Dysphagia Assessment and Management Quiz
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Questions and Answers

What symptoms might indicate dysphagia?

  • Always drinking cold liquids
  • Feeling hungry after meals
  • Frequent throat clearing without eating
  • Extra effort needed to chew or swallow (correct)

    • Which of the following is NOT a specific cause of dysphagia?

  • Spinal cord injury
  • Hypertension (correct)
  • Parkinson’s disease
  • Multiple sclerosis

    • What is the purpose of the Fiberoptic Endoscopic Evaluation of Swallowing (FEES)?

  • To evaluate taste preferences
  • To measure the effectiveness of medication
  • To assess pharyngeal and laryngeal structure during swallowing (correct)
  • To provide a static view of digestibility

    • What does the Modified Barium Swallow Study (MBSS) help identify?

    <p>The specific site of aspiration and its causes</p> Signup and view all the answers

    Which of the following interventions can be used for managing dysphagia?

    <p>Dietary modification by thickening liquids</p> Signup and view all the answers

    What could be a sign of aspiration during swallowing assessment?

    <p>Delayed swallowing onset</p> Signup and view all the answers

    Which assessment method focuses on the airway protection during swallowing?

    <p>Videofluroscopic swallowing study</p> Signup and view all the answers

    What does pocketing refer to in the context of dysphagia?

    <p>Keeping food in the mouth without swallowing</p> Signup and view all the answers

    What is a potential limitation to using maneuvers for swallowing improvement?

    Signup and view all the answers

    What role does modifying posture play in feeding therapy for children?

    <p>It reduces swallowing difficulties by improving oral control.</p> Signup and view all the answers

    Which of the following best describes 'Flavor Mapping'?

    <p>It analyzes the child's preferences to identify patterns in flavors and textures.</p> Signup and view all the answers

    What is the purpose of 'Flavor Masking' in feeding therapy?

    <p>To cover the taste of new foods using familiar flavors.</p> Signup and view all the answers

    Which professional is not typically a part of the feeding team?

    <p>Physical Trainer</p> Signup and view all the answers

    What is the main goal of using transitional foods in feeding therapy?

    <p>To help children adjust to new foods by integrating them with favorites.</p> Signup and view all the answers

    What is the primary purpose of the supraglottic swallow technique?

    <p>To close the vocal folds and protect the airway during swallowing</p> Signup and view all the answers

    Which of the following is NOT an example of oral-motor therapy or exercises?

    <p>Swallowing food pills</p> Signup and view all the answers

    What characteristic distinguishes the Masako exercise from a maneuver?

    <p>It focuses on improving movement and strength of the posterior pharyngeal wall.</p> Signup and view all the answers

    What is the primary function of a nasogastric tube (NG-tube)?

    <p>To deliver non-oral nutrition for short-term use</p> Signup and view all the answers

    Which exercise involves lifting the head to facilitate the opening of the upper esophageal sphincter?

    <p>Shaker exercise</p> Signup and view all the answers

    What feeding disorder is characterized by extreme food selectivity in children?

    <p>Avoidant/restrictive food intake disorder</p> Signup and view all the answers

    Which type of tube is preferred for short-term non-oral nutrition?

    <p>Nasogastric tube (NG-tube)</p> Signup and view all the answers

    Which of the following best describes oral hygiene in the context of swallowing therapy?

    <p>It is an integral part of maintaining oral health for effective swallowing.</p> Signup and view all the answers

    What is a common characteristic of the active sleep state in infants?

    <p>Random limb movements occur.</p> Signup and view all the answers

    What is the primary function of the rooting reflex in infants?

    <p>To help the infant latch onto the nipple</p> Signup and view all the answers

    Which of the following best describes nutritive sucking compared to non-nutritive sucking?

    <p>Nutritive sucking involves swallowing once followed by breathing in bursts.</p> Signup and view all the answers

    During an assessment, if a child is described as having an alert agitated state, which of the following is true?

    <p>The child is difficult to comfort.</p> Signup and view all the answers

    What occurs during the tonic bite reflex?

    <p>The child clamps down on teeth or gums and has difficulty releasing</p> Signup and view all the answers

    What is a significant indicator of feeding disorders in children?

    <p>Refusal to eat different types of food.</p> Signup and view all the answers

    Which abnormal reflex indicates difficulty with oral feeding and manipulation?

    <p>Tonic bite reflex</p> Signup and view all the answers

    Which of the following describes the muscle tone categories relevant to oral stability?

    <p>Normal, tense, flaccid</p> Signup and view all the answers

    Which physiological characteristic should be noted during infant assessment?

    <p>Heart rate ranges from 120-140 beats/min for both preterm and full-term infants.</p> Signup and view all the answers

    What best describes an infant's response during a swallow reflex assessment?

    <p>The swallow reflex can be described as delayed or absent.</p> Signup and view all the answers

    What type of movement does the swallow reflex perform?

    <p>It moves the bolus into the esophagus</p> Signup and view all the answers

    What might indicate oral motor weakness in a child?

    <p>Poor sucking ability and oral control of the bolus</p> Signup and view all the answers

    Which action should be taken to assess suck strength in infants?

    <p>Insert the gloved finger into the infant's mouth and assess the tongue's movement.</p> Signup and view all the answers

    What respiratory characteristic defines the drowsy state in infants?

    <p>Eyes are partly open and smooth limb movements occur.</p> Signup and view all the answers

    How does a cleft palate affect sucking ability?

    <p>It can create a poor labial seal leading to difficulties in sucking</p> Signup and view all the answers

    What is a common characteristic of jaw thrust in children?

    <p>The lower jaw appears stuck open, affecting food retention</p> Signup and view all the answers

    What is the primary goal of the chin-tuck posture during swallowing?

    <p>To redirect the movement of the bolus and narrow the airway opening.</p> Signup and view all the answers

    Which postural technique is primarily aimed at assisting patients with unilateral vocal paralysis?

    <p>Head rotation</p> Signup and view all the answers

    The head tilt technique is used primarily to address which issue during swallowing?

    <p>Residue on the weak side</p> Signup and view all the answers

    The effortful swallow method focuses on what aspect of swallowing?

    <p>Increasing the posterior tongue base movement.</p> Signup and view all the answers

    What is a potential risk when applying postural techniques for swallowing?

    <p>Excessive strain on the patient's neck muscles.</p> Signup and view all the answers

    What is the purpose of the Mendelsohn maneuver during swallowing?

    <p>To elevate the larynx and open the esophagus.</p> Signup and view all the answers

    Swallowing maneuvers such as the supraglottic swallow mainly focus on what aspect of the swallowing process?

    <p>Altering the strength of swallowing movements.</p> Signup and view all the answers

    Which of the following conditions may make postural techniques inappropriate for a patient?

    <p>Severe cognitive impairment.</p> Signup and view all the answers

    Study Notes

    Swallowing

    • Dysphasia is difficulty moving food from mouth to stomach
    • Feeding disorders are avoidance of certain foods

    Phases

    • Oral preparatory phase: food and liquids are manipulated, chewed, and formed into a bolus (voluntary)

    • Oral phase: tongue moves food/liquid to the back of the mouth (voluntary)

    • Pharyngeal phase: involuntary movement. Food is transported from esophagus to stomach

      • Aspiration: food/liquid enters trachea below vocal folds
      • Penetration: food/liquid enters trachea but stays above vocal folds

    • Esophageal phase: food transportation from esophagus to stomach

    • Residue: food left in mouth or pharynx after a swallow

    • Regurgitation: food from the pharynx goes back into the nasal cavity

    Oral Phase Issues

    • Poor oral control: weak lips, tongue, or jaw; poor sensitivity
    • Food spill: food/liquid leaks from oral cavity
    • Premature spillage: food falls off tongue before swallow; due to reduced tongue strength/range of motion
    • Chewing difficulty: reduced mandible/tongue strength or poor sensitivity
    • Food residual: food in oral cavity after swallow; residual food between cheeks and tongue, under tongue, on hard palate

    Pharyngeal Phase Issues

    • Coughing/choking/wet voice quality: delayed or absent swallow reflex. Reduced laryngeal elevation/closure
    • Nasal regurgitation: food/liquid leaks from nasal cavity due to inadequate velopharyngeal closure

    Additional Information

    • Excessive saliva and mucus: due to aspiration and body's attempt to clear away foreign material
    • Signs of dysphagia: drooling, poor oral control, chest infections/pneumonia, food sticking in throat, globus sensation, complaints of pain when swallowing, frequent throat clearing, coughing during/after eating, difficulty coordinating breathing/swallowing, extra effort to chew, malnutrition/dehydration, keeping food in mouth
    • Dysphagia causes: stroke, traumatic brain injury, spinal cord injury, dementia, Parkinson's disease, multiple sclerosis, ALS, muscular dystrophy, developmental disabilities

    Assessment

    • Interview/Case history/medical records including potential impact of medications
    • Seating: postural/position evaluation
    • Screening/Bedside assessment
    • FEES (Fiberoptic endoscopic evaluation of swallowing): to view pharyngeal/laryngeal structures, assess adequate airway, timing of swallow, spillage, residue, aspiration, reflux. Identify strategies for swallowing improvement, postural/diet modification
    • MBS (Modified barium swallow study): radiographic procedure to directly view oral, pharyngeal, esophageal function. Evaluate aspiration/penetration, causes, strategies to increase swallowing safety.

    Interventions

    • Seating position
    • Dietary modification (thicken up food/liquids, soften, chop food)
    • Postural position technique (chin tuck, rotating head)
    • Swallowing maneuvers (supraglottic swallow, holding breath before swallowing)
    • Effortful swallow (patient instructed to swallow saliva)
    • Masako/tongue hold (prevent coughing/choking) (patient holds tongue forward between teeth during swallow)
    • Shaker exercises/head-lifting: increase opening of the upper esophageal sphincter (helps to increase hyoid/laryngeal excursion)
    • Oral hygiene
    • Nasogastric tube (NGT): inserted to provide non-oral nutrition (short-term use)
    • Gastrostomy tube (PEG/G-tube): for long-term nutrition

    Children

    • Feeding disorders: avoidance of eating or limited food types
    • Assessment: case history (medical/feeding status/nutritional information), alterations in feeding-related behaviors (deep/active sleep; drowsy; awake/alert; agitated; crying), physiologic status (heart rate, respiratory rate, oxygen saturation)

    Other Features

    • Non-nutritive sucking

    • Primitive reflexes: Babkin, rooting, phasic bite, tongue thrust, sucking, swallow

    • Abnormal reflexes: tonic bite reflex, tongue retraction, jaw thrust

    Principles of Oral Structure/Movement/Function

    • Movement of the jaw (size, at rest, movement, strength) , Cheeks (tone, strength), Lips (at rest, tone, strength, deviation), Tongue (size, tone, movements), Palate (at rest, hard/soft), Pharynx and Larynx (vocal quality, gag response), and Facial Sensitivity (face, mouth)

    Treatment for Infants & Children

    • Modify posture
    • Manually support jaw/lips/tongue to improve lip sealing and motion
    • Adaptive equipment: modification of nipples or use of straws
    • Alerting food: changing food consistency, temperature
    • Feeding team: Physician, dietitian, behavioural specialist, occupational therapist, SLP

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    Related Documents

    Swallowing Guide PDF

    Description

    This quiz evaluates your understanding of dysphagia, including its symptoms, diagnostic methods such as FEES and MBSS, and management strategies. Test your knowledge on feeding therapy techniques and the roles of various professionals involved in treating dysphagia.

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