chart review

Question 1

patient cannot form a bolus. What’s your diagnosis? any compensatory strategies, exercises, or maneuvers?

Answer 1

D: Reduced range of tongue motion and coordination
C: Thick consistencies
E: ROM, resistive lingual, or LSVT
M: n/a
P: n/a

Question 2

material falls into the anterior sulcus. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers?

Answer 2

D: reduced labial tension
C: n/a
E: hold cohesive bolus
M: n/a
P: n/a

Question 3

material falls into the lateral sulcus. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? posture?

Answer 3

D: reduced buccal tension/tone
C: n/a
E: hold cohesive bolus
M: n/a
P: n/a

Question 4

tongue moves forward to start swallow. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 4

D: Tongue thrust
C: n/a
E: n/a
M: n/a
P: n/a

Question 5

delayed oral onset of swallow. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 5

D: apraxia of swallow/ reduced oral sensation
C: bolus manipulation/increase sensory

E: n/a
M: n/a
P: head back

Question 6

residue in the anterior sulcus. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 6

D: reduced labial tension
C: smaller bolus
E: cohesive bolus or neuromuscular stimulation
M: n/a
P: n/a

Question 7

residue in the lateral sulcus. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 7

D: reduced buccal tension/tone
C: smaller bolus
E: cohesive bolus, NMS
M: n/a
P: n/a

Question 8

residue in the floor of the mouth. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 8

D: reduced tongue shaping/failure of peripheral seal

C: smaller bolus
E: hold cohesive bolus
M: n/a
P: n/a

Question 9

residue in the mid tongue depression. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 9

D: tongue scarring
C: n/a
E: n/a
M: n/a
P: n/a

Question 10

residue on the tongue. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 10

D: reduced tongue range of motion or strength
C: thin bolus
E: ROM, resistive lingual
M: n/a
P: n/a

Question 11

residue on hard palate. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 11

D: reduced tongue elevation or strength
C: thin bolus
E: ROM or resistive lingual
M: n/a
P: n/a

Question 12

incomplete tongue/palate contact. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 12

D: reduced tongue elevation
C: n/a
E: ROM
M: n/a
P: n/a

Question 13

premature loss of bolus. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 13

D: reduced anterior soft palate positioning or poor tongue control
C: thick bolus
E: hold cohesive bolus
M: supraglottic
P: chin tuck

Question 14

head of bolus enters the pharynx and the pharyngeal swallow hasn’t been triggered. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 14

D: delayed pharyngeal swallow
C: thick bolus
E: thermal tactile stimulation
M: supraglottic
P: chin tuck

Question 15

nasal penetration during swallow. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 15

D: reduced velopharyngeal closure
C: n/a
E: n/a
M: n/a
P: n/a

Question 16

bony outgrowth from cervical osteophytes. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 16

D: cervical osteophytes
C: smaller bolus
E: n/a
M: supraglottic
P: n/a

Question 17

coating on the pharyngeal wall after a swallow. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 17

D: reduced pharyngeal contraction bilaterally
C: thin bolus
E: neuromuscular electrical stimulation
M: supraglottic
P: lying on one side

Question 18

vallecular residue after a swallow. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 18

D: reduced tongue base contraction
C: thin bolus
E: ROM
M: masako or effortful swallow
P: chin tuck

Question 19

coating on a depression in the pharyngeal wall. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 19

D: scar tissue
C: thin bolus
E: n/a
M: supraglottic
P: n/a

Question 20

residue at the top of the airway. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 20

D: reduced laryngeal elevation
C: thin bolus
E: pitch glides (Laryngeal elevation exercises)
M: mendelsohn
P: n/a

Question 21

residue in pyriform sinus. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 21

D: reduced cricopharyngeal opening or reduced laryngeal motion elevation
C: thin bolus
E: LEE, shaker exercises
M: n/a
P: head rotation

Question 22

residue throughout the pharynx. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 22

D: generalized pharyngeal dysfunction
C: thin
E: LEE, vital stim
M: masako, mendelsohn, effortful
P: lying down on one side

Question 23

penetration. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 23

D: reduced laryngeal vestibular closure
C: thin
E: LEE (pitch glides)
M: mendelsohn or super-supraglottic
P: n/a

Question 24

aspiration after swallow. what’s your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 24

D: reduced laryngeal elevation
C: n/a
E: LEE (pitch glides)
M: mendelsohn
P: n/a

Question 25

aspiration during swallow. what's your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 25

D: reduced laryngeal closure C: thick E: laryngeal vestibular closure exercises M: n/a P: chin down, head rotated to damaged side

Question 26

esophageal tp pharyngeal backflow. what's your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 26

D: gastroesphogeal reflux C: n/a E: n/a M: n/a P: n/a

Question 27

food enters into the esophagus flow back into trachea. what's your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 27

D: tracheoesphogeal fistula C: maybe thick bolus E: n/a M: n/a P: maybe chin tuck

Question 28

unable to align teeth. what's your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 28

D: reduced mandibular movement C: n/a E: n/a M: n/a P: n/a

Question 29

unable to lateralize material with tongue. what's your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 29

D: reduced tongue lateralization C: maybe thick E: ROM M: n/a P: n/a

Question 30

unilateral valleculaer residue. what's your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 30

D: unilateral dysfunction of posterior movement of tongue C: thin E: n/a M: masako, effortful P: chin tuck

Question 31

residue in one pyriform sinus. what's your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 31

D: unilateral reduced laryngeal elevation and reduced cricopharyngeal opening C: thin E: shaker M: effortful P: head rotated to damaged side

Question 32

reduced vocal fold adduction. what's your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 32

D: vocal fold paralysis C: n/a E: vocal fold adduction exercises M: supraglottic P: chin down, head rotated to damaged side

Question 33

residue in the laryngeal vestibule. what's your diagnosis? any compensatory strategies, exercises, or maneuvers? Posture?

Answer 33

D: reduced laryngeal elevation C: thick E: tongue elevation exercises M: mendelsohn P: chin down and head turn