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SLHS 408 > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

Etiology of Flaccid Impairment

A

Lower motor neuron damage

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2
Q

Symptoms of Flaccid Impairment

A
  • Weakness (could also be paralysis)
  • Hypotonia
  • Diminished reflexes
  • Fatigue
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3
Q

Examples of Flaccid Impairment

A
  • Brainstem CVA
  • Muscular dystrophy
  • ALS
  • Myasthenia Gravis
  • Guillain-Barre
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4
Q

How does a Flaccid Impairment affect swallowing?

A
  • Poor chewing/movement of bolus
  • Weakness of velopharynx (nasal regurgitation)
  • Poor closure of larynx (aspiration)
  • Poor propulsion (squeezing) of the bolus downward (pharyngeal residue)
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5
Q

Etiology of Spastic Impairment

A

Upper motor neuron damage

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6
Q

Symptoms of Spastic Impairment

A
  • Weakness
  • Loss of fine, skilled movements
  • Increased tone
  • Increased reflexes
  • Spasticity
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7
Q

Examples of Spastic Impairment

A
  • CVA
  • Anoxic brain injury (CP)
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8
Q

How does a Spastic Impairment impact swallowing?

A
  • Poor chewing/movement of bolus
  • Poor timing and coordination of specific movements that initiate swallow
  • Poor closure of larynx (aspiration)
  • Weakness/improper movement of velopharynx (nasal regurgitation)
  • Poor propulsion (squeezing) of the bolus downward AND now may have spasms in the esophagus
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9
Q

Etiology of Ataxic Impairment

A

Cerebellar damage

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10
Q

Symptoms of Ataxic Impairment

A
  • Slowness and inaccuracy of movement
  • Difficulty with coordination of movement
  • Tremors
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11
Q

Examples of Ataxic Impairment

A
  • Degenerative diseases
  • CVA
  • Tumors
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12
Q

How does Ataxic Impairment impact swallowing?

A
  • Biting tongue/cheek when eating
  • Poor respiratory coordination during swallowing (can lead to aspiration)
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13
Q

Etiology of Hypokinetic Impairment

A

Basal ganglia dysfunction

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14
Q

Symptoms of Hypokinetic Impairment

A
  • Slowness of movements
  • Diminished movements
  • Sensory impairments
  • Rigidity
  • Tremors
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15
Q

Examples of Hypokinetic Impairment

A

Parkinson’s Disease

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16
Q

How does a Hypokinetic Impairment impact swallowing?

A
  • Drooling
  • Tremor of oral musculature impacts oral prep and transit
  • Decreased frequency of swallow
  • Poor timing of swallow (aspiration)
  • Decreased movement of structures that close the larynx and protect the airway (aspiration)
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17
Q

Etiology of Hyperkinetic Impairment

A

Basal ganglia dysfunction

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18
Q

Symptoms of Hyperkinetic Impairment

A
  • Abnormal, rhythmic movements
  • Irregular and unpredictable movements
  • Slow, involuntary movements
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19
Q

Examples of Hyperkinetic Impairment

A

Huntington’s Disease

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20
Q

How does a Hyperkinetic Impairment impact swallowing?

A
  • Motor control across all phases of the swallow are affected
  • Any number of impairments can be seen
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21
Q

In the TMN tumor staging system, T stands for _____.

A

Tumor size
- T1 (smallest)
- T4 (largest)

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22
Q

In the TMN tumor staging system, N stands for _____.

A

Nodal status

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23
Q

In the TMN tumor staging system, M stands for _____.

A

Presence or absence of Metastasis outside the region

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24
Q

Why would a surgeon not be able to perform a primary closure?

A

If there is a large area without sufficient tissue to close the wound

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25
Q

Transporting healthy, live tissues from one location of the body to another, with its blood supply intact, is called a _____.

A

Flap

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26
Q

Transporting skin, without a blood supply is called a _____.

A

Graft

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27
Q

What is xerostomia?

A

Oral dryness, dry mouth

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28
Q

Tissue that has been radiated may be red, inflamed, and have ulcers; this is called _____.

A

Mucositis

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29
Q

What are three late effects of radiation in head and neck cancer?

A
  • Trismus (jaw stiffness)
  • Decreased muscle bulk
  • Fibrosis (stiffness
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30
Q

If there is cancer of the tonsils, what site would that be labelled as?

A

Oropharyngeal

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31
Q

If there is cancer of the pharyngeal walls, what site would that be labeled as?

A

Hypopharyngeal

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32
Q

Cancer of the AE folds would be labeled as a pharyngeal cancer.

a. True
b. False

A

b. False

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33
Q

What structures are included in a label of glottic cancer?

A
  • TVF
  • Anterior commissure
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34
Q

It is likely that someone with laryngeal cancer will experience loss of oral control and coordination.

a. True
b. False

A

b. False

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35
Q

Decreased hyolaryngeal excursion can lead to _____.

A

Decreased laryngeal closure- aspiration

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36
Q

10.5% of premature infants born at less than _____ weeks gestation have dysphagia.

A

37

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37
Q

Prevalence increases to 24.5% among those with birth weight less than _____ lbs.

A

3.3

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38
Q

Infants with cleft lip/palate may have _____ reflexes and sucking.

A

Normal

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39
Q

Cleft lip causes impairment of _____ around the nipple.

A

Lip closure

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40
Q

Cleft palate prevents the baby from generating the _____ needed to express milk from the nipple.

41
Q

_____ can occur if the cleft extends posteriorly into the hard/soft palate.

A

Nasal regurgitation

42
Q

Laryngeal cleft can cause food or liquid to be _____, resulting in aspiration.

A

Misdirected into the airway

43
Q

_____ causes the supraglottic structures to collapse with _____.

A

Laryngomalacia; inspiration

44
Q

The swallowing impact on laryngomalacia is due to increased _____ associated with feeding.

A

Respiratory effort

45
Q

Increased respiratory effort can cause ____, which interferes with airway protection during swallowing.

46
Q

An _____ is an abnormal narrowing caused by scarring or contraction of smooth muscle.

A

Esophageal stricture

47
Q

If food passage through the esophagus is impaired, the baby may have poor _____.

A

Weight gain

48
Q

Respiratory distress syndrome is more common in infants born before _____ weeks of gestation.

49
Q

The infant’s immature lungs lack sufficient _____.

A

Surfactant

50
Q

Babies with RDS may not be able to tolerate _____ during swallowing.

51
Q

As endurance declines, a baby may not be able to adequately _____ during oral intake.

A

Protect the airway

52
Q

Preterm birth interrupts the normal trajectory of the _____.

53
Q

When the brain/CNS is underdeveloped, the infant may have low _____ and weakness of the muscles of _____.

A

Tone; swallowing

54
Q

Unlike conditions associated prematurity, the muscles of a baby with CP are _____, leading to lack of control in the swallow mechanism.

A

Hypertonic

55
Q

Any neurological impairment of the CNS can cause inability to coordinate _____ sequence.

A

Suck-swallow-breathe

56
Q

Cardiac conditions may interfere with _____, which leads to difficulty coordinating respiration and swallowing.

A

Oxygenation

57
Q

The _____ nerve may be damaged during surgical repair of a cardiac condition.

58
Q

The inability to interpret sensory input, integrate information, and modulate an appropriate motor response is called _____.

A

Sensory integration dysfunction

59
Q

In babies, hypersensitivity can cause an _____ to oral stimulation.

A

Overreaction

60
Q

Some responses of hypersensitivity can include _____ and _____ of eating.

A

Gagging; avoidance

61
Q

Later, hypersensitivity can lead to extreme _____.

A

Selectiveness

62
Q

In children/babies, aspiration is often _____.

63
Q

Aspiration leads to problems of the _____.

A

Respiratory system

64
Q

Poor oral intake can result in _____, _____, _____, and _____.

A

Insufficient nutrition; poor growth; delayed development; food aversions

65
Q

One psychosocial impact on children with dysphagia and their families is _____.

A

Frustration

66
Q

When LMNs are damaged, it causes what type of dysarthria?

67
Q

When UMNs are damaged, it causes what type of dysarthria?

68
Q

Which are symptoms of flaccid dysarthria?

a. Weakness
b. Hypotonia
c. Increased reflexes
d. Fatigue

A

a. Weakness
b. Hypotonia
d. Fatigue

69
Q

Which is NOT a disease/disorder associated with flaccid dysarthria?

a. Brainstem CVA
b. Muscular Dystrophy
c. Alzheimer’s Disease
d. ALS

A

c. Alzheimer’s Disease

70
Q

In flaccid dysarthria, there may be weakness of the velopharynx. Regarding swallowing, what can this cause?

A

Nasal regurgitation

71
Q

Which of the following are diseases/disorders associated with spastic dysarthria?

a. CVA
b. Parkinson’s Disease
c. Cerebral Palsy
d. Guillain-Barre
e. Anoxic brain injury

A

a. CVA
c. Cerebral Palsy
e. Anoxic brain injury

72
Q

What symptom do flaccid and spastic dysarthria have in common?

73
Q

What does poor closure of the larynx during the swallow result in?

A

Aspiration

74
Q

Poor chewing and movement of the bolus can result in:

A

Oral residue

75
Q

Ataxic impairments are the result of damage to the:

A

Cerebellum

76
Q

Symptoms of ataxic dysarthria include:

a. Slowness and inaccuracy of movement
b. Hypertonicity
c. Diminished reflexes
d. Difficulty of coordination of movement
e. Tremor

A

a. Slowness and inaccuracy of movement
d. Difficulty of coordination of movement
e. Tremor

77
Q

Which disease is associated with hypokinetic dysarthria?

A

Parkinson’s Disease

78
Q

Which symptom does hypokinetic dysarthria and ataxic dysarthria NOT have in common?

a. Slowness of movement
b. Diminished or inaccurate movement
c. Rigidity
d. Tremors

A

c. Rigidity

79
Q

People with ataxic dysarthria may experience what type of oral stage impairment during eating?

A

Inability to suck, biting tongue/cheek

80
Q

What is the cause of hypokinetic dysarthria?

A

Damage to the basal ganglia

81
Q

Diminished movements and reduced sensation can result in which swallowing impairments?

A

Drooling, poor larynx closure, disordered timing of swallow onset, decreased frequency of swallow

82
Q

What is the most likely outcome of inappropriate timing of the swallow onset?

A

Aspiration

83
Q

What do hypokinetic dysarthria and hyperkinetic dysarthria have in common?

A

Both are caused by dysfunction in the basal ganglia

84
Q

What is the result of poor propulsion of the bolus through the pharynx?

A

Pharyngeal residue

85
Q

Which is NOT considered a later effect of radiation?

a. Trismus
b. Decreased muscle bulk
c. Xerostomia
d. Fibrosis

A

c. Xerostomia

86
Q

Which type of head/neck cancer treatment causes continued fibrosis to the body long after treatment ends?

87
Q

In surgical treatment for head/neck cancer, a flap refers to transporting skin without a blood supply to close a wound.

a. True
b. False

88
Q

Which structures are associated with an oral/oropharyngeal cancer?

A

Floor of mouth, mandible, tonsils

89
Q

Which structure is associated with a supraglottic laryngeal cancer?

A

Aryepiglottic folds

90
Q

The anterior commissure is one of two structures associated with a glottic laryngeal cancer.

a. True
b. False

91
Q

Which structure is associated with a hypopharyngeal cancer?

A

Pharyngeal walls

92
Q

Decreased hyolaryngeal excursion can result in:

A

Decreased laryngeal closure, decreased UES opening

93
Q

About 10% of premature infants born at less than 37 weeks gestation have dysphagia.

a. True
b. False

94
Q

Which of the following is a structural anomaly in neonates that can cause dysphagia?

a. Laryngomalacia
b. Respiratory Distress Syndrome
c. Cerebral Palsy
d. Sensory integration dysfunction

A

a. Laryngomalacia

95
Q

Which of the following is a swallowing problem generally NOT associated with cleft lip/palate?

a. Incomplete closure around the nipple
b. Inability to generate suction needed for expressing milk
c. Nasal regurgitation
d. Abnormal/non-rhythmic sucking pattern

A

d. Abnormal/non-rhythmic sucking pattern

96
Q

Laryngeal cleft can cause:

A

Liquid to be mis-directed into the airway

97
Q

If a baby experiences shortness of breath, this can interfere with:

A

Airway protection during the swallow

SLHS 408 (3 decks)

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