Lecture 3 Flashcards
1
Q
Decisions after CBE
A
- no EDS issue, discharge from SLT
- onward referral; not SLT scope
- make recommendation for NBM
- make recommendations for diet and fluids +/- conpensatory strategies
- consider candidacy for rehabilitation
- unclear what is happening with swallow
2
Q
Term for pain when swallowing
A
Odynophagia
3
Q
Videofluoroscopic swallow study (VFSS) (objective assessment)
A
- a dynamic, radiological assessment considers oral, pharyngeal and upper oesophageal phases of swallowing
- identifies aspiration, penetration, structural abnormalities
4
Q
What to consider for VFSS
A
- level of consiousness
- ability and/or willingness to follow instructions
- posture, sitting or standing balance
- medical fitness for journey, exam and potential waiting time
5
Q
Disadvantages of VFSS
A
- can be expensive
- radiation limits the frequency (for clinician and client)
- need trained SLTs
- availability
6
Q
Fibreoptic endoscopic evaluation of swallowing (FEES)
A
- can be used to compliment VF studies with reduced cost and risk
- provides data regarding flow of food and fluid pre swallow and the amount of residue post-swallow
- can be left in place for long period of time and May be more appropriate for patients who cannot tolerate transfer to a radiological suite
- provides accurate information on vocal fold movement
7
Q
Other assessments that are less commonly used
A
- high resolution
- ultrasound
- IOPI (The Iowa Oral Performance)
- surface electromyography
8
Q
Principles of management plans
A
- base your management on a solid assessment (solid means integrating your data from a range of sources)
- you should always involve MDT collagues
- you should take patient preferences into account when planning and have their agreement
9
Q
Nasogastric feeding (NG)
A
- a feeding tube is passed through the nose, down oesphagus and into the stomach
- temporary measure
- a dietician calculates nutritional requirements
10
Q
Percutaneous endoscopic gastronomy (PEG)
A
- more permanent but can be removed
- an endoscope with a powerful light source identifies the point of incision. A thread is pulled through the needle at incision, pulled up but the endoscope, attached to the PEG tube and pulled back down
11
Q
Accommodating dysphagia
A
- accommodate rather than trying to change dysphagia
- aim to achieve a safe functional, efficient swallow
- not intended to change the swallow
12
Q
Reasons for postural changes in EDS compensation
A
- aims to redirect the bolus to compensate for weakness
- can change the sensory input
- Influence pressure changes in the pharynx
13
Q
Alternate liquids/solids (wash down)
A
Clears oral cavity
14
Q
Rate of intake
A
Eating at a steady pace/pace you can maintain
15
Q
Bolus placement in oral cavity
A
