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DYSPHAGIA Flashcards

1
Q

which phase includes base of tongue retraction and laryngeal vestibule closure?

A

pharyngeal

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2
Q

what would pyriform sinus residue indicate?

A

reduced laryngeal elevation
reduced UES opening

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3
Q

what would valleculae residue indicate?

A

reduced base of tongue retraction

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4
Q

what do posterior cricoarytenoid muscles do?

A

ABduct the VFs

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5
Q

which branch of the vagus nerve (CN X) supplies the TAs, IAs, LCAs, PCAs?

A

recurrent laryngeal

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6
Q

this test requires the individual to drink 3 oz of water. it also requires a brief cognitive screen. what test is this?

A

Yale Swallow Protocol

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7
Q

T/F: a clinical sign is something observed by the SLP during physical examination.

A

TRUE

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8
Q

which one is true regarding FEES?
A. can assess sensory function
B. can view the swallow as it happens
C. can view oral and oral prep phase
D. exposure to radiation

A

A. can assess sensory function

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9
Q

which of the following muscles is involved in mastication?
A. hyoglossus
B. superior longitudinal muscle
C. lateral pterygoid
D. levator veli palatini

A

C. lateral pterygoid

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10
Q

T/F: chin tuck would be most beneficial for reduced pharyngeal contraction, reduced tongue control/strength, and pyriform sinus residue.

A

FALSE

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11
Q

what would chin tuck be beneficial for?

A

delayed pharyngeal swallow, reduced airway closure, and for reduced TBR

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12
Q

head extension

A

compensatory strategy

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13
Q

super-supraglottic swallow

A

compensatory AND rehabilitative strategy

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14
Q

effortful swallow

A

compensatory AND rehabilitative swallow

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15
Q

mendelson maneuver

A

compensatory AND rehabilitative

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16
Q

which strategy is the following: Breathin, let some air out and hold your breath, put a small amount of food or liquid in your mouth, swallow, cough or clear your throat while exhaling, swallow again?

A

supraglottic swallow

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17
Q

do NOT perform with a bolus?

A

masako maneuver

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18
Q

at what age is it recommended to terminate nipple feeding?

A

12 months

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19
Q

which reflux is test by poking the bottom of a baby’s foot, causing the baby’s leg to withdraw and toes extend?

A

flexor withdrawal

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20
Q

at what age does transitional feeding occur?

A

4-7 months

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21
Q

which muscles ADduct the true vocal folds and help approximation of the ventricular folds?

A

LCA, IA, and TA

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22
Q

how do we know the pharyngeal swallow has been triggered?

A

first brisk hyoid movement

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23
Q

what moves the epiglottis into the horizontal position?

A

laryngeal elevation and tongue base retraction

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24
Q

which area is created by the BOT and epiglottis?

A

valleculae

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25
muscle relaxes to open UES/PES
cricopharyngeus
26
which phase includes BOT retraction and LV closure
pharyngeal phase
27
which phase includes posterior bolus propulsion
oral phase
28
which structure moves posteriorly to meet the PPW?
base of tongue
29
which structures moves horizontally, then fully inverts over the LV?
epiglottis
29
which area goes around the laryngeal vestibule and ends above the UES/PES
pyriform sinuses
30
what events facilitates opening the UES/PES
laryngeal elevation
31
initiation of the pharyngeal swallow
pharyngeal MOTOR response to sensory input
32
what moves the epiglottis into the fully inverted position?
-laryngeal elevation -pharyngeal contraction/ squeeze
33
which two structures come together at the top of the pharynx to push the bolus through the pharynx?
TB & PPW
34
muscles of the lips
orbicularis oris zygomaticus
35
what structures close the LV laterally to medially?
true and false VF
36
what structures close the laryngeal vestibule posteriorly to anteriorly?
arytenoids tilt forward
37
residue in valleculae
d/t reduced BTR
38
residue in pyriform sinuses
d/t reduced laryngeal elevation or reduced UES opening
39
residue in valleculae
d/t reduced BTR
40
residue in pyriform sinuses
d/t reduced laryngeal elevation or reduced UES opening
41
when muscle contracts
structure at point of insertion moves closer to the structure at point of origin
42
orbicularis oris
opens, closes, protrudes inverts, and twist lips
43
zygomaticus
draw lip upward and outward
44
buccinator
flattens cheeks
45
uvulae
shortens and raises the uvula
46
cricopharyngeus
relaxes to allow food to pass through UES/PES
47
recurrent laryngeal nerve (branch of vagus)
TA LCA IA PCA
48
superior laryngeal nerve (branch of vagus)
CT
49
can assess anatomy and physiology of upper aerodigestive mechanism used in swallowing
VFSS & FEES
50
can vary amount and textures
VFSS & FEES
51
able to view the pharyngeal swallow as it happen
VFSS
52
can view esophageal phase
VFSS
53
image lost during the actual swallow
FEES
54
can crudely assess sensory functions
FEES
55
can view management of secretions and reaction to them
FEES
56
can document penetration and aspiration
FEES
57
can document penetration and aspiration
VFSS & FEES
58
can EASILY view airway closure
FEES
59
can evaluate compensatory strategies
VFSS & FEES
60
readily accessible
VFSS (only if in the hospital) FEES
61
portable
VFSS FEES
62
exposure to radiation
VFSS
63
can view repeated swallows
VFSS & FEES
64
super-supraglottic swallow
compensatory AND rehabilitative
65
mendelson maneuver
compensatory AND rehabilitative
66
effortful swallow
compensatory AND rehabilitative
67
suckling
0-4 months A-P tongue movements, loose lips, wide mandible excursion -> jaw opens and tongue moves back and forth
68
sucking
4-6+ months superior to inferior tongue movements, lip closure, tongue grooving
69
NICU full term in weeks
37-40
70
late pre term
34-36 weeks
71
pre term
28-34 weeks
72
extremely premature
below 28 weeks
73
avg birth weight
over 2500 grams
74
overall neurologically immature; immature oral sensorineural skills; poor endurance; frequent state changes; hypotonia
preterm infants
75
NICU handling
cluster care one stimulus at a time read infant cues positive touch
76
NICU major stress cue
apnea and bradycardia
77
SSB
suck, swallow, breathe coordination
78
swallowing begins in utero at how many weeks?
12-13
79
more stabilized pattern of rhythmic sucking and swallowing in utero at how many weeks?
34-36
80
coordination of suck swallow breathe process occurs when?
after birth
81
bottle and breast feeding milestone
4-6 monthst
82
transitional feeding age
4-7 months
83
spoon feeding age
5-7 months
84
cup drinking age
1 month after development of spoon feeding
85
termination of nipple feeding age
12 months
86
straw drinking age
variable (1-3 years)
87
chewing (normal rotary) age
24-36 months
88
biting
more advanced skill do not start until child can move food from midline to lateral chewing
89
not spoon feeding by 9 months
criteria for referral
90
not able to chew or self-feed finger foods or a spoon by 18 months
criteria for referral
91
not drinking from a cup by 24 months
criteria for referral
92
excessive drooling past 5 years
criteria for referral
93
operant conditioning
using rewards and consequences to shape feeding behaviors
94
classical conditioning
associating new foods with positive experiences to reduce aversion
95
hypersensitive
lower threshold for sensory info
96
hyposensitive
not processing enough sensory info
97
stability
muscle tone and coordination contraction of the muscles
98
by what age can most infants control saliva?
6 months
99
sialorrhea
excess saliva
100
nonmaleficence
above all, do no harm
101
beneficence
avoid harm, but provide positive benefits as well
102
justice
fairness
103
what muscles adduct the true vocal folds and help approximation of the ventricular folds?
LCA IA TA
104
T/F: during FEES, the esophagus/ esophageal phase can be seen?
false
105
what is the distinction between supraglottic swallow and super-supraglottic swallow?
super supraglottic swallow requires you to hold you breath WITH EFFORT
106
T/F: pediatric VFs have a downward slant from posterior to anterior which is not found in adults
TRUE
107
how do we know the pharyngeal swallow has been triggered?
first brisk hyoid movement
108
when is instrumental swallow examinations warranted?
done after CSE, when clinical evaluation fails to answer relevant questions
109
what moves the epiglottis into the horizontal position?
laryngeal elevation and tongue base attraction
110
what is the main goal for instrumental swallow eval?
identify conditions under which patients CAN eat rather than keeping patients from eating orally
111
which area is created by the BOT and epiglottis?
valleculae
112
this muscle relaxes to allow the UES/PES to open?
cricopharyngeus
113
which phase includes bolus formation and manipulation?
oral prep phase
114
which phase includes BOT retraction and LV closure
pharyngeal phase
115
which phase includes posterior bolus propulsion
oral phase
116
which portion of the bolus enters the pharynx last?
bolus tail
117
which structure moves posteriorly to meet the PPW?
base of tongue
118
which structure moves horizontally, then fully inverts over the laryngeal vestibule/
epiglottis
119
which area goes around the laryngeal vestibule and ends above the UES/PES
laryngeal elevation
120
initiation of the pharyngeal swallow
the pharyngeal MOTOR response to sensory inputs
121
along with laryngeal elevation, what moves the epiglottis to the fully inverted position?
pharyngeal contraction/ squeeze
122
what two structures come together at the top of the pharynx to push the bolus through the pharynx?
TB and PPW
123
which muscles are we assessing, when we examine the pharyngeal stripping wave?
constrictor muscles
124
in this phase, the bolus passes through the UES, then through the LES?
esophageal phase
125
what are the two muscles of the lips?
orbicularis oris zygomaticus
126
if the larynx doesn't elevate fully, it will affect the UES in these ways
distance and duration
127
muscles of mastication
masseter, pterygoids, temporalis
128
which muscles elevate, tense, and retract the soft palate?
LVP, TVP, musculus uvulae
129
which muscles stabilize the floor of the mouth
geniohyoid, mylohyoid, digastricus, stylohyoid
130
extrinsic muscles of the tongue
genioglossus hyoglossus styloglossus palatoglossus
131
which muscle facilitates posterior oral containment by raising the back of the oral tongue and drawing down the palate?
palatoglossus
132
intrinsic muscles of the tongue
longitudinal transverse vertical
133
other than laryngeal elevation, what do the long pharyngeal muscles do?
shorten and widen the pharynx
134
what are the long pharyngeal muscles?
stylopharyngeus salpingopharyngeus palatopharyngeus
135
what structures close the laryngeal vestibule laterally to medially
true and false VFs
136
what structures close the laryngeal vestibule posteriorly to anteriorly?
arytenoids tilt forward

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