Lecture 2

Question 1

Aspects of mealtime environment

Answer 1

• lighting
• noise
• meal layout
• meal assistance
• food/drink presentation
• presence of others

Question 2

What is penetration?

Answer 2

Enters level above vocal folds, cleared with coughing

Question 3

What is aspiration?

Answer 3

Goes below vocal folds, into lungs

Question 4

What is the Risk of aspiration

Answer 4

If any aspirated material is pathogenic, aspiration pneumonia can develop

Question 5

Risk factors influencing the development of aspiration pneumonia?

Answer 5

• Dependant for feeding/oral care
• number of decayed teeth
• tube feeding
• number of medications
• smoking
• having dementia
• stroke
• alcohol abuse

Question 6

Clinical bedside examination of swallowing (CBE)

Answer 6

• aims to provide an overview of the oral and pharyngeal phases of swallowing during eating and drinking tasks
• useful to be carried out when the client is having a meal

Question 7

Advantages of CBE

Answer 7

• easily incorporated into a clinic or ward visit
• non-invasive and no exposure to toxic substances

Question 8

Disadvantages of CBE

Answer 8

• does not necessarily tell you about the underlying impairment
• pharyngeal function is inferred

Question 9

What’s involved in a CBE?

Answer 9

• client is presented with trials of food and liquids of different consistencies and bolus sizes
• SLT observes swallow and aims to create a profile of areas of strengths and breakdowns

Question 10

What to determine in a CBE

Answer 10

• is the client safe on oral intake? If so what type?
• is the swallow efficient for meeting nutrition/hydration needs
• what factors are influencing the swallow, e.g. fatigue, cognition, caregiver approach
• is further objective assessment necessary

Question 11

Extra things to note in a CBE

Answer 11

• lip seal
• bolus control
• timing of swallow
• coughing (immediate or delayed)
• number of swallows per bolus
• drooling

Question 12

Laryngeal palpation of the swallow

Answer 12

• the SLT uses their fingers to palpate the swallow for timing, completion of laryngeal elevation and excursion and number of swallows

Question 13

Signs/symptoms of aspiration

Answer 13

• immediate cough/throat clear
• delayed cough/throat clear
• wet voice or voice change
• colour change
• ear tearing
• post prandial sleepiness
• drop >2% in 02 sats

Question 14

Adjuncts to the CBE; cervical auscultation

Answer 14

• listens to the sound of swallowing
• the bigger the bolus and the thicker the consistency, the longer the sound