Dysphagia Articles Quiz 2

Front 1

Rasley et al, 1992

Back 1

Postural techniques can eliminate aspiration of barium of at least small volumes in most patients.
Recommends changes of posture during MBS procedures.

Hint 1

Prevention of Barium Aspiration during Videofluroscopic Swallowing Studies

Front 2

Kahrilas et al, 1991

Back 2

the opening of the UES can be modified using volitional techniques such as the Mendelsohn maneuver that affect hyoid and laryngeal elevation

Hint 2

Volitional augmentation of upper esophageal sphincter opening during swallowing

Front 3

Bisch et al, 1994

Back 3

Few significant effects of temperature on swallowing disorders or swallow measures (except 1ml cold)
Increase in bolus volume and viscosity decreased pharyngeal delay times in pts with neurologic impairment.

Hint 3

Pharyngeal Effects of Bolus Volum, Viscosity, and Temperature in Patients with Dysphagia resulting from neurologic Impairment and in normal subjects.

Front 4

Leder & Ross, 2000

Back 4

No causal relationship between trachotomy and aspiration status was exhibited.

Hint 4

Investication of the causal relationship between tracheotomy and spiration in the acute care setting

Front 5

Logemann et al, 1989

Back 5

Head rotation can improve swallowing in patients with unilateral oropharyngeal dysphagia. Beneficial effects include 1) functional exclusion of the relatively flaccid, weakened pharyngeal wall, and 2) reduced UES tone. (operative mechanism depends on dominant mechanism of dysphagia)

Hint 5

The benefit of head rotation on pharyngoesophageal dysphagia

Front 6

Langmore & Logemann, 1991

Back 6

Logemann argues that FEES is necessary because bedside swallow exams fail to detect 38-40% of aspiration and do not allow for observation of the physiology of pharyngeal swallow. Langmore argues that FEES is not always feasible or necessary, and endoscopy is often sufficient. Read the article.

Hint 6

After the Cllinical Bedside Swallowing Examination: What Next?

Front 7

Welch et al, 1993

Back 7

Chin tuck procedures causes a posterior shift of the anterior pharyngeal wall and the laryngeal entrance, while widening the angel of the epiglottis to the anterior tracheal wall, improving airway protection. Widening of the valleculae is not uniform.

Hint 7

Changes in pharyngeal dimentions effected by chin tuck

Front 8

Shanahan, T., 1993

Back 8

Not all patients who aspirate because of a delayed pharyngeal swallow or reduced airway closure benefit from the chin-down procedure. Those who do not benefit show a significantly loarger increase in the epiglottic angle.

Hint 8

Chin-Down Posture Effect on Aspiration in Dysphagic Patients

Front 9

de Lama Lazzara et al, 1986

Back 9

The anterior faucial arches are mon of the most sensitive areas for triggering the swallowing reflex. Use of thermal sensitization improved triggering of the swallowing reflex in 23 of 25 neurologically impaired patients. Effects immediate. Longterm effects are unknown. No reflex will be triggered if reflex is absent.

Hint 9

Impact of Thermal Stimulation on the Triggering of the Swallowing Reflex

Front 10

Martin et al, 1993

Back 10

Videofluoroscopy allows visualization of the biomechanics of oropharyngeal and cervical esophagus and to determine if patient is able to maintain laryngeal valving. 3 breath-hold maneuvers were easy, inhale hard, inhale/exhale hard. Arytenoid & TVF produced on all maneuvers; FVF and ant arytenoid tilting only during hard holds.

Hint 10

Normal laryngeal valving patterns during three breath-hold maneuvers: a pilot investigation

Front 11

Fujiu & Logemann, 1996

Back 11

Inhibits triggering of pharyngeal swallow, increases pharyngeal residue, shortens airway closure. Does allow pt to actively change the degree of muscular contraction of the PPW (posterior pharyngeal wall)

Hint 11

Effect of a Tongue-Holding Maneuver on Posterior Pharyngeal Wall Movement During Deglutition

Front 12

Logemann, 1996 (Editorial)

Back 12

More research needs to be done on the effects of preswallow sensory input in normal individuals and dysphagics.
Normal swallowers exhibit systematic changes in temporal measures of oropharyngeal swallow as a result of changes in bolus volume and viscosity (effects of taste unknown)

Hint 12

Preswallow sensory input: its potential importance to dysphagic patients and normal individuals

Front 13

Davis et al, 1987

Back 13

Residue in the oral cavity decreased markedly with the prosthesis (25% with, 90% without) t/d and k/g productions were also more normal

Hint 13

Effect of a maxillary glossectomy prosthesis on articulation and swallowing.