Dysphagia

Question 0

Jaw elevators

Answer 0

Temporalis
Masseter
Internal, medial pertergoid

Question 1

Types of saliva, produced where?

Answer 1

Viscid-thick, serous-thin

Parotid glands… Serous
Submandibular glands… Mostly serous
Sublingual glands… Mostly viscid

Question 2

Jaw depressors

Answer 2

External, lateral pertergoid
Anterior belly of digastric
Mylohyoid
Geniohyoid

Question 3

Lateral movement of jaw, muscle

Answer 3

Internal pertergoid

Question 4

Anterior digastric muscle fx

Answer 4

Pulls hyoid up and out

Question 5

Floor of mouth muscle

Answer 5

Mylohyoid

Fan shaped, elevates and pulls hyoid forward

Question 6

Floor of mouth muscles, top to bottom

Answer 6

Geniohyoid…. Narrow, midline
Mylohyoid… Biggest
Anterior digastric

Question 7

Intrinsic muscles of tongue, nerve, and which parts are voluntary

Answer 7

CN 12

Superior longitudinal…widen, thicken, shorten! Raises tip
Inferior longitudinal… Same, depresses tip
Transverse muscle… Long, narrow, thick
Vertical muscle…. Widens and flattens tip

Front 2/3 volition all back 1/3 reflex

Question 8

Extrinsic tongue muscles, nerve

Answer 8

CN 12 , cn 10-palatoglossus only
Depress and retract

Genioglossus...bulk
Styloglossus... Bulk
Hyoglossus
Chondroglossus
Palatoglossus, 10, elevates floor, closes oral from pharynx

Question 9

Pharynx muscles, outer circle

Answer 9

Horizontal… Constrictors

Superior, 5
Middle, 2
Inferior, 2: thyropharyngeus, cricopharyngeus

Question 10

Pharynx muscles, inner circle

Answer 10

Vertical… Levators

Salpingopharyngeus
Stylopharyngeus
Palatopharyngeus

Question 11

Tipper or dipper most common?

Answer 11

Tipper… Over 80%

Question 12

Tongue thrust common with

Answer 12

CP

Frontal lobe injury

Question 13

Velum moves…

Answer 13

Down in oral prep, close to tongue
Up in transit

Liquids only, des not come down for solids. Spilling normal

Question 14

Duration of oral phase

Answer 14

Less than 1-1.5 sec

More time, more viscosity

Question 15

Location of neuroinnervation of swallow

Answer 15

Nucleus Tractus solitarus in medulla gets the sensory info

Goes to cn10s nucleus ambiguous to trigger mvmt

Question 16

Nerves for pharyngeal swallow

Answer 16

Both sensory and motor

10, 11

Question 17

Duration of pharyngeal phase

Answer 17

1 sec

Question 18

Duration of esophageal phase

Answer 18

8-20 sec

Question 19

Can you diagnose at bedside?

Answer 19

Oral stage only

Question 20

Recommend for poor oral control

Answer 20

Thickened liquids, then get thinner

Question 21

Recommend for delayed pharyngeal swallow

Answer 21

Thicker, like applesauce

Question 22

Reduced base of tongue strength

Answer 22

Best with liquids

Question 23

Recommend for reduced laryngeal elevation

Answer 23

Liquids best

Question 24

Recommend for reduced closure of larynx

Answer 24

Best with thicker

Question 25

Strategies to try first

Answer 25

Postural changes… Chin tuck

Question 26

A patient aspirating more than what percent of bonus should not be feeding orally

Answer 26

10%

Question 27

OPSE

Answer 27

Oral pharyngeal swallow efficiency

Measures transit time, % residue and % aspirated

Question 28

Indirect vs direct therapy

Answer 28

Always do both

Direct uses real food, indirect is exercises without food