Week 3-4

Question 1

3 systems required for cerebellum

Answer 1

Visual/vestibular nuclei in brainstem, proprioception, balance/vestibular reflexes and eye movements for feedback to muscles and joints.

Question 2

What is ataxia?

Answer 2

Challenges with smooth processing due to issues with cerebellum. Might be assumed drunk walking into the ER with a cerebellum stroke.

Question 3

How do we stay upright?

Answer 3

If at least 2 of 3 systems are intact. ex. visual/vestibular, proprioception, balance

Question 4

What is the function of the Basal Ganglia?

Answer 4

Picks what the sequence should be and work with the Thalamus to give motor sequence a smooth output.

Initiating the movement and motor planning the movement.

Question 5

What is bradykinesia?

Answer 5

Difficulty initiating movements. Slower. Movement generation affected. Does NOT cause paralysis.

Question 6

Is paralysis a Basal Ganglia problem?

Answer 6

NO!!

Question 7

What is dysmetria?

Answer 7

Over or under reaching

Question 8

What is agnosia in the oral stage?

Answer 8

Inability to recognize food.

Question 9

Oral phase dysphagia

Answer 9

Difficulties pertain to either the oral prep and or oral transit phases

Question 10

Pharyngeal phase dysphagia

Answer 10

Difficulties propelling the bolus from the oropharynx into the esophagus
Transport and/or airway protection

Question 11

Esophageal phase dysphagia

Answer 11

Difficulties related solely to esophageal dysfunction, we do not treat these patients, these patients are treated by a GI doctor

Question 12

Can there be combinations of dysphagia phases?

Answer 12

Yes ex. oropharyngeal dysphagia

Question 13

What are the common complications of dysphagia?

Answer 13

Pocketing versus Stuffing, drooling (sialorrhea), laryngeal penetration, aspiration, silent aspiration, aspiration pneumonia, gastroesophageal reflux

Question 14

What is sialorrhea?

Answer 14

Excessive drooling, comes out anteriorly. Cannot manage their secretions. Often people with neurologic disorders don’t realize they are excessively drooling.

Question 15

What is pocketing?

What is stuffing?

Answer 15

Pocketing- food remains in mouth after the meal

Stuffing- food remains in mouth during meal (often peds), should clear after the meal.

Question 16

What is anterior loss?

Answer 16

Drooling out of the mouth.

Question 17

Laryngeal Penetration

Answer 17

Entry of material to larynx but the material does not penetrate the vocal folds.

Question 18

Deep penetration

Answer 18

Touches the vocal folds all that needs to happen is inhale for it to fall into the trachea

Question 19

What is aspiration?

Answer 19

Material goes below the level of the true vocal folds

Question 20

What is silent aspiration?

Answer 20

Materials goes below the level of the true vocal folds, but no cough response

Question 21

What is aspiration pneumonia?

Answer 21

Part of the bolus or bacteria from oral cavity in saliva enters the airway and gets into lungs bacterial based, which means antibiotics can get rid of it.

Question 22

Where is infection aspiration pneumonia within the lungs?

Answer 22

Typically found in lung bases typically in right lower lobe if it’s a lot of stuff both lobes.

Question 23

Why does aspiration pneumonia typically occur in the lower lobes of the lungs?

Answer 23

Because of gravity pulling the weight down.

Question 24

What is bronciolitis?

Answer 24

Kids which chronic bronchiolitis are the aspirators. Doesn’t get to the alveoli.

Question 25

What is gastroesophageal reflux?

Answer 25

Stomach contents regurgitated into esophogus. Huge inflammatory response to the larynx. Can cause a chronic cough because of the swelling.

Question 26

What is an adult Feeding Disorder?

Answer 26

Disordered placement of food in the mouth Difficulty in food manipulation including mastication. Oral prep phase involved and sometimes oral transit phase involved. As an SLP we would call it an oral dysphagia.

Question 27

What is a pediatric feeding disorder?

Answer 27

May describe a failure to demonstrate developmentally appropriate eating and drinking behaviors as related to a problem in any one of the following domains: Medical, Nutritional, Feeding Skills, Psychosocial

Question 28

What is oral intake?

Answer 28

Are they eating enough to sustain themselves?

Question 29

How is oral intake measured?

Answer 29

Percentage of meal eaten or in the pediatric world mL or cc's

Question 30

How many cc's or mL are in one oz?

Answer 30

30

Question 31

What is sarcopenia?

Answer 31

Healthy muscle tissue replaced by connective tissue

Question 32

What is cachexia?

Answer 32

Can be an underlying condition of sarcopenia, but often because of a metabolic problem. Muscles wasting away and no longer function the way they used to be. Body cannot absorb and put weight on.

Question 33

What is stunting?

Answer 33

low height for age, in developing countries what should the individuals height be v.s. what it is?

Question 34

What is wasting?

Answer 34

low weight for height

Question 35

What does it mean to be underweight?

Answer 35

low weight for age

Question 36

What are micronutrient insufficiencies?

Answer 36

lack of important vitamins and | minerals because of their diet.

Question 37

What does malnutrition look like with obesity?

Answer 37

see this more in first world countries, these individuals who don’t have enough vitamins and minerals in their diets.

Question 38

What is a diet related disease?

Answer 38

Heart disease stroke diabetes and cancer.

Question 39

What is an ng tube?

Answer 39

nasogastric tube- runs from nose to stomach, most commonly seen in acute care in ped patients who cannot tolerate a surgery and most people think of these as being “short term” could be 3 days to 8 months.

Question 40

What is a g-tube?

Answer 40

Feeding tube placed directly into the stomach. Done in a surgical suite.

Question 41

What is a PEG tube?

Answer 41

Done at the bedside, done with adults more than children. Goes directly to the stomach, just placed differently than a g-tube.

Question 42

What is a J-tube?

Answer 42

Goes to the jejunum of the small intestine, patient has severe reflux or they have something wrong with their stomach that it has to heal. Product has to be partially digested so the food is different going into their tube. ex. nj tube, gj tube

Question 43

What is TPN?

Answer 43

Nutrition goes into the veins and is metabolized by the liver

Question 44

What populations get TPN?

Answer 44

preemies before their guts develop, gut is not digesting food young children who are really sick- can lead to liver failure

Question 45

What is an IV fluid?

Answer 45

Short term keeps you hydrated while your gut is in the acute phase with a bug or food poisoning.

Question 46

2 most common risk factors for aspiration pneumonia

Answer 46

How much is being aspirated during each event? How frequently is it occurring? Higher amount puts them at greater risk, no volume found yet.

Question 47

Additional risk factor for aspiration peumonia?

Answer 47

Age! Older adults are at greater risk for developing aspiration p than any other group!

Question 48

What is dehydration?

Answer 48

excessive loss of body fluid

Question 49

What is hypovolemia?

Answer 49

Not enough volume often when IV fluids with added electrolytes are added. Know what it is but physicians job to diagnose. Hypovolemia causes decrease in volume of blood plasma

Question 50

What is the most common cause of dehydration according to the WHO?

Answer 50

Diarrhea