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PRAXIS REVIEW > swallowing 2 > Flashcards

swallowing 2 Flashcards

1
Q

indirect treatment involves food (t/f)

A

false; indirect treatment doesn’t involve food

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2
Q

examples of indirect treatment are

A

oral-motor control exercises, exercises designed to stimulate the swallow reflex, exercises designed to improve adduction of tissue at the top of the airway, exercises to increase base of tongue strength

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3
Q

what is the benefit of the supraglottic swallow

A

helps close the airway at the level of the VFs to prevent aspiration

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4
Q

How to do the supraglottic swallow

A

the pt is asked to hold the food in the mouth, take a deep breath n d hold it soon after initiating a slight exhalation, swallow while holding the breath, and cough soon after the swAllow

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5
Q

super-supraglottic swallow benefits

A

helps close the airway before and during swallow; also promotes false VF closure

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6
Q

how to do super-supraglottic swallow

A

The pt is asked to inhale and hold the breath tightly by bearing down (an action that tilts the arytenoids and helps closed the false folds) and swallow while holding the breath and bearing down. The pt coughs soon after the swallow using this technique.

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7
Q

benefits of the effortful swallow

A

helps increase the posterior motion of the tongue and increase pharyngeal pressure

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8
Q

how to do effortful swallow

A

the pt is asked to squeeze as hard as possible while swallowing; this may be more effective when combined with infra hyoid motor electrical stimulation

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9
Q

benefits of Mendelssohn maneuver

A

helps elevate the larynx and thus widens the cricopharyngeal opening

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10
Q

how to Mendelsohn maneuver

A

pt is first educated about laryngeal elevation, then asked to palpate the laryngeal elevation when swallowing saliva, and finally, taught to hold the laryngeal elevation during swallowing for progressively longer durations

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11
Q

leading cause of non-fatal TBI in the US

A

falls (35%)

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12
Q

mild TBI rarely results in dysphagia (T/F)

A

True; mod-severe TBI can result in dysphagia

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13
Q

dysphagia can result in malnutrition, aspiration pneumonia and what else?

A
  • dehydration
  • other lung disease processes
  • possibly death
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14
Q

incidence of dysphagia is as high as ___% in patients admitted to rehabilitation for TBI

A

93%

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15
Q

factors that can affect swallowing post-TBI

A 
medications (sedation, pain)
ventilation (trach, intubation)
injury (head/neck, etc)
poor safety awareness
motivation
issues w/ insight
depression/mood
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16
Q

what Is the impact of cognitive-communication and behavioral deficits in swallowing?

A

inattention - forget to eat, distractable or eat impulsively
low arousal - may cause swallow trigger delay
memory - may forget appropriate consistency or strategies
ex dysfunction- planning/organizing/attn deficits leads to not generalizing strategies to “real life” eating situations
behavior/agitation - outbursts may create higher risk for aspiration/choking or inadequate oral intake

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17
Q

assessment of dysphagia components

A
  • Pt hx
  • OME (CN involvement, dentition, oral hygiene)
  • cog-comm screen
  • observation of fx
  • instrumental/non-instrumental
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18
Q

the purpose of rehabilitative/restorative interventions is to restore function (t/f)

A

true

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19
Q

what is the purpose of compensatory interventions? (i.e., strategies, diet modifications)

A

not to restore fx, but prevent aspiration or s/s of dysphagia

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20
Q

exercises that impact swallowing physiology and bolus flow are (rehabilitative/compensatory)

A

rehabilitative

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21
Q

tongue hold exercise is for which pts

A

for pts w/ decreased contact b/w tongue base and pharyngeal wall

22
Q

how to do tongue hold

A

bite your interior tongue and swallow (creates bulkiness in the anterior pharyngeal swallow and allows for increased contact b/w tongue base & pharyngeal wall)

23
Q

shaker exercise targets

A

decreased UES opening and weakness of suprahyoid muscles

24
Q

how to perform shaker exercise

A

lie on back (supine), perform 3 head lifts, sustain fo 1 minute each, then 1 minute rest, then 30 consecutive head lifts for 2 seconds each

25
Q

goal of shaker exercise

A

increase hyo-laryngeal excursion, increase strength in supra hyoid muscles, & shortening the thyroid-hyoid space

26
Q

tongue is considered compensatory/rehabilitative/both

A

both

27
Q

what are the 3 modifications for liquids

A

thin, nectar, honey

28
Q

what are the modification levels for solids

A

puree
mechanical soft (cooked, ground, soft)
mechanically advanced (cooked, chopped, softened)
regular/solid

29
Q

chin tuck benefits

A

expands vallecular space and narrows laryngeal vestibule w/ decreases the chance of aspiration

30
Q

chin tuck is for pts w/

A
  • reduced tongue base retraction

- decreased airway protection due to delayed swallow

31
Q

head turn is used for

A

unilateral pharyngeal or laryngeal weakness

32
Q

how to perform head turn

A

turn your head to the impaired side

33
Q

how head turn helps

A

it closes off the weak side and keeps the bolus going towards the stronger sided

34
Q

head tilt is used for

A

unilateral oral weakness

35
Q

how to perform head tilt

A

tilt head to stronger side as it redirects the bolus to the stronger side, so you can can chew on the stronger side

36
Q

supraglottic swallow is used for

A

reduced airway protection

37
Q

how to do supraglottic swallow

A

hold breath, swallow, then cough, inhale

38
Q

supraglottic swallow benefits

A

increased airway protection, increased arytenoid approximation, approximation of false VFs, increased opening of UES

39
Q

how to do super-supraglottic

A

hold breath, bear down, swallow, cough, swallow again

40
Q

super-supraglottic swallow is for

A

reduced airway closure

41
Q

how to do effortful swallow

A

squeeze and swallow hard

42
Q

effortful swallow targets

A

vallecular and/or pyriform sinus residue and reduced airway closures, also increases hyolaryngeal excursion and improving laryngeal closure

43
Q

how to do Mendelsohn maneuver

A

start to swallow until they feel there cricoid cartilage raised, then swallow while it’s raised, and let it go

44
Q

mendelsohn maneuver targets

A

decreased hyolaryngeal excursion and/or decreased duration of UES opening

45
Q

best swallowing treatment is

A

the act of swallowing itself (functional)

46
Q

oral motor exercises in dysphagia treatment

A

very little to no evidence, needs additional research and studies

47
Q

poor oral hygiene is a risk factor for aspiration pneumonia (T/F)

A

True

48
Q

purpose of Frazier free water protocol

A

a means of increasing hydration and quality of life in pts

49
Q

Frazier free water protocol based off

A

based on pt noncompliance w/ thickened liquids as well as research supporting safety of water when aspirated (human body is made up of 60% water and when small ants are aspirated, water is quickly absorbed into the lungs & tissue; water has a neutral pH)

50
Q

oral hygiene is an important component to Frazier free water protocol (T?F)

A

true; oral hygiene is a must prior to consuming water in order to decrease bacteria

PRAXIS REVIEW (7 decks)

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