Maneuvers and Management for specific disorders

Question 1

How do you complete a supraglottic swallow?

Answer 1

Deep breath, hold your breath, swallow, cough, swallow.

Question 2

How do you complete a super-supraglottic swallow?

Answer 2

Hold your breath tightly, bear down. Swallow Cough. Swallow.

Question 3

What are two reasons do use a supraglottic swallow and the rational?

Answer 3

1. Reduced or late vocal fold closure
   Rationale: Voluntary breath hold usually closes vocal folds before and during swallow
2. Delayed pharyngeal swallow
   Rationale: Closing vocal folds before and during delay

Question 4

What is the reason to use a super-supraglottic swallow and the rationale?

Answer 4

Reduced closure of airway entrance

Rationale: Effortful breath hold tilts arytenoid forward closing airway entrance before and during swallow

Question 5

How do you complete an effortful swallow?

Answer 5

As you swallow, squeeze hard with all your muscles

Question 6

What is the reason to use a effortful swallow and the rationale?

Answer 6

Reduced posterior movement of the tongue base

Rationale: Effort increases posterior tongue base movement

Question 7

How do you complete the Mendelsohn maneuver?

Answer 7

As you swallow, several times feel your Adamns apple elevate. Now don’t let it drop for several seconds after you swallow

Question 8

What are two reasons do use the Mendelson maneuver and the rational?

Answer 8

1. Reduced laryngeal movement
   Rationale: Laryngeal movement opens the upper esophageal sphincter; prolonged laryngeal elevation prolongs UES opening
2. Discoordinated swallow
   Rationale: Normalizes timing of pharyngeal swallow events