disorders of deglutition

Question 1

the patient cannot hold food in the mouth anteriorly

Answer 1

reduced lip closure

Question 2

the patient cannot form a bolus

Answer 2

Reduced range of tongue motion or
coordination

Question 3

the patient’s materials falls into the anterior sulcus

Answer 3

reduced labial tension

Question 4

the patient’s materials falls into the lateral sulcus

Answer 4

reduced buccal tension/tone

Question 5

the patient’s tongue moves forward to start swallow

Answer 5

tongue thrust

Question 6

tongue thrust is proceeded by…

Answer 6

an abnormal hold position of the bolus against the central incisors, or inability to hold the bolus at all

Question 7

the patient has a delayed oral onset of swallow

Answer 7

apraxia of swallow or reduced oral sensation

Question 8

how can we increase sensory stimulation?

Answer 8

by using a cold, hot, or sour bolus or one that is more textured

or increasing the pressure of the spoon

Question 9

the patient exhibits residue in anterior sulcus

Answer 9

reduced labial tension

Question 10

the patient exhibits residue in lateral sulcus

Answer 10

reduced buccal tension/tone

Question 11

the patient exhibits residue on the floor of the mouth

Answer 11

reduced tongue shaping or failure of
the peripheral seal of the tongue to the anterior and lateral alveolus

Question 12

the patient exhibits residue in the mid tongue depression

Answer 12

tongue scarring

Question 13

patient exhibits residue on the tongue

Answer 13

reduced tongue range of movement
or strength

Question 14

patient exhibits residue on the hard palate

Answer 14

reduced tongue elevation or strength

Question 15

incomplete tongue-palate contact

Answer 15

reduced tongue elevation

Question 16

Premature loss of a bolus into the pharynx is (normal/not normal) during mastication but (normal/not normal) while holding a liquid or pudding bolus

Answer 16

normal; not normal

Question 17

Premature loss of liquid or paste into the valleculae is an indication of..

Answer 17

reduced anterior soft palate positioning and/or poor tongue
control

Question 18

Piecemeal deglutition may indicate..

Answer 18

fear of swallow

Question 19

define piecemeal deglutition

Answer 19

carefully meters out small amounts to be swallowed

Question 20

oral transit time is longer than 1-1.5 seconds

Answer 20

slow oral transit time

Question 21

The head of the bolus enters the pharynx and the pharyngeal swallow has not been triggered

Answer 21

delayed pharyngeal swallow

Question 22

how are premature loss of bolus and delayed pharyngeal swallow different?

Answer 22

PLB happens during the oral preparatory or oral phase of swallow

Question 23

pharyngeal delay is timed from 1st frame showing the bolus head passing the point where the lower edge of the mandible crosses
the xx until the 1st frame of xx

Answer 23

tongue base; laryngeal elevation

Question 24

In an infant, an abnormal delay is defined as more than xx between the last tongue pump and the onset of pharyngeal, or aspiration occurring during bolus collection

Answer 24

one second

Question 25

nasal penetration during the swallow is observed

Answer 25

reduced velopharyngeal closure

Question 26

If nasal backflow occurs later in the swallow, it may be the result of a dysfunction farther down in the xx

Answer 26

pharynx

Question 27

bony outgrowth from cervical vertebrae and may narrow the pharynx or direct the bolus toward the airway entrance

Answer 27

cervical osteophytes

Question 28

coating on the pharyngeal wall after the swallow

Answer 28

reduced pharyngeal contraction bilaterally

Question 29

vallecular residue after the swallow

Answer 29

reduced tongue base contraction

Question 30

coating in a depression on the pharyngeal wall

Answer 30

scare tissue; pharyngeal pouch

Question 31

the patient exhibits residue at the top of the airway

Answer 31

reduced laryngeal elevation

Question 32

the patient exhibits residue in pyriform sinuses

Answer 32

reduced laryngeal motion elevation and or reduced cricopharyngeal opening

Question 33

the patient exhibits residue throughout the pharynx

Answer 33

generalized pharyngeal dysfunction which includes: -reduced posterior movement of the tongue base -reduced pharyngeal wall movement usually includes reduced laryngeal elevation as well

Question 34

food or liquid enters the vestibule to any level but not below the superior surface of the true vocal folds

Answer 34

laryngeal penetration

Question 35

entry of food or liquid into the true vocal folds

Answer 35

laryngeal aspiration

Question 36

what are some reasons or etiologies for laryngeal penetration?

Answer 36

Larynx lifts inadequately Arytenoid cartilage fails to tilt forward adequately Larynx lift too slowly during swallow

Question 37

aspiration during swallow is observed

Answer 37

reduced laryngeal closure

Question 38

Normal pharyngeal transit time is less than xx regardless of patient age or food consistency

Answer 38

one second

Question 39

patient exhibits esophageal-to-pharyngeal backflow

Answer 39

gastroesophageal reflux

Question 40

why does gastroesophageal reflux occur?

Answer 40

failure of the lower esophageal sphincter

Question 41

what could happen if the patient has an tracheoesophageal fistula?

Answer 41

Food enter the esophagus flow back into trachea

Question 42

where does Zenker’s diverticulum occur?

Answer 42

cricopharyngeal region

Question 43

describe Zenker's diverticulum

Answer 43

appears as a round balloon that fills with radio-opaque material that empties after the swallow

Question 44

patient is unable to align their teeth

Answer 44

reduced mandibular movement

Question 45

patient is unable to lateralize material with the tongue

Answer 45

reduced tongue lateralization

Question 46

unilateral valleculae residue is observed

Answer 46

unilateral dysfunction in posterior movement of the tongue

Question 47

residue in one pyriform sinus is observed

Answer 47

unilateral reduced laryngeal elevation and reduced cricopharyngeal opening

Question 48

patient exhibits reduced vocal fold adduction

Answer 48

vocal fold paralysis