Swallowing

Question 1

Which issue during swallowing is associated with a problem during the pharyngeal phase of swallowing?

Answer 1

reduced movement of the tongue

Question 2

What is cervical auscultation?

Answer 2

a swallowing assessment technique in which a stethoscope is placed over the thyroid cartilage to make sounds louder during swallowing

Question 3

What is scintigraphy?

Answer 3

a swallowing assessment technique in which a person drinks radioactive material and then is scanned so that an image is produced

Question 4

What is videofluroscopy?

Answer 4

a swallowing assessment technique in which a patient drinks a tiny bit of liquid barium and the SLP records the swallow

Question 5

What is fiberoptic endoscopic evaluation of swallowing?

Answer 5

a swallowing assessment technique in which a tube is passed through a patient’s nose to examine their swallow

Question 6

What are the goals of oral motor exercises?

Answer 6

increase tongue movement; increase range of tongue movements; increase the range of lateral movements of the jaw

Question 7

What is used to quantify the time and frequency of gastroesophageal reflux into the esophagus?

Answer 7

a pH probe or intraluminal pH monitoring study

Question 8

What are the four phases of swallowing?

Answer 8

oral prep phase, oral phase, pharyngeal phase, and esophageal phase

Question 9

What part of the brain is responsible for swallowing?

Answer 9

medulla oblongata which has the central pattern generator

Question 10

What is the oral phase of swallowing?

Answer 10

moving bolus from the front to the back of the mouth

Question 11

What is an option to provide a client with a weak pharyngeal swallow and minimal laryngeal elevation and excursion following stimulation?

Answer 11

gastrostomy tube

Question 12

The disorders of the pharyngeal phase of swallowing include

Answer 12

delayed or absent swallowing reflex

Question 13

What treatment technique results in the widening of the vallecula space?

Answer 13

head down (chin tuck)

Question 14

What is known about medically fragile babies with feeding difficulties?

Answer 14

They have issues with oral-motor development; they often need to be fed through nasogastric tubes; to be fed orally, they must be at least 35 weeks old; it’s hard to breastfeed them

Question 15

What is cricopharyngeal myotomy?

Answer 15

split the cricopharyngeal muscle to create a sphincter for swallowing

Question 16

What is esophagotomy?

Answer 16

put a feeding tube into the esophagus and stomach through a stoma; this is for people who cannot tolerate oral feeding

Question 17

Why do you select a pureed diet?

Answer 17

no mastication involved

Question 18

What should an SLP do for a patient who has tongue weakness and cannot properly form a bolus?

Answer 18

tilt their head down as food is placed in their mouth and then tilt it back

Question 19

If a patient had a hemilaryngectomy, delayed triggering of swallowing reflext, and inadequate laryngeal closure, then what should an SLP do?

Answer 19

Have the patient tilt their head downward to hold the food in the valleculae until the reflex is triggered

Question 20

What is the supraglottic swallow used for?

Answer 20

to address delayed onset of swallow; delayed closure of vocal folds and delayed closure of larygneal vestibule

Question 21

What is the super-supraglottic swallow used for?

Answer 21

to address the laryngeal vestibule not closing as much

Question 22

What is the effortful swallow used for? How is it used?

Answer 22

to address the pharynx not constricting as much and lack of tongue base moving posteriorly; this is used to help the tongue base move posteriorly

Question 23

What is the difference between direct treatment and indirect treatment of swallowing?

Answer 23

direct treatment involves food and drink and indirect treatment does not

Question 24

For direct treatment of the oral phase of swallowing, an SLP can use

Answer 24

teach patient to use their tongue to sweep food from the lateral sulci; increase tongue to palate contact or use a palatal obdurator to do that; place food at the back of the oral cavity or back of the tongue

Question 25

For direct treatment of the pharyngeal phase of swallowing, an SLP can use

Answer 25

teach patient to use a chin tuck; tilt their head towards the weak side if their pharyngeal constriction is weak on one side; tilt their head towards the stronger side if the have unilateral paralysis of laryngeal function, decreased laryngeal elevation

Question 26

To stimulate the swallow reflex, the following exercises can be used,

Answer 26

liquid swallow after stimulation; use thermal stimulation; tell them to swallow after stimulation without food

Question 27

What indirect treatment of swallowing targets the UES?

Answer 27

The Shakur method

Question 28

What indirect treatment of swallowing increases tongue base strength?

Answer 28

the Masako maneuver

Question 29

What is the difference between a hemiglossectomy and a subtotal glossectomy?

Answer 29

hemiglossectomy: 50% of the oral tongue and some of the tongue base is removed

subtotal glossectomy: at least 50 to 100% of the oral tongue and tongue base is removed

Question 30

What is the difference between esophagotomy and a gastrostomy?

Answer 30

For an esophagotomy, a feeding tube is inserted into the esophagus and stomach through the hole. For an gastrostomy, the feeding tube is inserted into the stomach through the stoma.

Question 31

What is nasogastric feeding?

Answer 31

another method for individuals who cannot tolerate oral feeding. A tube is inserted through the nose, pharynx, and esophagus into the stomach, and feeds the patient