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51 Cards in this Set

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  • Back
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Swallowing problems usually worsen over the course of degenerative disease -- T or F?
T
p. 329
In neurologic diseases, no conclusive evidence has been found regarding the relationship between disease stage and severity of dysphagia -- T or F?
T
p. 329
The patient w/ dysphagia secondary to degenerative disease should be evaluated on a regular basis in order so that __, __, and __
1) compensation for deteriorating fuction can be given 2) Patient is put at minimal risk for aspiration/lung problems, and 3) adequate nutrition and hydration are maintained
p. 330
Initially, patients w/ AD develop__
Food agnosia
p. 330
As AD progresses, patients develop __
swallowing and feeding apraxia
p. 330
Patients may also develop__
oral tactile agnosia
p. 330
Physiologic change in the swallow of AD patients includes __, __, and __ including __, __, and __
reduction in lateral tongue motion for chewing, delay in TPS, pharyngeal motor abnormalities, bilateral pharyngeal wall weakness, reduced TB motion, reduced laryngeal elevation
p. 331
Apraxia and agnosia may cause __ in AD patients
delay in oral phase initiation
p. 331
In AD patients, it is critical to ___
measure length of time it takes them to initiate oral stage, accept food in mouth
p. 331
___may help these patients
Heightening sensory awareness for food/swallow
p. 331
Some patients w/ dementia may experience __, which may manifest as __
separation btw brainstem and cortical aspects of swallow, significant delay in TPS
p. 331
In ALS patients w/ corticobulbar involvement, swallowing impairment often begins w/ __
reduced tongue mobility
p. 332
As a result of reduced tongue mobility, ALS patients may ultimately ___
avoid thicker foods requiring more pressure generation, chewing
p. 332
__ and __ may also become impaired in ALS patients
Velar function, lip closure
p. 332
In the later stages of ALS, patients may experience __ and resulting __
reduced laryngeal elevation, reduced airway entrance closure and penetration
p. 332
Patients w/ AlS at some point experience __, __ and __
reduced TB mvt, reduced pharyngeal contraction, delayed TPS
p. 332
ALS patients can feed orally as long as ___
laryngeal function remains adequate to protect the airway. patient can gradually reduce viscosity of intake
p. 332
In a study of ALS patients w/ corticobulbar involvement, disease progressed from ___
involvement of oral musculature to neuromuscular control of respiration and extremities
p. 333
In patients w/ corticospinal ALS involvement, ___ is often the first sign of dysphagia
slowly progressing weight loss
p. 333
Swallowing disorders manifesting as the first signs of motor neuron disease, may be accompanied by __
tongue fasciculations
p. 333
Werding-Hoffman Disease is diagnosed when an infant __
misses motor milestones btw 12 and 18 months of age
p. 333
Children w/ Werding-Hoffmann are usually paralyzed by the age of __
3.5
p. 333
In these children, pharyngeal stage is usually affected at __
18-24 months in the presence of intact oral function
p. 333
In the oral phase, patients w/ PD exhibit __
lingual rolling pattern
p. 334
Aspiration in patients w/ PD is usually caused by ___
material remaining in pharynx after the swallow b/c of poor tongue base, pharyngeal wall mvt
p. 334
Swallowing problems in patients w/ PD may start w/ ___, progress to ___, then later involve ___
1. reduced tongue base retraction and lingual rolling, 2. DTPS, 3. worsened TB retraction, laryngeal elevation and closure, pharyngeal contraction
p. 335
Patients w/ PD typically exhibit ___
tremor at rest
p. 335
__ may be the first sign of PD
oropharyngeal swallowing problems
p. 335
Before beginning swallowing therapy w/ a newly diagnosed PD patients, clinicians should __
wait for a few weeks to see effects of medications
p. 335
Patients w/ PD respond well to ROM exercises -- T or F?
T (but makes no sense)
p. 336
Swallowing problems in people w/ postpolio include __, __, and __
reduced TB retraction, reduced laryngeal elevation, unilateral and bilateral pharyngeal wall weakness
p. 336
In patients w/ postpolio, residue may ___ and ___
remain in pharynx, be aspirated after the swallow
p. 336
Patients w/ postpolio often don't perceive effects of posture changes on swallow -- T or F?
T
p. 336
__ and __ may be the most common swallowing problems in patients w/ MS
Delay in TPS, pharyngeal wall weakness
p. 337
Patients w/ MS respond well to ___
sensory enhancement techniques
p. 337
In MG, ___ muscles are typically affected first, causing __
ocular, ptosis
p. 337
Patients w/ MG may be misdiagnosed as having ___
psychogenic problems
p. 338
Diagnosis of MG involves__
tensilon injection
p. 338
Iin patients w/ MG, fatigue can be assessed by ___
MBS before and after the patient eats for 15-20 min.
p. 338
Muscular dystrophy comes in many types including ___ and ___
myotonic and oculopharyngeal
p. 338
Myotonic distrophy is characterized by __ and often affects the __, __, and __
prolonged contraction/difficulty relaxing muscles, sternocleidomastoid, muscles of mastication, UES
p. 338
___ is most common swallowing problem in patients w/ MD
reduced strength of pharyngeal constrictors
p. 339
Dermatomyositis is a ___ in which ___ is the main characteristic
collagen disease, polymyositis/multiple muscle involvement
p. 339
Dysphagia in patients w/ dermatomyositis includes ___ and ___
reduced pharyngeal contraction, UES opening
p. 339
___, __, __ and __ may initially present w/ swallowing problems
PD, MG, ALS, Guillain-Barre
p. 339
When patient w/ no ID'd medical Dx presents with oropharyngeal dysphagia, what should be done?
Compare mvt patterns in mouth and pharynx with those frequently seen in patients w/ specific neurologic disorders
p. 340
Swallowing therapist should also observe patient's __, __, and __
posture, gait, fine motor control
p. 340
Rheumatoid arthritis may invade the ___, causing __
crico-arytenoid joint, restricted movement of arytenoids during swallowing
p. 340
A flareup in rheumatoid arthritis may cause ___
swelling in arytenoid, resulting in collection of food around arytenoids and airway entrance
p. 340
Rheumatoid arthritis may also cause __ and ___
1) swelling in cervical vertebrae, constricting posterior pharyngeal wall 2) damage to TMJ
p. 341
In patients w/ COPD, ___ are best because ___
compensatory strategies, other types of exercises put further strain on system
p. 341