Ch. 3 Evaluation Of Swallowing Flashcards
T/F
Diagnostic= involves some kind of imaging
True
T/F
Bed side = screening tool and diagnostic tool
False
It’s not a diagnostic tool
T/F
Screening is 100% accurate
False
T/F
A false positive is when you think the pt. Aspired but they didn’t
And
A false negative is when you think the pt. did not aspired but they did
True
When a pt. says “i feel like there’s food ‘stuck’ high in my throat” and you see residue in the base of the tongue/ epiglottic area, what kind of symptom is this?
Valleculae hesitation/ pooling
When the pt. says “ i feel the food is ‘stuck’ in the middle of my throat” and you see in the MBS or FEES some residue below the larynx, what type of symptomatology is it?
Pyriforms pooling
When pt. Says “ i feel pain in my upper chest and i feel like my food is stuck in lower throat” what kind of symptomatology is this?
UES dysfunction
What are some signs of aspiration?
Choking
Coughing
T/F
20% of ppl aspirate without coughing
False
50%+
Name 6 things that a bedside provides
Medical hx, pt.'s perception Pt's status: respiratory, nutritional Pt's oral anatomy Respiratory function Cognitive status Sensory Sign and symptoms
Name 5 materials you take to a bedside
Laryngeal mirror Tongue blades Cup Spoon Straw Syringe Towel Gloves Eyewear
Before doing the Bedside screening, what should you do to PREP?
Chart Review
What information can you see in the chart review?
Respiratory status hx: Vent? Intubated? Respiratory rate, time saliva swallows &phase of respiration Time cough Time breath hold- 1sec 3 sec Breathing pattern: mouth or nose
Dysphagia hx:onset? Symptoms? Localization?
Hx of Pneumonia:fever?
Nutritional status: diet type? Duration? Complications?
Medications: xerostomia? Alertness?
When you do the bed side swallow screener you also do a ______________
Physical Exam
WHat do you check for on a physical exam?
Posture
ORAL MECH
What are the MAIN two things that you check on an ORAL MECH?
Anatomy and Physiology
What do you look for when looking at the anatomy and physiology in an Oral Mech exam?
Anatomy :
lips, hard palate, soft palate, uvula, faucial arches, teeth, secretion. Scarring and assymetry.
Physiology:
open mouth, stimuli (taste, temp, texture), chewing, sensitivity.
Labial function: /i/, /u/ ddk /pa/
Lingual function: extension, retraction, corners or mouth, clear sulcus, tip to alveolar ridge, rub along palate
soft palate: sustained /a/ palatal reflex gag reflex
Aparaxia
Abnormal oral reflexes (tongue trust, increase gag, tonic bite)
What are you to noticed during a Laryngeal Function Exam?
gurgly voice, penetration, aspiration?
Hoarseness/ breathiness< incomplete glottic clousure
DDks… neuro inpairment?
Hard cough/strong throat> reflexive… strong enough?
Vocal scaling> CT m. SLN
Phonation time, lanryngeal control, respiratory function
What are other two further diagnostic procedures that you can do?
Pulmonary Function Testing (PFT)
Spirometer: capacity FVC, FEV
Manometer: Strenght MIP MEP
Pneutachometry
In what conditions does the pt. have to be in in order for you to skip the bed side screener and send them straight to a MBS?
pt. is actually ill bad pulmonary function very weak cough 80+ years old bad cognition suspect aspiration
What material should you start with when doing a bedside?
the easiest to the pt.
small quality
When doing the trial swallows what should you note for?
Pt.'s reaction for food Oral mvmnts coughing, throat clearing secretion level meal duration and amt resp/ swallow corrdination
What do you want to get out of a bed side? what are the Results of a bedside?
POsture resulting in best/ safest swallow
Best positioning for food in mouth
Best food consistency
Hypothesis as to nature of swallowing disorder
Recommendations for dx
What are the 4 IMAGING DX instrumentations?
Videofluoroscopy* most common (xray view) MBS
FEES/ FEESST/ Videoendoscopy
Ultrasound/ fMRI/ PET
Scintigraphy
