Swallowing Impairment Outline

Question 1

If there is an impairment in the oral stage, what might we see in a swallowing evaluation? (4)

Answer 1

1) Anterior spillage, drooling
2) Premature posterior spillage
3) Prolonged oral transit
4) Oral residue/pocketing

Question 2

If there is an impairment with swallow initiation, what might we see in a swallowing evaluation? (2)

Answer 2

1) Pre-swallow pooling in valleculae

2) Penetration/aspiration BEFORE the swallow

Question 3

If there is an impairment with velopharyngeal seal, what might we see in a swallowing evaluation? (1)

Answer 3

1) Nasal regurgitation

Question 4

If there is an impairment with pharyngeal constriction, what might we see in a swallow evaluation? (1)

Answer 4

1) Diffuse pharyngeal residue

Question 5

If there is an impairment with the UES, what would we see in a swallowing evaluation? (1)

Answer 5

1) Residue in pyriform sinuses

Question 6

If you see premature posterior spillage during a swallow evaluation, what phase is causing the problem?

Answer 6

Oral prep

Question 7

If you see pre-swallow pooling during a swallow evaluation, what step is causing the problem?

Answer 7

Swallow initiation

Question 8

If you see nasal regurgitation during a swallow evaluation, what step is causing the problem?

Answer 8

Velopharyngeal seal

Question 9

If you see vallecular residue during a swallow evaluation, what step is causing the problem?

Answer 9

BOT retraction

Question 10

If you see penetration/aspiration DURING the swallow, what step is causing the problem? (2)

Answer 10

1) Epiglottic deflection

2) Glottal closure

Question 11

If you see pyriform residue during a swallowing evaluation, what step is causing the problem? (2)

Answer 11

1) Hyolaryngeal excursion

2) UES constriction

Question 12

If you see diffuse pharyngeal residue during a swallowing evaluation, what step is causing the problem?

Answer 12

Pharyngeal constriction

Question 13

What swallowing difficulties are seen with weak lingual strength/mobility/ROM? (4)

Answer 13

1) Difficulty forming a bolus
2) Pocketing in anterior and lateral sulci
3) Oral residue
4) Premature posterior spillage

Question 14

What swallowing difficulties are seen with poor dentition? (1)

Answer 14

1) Decreased ability to break down food

Question 15

What swallowing difficulties are seen with decreased jaw ROM? (2)

Answer 15

1) Poor lip closure

2) Poor mastication

Question 16

What swallowing difficulties are seen with decreased hyolaryngeal excursion? (2)

Answer 16

1) Poor epiglottic deflection —> results in vallecular residue and decreased airway protection.
2) Poor UES opening —> results in pyriform residue and/or back flow of contents into pharynx

Question 17

What swallowing difficulty is seen with unilateral pharyngeal weakness? (1)

Answer 17

1) More pharyngeal residue on one side