Assessment Flashcards
3 types of assessments
screenings, clinical assessment, and instrumental assessments
Clinical Assessments
basically assessing everything you can without using external tools. Integrate info from case hx, observations, other professionals. Observe/assess function during speech and swallow tasks of main articulators, identify presence/observe characteristics of dysphagia based on signs and symptoms. Determine if an instrumental assessment is needed, if patient is appropriate for treatment/management, make clinical recommendations
A ___ is something a medical professional can observe in the absence of communication. A ___ is what the individual complains of
Sign; symptom
This is an example of a (sign/symptom): “it hurts when I swallow”
Symptom
This is an example of a (sign/symptom): the patient coughs, a lot of throat clearing
Sign
How respiratory problems affect swallowing
depending on severity of respiratory problem, may not be able to withstand swallowing apnea duration. Decreased oxygenation levels indicate higher risk of swallowing impairment. Oxygen starvation and/or respiratory problems are at risk to have a different exhale-swallow-exhale pattern.
t/f: Oxygen starvation and/or respiratory problems are at risk to have a different exhale-swallow-exhale pattern.
T
what to look for during CSE of facial muscles/muscles of mastication:
strength for opening/closing mandible, palpation of masseter muscles while biting down, assess for TMJ stiffness (aka lockjaw), assess lateral movements
what to look for during CSE of tongue musculature
tongue movement (protrusion, lateral, rapid tongue movements, movement of tongue to roof of mouth) protrustion against resistance, inspection for atrophy, structural changes, general assessment of sensation
what to look for during CSE of oral cavity
inspect and assess lesions, candidiasis, saliva flow (xerostoma?), general dental status
what to look for during CSE of oropharynx
inspect/assess velum. Observe during rest and phonation
what to look for during CSE of pharynx
Not able to do! We need instrumentation
what to look for during CSE of larynx
ask patient to phonate and note breathiness, hoarseness, wet/gurgling quality. Ask client to complete dry swallow and feel for laryngeal elevation
hierarchy of PO trials
thins, nectars, honeys, puddings, puree, mechanical soft, solids
What to look for during PO trials
pocketing, labial spillage, slow oral transit time, excessive tongue movement, delayed or reduced laryngeal elevation, coughing/throat clearing (related to PO), wet/gurgly vocal quality, poor secretion management
t/f: ability to self-feed is a strong indicator of safety
T
instrumental assessments (2 main ones)
MBS and FEES
indications of assessments (why we should assess)
neurological impairments (congential or acquired), structural/mechanical impairment (head/neck cancer, tracheostomy, VF paralysis, spine repair, craniofacial anomalies)
contraindications of assessment (why you shouldn’t assess)
patient is medically unstable, or unable to cooperate/participate. Patient is unable to be properly positioned, size of patient prevents adequate imagining, allergy to barium
when assessing velum function what CN are you assessing
IX and X
when assessing facial expressions what CN are you assessing
VII
when assessing mastication what CN are you assessing
V
when assessing bolus formation what CN are you assessing
VII (saliva), V (mastication), XII (tongue)
when assessing oral anterior-posterior propulsion what CN are you assessing
XII
