Evaluation of Dysphagia

Question 1

An abnormality in the transfer of food from mouth to stomach

Answer 1

Dysphagia

Question 2

Dysphagia results to interruption in:

Answer 2

• eating pleasure

- maintenance of nutrition and hydration

Question 3

What are the indicators of swallowing dysfunction? (8)

Answer 3

• difficulty bringing food to mouth
• inability to shape food to bolus
• coughing or throat clearing before, during, after swallowing
• gurgling voice
• changes in breathing pattern
• delayed or absent swallow response
• poor cough
• reflux of food after meal

Question 4

T/F

Dysphagia is a disease not a symptom of an underlying condition

Answer 4

False

Question 5

Origin of dysphagia caused by the conditions in nervous system

Answer 5

Neurogenic

Question 6

Origin of dysphagia caused by problems with teeth or oral muscles

Answer 6

Mechanical

Question 7

Origin of dysphagia caused by fear of swallowing

Answer 7

Psychiatric

Question 8

Origin of dysphagia caused by circumstances related to illness d/t medical examination or tx

Answer 8

iatrogenic

Question 9

It is the foundation for evaluation tx of swallowing disorder

Answer 9

Anatomy and Physiology

Question 10

What are the 4 phases of swallowing

Answer 10

1. Oral Preparatory Phase
2. Oral Phase
3. Pharyngeal Phase
4. Esophageal Phase

Question 11

Phase where stimulation of salivary glands, chewing and formation of bolus occurs

Answer 11

Oral Preparatory Phase

Question 12

Phase where tongue begins posterior movement of bolus

Answer 12

Oral Phase

Question 13

transit time during Oral phase

Answer 13

1 to 1.5 seconds

Question 14

phase where swallow reflex occurs

Answer 14

Pharyngeal phase

Question 15

What happens during Swallow Reflex

Answer 15

• velar elevation/retraction
• hyoid anterior and superior movement
• laryngeal closure
• Cricopharyngeal sphincter opening
• tongue base opening

Question 16

transit time during pharyngeal phase

Answer 16

1 second or less

Question 17

During pharyngeal phase it divides at the ___ and flows down to the ____ sinuses

Answer 17

vallecula; piriform

Question 18

phase where the food flows from upper esophageal sphincter to the lower esophageal sphincter to the stomach

Answer 18

Esophageal phase

Question 19

transit time during esophageal phase

Answer 19

8 to 20 seconds

Question 20

term used when something you swallow goes down the wrong way; enters the airway/lungs

Answer 20

Aspiration

Question 21

it is a flap of cartilage that covers the trachea when swallowing to prevent food or liquids from entering the lungs

Answer 21

Epiglottis

Question 22

when acute symptoms of aspirations occurs check for:

Answer 22

changes in color of pt
prolonged coughing
gurgling voice

Question 23

During the preparatory examination:

in medical chart review check the:

Answer 23

• diagnosis
• prescribed medications
• current hydration and nutrition status
• other pertinent medical hx

Question 24

During the preparatory examination:

in Cognitive Perceptual Status, you check the:

Answer 24

(AOAAG)
alertness
orientation
ability to follow instructions
attention span
general behavior

Question 25

During the preparatory examination:

in Respiratory Status check the:

Answer 25

resting respiratory rate
breathing pattern
respiratory distress
concerns with breathing

Question 26

what are the two types of feeding method

Answer 26

• NGT (Nasogastric Tube)

- PEG (Percutaneous Gastronomy)

Question 27

Things to check during examining the physical status

Answer 27

• Head, Trunk control
• balance
• tone

Question 28

During pre-swallowing examination,

it is important to check for:

Answer 28

-Sensory examination
-oromotor, pharyngeal and laryngeal control function
NPO status

Question 29

What are the indications of poor oral examination

Answer 29

• drooling
• food in mouth
• food falling out of mouth
• unaware

Question 30

How to do sensory examination

Answer 30

• light tough detection and localization
• deep pressure
• temperature sensation

Question 31

4 steps during clinical swallowing examination

Answer 31

1. Review directions to pt
2. make sure pt is in optimal sitting position for feeding
3. encourage the patient to cough when necessary
4. 2 swallow of each material

Question 32

During swallowing examination, what are the 3 foods given

Answer 32

• 1/3 tsp of paste/pudding-like consistency
• 1/3 thin liquid
• small piece of cookie

Question 33

it means that swallowing is PAINFUL

Answer 33

Odynophagia

Question 34

means that food or gastric secretions come back into the throat or mouth

Answer 34

Reflux or Regurgitation

Question 35

occurs when patient feel that food is causing them to throw up and vomit

Answer 35

Gagging

Question 36

a feeling of lump in the throat

Answer 36

Globus Pharyngeus

Question 37

dry mouth

Answer 37

Xerostomia