Chapter 6 Flashcards
- Should all swallowing patients be given an instrumental examination before feeding?
-No, not all. Some patients are not competent physically or cognitively to tolerate the test, and with some we may have no reason to suspect that they are at risk of aspiration.
- Are the observations from one single instrumental evaluation alone sufficient to allow the clinician to make the decision to change the patient’s mode of feeding?
-No, the decision to change the patient’s mode of feeding should be made after an in depth assessment from the dysphagia management team
- Can silent aspiration always be identified using modified barium swallow?
-No, it can’t. Silent aspiration can be undetected on clinical swallow examination including MBS
(check this one out in the book)
- What framerate does ASHA recommend MBS be digitized at?.
-ASHA recommends 60fps
- What does the modified barium swallow test study?
The modified barium swallow test studies the timing of movements of the tongue, palate, and larynx
- Can trace aspiration be identified on a modified barium swallow test?
-No, trace aspiration can sometimes be missed on a MBS swallow test
- What protective measures to clinicians need to use during the modified barium swallow?
The modified barium swallow requires clinicians to wear protective shields and a dosimetry badge for radiation safety
- Can the modified barium swallow test assess laryngeal elevation?
Yes, it can assess laryngeal elevation!
- Is silent aspiration usually a sign of loss of vocal fold closure ability?
-No, it’s a sign of a sensory neurological disorder
- During a FEES, should the clinician observe anatomical structures during quiet and forced respiration, coughing, speaking, and dry swallows before swallowing trials with food and drink?
-Yes, they should
review other side of card and repeat to self
- Is the FEESST the only reliable swallowing test of both sensory and motor functions during swallowing?
-Yes, it is
- Should fluids, but not food, be used during a FEES examination?
-No, food and fluids may be used during a FEES
- Can the FEES and FEESST tests serve as a feedback tool to the patient undergoing swallowing therapy?
-Yes, they can!
- Is touching the epiglottis or aryepiglottic fold with the tip of a small endoscope an equivalent to sensory testing via the air pulse sensation test of FEESST?
-it is an alternative, but not an equal one in reliability or validity.
- Does the Penetration-Aspiration Scale describee increasing swallowing safety as the numbers on the penetration-aspiration scale increases?
-F, the swallowing safety decreases as penetration-aspiration scale score increases
- Is ultrasound a highly irritating diagnostic tool that is not well tolerated by patients?
-No, it is one of the most well-tolerated assessment methods
- Do an esophagram test and a modified barium swallow test provide the radiologist with similar data from which to make decisions about dysphagia?
-No, an esophagram concentrates on the esophagus, while an MBS tends to focus on events before the bolus enters the esophagus.
- What are ASHA’s objectives of instrumental assessment of dysphagia? (4 things)
A.Visualize swallowing-related structures and secretions
B. Assess swallowing-related structures and their functions
C. Assist in determining which feeding method should be recommended
D. Trial different swallowing management strategies
- What is the decision to recommend a MBS based on?
-Findings of the clinical swallow examination
- What are 2 of the most common instrumental tests of swallowing?
-FEES and modified barium swallow test
- The modified barium swallow test is a dynamic test of swallowing. What does that mean?
-The bolus is followed with a fixed x-ray unit as it moves from the oral cavity to the esophagus
- What can maneuvers and postures during swallowing be evaluated using?
-FEES and MBS
- How is airway closure during a normal swallow visualized during FEES?
-The whiteout phase as the pharyngeal walls contract to block the camera
- What does the FEESST provide an indication of?
- sensory function of the aryepiglottic space
- the likelihood of silent aspiration
- Tongue strength during swallowing is measured by the pressure between what?
-The tongue and the hard palate
- The value of ultrasound testing for dysphagia consists of what 3 things?
- It can be repeated often to track changes in swallowing
- It provides information about the oral phase of swallowing
- It is not invasive
- What is an objective test to determine if there is paralysis in a muscle of the larynx?
-Laryngeal electromyography
- Instrumental evaluation is not suggested when which three conditions occur?
- Unstable medical conditions
- Inability to cooperate or participate in assessment
- Assessment outcomes will not change clinical decisions
- Airway protection can be determined during FEESST by delivering _____________ to the hypopharyngeal tissues innervated by the ____________________.
-A pressure-and duration-controlled calibrated pulse of air; the internal branch of the superior laryngeal nerve
- The airway protective reflex is known as the ______________.
-Laryngeal adductor reflex (LAR)
- What are 2 fluorographic tests of swallowing function?
- the esophagram
- the modified barium swallow
- The fluorographic test that offers a full view of the esophagus using barium is called the ________________.
-esophagram
- During a modified barium swallow test when barium is seen to coat the laryngeal surface of the epiglottis, the condition is described as ______________________.
-penetration
- The MBS concentrates on which three phases of deglutition?
- Oral preparatory
- Oral
- Pharyngeal
- What is the most typical instrumental test to determine the presence of gastroesophageal reflux?
-esophagogastroduodenoscopy
- Why is high resolution manometry superior to manometry?
-Because there are more sensors, which allows for more detailed and accurate measures for esophageal peristalsis
