Logemann Chapter 10

Front 1

Swallowing problems usually worsen over the course of degenerative disease -- T or F?

Back 1

T

Hint 1

p. 329

Front 2

In neurologic diseases, no conclusive evidence has been found regarding the relationship between disease stage and severity of dysphagia -- T or F?

Back 2

T

Hint 2

p. 329

Front 3

The patient w/ dysphagia secondary to degenerative disease should be evaluated on a regular basis in order so that __, __, and __

Back 3

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

Hint 3

p. 330

Front 4

Initially, patients w/ AD develop__

Back 4

Food agnosia

Hint 4

p. 330

Front 5

As AD progresses, patients develop __

Back 5

swallowing and feeding apraxia

Hint 5

p. 330

Front 6

Patients may also develop__

Back 6

oral tactile agnosia

Hint 6

p. 330

Front 7

Physiologic change in the swallow of AD patients includes __, __, and __ including __, __, and __

Back 7

reduction in lateral tongue motion for chewing, delay in TPS, pharyngeal motor abnormalities, bilateral pharyngeal wall weakness, reduced TB motion, reduced laryngeal elevation

Hint 7

p. 331

Front 8

Apraxia and agnosia may cause __ in AD patients

Back 8

delay in oral phase initiation

Hint 8

p. 331

Front 9

In AD patients, it is critical to ___

Back 9

measure length of time it takes them to initiate oral stage, accept food in mouth

Hint 9

p. 331

Front 10

___may help these patients

Back 10

Heightening sensory awareness for food/swallow

Hint 10

p. 331

Front 11

Some patients w/ dementia may experience __, which may manifest as __

Back 11

separation btw brainstem and cortical aspects of swallow, significant delay in TPS

Hint 11

p. 331

Front 12

In ALS patients w/ corticobulbar involvement, swallowing impairment often begins w/ __

Back 12

reduced tongue mobility

Hint 12

p. 332

Front 13

As a result of reduced tongue mobility, ALS patients may ultimately ___

Back 13

avoid thicker foods requiring more pressure generation, chewing

Hint 13

p. 332

Front 14

__ and __ may also become impaired in ALS patients

Back 14

Velar function, lip closure

Hint 14

p. 332

Front 15

In the later stages of ALS, patients may experience __ and resulting __

Back 15

reduced laryngeal elevation, reduced airway entrance closure and penetration

Hint 15

p. 332

Front 16

Patients w/ AlS at some point experience __, __ and __

Back 16

reduced TB mvt, reduced pharyngeal contraction, delayed TPS

Hint 16

p. 332

Front 17

ALS patients can feed orally as long as ___

Back 17

laryngeal function remains adequate to protect the airway. patient can gradually reduce viscosity of intake

Hint 17

p. 332

Front 18

In a study of ALS patients w/ corticobulbar involvement, disease progressed from ___

Back 18

involvement of oral musculature to neuromuscular control of respiration and extremities

Hint 18

p. 333

Front 19

In patients w/ corticospinal ALS involvement, ___ is often the first sign of dysphagia

Back 19

slowly progressing weight loss

Hint 19

p. 333

Front 20

Swallowing disorders manifesting as the first signs of motor neuron disease, may be accompanied by __

Back 20

tongue fasciculations

Hint 20

p. 333

Front 21

Werding-Hoffman Disease is diagnosed when an infant __

Back 21

misses motor milestones btw 12 and 18 months of age

Hint 21

p. 333

Front 22

Children w/ Werding-Hoffmann are usually paralyzed by the age of __

Back 22

3.5

Hint 22

p. 333

Front 23

In these children, pharyngeal stage is usually affected at __

Back 23

18-24 months in the presence of intact oral function

Hint 23

p. 333

Front 24

In the oral phase, patients w/ PD exhibit __

Back 24

lingual rolling pattern

Hint 24

p. 334

Front 25

Aspiration in patients w/ PD is usually caused by ___

Back 25

material remaining in pharynx after the swallow b/c of poor tongue base, pharyngeal wall mvt

Hint 25

p. 334

Front 26

Swallowing problems in patients w/ PD may start w/ ___, progress to ___, then later involve ___

Back 26

1. reduced tongue base retraction and lingual rolling, 2. DTPS, 3. worsened TB retraction, laryngeal elevation and closure, pharyngeal contraction

Hint 26

p. 335

Front 27

Patients w/ PD typically exhibit ___

Back 27

tremor at rest

Hint 27

p. 335

Front 28

__ may be the first sign of PD

Back 28

oropharyngeal swallowing problems

Hint 28

p. 335

Front 29

Before beginning swallowing therapy w/ a newly diagnosed PD patients, clinicians should __

Back 29

wait for a few weeks to see effects of medications

Hint 29

p. 335

Front 30

Patients w/ PD respond well to ROM exercises -- T or F?

Back 30

T (but makes no sense)

Hint 30

p. 336

Front 31

Swallowing problems in people w/ postpolio include __, __, and __

Back 31

reduced TB retraction, reduced laryngeal elevation, unilateral and bilateral pharyngeal wall weakness

Hint 31

p. 336

Front 32

In patients w/ postpolio, residue may ___ and ___

Back 32

remain in pharynx, be aspirated after the swallow

Hint 32

p. 336

Front 33

Patients w/ postpolio often don't perceive effects of posture changes on swallow -- T or F?

Back 33

T

Hint 33

p. 336

Front 34

__ and __ may be the most common swallowing problems in patients w/ MS

Back 34

Delay in TPS, pharyngeal wall weakness

Hint 34

p. 337

Front 35

Patients w/ MS respond well to ___

Back 35

sensory enhancement techniques

Hint 35

p. 337

Front 36

In MG, ___ muscles are typically affected first, causing __

Back 36

ocular, ptosis

Hint 36

p. 337

Front 37

Patients w/ MG may be misdiagnosed as having ___

Back 37

psychogenic problems

Hint 37

p. 338

Front 38

Diagnosis of MG involves__

Back 38

tensilon injection

Hint 38

p. 338

Front 39

Iin patients w/ MG, fatigue can be assessed by ___

Back 39

MBS before and after the patient eats for 15-20 min.

Hint 39

p. 338

Front 40

Muscular dystrophy comes in many types including ___ and ___

Back 40

myotonic and oculopharyngeal

Hint 40

p. 338

Front 41

Myotonic distrophy is characterized by __ and often affects the __, __, and __

Back 41

prolonged contraction/difficulty relaxing muscles, sternocleidomastoid, muscles of mastication, UES

Hint 41

p. 338

Front 42

___ is most common swallowing problem in patients w/ MD

Back 42

reduced strength of pharyngeal constrictors

Hint 42

p. 339

Front 43

Dermatomyositis is a ___ in which ___ is the main characteristic

Back 43

collagen disease, polymyositis/multiple muscle involvement

Hint 43

p. 339

Front 44

Dysphagia in patients w/ dermatomyositis includes ___ and ___

Back 44

reduced pharyngeal contraction, UES opening

Hint 44

p. 339

Front 45

___, __, __ and __ may initially present w/ swallowing problems

Back 45

PD, MG, ALS, Guillain-Barre

Hint 45

p. 339

Front 46

When patient w/ no ID'd medical Dx presents with oropharyngeal dysphagia, what should be done?

Back 46

Compare mvt patterns in mouth and pharynx with those frequently seen in patients w/ specific neurologic disorders

Hint 46

p. 340

Front 47

Swallowing therapist should also observe patient's __, __, and __

Back 47

posture, gait, fine motor control

Hint 47

p. 340

Front 48

Rheumatoid arthritis may invade the ___, causing __

Back 48

crico-arytenoid joint, restricted movement of arytenoids during swallowing

Hint 48

p. 340

Front 49

A flareup in rheumatoid arthritis may cause ___

Back 49

swelling in arytenoid, resulting in collection of food around arytenoids and airway entrance

Hint 49

p. 340

Front 50

Rheumatoid arthritis may also cause __ and ___

Back 50

1) swelling in cervical vertebrae, constricting posterior pharyngeal wall 2) damage to TMJ

Hint 50

p. 341

Front 51

In patients w/ COPD, ___ are best because ___

Back 51

compensatory strategies, other types of exercises put further strain on system

Hint 51

p. 341