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Dysphagia Midterm > Chapter 3 > Flashcards

Chapter 3 Flashcards

1
Q

What is the most popular screener for swallowing?

A

Bedside Assessment of Swallowing

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2
Q

What is the main purpose of the bedside?

A

Identify if the pt. has dysphagia and if further testing should be performed.

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3
Q

What is a false positive?

A

Clinician states that pt. IS aspirating when they are NOT

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4
Q

What is a false negative?

A

Clinician states that pt. is NOT aspirating when they ARE!

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5
Q

T or F: The beside screener is very accurate.

A

False!!!

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6
Q

What are the main symptoms for VALLECULAE POOLING?

A
  • Base of tongue/epiglottic area

* Feeling that something is stuck HIGH in throat

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7
Q

What are the main symptoms for PYRIFORM POOLING?

A
  • Just below larynx

* Feeling that something is stuck in the MIDDLE of throat

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8
Q

When or where is premature spilling happening?

A

PYRIFORM SINUSES!!!/POOLING

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9
Q

What are the symptoms of UES DYSFUNCTION?

A
  • Pain in UPPER chest or inches below larynx

* Something stuck in LOWER throat or HIGH in chest

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10
Q

What are the symptoms of ASPIRATION?

A
  • chocking
  • coughing
  • silent aspiration (50%)
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11
Q

What info does the beside provide?

A
  • pt.’s hx, dx, perception of problem
  • medical status
  • oral anatomy (Oral mech)
  • respiratory function
  • cognitive status
  • sensory (taste, temp, texture)
  • signs and symptoms during swallow attempts
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12
Q

What are the MATERIALS needed for the beside?

A
  • cup
  • straw
  • spoon
  • syringe
  • tongue blades
  • laryngeal mirror
  • towel/cloth
  • gloves/gown
  • eyewear/mask
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13
Q

Before the bedside what is something you need to do to PREP?

A

Look at CHART REVIEW!!!

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14
Q

What imp. info does the chart review include?

A
  • RESPIRATORY STATUS (trach? vent? intubated?)
    - breathing patter : mouth or nose breather?
    - resp. rate at rest
  • DYSPHAGIA HX: (onset? symptoms? pt. awareness? localization?)
  • HX OF PNEUMONIA?
  • NUTRITIONAL STATUS (diet type?)
  • MEDICATIONS
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15
Q

What are you looking at physically when you perform the bedside?

A
  • POSTURE
  • ORAL MECH STRUCTURES AND FX (lips, hard/soft palate, uvula, teeth etc.)
  • APRAXIA?
  • ABNORMAL REFLEXES? (tongue thrust, increased gag, tonic bite)
  • LARYNGEAL FX EXAM:
    • gurgly voice? (could indicate penetration/aspiration)
  • hoarsness/breathiness
  • ddk’s (neuro?)
  • hard cough/throat clear
  • vocal scaling (ct m.)
  • phonation time (resp. fx)
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16
Q

What are some Pulmonary function testing that can be done? (usually not part of bedside)

A

SPIROMETRY (capacities, volumes)

MANOMETRY (strength, pressure)

17
Q

T or F: You always perform the TRIAL SWALLOWS with any pt. when you are doing the beside.

A

FALSE!!! if pt. is acutely ill, disoriented, uncooperative, you suspect silent aspiration don’t do it!!!

18
Q

What are some of the RESULTS you get from the bedside?

A
  • POSTURE that elicits better swallow
  • BEST POSITIONING for food in mouth
  • FOOD CONSISTENCY
  • HYPOTHESIS of why they could have dysphagia
  • RECOMMENDATIONS for dx
19
Q

What is the most popular imaging?

A

VIDEOFLUOROSCOPY (b/c you can see all of the swallowing stages!!)

20
Q

What are the imaging dx instrumentations :

A
  • VIDEOFLUOROSCOPY (MBS)
  • FEES/FEESST
  • PET/fMRI (ultrasound)
  • SCINTIGRAPHY
21
Q

What are the non-imaging dx instrumentations :

A
  • Acoustics (stethoscope/accelerometer (micro)
  • EMG (m. activity)
  • EGG (m. vf vibration at thyrohyoid level)
  • Manometry
22
Q

What are some of the INDICATIONS of the MBS?

A
  • view normal and abnormal A&P of swallow
  • evaluate airway protection
  • evaluate postures, maneuvers, compensatory strategies
  • provide recommendations
  • determine therapeutic techniques
  • collaborate and educate other team members and family
23
Q

What are some of the CONTRAINDICATIONS of the MBS?

A
  • medically unstable, lethargic, unoriented etc.
  • allergy to barium
  • pt. is unable to be adequately positioned
  • size of pt. (obese)
  • if the study does not make much difference in the pt’s medical management
24
Q

What are some of the LIMITATIONS of the MBS?

A
  • radiation exposure
  • barium is not pleasant and it is unnatural
  • does not fully represent mealtime function
  • limited ability to evaluate a fatigue effect on swallowing
25
Q

T or F: The FEES does NOT provide a good view of the vf’s.

26
Q

T or F: The FEES exposes the pt. to radiation.

27
Q

T or F: In the FEES you have a clear view of the pharyngeal stage of swallowing.

A

FALSE! : there is a white out period during this phase. you only see the BEFORE and AFTER!

Dysphagia Midterm (3 decks)

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