D1

Front 1

dysphagia is

Back 1

difficulty moving food from mouth to stomach

Front 2

patients who report oropharyngeal swallowing disorders are _____ to describe them and are _____ in their localization and definition of the problem

Back 2

able, accurate

Front 3

patients with esophageal disorders may be highly ______ in describing and localizing their dysfunction

Back 3

inaccurate

Front 4

literature on swallowing falls into three categories:

Back 4

1. oral stage of the swallow, 2. triggering of the pharyngeal phase 3. pharyngeal and esophogeal stages

Front 5

feeding techniques describes

Back 5

describe procedures to improve the oral stages of the swallow, including manipulation of food in prep stage and transport of food through the oral cavity

Front 6

swallowing therapy describes techniques to improve the _______ of the swallow and the _________of the swallow

Back 6

triggering, pharyngeal stage (in addition to the prep stage of oral manipulation and oral stage)

Front 7

feeding is limited to

Back 7

placement of food in the mouth, manip of food in oral cavity, and oral stage of the swallow when bolus is propelled backwards by the tongue

Front 8

therapy designed to improve feeding attemps to improve (1-5)

Back 8

1. positioning of food in mouth 2. manipulation of food in the mouth with tongue 3. chewing a bolus of varying consistencies 4. recollecting the bolus into a cohesive mass 5. organizing lingual action to propell the bolus posteriorly.

Front 9

feeding techniques deal with the ______and _____ stages of the swallow that terminate when ______________.

Back 9

the oral prep and oral stages of the swallow that terminate when pharyngeal swallow is triggered.

Front 10

swallowing therapy includes

Back 10

reducing any delay in triggering the pharyngeal swallow, improving pharyngeal transit timethe individual neuromotor actions comprising the pharyngeal stage of swallow, as well as all of the techniques used to improve oral and oral prep stage of swallow

Front 11

swallowing refers to the entire act

Back 11

of deglutition from placement of food in the mouth until the gastroesophageal junction

Front 12

the first task of a swallowing therapist is to

Back 12

identify patients who are at high risk for oropharyngeal dysphagia

Front 13

screening involves looking for __________ of oropharyngeal dysphagia

Back 13

signs and symptoms

Front 14

screening procedures do not define

Back 14

anatomy or physiology of the oropharynx.

Front 15

if the technique provides physiologic data,

Back 15

it is a diagnostic procedure

Front 16

what are the 4 symptoms of oropharyngeal dysphagia?

Back 16

1. aspiration 2. penetration 3. residue 4. backflow

Front 17

aspiration

Back 17

entry of food or liquid into the airway below the true vocal folds

Front 18

penetration

Back 18

entry of food or l into the larynx at some level down to but not below the true vocal cords

Front 19

residue

Back 19

food that is left behind in the mouth or pharynx after the swallow

Front 20

backflow

Back 20

food from the esophagus into the pharynx and/or from the pharynx into the nasasl cavity

Front 21

the swallowing therapist's job is to

Back 21

1. identify the symptoms and from the symptoms identify the underlying abnormalities in anatomy that cause symptoms

Front 22

what are complications of dysphagia?

Back 22

pneumonia, malnutrition, and dehydration

Front 23

give the patient a ____ amount of material during bedside

Back 23

small

Front 24

begin the radiographic exam with a small amount (____) and ____ volume as tolerated

Back 24

1 ml, increasing

Front 25

any patient whose aspiration is larger than approximately _____ per bolus of a particular food consistency despite interventions should be resticted from eating that consistency

Back 25

10%

Front 26

approximately ____ percent of patients who aspirate do not cough in response to this aspiration

Back 26

50%

Front 27

even the most experienced clinicians fail to ID approximately _____ percent of the patients who aspirate during a bedside

Back 27

40%

Front 28

older individuals are at higher risk ofr oropharyngeal disorders because of stroke and so on, and ____ dysfunction, because of age

Back 28

esophageal

Front 29

symptomatic treatment results in

Back 29

longer, more expensive care and less effective long-term health for the patient.

Front 30

diagnosis of dysphagia is designed to identify the ____________ of each patient's ________ and ________

Back 30

identify the abnormal elements of each patient's anatomy and physiology

Front 31

the anatomic areas involved in deglutition in clude the

Back 31

oral cavity, pharynx, larynx, and esophagus

Front 32

between the anterior and posterior faucial arches are the

Back 32

palatine tonsils

Front 33

the ___ is the space formed between the alveolus and cheek or lip musculature

Back 33

sulcus (lateral sulcus, anterior sulcus)

Front 34

muscles forming the floor of the mouth includes

Back 34

1. mylohyoid 2. geneohyoid 3. anterior belly of digastric (all of which attach to the body of the mandible anteriorly and the body of the hyoid bone posteriorly)

Front 35

the ____ forms the foundation for the tongue

Back 35

hyoid bone

Front 36

the laryx is suspended from the hyoid bone by the _____ and ____

Back 36

thyrohyoid ligament and thyfohyoid muscle

Front 37

if the hyoid elevates and moves forward,

Back 37

so will the larynx

Front 38

the oral tongue includes

Back 38

tip, blade, front, center, and back

Front 39

the oral tongue ends at the

Back 39

circumvillate papillae

Front 40

the oral stages of swallow is under

Back 40

cortical or voluntary neural control

Front 41

the tongue base (pharyngeal portion) begins at _____ and extends to the _____

Back 41

circumvillate papillae, hyoid bone

Front 42

the tongue base is under ______ but can be placed ____

Back 42

involuntary neural control coordinated in the brainstem (medullary swallow center), can be placed under voluntary control

Front 43

the roof of the mouth is formed by the

Back 43

maxilla (hard palate), velum (soft palate), uvula

Front 44

the ______ muscle helps to pull the soft palate down and forward

Back 44

palatoglossus muscle

Front 45

velopharyngeal port closure happens with a combo of muscle pulls such as:

Back 45

palatopharyngeus, levator palatal muscle, and fibers of the superior pharyngeal constrictor

Front 46

three large salivary glands are on each side

Back 46

1. parotid glands 2. submandibular 3. sublingual

Front 47

the parotid gland produces _________ fluid

Back 47

serous

Front 48

the submandibular and sublingual gland produce

Back 48

both types of fluid (sublingual glands more mucous)

Front 49

pharyngeal structures involved in deglutition include three pharyngeal constrictors:

Back 49

superior, medial, and inferior, which form the posterior and lateral pharyngeal walls

Front 50

median raphe

Back 50

the midline of the posterior pharyngeal wall. pharyngeal constrictor muscles arise here and run laterally to attach to structures located anteriorly

Front 51

inferior fibers of the superior constrictor that attach to teh tongue base are known as the

Back 51

glossopharyngeus muscle

Front 52

the fibers of the inferior constrictor attach

Back 52

to the sides of the thyroid cartilage anteriorly

Front 53

teh spaces that are formed between fibers of the inferior constrictor and the thyroid cartilage are called

Back 53

pyriform sinuses, which end inferiorly at the cricopharyngeal muscle.

Front 54

the _______ is the most inferior structure of the pharynx

Back 54

cricopharyngeal muscle

Front 55

cricopharyngeal muscle fibers attach to the

Back 55

posterolateral surface of the cricoid lamina

Front 56

the cricopharyngeal muscle fibers are in some degree of _______ ________ in the awake individual to prevent air from entering the esophagus during respiration

Back 56

tonic contraction

Front 57

during sleep, the cricopharyngeous

Back 57

loses some of its tonic contraction

Front 58

a secondary role of the UES is to

Back 58

reduce the risk of material backflowing from the esophagus and into the pharynx

Front 59

the UES is defined as a ______ zone of elevated pressure capable of withstanding pressures of up to _______ of water in the esophagus.

Back 59

2-4 cm , 11cm of water.

Front 60

the cricopharyngeal sphincter has greatest pressure ________ to the swallow and ________

Back 60

immediately prior, during inspiration

Front 61

the esophagus is a collapsed muscular tube approximately ____ cm long with a sphincter at each end

Back 61

23-25cm

Front 62

the esophagus has ___ layers of muscle: the ______ and the ______

Back 62

2: inner circular, outer longitudinal

Front 63

the ____ wall of the trachea is the _____ wall of the esophagus

Back 63

posterior, anterior

Front 64

the pharynx opens into the
______

Back 64

larynx

Front 65

the larynx serves primarily as a

Back 65

valve to keep food from entering the airway during swallowing

Front 66

the topmost structure of the larynx is the _______

Back 66

epiglottis, the top third which rests against the base of the tongue

Front 67

the epiglottis is attached to the hyoid bone by the ______ and the base of the epiglottis is attached by ligament to the _______

Back 67

hyoepiglottic ligament, thyroid notch

Front 68

the wedge shaped space formed between the base of the tongue and the epiglottis is the

Back 68

valleculae

Front 69

the valleculae is subdivided by the

Back 69

hyoepiglottic ligament

Front 70

the valleculae and the two pyriform sinuses are known as the

Back 70

pharyngeal recesses into which food may fall and reside before or after the pharyngeal swallow triggers

Front 71

the ____ are located against the base of the tongue and take up a small amount of vallecular space

Back 71

lingual tonsils

Front 72

the opening into the larynx is known as the

Back 72

laryngeal vestibule

Front 73

the laryngeal vestibule is bounded by the

Back 73

epiglottis, aryepiglottic folds, and arytenoid cartilage, and ends at the superior surface of the false vocal folds

Front 74

the aryepiglottic folds contain

Back 74

the aryepiglottic muscle, quadrangular membrane, and cuneiform cartilages

Front 75

the aryepiglottic folds form the _____ walls of the laryngeal vestibule

Back 75

lateral

Front 76

the arytenoids ____ _______ during swallowing

Back 76

tilt anteriorly - which contributes to the closure of the airway entrance

Front 77

the space that is formed between the false and true vocal folds is known as the

Back 77

laryngeal ventricle

Front 78

together the ________ and ______; the _____, base of ______, __________, ______ form three levels of sphincter in the larynx

Back 78

epiglottis and aryepiglottic folds, arytenoids, epiglottis, false VF, true VF

Front 79

the larynx and trachea are suspended in the neck between the ______ and the ______

Back 79

hyoid bone, sternum

Front 80

the act of deglutition is described in four phases:

Back 80

1. oral prep phase, 2. oral phase of the swallow 3. pharyngeal phase 4. esophageal phase

Front 81

swallowing frequency is greatest during ______ and least during ______

Back 81

eating, sleep

Front 82

mean deglutition frequency is approx ____ swallows per day

Back 82

580

Front 83

swallowing and respiration are ________ functions

Back 83

reciprocal

Front 84

respiration _____ during the pharyngeal phase of deglutition in humans of all ages, including infants

Back 84

halts

Front 85

swallows of saliva in the pharynx usually do not

Back 85

include any oral prep or oral stage of the swallow

Front 86

from the time the material is placed in the mouth ____ seal is maintained, which requires an _____ nasal airway

Back 86

labial, open

Front 87

the tongue cups around the liquid bolus with teh sides of the tongue sealed against the ________ ________

Back 87

lateral alveolus