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Dysphagia > Week 2, quiz 2 > Flashcards

Week 2, quiz 2 Flashcards

1
Q

What is the cause not not being able to hold the bolus in the mouth?

A
  • lip weakness

- decreased lip seal

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2
Q

What is the reason for not being able to form the bolus?

A
  • tongue weakness
  • jaw weakness
  • reduced saliva production
  • poor dentition
  • decreased ROM of the tongue/jaw
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3
Q

What is the cause of material falling into the buccal cavity?

A
  • buccal weakness

- lip weakness

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4
Q

What is the cause of repetitive lingual rolling?

A

-Parkinson’s disease

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5
Q

What is the cause of searching tongue movements/delayed oral phase?

A
  • apraxia

- tactile agnosia (dementia patients)

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6
Q

What causes a cough before the swallow? (premature spillage)

A

-reduced tongue strength and/or coordination

can’t contain the bolus

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7
Q

What causes the tongue to move forward?

A

tongue thrust

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8
Q

which phase involves food not being hold in the mouth?

A

oral prep phase

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9
Q

Which phase can have lingual rolling as a symptom?

A

oral phase

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10
Q

What phase involves not being able to hold the bolus?

A

the oral prep phase

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11
Q

Which phase can have searching tongue movements/delayed oral phase as a symptom?

A

oral phase

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12
Q

What phase can have the symptom of not being able to form the bolus?

A

oral prep phase

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13
Q

What phase can have the symptom of coughing before the swallow?

A

oral phase

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14
Q

What phase can have the symptom of material falling into the buccal cavity?

A

oral prep phase

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15
Q

What phase can have the symptom of moving the tongue forward?

A

oral phase

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16
Q

When is premature spillage normal?

A

mechanical soft and solid boluses

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17
Q

what is the cause of nasal regurgitation?

A

reduced VP closure

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18
Q

What is the cause of residue in the vallecula?

A

reduced BOT-R

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19
Q

What is the cause of residue in the pyriforms?

A
  • reduced LE (causes esophagus to not open enough)

- cricopharyngeal dysfunction

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20
Q

What is the cause of cough during the swallow?

A
  • reduced LE (may not get the epiglottis to come down)

- reduced laryngeal adduction (reduced laryngeal vestibule closure)

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21
Q

What is the cause of a cough after the swallow?

A
  • reduced BOT-R (if spillage from the vallecula)

- reduced LE or CP dysfunction (is spillage is from the pyriforms)

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22
Q

What is the cause of residue in the pharyngeal walls?

A

-reduced pharyngeal constriction

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23
Q

What phase can nasal regurgitation be a symptom in?

A

pharyngeal phase

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24
Q

residue in the vallecula can be a symptom of what phase?

A

pharyngeal

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25
residue in the pyriforms can be a symptom in what phase?
pharyngeal
26
residue in the pyriforms can be a symptom in what phase?
pharyngeal
27
coughing during the swallow can be a symptom of what phase?
pharyngeal
28
coughing after the swallow can be a symptom of what phase?
pharyngeal
29
residue of the pharyngeal wall can be a symptom of what phase?
pharyngeal
30
What is cricopharyngeal mytonomy?
when you put a slit in the CP muscle so it becomes looser
31
What is fibrosis?
stiffening of the tissue
32
What can cause fibrosis?
radiation
33
What can amplify a patient's current dental issues?
dry mouth
34
What is the formal name for dry mouth?
xerstomia
35
What is something that can be done to reduce fibrosis?
aggressive ROM exercises before, during, and after treatment
36
Explain tumor rating system
T: size/location of tumor N: involvement of nodes M: # of distant metastases
37
When should a patient's first swallows be done after surgery and radiation?
during an MBSS (so you can see how surgical changes are affecting the swallow)
38
Changes in the tissue/swallow function may appear up to how long?
one year
39
When is it suggested to start ROM exercises post surgery?
about 10-14 days
40
Why might a surgeon take more tissue than you might think is necessary from the oral cavity?
cancer cells in the oral cavity will spread if they are disturbed so surgeons will cut around the cancer
41
What is lingual labial closure?
when part of the tongue is sutured to the lip
42
What can lingual labial closure affect?
ROM - BOT-R - A/P transfer - formation of the bolus
43
Why is it important to know if the faucial arches were removed during surgery?
this would affect the trigger point for the swallow
44
What percent of laryngeal cancers are in the glottis area (at the VFs)?
60%
45
What laryngeal cancers are malignancies of the supraglottis area?
35%
46
What percentage of cancers are in the subglottic area?
5%
47
Do cells in the laryngeal cavity shed more or less than in the oral cavity?
less
48
What structures are removed during a supraglottic/horizontal laryngectomy?
- hyoid - epiglottis - aryepiglottic folds - false folds
49
What maneuver should be considered to help BOT-R if the patient had a supraglottic laryngectomy?
super-supraglottic maneuver
50
What is removed during a hemilaryngectomy?
- 1 false fold - half of the ventricle - 1 true vocal folds - some thyroid cartilage
51
When might someone consider doing a hemilaryngectomy?
if the tumor is confined to one side
52
What are some postural techniques you can use to help someone with a hemilaryngectomy?
chin tuck and head rotation
53
What do strictures of the pharynx/esophagus do?
"hold up" large boluses
54
What is a way to treat pharyngeal/esophageal strictures?
- esophageal dialation | - CP mytonomy
55
When should you suspect if there are problems with swallowing years after treatment?
recurrence of cancer
56
Any neurologic patient is going to have reduced what?
sensitivity to aspiration
57
People with neurological disorders won't have what in regards to residual food?
normal response, the normal response is to have multiple swallows
58
What should you do if you patient with neurological disorder fatigues easily?
- not suggest maneuvers | - suggest smaller meals
59
How long should you wait to assess swallowing if the patient has been intubated?
24 hours
60
What percentage of patients will aspirate if they have a swallow eval done within 24 hours of extubation?
50% or more
61
How could you assess the swallow of a comatose patient?
TTGS; thermal-tactile-gustatory stimulation - give a mild stimulate (ice chips, gingerale) - can get data about the strength of the swallow, pharyngeal reflex time, etc)
62
What is an example of TTGS
lemon glycerin swab
63
what percentage of patients with cva will have dysphagia?
80%
64
What percentage of patients with cva will have persistent dysphagia?
30-50%
65
What does reduced o2 sats do to a patient with pneumonia?
exacerbates the neurological deficits
66
How will the oral stage be in a unilateral medullary stroke?
probably fine
67
What will the pharyngeal stage of a unilateral stroke to the medulla look like?
probably absent
68
A stroke the the medulla will likely cause what swallowing symptoms?
- reduced LE - unilateral pharyngeal weakness - unilateral VF paralysis
69
What techniques would likely be helpful for someone with a cva to the medulla?
Mendehlson maneuver and head rotation
70
What is the cause of not being able to hold food in the mouth?
- decreased lip seal | - lip weakness

Dysphagia (4 decks)

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