Chapter 1

Question 1

What is dysphagia?

Answer 1

A chronic difficulty moving the bolus and/or swallowing.

Question 2

T or F: Dysphagia is always secondary to something else.

Answer 2

TRUE!

Question 3

What are some of the ETIOLOGIES related to dysphagia?

Answer 3

• Infections
• Structural malformations
• Neurologic impairment or damage

Question 4

What are the 4 main CONSEQUENCES of dysphagia?

Answer 4

• dehydration
• malnutrition
• aspiration pneumonia
• poor quality of life

Question 5

What are the types of dysphagia?

Answer 5

• oral
• pharyngeal
• oropharyngeal
• esophageal

Question 6

A person with ORAL dysphagia may have problems with ….

Answer 6

tongue mvmt
lip closure
pocketing (keeps food in mouth/cheeks)
transport

Question 7

A person with PHARYNGEAL dysphagia may have problems with….

Answer 7

airway protection (epiglottic dysfunction)
residues/pooling
motility
UES

Question 8

A person with ESOPHAGEAL dysphagia may have problems with….

Answer 8

motility 
LES 
fistula 
diverticulum 
reflux/ulcer

Question 9

What are the 3 stages of swallowing and how much does each one last?

Answer 9

1) Oral Stage - (time varies upon bolus consistency)
2) Pharyngeal Stage (1 sec)
3) Esophageal Stage (8-20 sec)

Question 10

What are some of the SYMPTOMS of ORAL and/or PHARYNGEAL dysphagia?

Answer 10

• chocking and/or coughing
• penetration
• aspiration
• diff. initiating swallow
• food sticking in throat
• sialorrhea (excessive saliva)
• xerostomia (dry mouth)
• weight loss
• change in dietary habits
• recurrent pneumonia
• change in voice or speech (gurgly/wet)
• nasal regurgitation

Question 11

What are some of the SYMPTOMS of ESOPHAGEAL dysphagia?

Answer 11

• sensation of food sticking in chest or throat (UES)
• oral or pharyngeal regurgitation
• change in dietary habits
• reflux
• aspiration
• recurrent pneumonia

Question 12

T or F: When the bolus enters the VF’s it is considered PENETRATION!

Answer 12

FALSE - it is considered ASPIRATION!

Question 13

T or F: When the bolus enters the laryngeal vestibule it is considered PENETRATION.

Answer 13

TRUE

Question 14

Does a silent aspiration have a reflexive cough?

Answer 14

NO!

Question 15

If you are suspecting the patient is silently aspirating…how can you confirm it?

Answer 15

MBS - videofluoroscopy

Question 16

What are some possible signs of silent aspiration?

Answer 16

teary eyes

runny nose

Question 17

T or F: Feeding and swallowing are considered the same thing.

Answer 17

FALSE!

Question 18

What is the difference between FEEDING and SWALLOWING?

Answer 18

Feeding: placement of food in mouth before initiating swallow

Swallow: The process in which the bolus is transported from mouth to stomach

Question 19

How long does it take to perform a bedside screening?

Answer 19

10-15 minutes

Question 20

T or F: In a bedside you can assess the A&P of the swallow.

Answer 20

FALSE! However, you can assess the pt.’s oral mech.

Question 21

T or F: When performing the bedside you use a small bolus to assess swallowing.

Answer 21

TRUE ( 3 oz of water)

Question 22

What are some of the TREATMENTS used with patients with dysphagia?

Answer 22

Diet modification
Compensatory strategies (posture, chin tuck, head rotation)
Maneuvers (supraglottic , effortful, Mendelsohn)
Exercise ( shaker, masako, oral muscle strengthening)
Stimulation (thermal/tactile stim)
Experimental (neuromuscularar electrical stim)
Prosthetic (palatal lift)
Surgical (CP myotomy, diverticulectomy)

Question 23

What are other professionals you might collaborate with when working with a pt. with dysphagia?

Answer 23

• Dietician
• Nursing
• Radiologist / Neurologist/ ENT
• PT
• OT
• Pharmacist
• Social Worker
• Psychologist