Treatment

Question 1

Evaluation leads to ?

Answer 1

treatment or no treatment

Question 2

When would you treat

Answer 2

swallow impairment

expect there will be a swallow impairment

patient/caregiver interested in therapy

PO vs. non-oral nutrition

Question 3

When would there be no treatment ?

no?

-

TX in hands of ?

there is swallow impairment but>

Answer 3

swallow impairment

wait and see cases

• spontaneous recovery
• no problem now but will develop later
• another specialist
• follow-up
• advocating

patient/caregiver doesn’t want treatment

Question 4

Compensatory: Postural changes

• change ?
• redirect
• work well for both ?

options:

Answer 4

pharyngeal dimension
bolus flow
neuro and mechanical etiologies

head back (chin up)
chin down/tuck
head rotation
head tilt

Question 5

Compensatory: 
utilized to ? 
like a ? 
may be necessary or only options with? 
can be? 
may keep people ? while ?
Can be completed in conjunction with ?

Answer 5

compensate for difficulty performing a task

crutch

severe structural anomalies

temporary

swallowing / rehabilitation is completed

rehab techniques

Question 6

Rehabilitative/restorative:

designed to

take advantage of ?

require some degree of

little ?

Answer 6

change physiology

bodies plasticity (peripheral and central )

strength , coordination, and endurance

little empirical data to support their use

Question 7

Compensatory: sensory input

increase improve

stimulus applied

some examples: 
... or .. bolus
-
-larger 
-self
-thermal 
-oral 
-?

Answer 7

sour or cold bolus

chewing

larger volume

self-feed

thermal tactile stimulation

oral stimulation

e-stim/vital stim

Question 8

compensatory: diet modifications
changes/modifications to: 
-
-
-
-

NPO?

• no ?
• thin
• thick
• .. consistency
• crushed
• … soft / .. soft
• regular

Answer 8

consistency
texture
quantity
temperature

non per oral 
no liquid by mouth 
thin liquid consistency 
thick liquid consistency 
pureed liquid consistency 
crushed medication 
mechanical soft/dental soft 
regular dietary consistency

Question 9

compensatory: prosthetics
who needs?

goal:

Answer 9

oral cancer (tongue or palate_
craniofacial anomalies
neurologic (XII involvement)

obturate, lift, reshape

Question 10

therapy procedures: 
.... treatments 
designed to 
take ? 
follow? ... practice  ?

indirect versus direct:
indirect
direct

Answer 10

neuro-muscular treatments
change physiology
voluntary control over the swallow
directions, practice independently

exercise programs, saliva swallows
involves introduction of food or liquid

Question 11

Rehabilitative: range of motion, strength, coordination, endurance

what is your goal: 
increase/maintain
consider? 
-improve/maintain
-increase/decrease 
-improve /maintain ? 
-improve 

…,….,…. !

• … adaptations
• ….adaptations

-

Answer 11

strength 
fatigue/tonicity
range of motion 
muscle tone 
coordination of structures 
endurance 

plasticity , plasticity, plasticity

peripheral adaptations
central adaptations

overload
specificity

Question 12

Rehabilitative:

swallow specific

not swallow specific

Answer 12

masako maneuver 
effortful swallow /SHOWA
super-supraglottic swallow
supraglottic swallow 
mendelsohn maneuver 

LSVT
expiratory muscle strength training
shaker maneuver
tongue strengthening ec

Question 13

Masako Maneuver:
to train the ? to bulge ? to compensate for

improve ?

retract ?

Answer 13

posterior pharyngeal wall (PPW) / anteriorly/ reduced BOT movement

BOT strength (maybe)

tongue and swallow

Question 14

effortful swallow /SHOWA:
to increase ? and thus improve ?

as you swallow, ?

Answer 14

posterior motion of the bOT during pharyngeal swallow / clearance from the valleculae

squeeze hard with all of the muscles in your neck and throat

Question 15

mendelsohn maneuver:
increase the ? and thereby increase the ?

can also improve overall?

you can feel your ? next time you swallow and you feel it lift? hold it up with your muscles for ?

Answer 15

extent and duration of laryngeal elevation / duration and width of UES opening

coordination

voice box moves up and down during swallow/ don’t let it drop/ several seconds

Question 16

supraglottic swallow:
close the airway at the level of the ?

inhale and? swallow while ? … immediately after your swallow without

super-supraglottic swallow:
to close the ?

inhale, hold your breath and? keep ? after you swallow?

Answer 16

TVFs before and during the swallow

hold breath/holding your breath/ cough / breathing in

airway entrance before and during the swallow

bear down hard/ holding your breath as you swallow/ cough

Question 17

Shaker maneuver:

series of
patient
head ?
repeated?

a significant increase was found in the magnitude of ? the maximum? and the cross-sectional area of the ?

Answer 17

head raise exercises
supine
holds ( isometric)
head raises (isotonic)

excursion of larynx/anteroposterior diameter/ UES opening

Question 18

LSVT

primary target

Answer 18

get loud, stay loud

voice and speech

Question 19

Expiratory Muscle strength training: 
results from only dysphagia tx on RCT 
-reductions in 
-increases in 
-improvements in 
-improvements in 

why does it work: the contributors:

• increases
• causes
• increases
• increases
• demands specific

Answer 19

PA score
hyoid displacements
SWAL-QOL
cough function

submental muscle activity
elevation of hyoid bone 
horizontal dimension of pharynx
subglottal pressure 
respiratory pattern

Question 20

tongue strengthening exercises:
significantly greater change in ?

tongue strengthening exercises improve ?

Answer 20

maximum tongue strength in group that received treatment

tongue strength

Question 21

cost effective:
… change
-… bases
-… improvement in

Answer 21

functional change (time efficient) 
physiological bases (ease of use) 
improvements in QOL (consistent use within and across patients, concurrent feedback independent of clinician, reduced patient/caregiver burden)