Deck 6/7

Question 1

examples of non-imaging techniques

Answer 1

• EMG
• EGG
• cervical auscultuation
• bedside swallow eval

Question 2

examples of imaging techniques

Answer 2

• videofluoroscopy/MBS
• FEES (fiberoptic endoscopic evaluation of swallowing)
• scintigraphy

Question 3

what is a cervical auscultation

Answer 3

utilizes the sound of swallowing by placing a microphone or stethoscope to the neck area

Question 4

what do you listen for in a cervical auscultation?

Answer 4

listen for the “click” of the opening of the eustacian tube & clunk associated with CP opening for timing of the swallow

Question 5

bedside swallow provides info on…

Answer 5

• oral anatomy
• respiratory functions and its relationship to swallow
• labial control
• lingual control
• palatal function
• pharyngeal wall contraction*
• laryngeal control
• general ability to follow directions
• reactions/symptoms during attempts to swallow

Question 6

diagnoses at risk for dysphagia

Answer 6

• neurological events/accidents
• neurological diseases
• H&N cancer

Question 7

in a bedside swallow eval, we are looking for medical, oral, pharyngeal, and esophageal ___ ____

Answer 7

red flags

Question 8

name some medical red flags

Answer 8

• diagnosis
• signs/symptoms
• weight loss
• age

Question 9

oral red flags

Answer 9

• leakage of material out of mouth
• pocketing
• drooling
• labial/lingual weakness

Question 10

pharyngeal red flags

Answer 10

• coughing
• throat clearing
• wet/gurgly voice quality
• drop in O2 sats

Question 11

esophageal red flags

Answer 11

• globus sensation
• belching
• heartburn
• coughing AFTER eating/drinking

Question 12

what does FEES stand for

Answer 12

fiberoptic endoscopic evaluation of swallowing

Question 13

what are pros and cons of a FEES

Answer 13

-no radiation exposure
-portability
-flexibility with regards to positioning
-time/length of exam
CONS:
-does not view the oral stage of swallowing
-“white out period”
-invasive
-aspiration during the swallow can only be inferred b/c of white out period

Question 14

what is the white out period?

Answer 14

when the moment of the actual swallow is not viewed due to the pharynx closing around the endoscopic tube & blocking the image

Question 15

when considering where to stand for an MBS, remember the 3 radiation safety guidelines

Answer 15

• barrier- lead apron and thyroid wrap, lead glove
• distance- stand away from direction of radiation
• time- dosimeters (measures amount of radiation (RADs) we get)

Question 16

MBS pros and cons

Answer 16

PROS:
-can be video taped
-variety of consistencies used
-can see all phases of swallow
CONS:
-small amount of radiation

Question 17

barium sulfate is cleared from the lungs within ___ hours if aspirated

Answer 17

72

Question 18

what consistencies does barium come in

Answer 18

• powder to mix with water for various textures
• liquid
• cookie
• tablets

Question 19

consistencies to look at in MBS

Answer 19

• thin/thick liquid
• pureed
• wet soft
• dry soft (bread)
• meat
• dry crumbly (cracker)
• tablet

Question 20

Pain with swallowing

Answer 20

Odynophagia

Question 21

Fear of swallowing

Answer 21

Phagophobia