Compensatory Strategies and Swallowing Maneuvers

Question 1

When is chin tuck used?

Answer 1

When pt. has delayed initiation of the swallow, impaired base of the tongue retraction, pharyngeal weakness, or decreased laryngeal elevation

Question 2

What does the chin tuck help?

Answer 2

shortening the distance between the epiglottis and the posterior pharyngeal wall and elevation of the larynx

Question 3

When is head rotation used?

Answer 3

When there is unilateral weakness, unilateral laryngeal dysfunction, or unilateral pharyngeal/ pyriform sinus residue

Question 4

What side is the head rotated to during a head turn?

Answer 4

the weakened side

Question 5

What does the head rotation help?

Answer 5

It closes off the weakened side and allows the pharyngeal muscles on the unimpaired side to draw the bolus down

Question 6

When is the head tilt used?

Answer 6

When there is unilateral oral and pharyngeal weakness

Question 7

What side is the head tilted towards during a head tilt?

Answer 7

the unimpaired side

Question 8

When is head back used?

Answer 8

When there is prolonged oral transit

Question 9

When is cyclical ingestion used?

Answer 9

When there is pharyngeal weakness and poor UES opening

Question 10

What does cyclical ingestion help?

Answer 10

it clears the valleculae and pyriform sinuses of residue

Question 11

What is cyclical ingestion?

Answer 11

Patient is instructed to alternate solids and
fluids to clear the oral cavity of residue
unable to be managed with lingual sweeping

Question 12

When are dry swallows used?

Answer 12

with a patient who exhibits post
swallow residue somewhere within the digestive
tract (oral residue, vallecular residue, pyriform sinus
residue)

Question 13

What are dry swallows?

Answer 13

Pt. is instructed to dry swallow after every bolus

swallow

Question 14

What are some bolus control strategies?

Answer 14

changing the placement of the bolus in the mouth, modifying the size of the bolus, practicing lingual sweeps, and slower intake rate.

Question 15

When is an expiratory cough post-swallow used?

Answer 15

When residue has penetrated the larynx after the swallow

Question 16

When are thickened liquids used?

Answer 16

When compensatory strategies do not help with the protection of the airway and when there is poor control of thin liquids in the oral cavity

Question 17

What is the supraglottic maneuver procedure?

Answer 17

Patient holds breath, swallows, coughs, and swallows again

Question 18

What is the goal of supraglottic maneuvers?

Answer 18

reduce aspiration and increase movement of the larynx

Question 19

What is the super- supraglottic maneuver procedure?

Answer 19

Pt holds breath, bears down, swallows, coughs, and swallows again

Question 20

What is the goal of the super supraglottic maneuver?

Answer 20

to reduce aspiration and increase the movement of the larynx

Question 21

When is thermal stimulation used?

Answer 21

before a bolus in ingested and cyclically throughout the meal

Question 22

What is the goal of the mendelsohn?

Answer 22

to extend hyolaryngeal excursion

Question 23

What does thermal stimulation help?

Answer 23

swallow initiation

Question 24

What is the mendelsohn procedure?

Answer 24

Patient is asked to put finger on larynx and and feel the laryngeal elevation. Patient is asked to swallow long and strong to increase laryngeal elevation

Question 25

What is the Shaker maneuver?

Answer 25

Patient lies down and must raise their head up so that they can see their toes and sustain the position

Question 26

What is the goal of the Shaker maneuver?

Answer 26

improve UES opening

Question 27

What is the masako maneuver?

Answer 27

Patient is asked to to hold their tongue in between their teeth while swallowing

Question 28

What is the goal of the masako maneuver

Answer 28

increase the movement of the posterior pharyngeal wall

Question 29

What is an effortful swallow?

Answer 29

patient is instructed to push their tongue against the roof of their mouth and squeeze as hard as possible during the swallow

Question 30

What is the goal of effortful swallows?

Answer 30

to improve the force of the swallow