
It's just kind of a cavity. Right? It's the appendix.
So always use these times to remind yourself to review your
because the more you visualize in your mind how your body
the information is going to stick in your mind so much
And that's really what we all want. Right?
We want you to learn more, but we want you to be able to
because what you're doing is really proven to be an
So, hi, Jose. There he is again.
We're going to talk about what else is involved in the
And we're talking about chewing. So you see we have the
muscles of mastication.
Mastication is a very big word just like we talked about,
or the official and proper word of talking about chewing.
That's what this part is on. So we're going to look at the
muscles of mastication.
We're going to talk about the health of their teeth.
And we're going to talk about the production of saliva,
because as we age, that can be a problem.
Well, your mouth can be kind of dry. Right? So we'll talk
about some strategies
and things you can be aware of. So check, check, and check.
As we're moving forward, tell yourself, "Alright. We have a
We're looking at these three things; muscles of mastication,
teeth health, production of saliva." Want to be a rock star
Pause the video, look away from your notes,
and see if you can recall the three things we're going to
study without looking at your notes.
Hey, welcome back. I hope you took advantage of that time.
That's using a strategy called pause and recall.
Anytime you force your brain to try to recall something
without reading it in your notes,
you are doing incredibly great work in helping that
go in your brain in an orderly fashion and in a way that
you're going to remember it
and be able to retrieve it. Keep in mind, just because you
can read a word,
doesn't mean your brain knows how to put it in in an ordered
You take control of that system and I promise, your studying
is going to be much more effective.
So that was Jose. Now, we're looking at Enrique.
Poor little guy. I mean, he's had so much go on in his life.
And we're going to use him again as our poster boy for
things that happen
with comorbidities in the oral cavity.
So we're going to look at his muscles of mastication, his
teeth health, and his production of saliva.
Well, it kind of goes without saying, whatever Jose is
Enrique will experience that and usually, on a more severe
or intense level.
So he is going to have some challenges in all these areas
and more than Jose.
That's why when they go out to eat, it can be, remember that
dramatic scene at the beginning?
Right. That can be a problem. So his teeth health, we're
going to keep a close eye on that,
and I'm going to explain to you why we have this increased
risk for tooth loss
because all the other things and inflammation that is going
on in his body,
you're an increased risk for gum disease and the eventual
Now, at the bottom, remember we talked about that. The
production of saliva.
Well, it's even worse for Enrique. And it might be because
of a disease process.
Or it could be because of some type of medication that he's
So why is that problematic? Well, anticholinergic
we use them for lots of applications. It causes your eyes to
dry out, your mouth to dry out.
It can cause constipation, and they also cause urinary
All things that Enrique does not need to be made worse in
But if I don't have enough saliva, it's uncomfortable.
Saliva is not available to help keep my mouth healthy.
And that's why it makes it more difficult, another one of
why it makes it more difficult for him to swallow.
Okay. So we talked about Jose, right?
Then we talked about poor Enrique in these three areas that
the slight problems
or changes that Jose will see will be magnified or
exaggerated in Enrique
because of his comorbidities.