Chapter 4 Flashcards
1
Q
- Can contraction of scars from surgical excision result in dysphagia long after surgery?
A
Yes, it can
2
Q
- Is dysphagia following surgery related to the area where the surgery was done?
A
No, it can occur in areas other than where it was done
3
Q
- Are high vagal lesions common after skull base surgery?
A
No, lower cranial neuropathies are common
4
Q
- Is injury to Cranial Nerve XII following surgery likely to result in loss or partial loss of sensation?
A
Yes, it is
5
Q
- Is the tongue alone capable of propelling the bolus to the anterior faucial arches?
A
No it isn’t, the tongue needs a contact point, otherwise the bolus moves away via gravity
6
Q
- Is surgery for tumors of the soft palate the best management technique to improve oral phase swallowing?
A
-No, it isn’t. It’s best to fit patients with a prosthetic device
7
Q
- Is laryngeal elevation reduced when the genioglossus and glossopharyngeal muscles are involved in the surgery?
A
-Yes, it is reduced
8
Q
- Does a tracheotomy tube provide an additional mechanism to aid in laryngeal elevation?
A
No, trach tubes usually result in tracheal lowering
9
Q
- Is Zenker’s diverticulum best treated with medication to control gastroesophageal reflux?
A
No, it is usually treated w/ surgery (like a cricopharyngeal myotomy) to control acid reflux
10
Q
- Surgery of the palate causes a swallowing disorder due to what 3 things?
A
- Bolus transfer
- Reduced propulsion
- Regurgitation
11
Q
- Following skull base surgery for a neoplasm that involves a high vagal injury, the patient will experience what?
A
-Vocal fold paralysis
12
Q
12. Injury to Cranial Nerve VII is likely to result in all BUT one of the following: A-Drooling B-Chewing C-Vocal fold weakness D-Compaction of food
A
C-Vocal fold weakness
13
Q
- Floor of the mouth surgery for oral cancer interferes primarily with what stage of swallowing?
A
-Oral preparatory
14
Q
- Surgery for cancer of the tongue resulting in partial glossectomy will effect propulsion if… (2 things)
A
- The tongue does not protrude on oral motor testing
- The lip seal is impaired
15
Q
- Surgery to remove tumors on the hard palate results in… (3 things)
A
- Oral phase dysphagia
- Hyper-nasal speech
- Regurgitation
16
Q
- Surgery to the hypopharyngeal walls results in (4 things)
A
- Partial loss of sensation in the hypopharynx
- Buildup of food in the hypopharynx
- Aspiration of liquids
- Aspiration of solids
17
Q
17. The need for a tracheostomy tube increases the likelihood of aspiration due to all EXCEPT A-Lowered air resistance B-Reduced subglottic air pressure C-Reduced lingual elevation D-Loss of sense of smell
A
-Reduced lingual elevation
18
Q
- What is the primary valve for preventing fluids or foods from entering the lungs?
A
-Vocal folds
19
Q
- What is the most common reason for not treating a patient with surgery for a Zenker’s diverticulum?
A
-Due to other medical problems, patient is unable to tolerate anesthesia
20
Q
- Dysphagia after cervical spine surgery is… (3 things)
A
- Common in the early postoperative period
- Often self-limited
- Often due to injury to the recurrent laryngeal nerve
21
Q
- Dysphagia after cervical spine surgery is due to (4 things)
A
- Scarring of the retrophayngeal space
- Disruption of the pharyngeal plexus
- Edema
- Pain
22
Q
- After skull base surgery patients may suffer aspiration due to which 2 things?
A
- Injury to the vagus
- Deconditioning
23
Q
- What do patients with a Zenker’s diverticulum often present with?
A
-Regurgitation
24
Q
- Dysphagia in patients with cancer of the upper aerodigestive tract is… (3 things)
A
- Often present at the time of diagnosis
- Often intractable
- Corrected with the successful treatment of the cancer
25
Q
- The term given to lip damage resulting in difficulty placing food in the mouth and on the tongue is _____
A
microstomia
26
Q
- Voice changes, liquid aspiration, and piriform sinus pooling may all be attributed to injury to which cranial nerve?
A
CN X Vagus
27
Q
- A valve used to increase subglottic air pressure in patients fitted with a tracheostomy tube is called ___
A
expiratory speaking valve / passy muir
28
Q
- The Passy Muir or expiratory speaking valve contributes to improved swallowing in two ways. What are they? :
A
- increasing subglottic pressure
- restoring proprioceptive cues during bolus preparation
29
Q
- A pouch near the cricopharyngeus muscle that collects food particles and is caused by muscle weakness is called a _____
A
-Zenker’s diverticulum
30
Q
- What is the main purpose of the tracheotomy tube?
A
to bypass an obstruction, allowing the patient to breathe
