Assessment

Question 1

Clinical Evaluation

Answer 1

• determine presence of dysphagia and need for instrumental exam
• components: oral mech exam, laryngeal functioning assessment, PO trials

Question 2

Instrumetnal Exams

Answer 2

Cervical auscultation (Borr et al 2007) says swallowing gives audible cues for identification of warning signs but not good as a stand-alone tool

• pulse oximetry
• FEES
• MBS
• manometry

Question 3

FEES

Answer 3

• fiberoptic endoscopic evaluation of swallowing
• assess pharyngeal and laryngeal structures
• objectively assess wallow of PO
• no transportation needed
• Langmore (2000)- thousands of exams done with no serious coplications
• more sensitive when visualizing the bolus and aspiration
• weakness: don’t see oral phase; white-out during swallow, can’t assess UES opening

Question 4

Secretions

Answer 4

Murray et al (1996): study with elderly hospitalized men, found that YES secretions are 100% predictive of dysphagia
-normals should not have secretions

Question 5

MBS

Answer 5

• modified barium swallow study
• visualize oral cavity and aspiration as it occurs
• posture: upright
• views: lateral and AP
• better detects residue in trachea
• better detections of amount aspirated
• better assessment of UES opening
• score with PAS

Question 6

PAS scale

Answer 6

(Rosenbek, 1996)

1. material does not enter the airway
2. material enters the airway, remains above the vocal folds, and is ejected from airway
3. material enters the airway, remains above the VFs, and is not ejected
4. material enters the airway, contacts the vocal folds, and is ejected
5. material enters the airway, contacts the vocal folds, and is not ejected
6. material enters the airway, passes below the vocal folds, and is ejected
7. material enters the airway, passes below the VFs, and is not ejected despite effort
8. material enters the airway, passes below the vocal folds, not effort made to eject