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Linares > chapter 5:Evaluation of Swallowing Disorders > Flashcards

chapter 5:Evaluation of Swallowing Disorders Flashcards

1
Q

screening procedures are used to identify ___________ patients who require more assessment.

A

high risk

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2
Q

screening procedures do not determine the nature of the patient’s______________

A

phisiology

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3
Q

the procedure should identify individuals who _____ or have _______, known as true positives or _______________ ___________.

A

aspirate
residue
procedural sensitivity

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4
Q

individuals who do not have these two symptoms are true negatives or ___________ _____________

A

procedural specificity

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5
Q

false positive is an individual who:

A

is said to aspirate when no aspiration occured

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6
Q

false negative is an individual who:

A

is said not to aspirate but does

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7
Q

table 5.1 (pg 137) provides _______ and ______ results that are equal to other non-invasive procedures

A

sensitivity

specificity

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8
Q

four abnormal behaviors during a screening procedure that need follow up study are:

A

a. rejection of food
b. food selectivity (picky eaters)
c. gagging
d. open mouth

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9
Q

MBS is suited to study the ___________ of the swallow

A

physiology

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10
Q

cineflurosocopy (motion picture film) was initially used before videofluroroscopy. while cine provided a better frame by frame analysis it did not record Voice. It uses higher doses of _______. and is no longer used

A

radiation

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11
Q

frame by frame analysis and timing data can be provided if you use a _______-

A

video counter timer

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12
Q

the purpose of an MBS is to 1) define ________ in anatomy or physiology that are causing the symptom and to 2) identify _________ strategies that may immediately improve the swallow

A

abnormalities

treatment

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13
Q

_______ and ________ transit time are also assessed during an MBS

A

oral

pharyngeal

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14
Q

also examined is the functioning of the following valves:

A

Velopharyngeal
laryngeal
UES

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15
Q

the MBS attempts to determine where aspiration may occur from the following four areas:

a) reduced ________function
b) delayed or absent ____________ swallow
c) reduced _____________ closure at the entrance of the vocal folds
d) _______ dysfunction

A

lingual (spillage)
pharyngeal (trigger)
laryngeal
UES

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16
Q

the clinician generallt places the food in the patients mouth using a plastic ____. special arrangements/ devices have to be made with infants or small children

A

spoon

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17
Q

generally at least 3 viscosities are used in an MBS:
thin_______, barium __________, and material requiring ________.
some clinicians may add other levels of viscosity materials to swallow

A

liquid
paste/pudding
chewing

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18
Q

generally for each viscosity, at least two swallows are required. for example logemann recommends two swallows of a thin liquid in these amounts:
__ mL, __ mL, __ mL and __mL.
these are followed by ____ drinking,

A

1, 3, 5, 10
cup
–some clinicians only do 3 and 5 ml amounts

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19
Q

logemann also recommends two swallows of pudding (___ teaspoon) and two swallows of a cookie ( __ of a cookie)

A

1/3

1/4

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20
Q

value of liquid is increased until or unless the patient _____

A

aspirates

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21
Q

if a patient proceddes from liquids to the cookie without aspiration, some clinicians present the patient with honey thickened or _____-thickened liquids, also given in incremental amounts , including cup drinking

A

nectar

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22
Q

there is little need to use incremental increases of pudding or cookie, because as viscosity of food increases the volume swallowed ______-

A

decreases

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23
Q

sometimes it is wise to have a patient self feed to determine if there are any issues with the material researching the mouth or if the patient might __________ the mouth with food.

A

overstuff

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24
Q

patients referred for MBS are often ill, have poor respiratory status, and are probably aspirating. if any large amount (more than__ teaspoon) of barium enters their airway, complications can occur, including respiratory _______

A

1

arrest

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25
Q

in an MBS beginning with minimal amounts of liquids ensures that the material will not block the ________ if aspirated. some evidence suggests that pnemonia is less likely to result from aspiration of liquids than thicker foods. the lungs are better able to clear liquids than food from the trachea by a ______.

A

airway

cough

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26
Q

the patient should be seated and initially viewed in the ________ plane.

A

lateral

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27
Q

most likely the ___________ or the __________ will provide assistance in seating the person especially if accommodations need to be made

A

radiologist

nurse

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28
Q

the image should show from the ____ to the level of the UES

A

lips

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29
Q

the arms of the patient should be on the side not on the arms of the chair. elevated arms cause the _____ to also be elevated possibly covering the pharynx on the MBS

A

shoulders

30
Q

sometimes an MBS should be taken of the upper esophagus if _______ is suspected

A

reflux

31
Q

a lateral view allows for the measure of the oral and _________ transit time

A

pharyngeal

32
Q

the oral transit time is measured from the initiation of the posterior movement of bolus thou\rough the oral cavity until the leading edge of the bolus passes the point where the _________ crosses the tongue base.

A

mandible

33
Q

the pharyngeal phase/transit time begins when the pharyngeal swallow triggers and terminates when the bolus passes through the _____

A

UES

34
Q

the pharyngeal delay time is the time between the end of the ____ transit time until the ________________-

A

oral

pharyngeal swallow is triggered

35
Q

Video fluoroscopy permits analysis of patterns of ___________________ movement, gross estimate of the amount of vallecular residue and pyriform residue and an estimate of the amount of material _________per bolus

A

Lingual, pharyngeal, laryngeal

Aspirated

35
Q

esophageal disorders are usually treated ________ or surgically

A

medically

36
Q

Approximately ______% of normal swallower a swallow down only one side

A

20

36
Q

videofluroscopy permits analysis of patterns of ______________ movement, gross estimate of the amount of valecular residue and pyriform residue and an estimate of the amount of material _________ per bolus

A

lingual, pharyngeal, laryngeal

aspirated

37
Q

approximately ___% of normal swallowers swallow down only one side

A

20

38
Q

the P-A view is helpful in looking at asymmetries in function of the pharyngeal walls and _________ and in viewing residues in the __________ and in one or both _________________.

A

larynx
valleculae
pyriform sinuses

39
Q

in the P-A it is best to repeat only swallows that cause disturbances in order to reduce the amount of ___________ exposure

A

radiation

40
Q

it is helpful to have the patient tilt the head back and repeat /ah/ in order to determine the vocal folds ability to ________ and ________

A

abduct

adduct

41
Q

typically the patient is asked to hold the material in the mouth until told to __________

A

swallow

42
Q

_______ are generally the most easily material ___________ and yet the least likely to block the airway.

A

liquids

aspirated

43
Q

if a patient aspirates on a particular material/ volume the examiner should attempt __________ strategies on the same material/ volume

A

treatment

44
Q

if aspiration is eliminated on several swallows as the result of intervention the volume should be __________

A

increased

45
Q

if a patient cannot intake a material from a spoon a ______________ can be used

A

tongue blade

46
Q

with masticated material the patient is told to go ahead and swallow as soon as he or she has completed the _________

A

chewing

47
Q

in patients with dementia the oral stage may be missed on the videofluoroscopy but the _____________ stage will be captured

A

pharyngeal

48
Q

trial therapy includes consideration of attempting the following:

a) position the ____ in a particular direction
b) use sensory-__________ boluses
c) ask the patient to follow specific ________ maneuvers
d) _________ positions

A

head
enhancing
swallow
postural

49
Q

total exposure in MBS trials and therap trials is generally less than ___ minutes

A

5

50
Q

any patients suspected of aspirating during the bedside exam should be __________.

A

referred

51
Q

t or f: the pharyngeal physiology cause of aspiration cannot be defined at bedside

A

true

52
Q

approximately ___% of patients who aspirated during video fluoroscopy were not identified as aspirating during the bedside.

A

40

53
Q

the ____________ therapist (SLP) and the radiologist should perform the exam together

A

swallowing

54
Q

the radiologist is trained to identify _________________

A

physical abnormalities

55
Q

the purpose of an MBS is to define the swallow _________ causing the _________

A

physiology

aspiration

56
Q

the clinician should select some _____ options that fit the patient’s oropharyngeal swallowing abnormalities.

A

intervention

57
Q

postural techniques ________ food flow and change ________ dimensions

A

redirect

pharyngeal

58
Q

table 5-2

A

head positioning

59
Q

postural techniques work well with ___________ impaired, cancer patients, and patients of all ages

A

cognitively

60
Q

postures may also improve ____ and ___________ transit times

A

oral

pharyngeal

61
Q

postural effects on residue/aspiration might be seen before and after _____

A

FEEs

62
Q

sensory awareness techniques are generally used with the following patients:

a) swallow _______
b) delayed onset of the oral ___________
c) delayed triggering of the ___________ swallow

A

apraxia
propulsion
pharyngeal

63
Q

sensory stimuli include : _________ pressure of the spoon, _____ bolus, ____ bolus, bolus requiring __________, larger _________ bolus, and _______________

A 
increasing downward
sour
cold
chewing
volume
thermal/tactie stimulation
64
Q

thermal stimulation utilizes size ____ laryngeal mirror that has been held in ___________ ice prior to the presentation of the bolus. the mirror is rubbed against the ________________

A

00
crushed
faucil pillars

65
Q

this technique may result in a faster ______ of the pharyngeal swallow, reducing the delay for severl ________ thereafter.

A

trigger

swallows

66
Q

swallow maneuvers put the pharyngeal swallow physiology under _________ control

A

voluntary

67
Q

four options of swallow maneuvers include:

a) supraglottic swallow designed to ________
b) super supraglottic swallow designed to _______
c) effortful swallow designed to _________
d) mendelsohn maneuver designed to___________

A

A) close the airway at the level of the vfs
B) close the airway at the top of the larynx
C) increase the posterior movement of tongue base
D) increase the laryngeal elevation

68
Q

elimination of certain food consistencies from the diet should be the last ______

A

Resort

69
Q

range of motion exercises for the lips, tongue and or jaw do not have an immediate effect but typically show an effect after ______ weeks

A

2-3

70
Q

the report should include recommendations regarding management of _______ intake, type of _______ procedures to employ and possible _______

A

Nutrition
Intervention
Referrals

Linares (6 decks)

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