Swallowing

Question 1

How do you prevent nasal speech

Answer 1

Uplifting the soft palate

Question 2

4 phases of swallowing

Answer 2

1. Oral preparatory
2. Oral
3. Pharyngeal
4. Esophageal

Question 3

What’s happening during pharyngeal phase

Answer 3

Bolus goes from mouth to esophagus

Question 4

Which swallow strategy prevents entry of liquid into larynx by forward motion of larynx

Answer 4

Chin tuck

Question 5

Which swallow strategy uses gravity to guide bolus into pharynx

Answer 5

Head tilt

Question 6

Relaxation of _____________ is required for esophageal clearance

Answer 6

Gastroesophageal sphincter

Question 7

Which swallow strategy encompasses breath holding and swallowing

Answer 7

Supraglottic

Question 8

Which phases of swallowing is voluntary and which is involuntary

Answer 8

Voluntary = oral preparatory and oral
Involuntary = pharyngeal and esophageal

Question 9

Which swallow strategy uses valsalva’s

Answer 9

Super supraglottic swallow

Question 10

What is happening during oral phase

Answer 10

Tongue elevates and occludes anterior oral cavity and pushes bolus back towards oropharynx

Question 11

Which swallow strategy has the patient holding the larynx high to lengthen duration of cricopharyngeal opening

Answer 11

Mendelsohn maneuver

Question 12

What patient should PEG be considered

Answer 12

If they can’t tolerate grade 3 thickened fluid or puréed diet 14 days after stroke

Question 13

How long does each phase last?

Answer 13

Oral preparatory - variable. Depends on the person.
Oral - <1 second
Pharyngeal phase - 0.6 - 1 second
Esophageal - 6-10 seconds

Question 14

Problems seen in oral preparatory phase

Answer 14

Pocketing or drooling

Question 15

Which phase of swallowing is aspiration most likely to occur

Answer 15

Pharyngeal

Question 16

Which swallow strategy decreases the space between base of tongue and posterior pharyngeal wall

Answer 16

Chin-tuck

Question 17

What is soft palate doing during oral preparatory phase

Answer 17

Depression and forward movement

Question 18

MC phase of swallowing where you have dysphagia

Answer 18

Pharyngeal

Question 19

Longest phase of swallowing

Answer 19

Esophageal

Question 20

Which swallow strategy closes the ipsilateral pharynx to force bolus to contralateral bolus?

Answer 20

Head rotation

Question 21

6 swallowing strategies

Answer 21

1. Chin Tuck
2. Head rotation
3. Supraglottic swallow
4. Super supraglottic swallow
5. Mendelsohn
6. Head tilt

Question 22

Contraction of what muscle is required in pharyngeal phase

Answer 22

Cricopharyngeal muscle

Question 23

What is the physiology of nasal speech aka hypernasality? Is due to partial or complete failure of _____________….

Answer 23

Partial or complete failure of soft palate to close off nasal cavity from oral cavity

Question 24

What is tongue moving during oral preparatory phase

Answer 24

Lateral