Voice and Swallowing Disorders

Question 1

Definition of dysphasia

Answer 1

Deficiency in generation of speech or sometimes comprehension

Question 2

Two types of dysphasia

Answer 2

Receptive

Expressive

Question 3

What is dysarthria?

Answer 3

Difficult or unclear articulation of speech that is otherwise linguistically normal
Affects speech clarity i.e. slurred speech

Question 4

Pathology of dysarthria

Answer 4

Damage to the nerve pathways to the muscles involved with speech

Question 5

Definition of dysphagia

Answer 5

Swallowing problems

Question 6

How is the risk of aspiration reduced in patients?

Answer 6

Promote safe, efficient swallowing

Question 7

Investigations for dysphagia

Answer 7

Neurology assessment
CNs
Swallowing trials
Videofluroscopy 
FEES
Cervical auscultation

Question 8

Treatment for dysphagia

Answer 8

Texture and fluid modification 
Positioning 
Postures and manoeuvres 
Modified feeding equipment 
Strengthening exercises

Question 9

Definition of dysphonia

Answer 9

Difficulty in speaking due to a physical disorder of the mouth, tongue, throat or vocal cords

Question 10

Causes of dysphonia

Answer 10

Vocal abuse / misuse (nodules/polyps)
Professional voice users 
Spasmodic dysphonia 
Vocal fold paralysis 
Functional voice disorders / psychosocial factors

Question 11

How do we manage speech?

Answer 11

Maximise function and range of movement (exercises)
Promote compensatory strategies (slow speech rate, decrease phase length)
Explore possible solutions e.g. decrease background noise
Improve intelligibility e.g. prosody, articulation, breath support for phonation
Provide ACC
- amplifiers
- lightwriters
- boardmaker
- alpha taker/chat box

Question 12

Complications of laryngectomy

Answer 12

Candida (thrush)

PE segment spasms

Question 13

What does the soft palate look like after radiotherapy?

Answer 13

Pale with blood vessels

Question 14

What can reflux affect?

Answer 14

The laryngeal muscles

Question 15

What is the main function of the laryngeal muscles?

Answer 15

To protect the airway

Question 16

Does the gag reflex protect the airway?

Answer 16

No

Question 17

Causes of a neurological swallowing disorder

Answer 17

Head injury 
Parkinsons
Stroke
MS
MND
Dementia

Question 18

Presentation of oral dysphagia

Answer 18

Person difficulty chewing
May begin to drool 
May 'pocket' food in the mouth and need encouragement to swallow it
Effortful chewing is tiring
Slow mealtimes

Question 19

Where does oral dysphagia occur?

Answer 19

In the mouth

Question 20

Where does pharyngeal dysphagia occur?

Answer 20

Throat

Question 21

Presentation of pharyngeal dysphagia

Answer 21

Coughing/chocking during eating/drinking

Aspiration

Question 22

What is silent aspiration?

Answer 22

When something is aspirated, however the patient has a lack of sensation and therefore does not reflexly cough

Question 23

Complications of dysphagia

Answer 23

Recurrent pneumonia / chest infections
Loss of weight / malnutrition
Social withdrawal