Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Endoscopy Final > Written Exam > Flashcards

Written Exam Flashcards

1
Q

Advantages of FEES

A
  • Unlimited time
  • Can repeat as often as needed
  • Portable exam; more accessible to patients
  • Don’t need to put patient at risk for aspirating food/liquid
  • Direct view; easier to localize spillage, residue
  • Better understanding of some abnormal patterns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Disadvantages of FEES

A
  • More limited view
  • Technically more difficult to learn
  • Some patients find it uncomfortable
  • Cannot adequately assess oral phase of swallow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When is FEES exam indicated? (practical/easier to do)

A
  • Patient is bedridden; weak
  • Patient has contractures; in pain
  • Patient is a quadriplegic, has neck halo
  • Patient on cardiac monitors; in ICU
  • Patient is on a ventilator
  • Need exam that day
  • Need repeat exam
  • Concern about excess radiation exposure
  • Corns about cost of fluoroscopy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Clinical findings better revealed endoscopically

A
  • Incomplete TVD adduction, immobile vocal cord; reduced mobility of arytenoids
  • Excess secretions; aspiration of secretions
  • Residue building up over several swallows
  • Impaired ability to adduct TVF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Advantages of fluoroscopy

A
  • more comprehensive view
  • easier to learn; administer
  • better understanding of some abnormal patterns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Disadvantages of fluoroscopy

A
  • radiation exposure
  • time-limited exam
  • inaccessible to some/many patients
  • frightening, fatiguing, uncomfortable for some patients
  • uses non-physiologic medium
  • need to present food/liquid to assess
  • more difficult to localize material; identify structures
  • more costly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Clinical findings better revealed with fluoroscopy

A
  • impaired tongue control and manipulation of the bolus
  • impaired tongue force for bolus thrust
  • impaired laryngeal elevation
  • reduced cricopharyngeal opening
  • reduced airway closure at level of arytenoid to epiglottal contact
  • reduced esophageal motility
  • aspiration during the swallow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Ability to assess therapeutic maneuvers: head turn/chin tuck

A

Fluoroscopy = good
FEES = excellent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ability to assess therapeutic maneuvers: other body position-side lying

A

Fluoroscopy = fair
FEES = excellent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ability to assess therapeutic maneuvers: alteration in bolus size, consistency

A

Fluoroscopy = excellent
FEES = excellent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Ability to assess therapeutic maneuvers: alteration in food delivery

A

Fluoroscopy = good
FEES = good

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ability to assess therapeutic maneuvers: effortful swallow

A

Fluoroscopy = excellent
FEES = fair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Ability to assess therapeutic maneuvers: supraglottic swallow

A

Fluoroscopy = good
FEES = excellent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Ability to assess therapeutic maneuvers: Mendelsohn maneuver

A

Fluoroscopy = excellent
FEES = good

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Ability to assess therapeutic maneuvers: time to try all of these

A

Fluoroscopy = poor
FEES = excellent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Typical diameter of flexible scope

A

3-4 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Flexible endoscope allows for as much as a __ degree field of view

A

90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Distance distortion

A

if you get too close to a structure you are going to lose resolution, if you move further away you will get a crisper image but you wont see every detail

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Radial distortion

A

because of the parallax effect – the center of the image will be the most accurate or symmetrical, and as you move away the angle of the scope the angle may make it look a little distorted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Transnasal placement of the laryngoscope will prevent visualization of the _____ stage of the swallow

A

oral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Major elements affecting optimum visualization

A

velar elevation
base of tongue contraction
clouding if the distal lens with bolus residue or oropharyngeal secretions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

The velum contributes to both the oral and ________ swallow

A

pharyngeal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When the distal tip of the endoscope is placed within the hypopharynx, the velum will/will not be in view

A

will not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Movement of the velum contributes to changes in the visualizations of events _____, _____, and ______ the swallow.

A

before, during, and after

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Scope position to maximize observation of velar function…

A
  • Scope position should allow for a view of the mucosa covering the vomer bone at the left or right periphery
  • You should see the superior surface of velum, contact of the velum with the posterior pharyngeal wall, and. the extent of elevation of the velum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

For swallowing, the lowest position of the endoscope should be just ______ the level of the tip of the epiglottis.

A

above

27
Q

How do you clear a clouded lens?

A
  • retract the scope
  • wait for spontaneous swallow
  • cue for swallow
  • light movement of the scope towards the PPW and score scope
  • last resort is to retract scope and clean with water
  • if patient has weak swallow keep scope high
28
Q

When viewing salient features you…

A
  • Want to see anatomic movements, bolus movement, and monitor protections of the airway during the examination
  • High scope position to monitor bolus travel, prevent clouding and then advance scope after. the swallow to scan for findings
  • You want to see the entire endolarynx
29
Q

General symptoms of VPD

A
  • Hypernasality
  • Nasal air emission
  • Compensatory articulation errors
30
Q

VPD etiologies

A
  • Cleft palate/submucuous cleft
  • Large pharynx/short velum
  • Neuromotor
  • Surgery
  • Developmental
  • Functional
31
Q

Quality patient for procedure

A
  • Hypernasality
  • Nasal air emission
  • Compensatory speech errors
  • Absence of functional O-N fistula
  • Unresponsive to speech therapy
  • Anticipating physical management
32
Q

What do I want to learn?

A
  • Pattern of closure/attempted closure
  • Type of patency
  • Approximate degree of patency
  • Approximate location of patency
33
Q

Patterns of VP closure

A
  • Circular - 35%
  • Sagittal - 5%
  • Coronal - 60%
34
Q

Types of patency

A
  • Normal speech and resonance and normal VP function
  • Consistent VPD
  • Task specific VPD
  • Irregular VPD
  • Abnormal resonance without VPD (e.g. neuromotor, large tonsils)
35
Q

Degrees of patency relative to breathing

A
  • WNL: 0-10%
  • Small: 11-20%
  • Moderate: 21-40%
  • Large: 41-100%
36
Q

Typical locations of patency

A
  • Central
  • Lateral (one or both sides)
  • Transverse
37
Q

Parts of a flexible endoscope

A
  • fiberoptic cable
  • housing
  • Insertion tube
  • Angular
  • Viewing lens
  • Focus ring
38
Q

Advantage of flexible endoscope

A
  • permits viewing of entire vocal tract
  • Suitable for VP, voice, and or swallow Dx/Rx
  • Well tolerated, usually no gagging
  • Permits study of connected speech
39
Q

Basic procedures of flexible endoscope

A
  • Choose a nostril
  • Choose a meatus
  • 3 options (proceed, pause, withdraw)
  • Position endoscope
  • Obtain speech sample or swallow
40
Q

SLPs do or do not make medical diagnoses

A

NOT

41
Q

SLPs are of expertise is _________.

A

Physiology

42
Q

SLPs are looking for function of what and what is the purpose?

A

Function of…
- Oral
- Velopharyngeal
- Pharyngeal
- Respiratory structures

Purpose..
- Speech
- Voice
- Swallowing

43
Q

Differences between otolaryngologists and SLPs

A

Otolaryngologists diagnose underlying pathology (anatomy)
- Treat with interventions: Medical, Surgical

SLPs
- assess nature of dysphonia or swallow issues physiology
- treat behaviorally: exercise-based exercises, compensatory techniques, retraining

44
Q

Documented dysphagia that needs retesting

A
  • Monitor progress
  • directly assess pharyngeal and laryngeal anatomy
  • Limit radiation exposure
45
Q

Precautions of FEES (flexible endoscopy)

A
  • Discomfort
  • Vomiting
  • Epistaxis
  • Mucosal perforation
46
Q

Contraindications for FEES (flexible endoscopy)

A
  • Severe agitation and/or inability to cooperate with the examination
  • Severe movement disorders that interfere with safe administration
  • Severe bleeding disorders and/or recent severe epistaxis
  • Recent trauma to the nasal cavity or surrounding tissue and structures
  • Bilateral obstruction of the nasal passages
46
Q

Clinicians should have a plan regarding?

A
  • Be trained in signs and symptoms of adverse reactions
  • Know the facility’s plan for response and intervention to such reactions
  • Be prepared to take appropriate actions if they occur
  • Have suction equipment and/or personnel trained in the use of such equiptment
  • Use a cardiac monitor for patients with significant pulmonary disease, cardiac arrhythmia, seizure disorders
47
Q

ASHA code of ethics about certification

A
  • SLPs do not require specific certification from ASHA or any other entity to perform instrumental assessments
  • SLPs with appropriate training and competence in performing FEES are qualified to use this procedure independently for the purpose of assessing swallow function
  • ASHA does not require the presence of a physician for an SLP to perform FEES
48
Q

Principle Ethics I

A

Individuals shall honor their responsibility to hold paramount to the welfare of person they serve professionally or who are participants in research and scholarly activities

49
Q

Principle of Ethics II

A

Individuals shall honor their responsibility to achieve and maintain the highest level of professional competences and performances

50
Q

Principle of Ethics IV

A

Individuals shall uphold the dignity and autonomy of the professions, maintain the collaborative and harmonious inter professional and inter professional relationships, and accept the progression self imposed standards

51
Q

Five primary purposes

A
  • Identify the physiologic correlates of swallowing
  • To document the status of anatomy and physiology correlates during swallow
  • To assist in determining if treatment is indicated
  • To assist in patient and family education
  • Develop a treatment plan
52
Q

Selecting the best tool…

A
  • The selection of instrumentation that answers the question being posed
  • The practical needs to perform an instrumental assessment when other means are available
53
Q

Which test answers the question: Recently extubated patient with raspy voice?

A

FEES

54
Q

Which test answers the question: Suspected oral processing issues

A

MBSS

55
Q

Which test answers the question: UES dysfunction

A

MBSS

56
Q

Which test answers the question: Patient unable to swallow their secretions

A

FEES, MBSS

57
Q

Which test answers the question: Uncontrolled bolus loss

A

FEES, MBSS

58
Q

Which test answers the question: Delayed initiation of swallow

A

FEES, MBSS

59
Q

Which test answers the question: Sequence of stripping wave

A

MBSS

60
Q

Which test answers the question: is epiglottic inverting

A

MBSS, FEES

61
Q

Which test answers the question: pathophysiology leading to impaired epiglottic inversion

A

MBSS

62
Q

What can be assessed on FEES?

A
  • Bolus hold
  • Laryngeal elevaation
  • Hyoid excursion
  • Laryngeal vestibule closure
  • Pharyngeal stripping wave
  • Pharyngeal contraction
  • Tongue base retraction
  • Secretion
  • Edma
  • Erythema
  • Tissue differences
  • Structures anomalies
63
Q

What can be assessed on MBSS?

A
  • Lip closure
  • Bolus
  • Bolus transport
  • Swallow initiation
  • Soft palate elevation
  • Laryngeal elevation
  • Hyoid excursion
  • Laryngeal vestibule closure
  • Pharyngeal stripping wave
  • Pharyngeal contraction
  • UES opening
  • Tongue base retraction

Endoscopy Final (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions