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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
Q

residue in the pyriforms can be a symptom in what phase?

A

pharyngeal

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26
Q

residue in the pyriforms can be a symptom in what phase?

A

pharyngeal

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27
Q

coughing during the swallow can be a symptom of what phase?

A

pharyngeal

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28
Q

coughing after the swallow can be a symptom of what phase?

A

pharyngeal

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29
Q

residue of the pharyngeal wall can be a symptom of what phase?

A

pharyngeal

30
Q

What is cricopharyngeal mytonomy?

A

when you put a slit in the CP muscle so it becomes looser

31
Q

What is fibrosis?

A

stiffening of the tissue

32
Q

What can cause fibrosis?

A

radiation

33
Q

What can amplify a patient’s current dental issues?

A

dry mouth

34
Q

What is the formal name for dry mouth?

A

xerstomia

35
Q

What is something that can be done to reduce fibrosis?

A

aggressive ROM exercises before, during, and after treatment

36
Q

Explain tumor rating system

A

T: size/location of tumor
N: involvement of nodes
M: # of distant metastases

37
Q

When should a patient’s first swallows be done after surgery and radiation?

A

during an MBSS (so you can see how surgical changes are affecting the swallow)

38
Q

Changes in the tissue/swallow function may appear up to how long?

A

one year

39
Q

When is it suggested to start ROM exercises post surgery?

A

about 10-14 days

40
Q

Why might a surgeon take more tissue than you might think is necessary from the oral cavity?

A

cancer cells in the oral cavity will spread if they are disturbed so surgeons will cut around the cancer

41
Q

What is lingual labial closure?

A

when part of the tongue is sutured to the lip

42
Q

What can lingual labial closure affect?

A

ROM

  • BOT-R
  • A/P transfer
  • formation of the bolus
43
Q

Why is it important to know if the faucial arches were removed during surgery?

A

this would affect the trigger point for the swallow

44
Q

What percent of laryngeal cancers are in the glottis area (at the VFs)?

A

60%

45
Q

What laryngeal cancers are malignancies of the supraglottis area?

A

35%

46
Q

What percentage of cancers are in the subglottic area?

A

5%

47
Q

Do cells in the laryngeal cavity shed more or less than in the oral cavity?

A

less

48
Q

What structures are removed during a supraglottic/horizontal laryngectomy?

A
  • hyoid
  • epiglottis
  • aryepiglottic folds
  • false folds
49
Q

What maneuver should be considered to help BOT-R if the patient had a supraglottic laryngectomy?

A

super-supraglottic maneuver

50
Q

What is removed during a hemilaryngectomy?

A
  • 1 false fold
  • half of the ventricle
  • 1 true vocal folds
  • some thyroid cartilage
51
Q

When might someone consider doing a hemilaryngectomy?

A

if the tumor is confined to one side

52
Q

What are some postural techniques you can use to help someone with a hemilaryngectomy?

A

chin tuck and head rotation

53
Q

What do strictures of the pharynx/esophagus do?

A

“hold up” large boluses

54
Q

What is a way to treat pharyngeal/esophageal strictures?

A
  • esophageal dialation

- CP mytonomy

55
Q

When should you suspect if there are problems with swallowing years after treatment?

A

recurrence of cancer

56
Q

Any neurologic patient is going to have reduced what?

A

sensitivity to aspiration

57
Q

People with neurological disorders won’t have what in regards to residual food?

A

normal response, the normal response is to have multiple swallows

58
Q

What should you do if you patient with neurological disorder fatigues easily?

A
  • not suggest maneuvers

- suggest smaller meals

59
Q

How long should you wait to assess swallowing if the patient has been intubated?

A

24 hours

60
Q

What percentage of patients will aspirate if they have a swallow eval done within 24 hours of extubation?

A

50% or more

61
Q

How could you assess the swallow of a comatose patient?

A

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
Q

What is an example of TTGS

A

lemon glycerin swab

63
Q

what percentage of patients with cva will have dysphagia?

A

80%

64
Q

What percentage of patients with cva will have persistent dysphagia?

A

30-50%

65
Q

What does reduced o2 sats do to a patient with pneumonia?

A

exacerbates the neurological deficits

66
Q

How will the oral stage be in a unilateral medullary stroke?

A

probably fine

67
Q

What will the pharyngeal stage of a unilateral stroke to the medulla look like?

A

probably absent

68
Q

A stroke the the medulla will likely cause what swallowing symptoms?

A
  • reduced LE
  • unilateral pharyngeal weakness
  • unilateral VF paralysis
69
Q

What techniques would likely be helpful for someone with a cva to the medulla?

A

Mendehlson maneuver and head rotation

70
Q

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

A
  • decreased lip seal

- lip weakness

Dysphagia (4 decks)

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