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COMPS > DYSPHAGIA > Flashcards

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
Q

muscle relaxes to open UES/PES

A

cricopharyngeus

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26
Q

which phase includes BOT retraction and LV closure

A

pharyngeal phase

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27
Q

which phase includes posterior bolus propulsion

A

oral phase

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28
Q

which structure moves posteriorly to meet the PPW?

A

base of tongue

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29
Q

which structures moves horizontally, then fully inverts over the LV?

A

epiglottis

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29
Q

which area goes around the laryngeal vestibule and ends above the UES/PES

A

pyriform sinuses

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30
Q

what events facilitates opening the UES/PES

A

laryngeal elevation

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31
Q

initiation of the pharyngeal swallow

A

pharyngeal MOTOR response to sensory input

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32
Q

what moves the epiglottis into the fully inverted position?

A

-laryngeal elevation
-pharyngeal contraction/ squeeze

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33
Q

which two structures come together at the top of the pharynx to push the bolus through the pharynx?

A

TB & PPW

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34
Q

muscles of the lips

A

orbicularis oris
zygomaticus

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35
Q

what structures close the LV laterally to medially?

A

true and false VF

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36
Q

what structures close the laryngeal vestibule posteriorly to anteriorly?

A

arytenoids tilt forward

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37
Q

residue in valleculae

A

d/t reduced BTR

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38
Q

residue in pyriform sinuses

A

d/t reduced laryngeal elevation or reduced UES opening

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39
Q

residue in valleculae

A

d/t reduced BTR

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40
Q

residue in pyriform sinuses

A

d/t reduced laryngeal elevation or reduced UES opening

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41
Q

when muscle contracts

A

structure at point of insertion moves closer to the structure at point of origin

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42
Q

orbicularis oris

A

opens, closes, protrudes inverts, and twist lips

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43
Q

zygomaticus

A

draw lip upward and outward

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44
Q

buccinator

A

flattens cheeks

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45
Q

uvulae

A

shortens and raises the uvula

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46
Q

cricopharyngeus

A

relaxes to allow food to pass through UES/PES

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47
Q

recurrent laryngeal nerve (branch of vagus)

A

TA
LCA
IA
PCA

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48
Q

superior laryngeal nerve (branch of vagus)

A

CT

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49
Q

can assess anatomy and physiology of upper aerodigestive mechanism used in swallowing

A

VFSS & FEES

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50
Q

can vary amount and textures

A

VFSS & FEES

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51
Q

able to view the pharyngeal swallow as it happen

A

VFSS

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52
Q

can view esophageal phase

A

VFSS

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53
Q

image lost during the actual swallow

A

FEES

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54
Q

can crudely assess sensory functions

A

FEES

55
Q

can view management of secretions and reaction to them

A

FEES

56
Q

can document penetration and aspiration

A

FEES

57
Q

can document penetration and aspiration

A

VFSS & FEES

58
Q

can EASILY view airway closure

A

FEES

59
Q

can evaluate compensatory strategies

A

VFSS & FEES

60
Q

readily accessible

A

VFSS (only if in the hospital)
FEES

61
Q

portable

A

VFSS
FEES

62
Q

exposure to radiation

A

VFSS

63
Q

can view repeated swallows

A

VFSS & FEES

64
Q

super-supraglottic swallow

A

compensatory AND rehabilitative

65
Q

mendelson maneuver

A

compensatory AND rehabilitative

66
Q

effortful swallow

A

compensatory AND rehabilitative

67
Q

suckling

A

0-4 months
A-P tongue movements, loose lips, wide mandible excursion -> jaw opens and tongue moves back and forth

68
Q

sucking

A

4-6+ months
superior to inferior tongue movements, lip closure, tongue grooving

69
Q

NICU full term in weeks

A

37-40

70
Q

late pre term

A

34-36 weeks

71
Q

pre term

A

28-34 weeks

72
Q

extremely premature

A

below 28 weeks

73
Q

avg birth weight

A

over 2500 grams

74
Q

overall neurologically immature; immature oral sensorineural skills; poor endurance; frequent state changes; hypotonia

A

preterm infants

75
Q

NICU handling

A

cluster care
one stimulus at a time
read infant cues
positive touch

76
Q

NICU major stress cue

A

apnea and bradycardia

77
Q

SSB

A

suck, swallow, breathe coordination

78
Q

swallowing begins in utero at how many weeks?

A

12-13

79
Q

more stabilized pattern of rhythmic sucking and swallowing in utero at how many weeks?

A

34-36

80
Q

coordination of suck swallow breathe process occurs when?

A

after birth

81
Q

bottle and breast feeding milestone

A

4-6 monthst

82
Q

transitional feeding age

A

4-7 months

83
Q

spoon feeding age

A

5-7 months

84
Q

cup drinking age

A

1 month after development of spoon feeding

85
Q

termination of nipple feeding age

A

12 months

86
Q

straw drinking age

A

variable (1-3 years)

87
Q

chewing (normal rotary) age

A

24-36 months

88
Q

biting

A

more advanced skill
do not start until child can move food from midline to lateral chewing

89
Q

not spoon feeding by 9 months

A

criteria for referral

90
Q

not able to chew or self-feed finger foods or a spoon by 18 months

A

criteria for referral

91
Q

not drinking from a cup by 24 months

A

criteria for referral

92
Q

excessive drooling past 5 years

A

criteria for referral

93
Q

operant conditioning

A

using rewards and consequences to shape feeding behaviors

94
Q

classical conditioning

A

associating new foods with positive experiences to reduce aversion

95
Q

hypersensitive

A

lower threshold for sensory info

96
Q

hyposensitive

A

not processing enough sensory info

97
Q

stability

A

muscle tone and coordination contraction of the muscles

98
Q

by what age can most infants control saliva?

A

6 months

99
Q

sialorrhea

A

excess saliva

100
Q

nonmaleficence

A

above all, do no harm

101
Q

beneficence

A

avoid harm, but provide positive benefits as well

102
Q

justice

A

fairness

103
Q

what muscles adduct the true vocal folds and help approximation of the ventricular folds?

A

LCA
IA
TA

104
Q

T/F: during FEES, the esophagus/ esophageal phase can be seen?

A

false

105
Q

what is the distinction between supraglottic swallow and super-supraglottic swallow?

A

super supraglottic swallow requires you to hold you breath WITH EFFORT

106
Q

T/F: pediatric VFs have a downward slant from posterior to anterior which is not found in adults

A

TRUE

107
Q

how do we know the pharyngeal swallow has been triggered?

A

first brisk hyoid movement

108
Q

when is instrumental swallow examinations warranted?

A

done after CSE, when clinical evaluation fails to answer relevant questions

109
Q

what moves the epiglottis into the horizontal position?

A

laryngeal elevation and tongue base attraction

110
Q

what is the main goal for instrumental swallow eval?

A

identify conditions under which patients CAN eat rather than keeping patients from eating orally

111
Q

which area is created by the BOT and epiglottis?

A

valleculae

112
Q

this muscle relaxes to allow the UES/PES to open?

A

cricopharyngeus

113
Q

which phase includes bolus formation and manipulation?

A

oral prep phase

114
Q

which phase includes BOT retraction and LV closure

A

pharyngeal phase

115
Q

which phase includes posterior bolus propulsion

A

oral phase

116
Q

which portion of the bolus enters the pharynx last?

A

bolus tail

117
Q

which structure moves posteriorly to meet the PPW?

A

base of tongue

118
Q

which structure moves horizontally, then fully inverts over the laryngeal vestibule/

A

epiglottis

119
Q

which area goes around the laryngeal vestibule and ends above the UES/PES

A

laryngeal elevation

120
Q

initiation of the pharyngeal swallow

A

the pharyngeal MOTOR response to sensory inputs

121
Q

along with laryngeal elevation, what moves the epiglottis to the fully inverted position?

A

pharyngeal contraction/ squeeze

122
Q

what two structures come together at the top of the pharynx to push the bolus through the pharynx?

A

TB and PPW

123
Q

which muscles are we assessing, when we examine the pharyngeal stripping wave?

A

constrictor muscles

124
Q

in this phase, the bolus passes through the UES, then through the LES?

A

esophageal phase

125
Q

what are the two muscles of the lips?

A

orbicularis oris
zygomaticus

126
Q

if the larynx doesn’t elevate fully, it will affect the UES in these ways

A

distance and duration

127
Q

muscles of mastication

A

masseter, pterygoids, temporalis

128
Q

which muscles elevate, tense, and retract the soft palate?

A

LVP, TVP, musculus uvulae

129
Q

which muscles stabilize the floor of the mouth

A

geniohyoid, mylohyoid, digastricus, stylohyoid

130
Q

extrinsic muscles of the tongue

A

genioglossus
hyoglossus
styloglossus
palatoglossus

131
Q

which muscle facilitates posterior oral containment by raising the back of the oral tongue and drawing down the palate?

A

palatoglossus

132
Q

intrinsic muscles of the tongue

A

longitudinal
transverse
vertical

133
Q

other than laryngeal elevation, what do the long pharyngeal muscles do?

A

shorten and widen the pharynx

134
Q

what are the long pharyngeal muscles?

A

stylopharyngeus
salpingopharyngeus
palatopharyngeus

135
Q

what structures close the laryngeal vestibule laterally to medially

A

true and false VFs

136
Q

what structures close the laryngeal vestibule posteriorly to anteriorly?

A

arytenoids tilt forward

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