7.2 Videofluoroscopic assessment of swallowing Flashcards
What is a Radiographic Assessment?
2
Patients are positioned in an upright posture
They drink and eat specific amounts of barium of different consistencies.
(Barium sulfate is a radio-opaque compound that shows up during x-ray)
What does a Radiographic Assessment evaluate?
2
Impairments in the swallowing physiology
Efficacy of therapeutic strategies
What are the consistencies of barium used in Radiographic Assessments?
(4)
Thin liquids – 3cc., 5cc., 10cc., continuous sips (3 Oz)
Nectar thick/Honey thick liquids
Pudding
Solids
What types of views are used in Radiographic Assessments?
2
Lateral
Anterior
What do we need to identify before a Radiographic Assessments?
Anatomical landmarks
During a Radiographic Assessments, what is usually placed on the mastoid to measure hyoid movement?
A penny
When performing Radiographic Assessments, what should the clinician always wear?
Radiation shields
What do we look for during Radiographic Assessments?
9
Oral preparation
Oral transit time
Initiation of swallowing – is it delayed or normal?
Closure of velopharynx
Closure of the epiglottis
Retraction of the tongue base
Elevation of the hyoid
Opening of the UES
Phrayngeal transit durations
What postural changes can be used for Prolonged Oral Transit?
Tilting head back
What postural changes can be used for Delayed Swallow Initiation?
Chin tuck
What postural changes can be used for Impaired Tongue Base Retration?
Chin tuck
What postural changes can be used for Unilateral Laryngeal Dysfunction?
Head rotation to impaired side
What postural changes can be used for Unilateral
Pharyngeal/Pyriform Sinus Residue?
Head rotation to impaired side
What postural changes can be used for Unilateral Oral + Pharyngeal Weakness?
Head tilt to the unimpaired side
Head tilts are always performed to the __________ because this ___________.
Good side
Facilitates the use of the good side
Head rotations are always performed to the __________ because this ___________ and __________.
Bad side
Shuts off the bad side
Forces use of the good side
What maneuvers might we ask a patient to perform during a Radiographic Assessments?
Supraglottic swallow
Effortful swallow
Masako
What is a Supraglottic Swallow?
4
Hold breath
Swallow hard
Cough
Swallow again
What is a Effortful Swallow?
What is it used for?
Very hard swallow
Training
What is a Masako?
What is it used for?
Holding the tongue between the teeth when swallowing
Training
What other strategies might we ask a patient to perform to clear residue during a Radiographic Assessments?
Liquid Wash
Repeat Swallows
What is a Liquid Wash?
Each swallow is followed by liquid
What are Repeated Swallows?
Multiple Swallows
How do we report VFSS Results?
3
Report physiological abnormality and bolus flow correlates.
Start report with the oral phase and finish with the UES.
Quantify everything possible (mildly delayed swallow initiation, moderate pyriform sinus residue, etc.)
What outline should we use when writing swallowing evaluation reports?
(4)
Broad diagnosis
Abnormal functions
Functions WNL
Proof (mention consistence, amount, patient reaction)
