Exam 3 Flashcards
(98 cards)
1
Q
Etiology of Flaccid Impairment
A
Lower motor neuron damage
2
Q
Symptoms of Flaccid Impairment
A
- Weakness (could also be paralysis)
- Hypotonia
- Diminished reflexes
- Fatigue
3
Q
Examples of Flaccid Impairment
A
- Brainstem CVA
- Muscular dystrophy
- ALS
- Myasthenia Gravis
- Guillain-Barre
4
Q
How does a Flaccid Impairment affect swallowing?
A
- Poor chewing/movement of bolus
- Weakness of velopharynx (nasal regurgitation)
- Poor closure of larynx (aspiration)
- Poor propulsion (squeezing) of the bolus downward (pharyngeal residue)
5
Q
Etiology of Spastic Impairment
A
Upper motor neuron damage
6
Q
Symptoms of Spastic Impairment
A
- Weakness
- Loss of fine, skilled movements
- Increased tone
- Increased reflexes
- Spasticity
7
Q
Examples of Spastic Impairment
A
- CVA
- Anoxic brain injury (CP)
8
Q
How does a Spastic Impairment impact swallowing?
A
- Poor chewing/movement of bolus
- Poor timing and coordination of specific movements that initiate swallow
- Poor closure of larynx (aspiration)
- Weakness/improper movement of velopharynx (nasal regurgitation)
- Poor propulsion (squeezing) of the bolus downward AND now may have spasms in the esophagus
9
Q
Etiology of Ataxic Impairment
A
Cerebellar damage
10
Q
Symptoms of Ataxic Impairment
A
- Slowness and inaccuracy of movement
- Difficulty with coordination of movement
- Tremors
11
Q
Examples of Ataxic Impairment
A
- Degenerative diseases
- CVA
- Tumors
12
Q
How does Ataxic Impairment impact swallowing?
A
- Biting tongue/cheek when eating
- Poor respiratory coordination during swallowing (can lead to aspiration)
13
Q
Etiology of Hypokinetic Impairment
A
Basal ganglia dysfunction
14
Q
Symptoms of Hypokinetic Impairment
A
- Slowness of movements
- Diminished movements
- Sensory impairments
- Rigidity
- Tremors
15
Q
Examples of Hypokinetic Impairment
A
Parkinson’s Disease
16
Q
How does a Hypokinetic Impairment impact swallowing?
A
- Drooling
- Tremor of oral musculature impacts oral prep and transit
- Decreased frequency of swallow
- Poor timing of swallow (aspiration)
- Decreased movement of structures that close the larynx and protect the airway (aspiration)
17
Q
Etiology of Hyperkinetic Impairment
A
Basal ganglia dysfunction
18
Q
Symptoms of Hyperkinetic Impairment
A
- Abnormal, rhythmic movements
- Irregular and unpredictable movements
- Slow, involuntary movements
19
Q
Examples of Hyperkinetic Impairment
A
Huntington’s Disease
20
Q
How does a Hyperkinetic Impairment impact swallowing?
A
- Motor control across all phases of the swallow are affected
- Any number of impairments can be seen
21
Q
In the TMN tumor staging system, T stands for _____.
A
Tumor size
- T1 (smallest)
- T4 (largest)
22
Q
In the TMN tumor staging system, N stands for _____.
A
Nodal status
23
Q
In the TMN tumor staging system, M stands for _____.
A
Presence or absence of Metastasis outside the region
24
Q
Why would a surgeon not be able to perform a primary closure?
A
If there is a large area without sufficient tissue to close the wound
25
Transporting healthy, live tissues from one location of the body to another, with its blood supply intact, is called a _____.
Flap
26
Transporting skin, without a blood supply is called a _____.
Graft
27
What is xerostomia?
Oral dryness, dry mouth
28
Tissue that has been radiated may be red, inflamed, and have ulcers; this is called _____.
Mucositis
29
What are three late effects of radiation in head and neck cancer?
- Trismus (jaw stiffness)
- Decreased muscle bulk
- Fibrosis (stiffness
30
If there is cancer of the tonsils, what site would that be labelled as?
Oropharyngeal
31
If there is cancer of the pharyngeal walls, what site would that be labeled as?
Hypopharyngeal
32
Cancer of the AE folds would be labeled as a pharyngeal cancer.
a. True
b. False
b. False
33
What structures are included in a label of glottic cancer?
- TVF
- Anterior commissure
34
It is likely that someone with laryngeal cancer will experience loss of oral control and coordination.
a. True
b. False
b. False
35
Decreased hyolaryngeal excursion can lead to _____.
Decreased laryngeal closure- aspiration
36
10.5% of premature infants born at less than _____ weeks gestation have dysphagia.
37
37
Prevalence increases to 24.5% among those with birth weight less than _____ lbs.
3.3
38
Infants with cleft lip/palate may have _____ reflexes and sucking.
Normal
39
Cleft lip causes impairment of _____ around the nipple.
Lip closure
40
Cleft palate prevents the baby from generating the _____ needed to express milk from the nipple.
Suction
41
_____ can occur if the cleft extends posteriorly into the hard/soft palate.
Nasal regurgitation
42
Laryngeal cleft can cause food or liquid to be _____, resulting in aspiration.
Misdirected into the airway
43
_____ causes the supraglottic structures to collapse with _____.
Laryngomalacia; inspiration
44
The swallowing impact on laryngomalacia is due to increased _____ associated with feeding.
Respiratory effort
45
Increased respiratory effort can cause ____, which interferes with airway protection during swallowing.
SOB
46
An _____ is an abnormal narrowing caused by scarring or contraction of smooth muscle.
Esophageal stricture
47
If food passage through the esophagus is impaired, the baby may have poor _____.
Weight gain
48
Respiratory distress syndrome is more common in infants born before _____ weeks of gestation.
28
49
The infant's immature lungs lack sufficient _____.
Surfactant
50
Babies with RDS may not be able to tolerate _____ during swallowing.
Apnea
51
As endurance declines, a baby may not be able to adequately _____ during oral intake.
Protect the airway
52
Preterm birth interrupts the normal trajectory of the _____.
Brain
53
When the brain/CNS is underdeveloped, the infant may have low _____ and weakness of the muscles of _____.
Tone; swallowing
54
Unlike conditions associated prematurity, the muscles of a baby with CP are _____, leading to lack of control in the swallow mechanism.
Hypertonic
55
Any neurological impairment of the CNS can cause inability to coordinate _____ sequence.
Suck-swallow-breathe
56
Cardiac conditions may interfere with _____, which leads to difficulty coordinating respiration and swallowing.
Oxygenation
57
The _____ nerve may be damaged during surgical repair of a cardiac condition.
Vagus
58
The inability to interpret sensory input, integrate information, and modulate an appropriate motor response is called _____.
Sensory integration dysfunction
59
In babies, hypersensitivity can cause an _____ to oral stimulation.
Overreaction
60
Some responses of hypersensitivity can include _____ and _____ of eating.
Gagging; avoidance
61
Later, hypersensitivity can lead to extreme _____.
Selectiveness
62
In children/babies, aspiration is often _____.
Silent
63
Aspiration leads to problems of the _____.
Respiratory system
64
Poor oral intake can result in _____, _____, _____, and _____.
Insufficient nutrition; poor growth; delayed development; food aversions
65
One psychosocial impact on children with dysphagia and their families is _____.
Frustration
66
When LMNs are damaged, it causes what type of dysarthria?
Flaccid
67
When UMNs are damaged, it causes what type of dysarthria?
Spastic
68
Which are symptoms of flaccid dysarthria?
a. Weakness
b. Hypotonia
c. Increased reflexes
d. Fatigue
a. Weakness
b. Hypotonia
d. Fatigue
69
Which is NOT a disease/disorder associated with flaccid dysarthria?
a. Brainstem CVA
b. Muscular Dystrophy
c. Alzheimer’s Disease
d. ALS
c. Alzheimer’s Disease
70
In flaccid dysarthria, there may be weakness of the velopharynx. Regarding swallowing, what can this cause?
Nasal regurgitation
71
Which of the following are diseases/disorders associated with spastic dysarthria?
a. CVA
b. Parkinson's Disease
c. Cerebral Palsy
d. Guillain-Barre
e. Anoxic brain injury
a. CVA
c. Cerebral Palsy
e. Anoxic brain injury
72
What symptom do flaccid and spastic dysarthria have in common?
Weakness
73
What does poor closure of the larynx during the swallow result in?
Aspiration
74
Poor chewing and movement of the bolus can result in:
Oral residue
75
Ataxic impairments are the result of damage to the:
Cerebellum
76
Symptoms of ataxic dysarthria include:
a. Slowness and inaccuracy of movement
b. Hypertonicity
c. Diminished reflexes
d. Difficulty of coordination of movement
e. Tremor
a. Slowness and inaccuracy of movement
d. Difficulty of coordination of movement
e. Tremor
77
Which disease is associated with hypokinetic dysarthria?
Parkinson's Disease
78
Which symptom does hypokinetic dysarthria and ataxic dysarthria NOT have in common?
a. Slowness of movement
b. Diminished or inaccurate movement
c. Rigidity
d. Tremors
c. Rigidity
79
People with ataxic dysarthria may experience what type of oral stage impairment during eating?
Inability to suck, biting tongue/cheek
80
What is the cause of hypokinetic dysarthria?
Damage to the basal ganglia
81
Diminished movements and reduced sensation can result in which swallowing impairments?
Drooling, poor larynx closure, disordered timing of swallow onset, decreased frequency of swallow
82
What is the most likely outcome of inappropriate timing of the swallow onset?
Aspiration
83
What do hypokinetic dysarthria and hyperkinetic dysarthria have in common?
Both are caused by dysfunction in the basal ganglia
84
What is the result of poor propulsion of the bolus through the pharynx?
Pharyngeal residue
85
Which is NOT considered a later effect of radiation?
a. Trismus
b. Decreased muscle bulk
c. Xerostomia
d. Fibrosis
c. Xerostomia
86
Which type of head/neck cancer treatment causes continued fibrosis to the body long after treatment ends?
Radiation
87
In surgical treatment for head/neck cancer, a flap refers to transporting skin without a blood supply to close a wound.
a. True
b. False
b. False
88
Which structures are associated with an oral/oropharyngeal cancer?
Floor of mouth, mandible, tonsils
89
Which structure is associated with a supraglottic laryngeal cancer?
Aryepiglottic folds
90
The anterior commissure is one of two structures associated with a glottic laryngeal cancer.
a. True
b. False
a. True
91
Which structure is associated with a hypopharyngeal cancer?
Pharyngeal walls
92
Decreased hyolaryngeal excursion can result in:
Decreased laryngeal closure, decreased UES opening
93
About 10% of premature infants born at less than 37 weeks gestation have dysphagia.
a. True
b. False
a. True
94
Which of the following is a structural anomaly in neonates that can cause dysphagia?
a. Laryngomalacia
b. Respiratory Distress Syndrome
c. Cerebral Palsy
d. Sensory integration dysfunction
a. Laryngomalacia
95
Which of the following is a swallowing problem generally NOT associated with cleft lip/palate?
a. Incomplete closure around the nipple
b. Inability to generate suction needed for expressing milk
c. Nasal regurgitation
d. Abnormal/non-rhythmic sucking pattern
d. Abnormal/non-rhythmic sucking pattern
96
Laryngeal cleft can cause:
Liquid to be mis-directed into the airway
97
If a baby experiences shortness of breath, this can interfere with:
Airway protection during the swallow
98
