Chapter 7 Évaluation

Question 1

Describe the rationale for early detection of swallowing disorders.

Answer 1

Early detection of dysphagia is important because complications from dysphagia increase :
1. patient morbidity (medical problems)
2. , lengthen hospitalization (health care cost),
3. may ultimately increase patient risk for death

Question 2

What are the main components of the clinical evaluation of swallowing in adults?

Answer 2

1. Patient history : review medical file + Anamnèse
2. MOP : physical inspection of swallowing musculature
3. Swallowing trials : observaation of swallowing competence

Question 3

Present the strengths and weaknesses of evaluation protocols.

Question 4

Discuss noninvasive techniques for improving the diagnostic accuracy of the clinical examination.

Question 5

Review screening and standardized tests for dysphagia.

Question 6

Present potential adjunctive measures of swallowing performance.

Question 7

What are symptoms

Answer 7

Symptoms usually are defined as any perceptible change in bodily function that the patient notices.

Question 8

How do you begin the physical examination of a patient with dysphagia?

Answer 8

Begin by asking the patient to describe the symptoms.

Question 9

True or False : The literature suggests that asking patients to localize where they believe the problem exists is not always reliable and may not be useful in guiding the tests selected for patient examination, particularly when they report the problem is localized to the neck.

Answer 9

True : Patients who report dysphagia localized to the neck and pharynx should not only have that specific region investigated, but also should have studies appropriate to the esophagus.

Question 10

One of the most common complaints from patients with dysphagia is that food or fluids “get stuck.” Most frequently they report that the sticking sensation is in the throat or esophagus.The medical term for this feeling is….

Answer 10

globus

Question 11

Congenital Disease
Disorders from childhood, particularly those of neurogenic origin such as……………………… should be noted.

Answer 11

cerebral palsy

Question 12

A patient who is taking a central nervous system depressant to control SEIZURES may have a concomitant depression in …………… …………….. that affects swallowing.

Answer 12

motor function

Question 13

With regards to surgery, note what kind of things?

Answer 13

1. Was it head or neck cancer
2. Was there an endotracheal tube
3. Heart, thryroid, brain surgery, upper cervical spine (cranial nerves)

Question 14

What type of previous test results would be relevant?

Answer 14

Endoscopy of the upper airway, esophagus, or stomach, should be explored.
* endoscopy = camera in digestive tract

Question 15

Which 5 observations in a patient who has had a stroke are important for detecting dysphagia?

Answer 15

1. dysphonia (harshness and breathiness), a wet-sounding voice,
2. dysarthria,
3. poor secretion management,
4. cough on trial swallows,
5. decreased laryngeal elevation.

Question 16

Which observations are most predictive of aspiration?

Answer 16

1. dysphonia after trial swallows of 5 and 10 mL of thin and thickened liquids,
2. unilateral jaw weakness,
3. failure on the 3-oz water test