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30 Cards in this Set
- Front
- Back
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True or False. Feeding and swallowing are related, but different activities.
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True
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Difficulty forming and holding bolus, spillage of food in the anterior and lateral sulcus and weak lip closure occurs in what phase of swallowing?
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Oral preparatory phase
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Difficulties propelling bolus through the pharynx and into the pharyngoesophageal sphinter (P-E) segment occurs in what phase of swallowing?
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Pharyngeal phase
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True or False. Swallowing phase is under voluntary control.
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False
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Difficulty passing bolus through the cricopharyngeus muscle and past the 7th cervical vertebra occurs in what phase of swallowing?
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Esophageal phase
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Formation of diverticulum (a pouch that collects food) development of tracheosophageal fistula (hole) or esophageal obstruction (e.g. by tumor)
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Esophageal phase
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True or False. When conducting a swallowing assessment, also screen the patient's speech, voice, language and writing skills
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True
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When conducting a laryngeal examination using indirect laryngoscopy or endoscopic examination, what structures does a clinician examine?
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1. Base of the tongue
2. Vallecula 3. Epiglottis 4. Pyriform sinuses 5. Vocal folds 6. Ventricular folds |
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True or False. During swallowing assessment, screen concrete and abstract language comprehension by giving giving a few simple verbal commands and by asking the patient to give the meaning of common proverbs and phrases.
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True
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What instrument can be used to measure pressure of the upper and lower esophagus.
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A manometer
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What would a clinician use to measure tongue and hyoid movements.
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Ultrasound examinations
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What treatment technique would you give a client with delayed or absent swallowing reflex
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Tilt head forward while swallowing
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What is the purpose of the Mendelsohn maneuver?
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The Mendelsohn maneuver helps elevate the larynx and thus widen the cricopharyngeal opening.
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What is the purpose of of Teflon injection in to the vocal fold?
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This surgical implant method is designed to improve airway closure during swallowing.
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What is the difference between penetration and aspiration?
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Penetration: the process in which food or liquids enter the larynx but does not become inhaled into the trachea. These foreign substances are ejected from the laryngeal area
Aspiration: the inhalation of food, liquid, or other foreign matter into the lungs |
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What are strictures?
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Strictures are narrowing of esophagus in any location preventing passage of the bolus; one example is hiatal hernia in which part of the stomach moves into the esophagus blocking bolus movement.
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What is Achalasia?
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The LES does not relax or completely relax preventing the passage of the bolus into the stomach.
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Where is the swallow center?
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Reticular formation of the medulla oblongata.
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True or False.Screening for dysphagia is a hand-on process.
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False
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List red flags that would indicate a need for swallowing evaluation.
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1. Recurrent pneumonia
2. Unplanned weight loss 3. Coughing with meds or at meals 4. NT consult or vocal cord paralysis 5. Labored breathing 6. Reporting of wet vocal quality (gurgly voice) – suggests residue on the surface of vocal folds |
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List postural strategies for swallowing disorders.
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Chin tuck posturing
Head rotation Head tilt Side lying Neck Extension |
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Bolus control techniques.
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3-second prep
Lingual sweep Cyclic ingestion Dry swallows Thermal gustatory stimulation Bolus placement Modification of bolus size Adaptations in rate of intake |
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What is Blue Dye tests used for?
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Used with tracheostomized patients. Blue dye is used to color secretions, food and liquid the patient consumes
Tracheal suctioning is used to test for the blue dye. If the dye is found in the suctioned secretions, there is a confirmation of aspiration |
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What is the role of the SLP for during modified barium swallowing assessments?
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1. Assess the efficacy of your treatment strategies
2. Ask for various positions, food consistencies, compensatory techniques 3. Can help to minimize the risk of aspiration by limiting the number of swallows a patient needs to perform 4. Informant to radiologist |
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True or False. Swallow does not exist if oral-pharyngeal transport is more than 15 seconds.
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True
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Discuss the food placement guideline
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Generally place food on stronger side to increase sensation and stimulability to food and reduce pocketing. Use spoon to press down on tongue as you place food; stimulates oral stage. Anterior placement for patients experiencing premature spillage into pharynx and who have good lip closure. Posterior placement for patients who have delayed oral transit time or who have poor lip closure. Lateral placement (best side) in patients with unilateral tongue weakness. Midline placement with patients with good tongue control and lip closure.
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List Huckabee and Pelletier's (1999) five areas of compensatory strategies .
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1. Postural strategies;
2. Bolus control techniques; 3. Volitional airway protection strategies; 4. Diet modifications, and 5. Prosthetic devices. |
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When should a clinician not trial feed but go to MBS instead?
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1. Tracheostomy patients
2. Those with severely impaired oral-motor function 3. Ventilator dependent spinal cord patients with massive problems demonstrated in early part of the eval. 4. Patients with brain stem damage, gurgly voice, no throat clearing or poor respiratory control 5. Absent swallow, no cough, or no throat clearing ability |
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List the oral and facial exam used in swallowing assessment.
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Observing Oral Hygiene
Testing Labial Function Testing Lingual Function Testing Oral Sensitivity Testing Chewing Ability |
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List signs of GERD
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1. Gagging when lying down;
2. Bad taste in mouth; 3. Burning in chest/pharynx |
