Podcast
Questions and Answers
What is the definition of a VFSS?
What is the definition of a VFSS?
- Quick and reliable method to identify stroke patients with dysphagia and aspiration risk
- Dynamic fluoroscopic image of moving bolus and oropharyngeal structures which is recorded on videotape or digital disk (correct)
- Patient asked to swallow saliva as many times as possible for 30 seconds while deglutition is counted through palpation of the larynx
- involves passing a fiberoptic laryngoscope through the nasal cavity into hypoharynx; can view larynx and surrounding structures (from a superior view);
What positions are patients in during the VFSS?
What positions are patients in during the VFSS?
Seated position, occasional standing, video chair, booster seat for peds
During the oral phase, we can visualize poor labial closure/drooling and anterior loss of PO. What else can be visualized on VFSS?
During the oral phase, we can visualize poor labial closure/drooling and anterior loss of PO. What else can be visualized on VFSS?
Drooling/anterior loss Prolonged oral prep) Tongue pumping and lingual mvmt (Parkinson’s) Serial or piecemeal deglutition Oral stasis/residue Poor mastication Decreased tongue elevation to palate
During a fees, part of the pharyngeal phase is obliterated by pharyngeal walls and bolus during the swallow when the endoscopic light is blocked. This is known as the ______.
During a fees, part of the pharyngeal phase is obliterated by pharyngeal walls and bolus during the swallow when the endoscopic light is blocked. This is known as the ______.
Fees can be used even with excessive oral secretions to assess PT’s tolerance of oral secretions.
Fees can be used even with excessive oral secretions to assess PT’s tolerance of oral secretions.
VFSS is performed to assess the pathophysiology of swallow dysfunction to determine LT and St goals and plan for nourishment and hydration. Why else do we perform VFSS?
VFSS is performed to assess the pathophysiology of swallow dysfunction to determine LT and St goals and plan for nourishment and hydration. Why else do we perform VFSS?
What planes are observed during the VFSS?
What planes are observed during the VFSS?
During the pharyngeal phase, we can visualize penetration/aspiration: when, why, how much, response. What else can we visualize?
During the pharyngeal phase, we can visualize penetration/aspiration: when, why, how much, response. What else can we visualize?
FEES involves passing a flexible nasal-endoscope that is connected to a ____________ source and ____________ to view the procedure and passed through the nose into the hypopharynx. The _____________ tip of the endoscope determines which structures are being viewed.
FEES involves passing a flexible nasal-endoscope that is connected to a ____________ source and ____________ to view the procedure and passed through the nose into the hypopharynx. The _____________ tip of the endoscope determines which structures are being viewed.
During FEES, we can assess pharyngeal/laryngeal sensitivity, all aspects of airway protection, and the pharyngeal and pre-esophageal phases of swallowing. What else can we assess/visualize?
During FEES, we can assess pharyngeal/laryngeal sensitivity, all aspects of airway protection, and the pharyngeal and pre-esophageal phases of swallowing. What else can we assess/visualize?
For VFSS which plane should be viewed first? Which plane do we view when there are concerns about symmetry?
For VFSS which plane should be viewed first? Which plane do we view when there are concerns about symmetry?
During a VFSS, you can view the oral and pharyngeal phases, as well as view the cervical esophagus.
During a VFSS, you can view the oral and pharyngeal phases, as well as view the cervical esophagus.
When given the choice, SLPS should opt to perform FEES over VFSS because it is cheaper and more practical.
When given the choice, SLPS should opt to perform FEES over VFSS because it is cheaper and more practical.
You cannot view real-time penetration/aspiration or amount during FEES.
You cannot view real-time penetration/aspiration or amount during FEES.
We cannot attempt compensatory strategies during a FEES due to the presence of the endoscope.
We cannot attempt compensatory strategies during a FEES due to the presence of the endoscope.
ndicate when penetration/aspiration (before, during and after) the swallow is likely to occur based on the following impairments:
Poor bolus control and delayed trigger
Reflux and reside
Reduced laryngeal closure and airway protection
ndicate when penetration/aspiration (before, during and after) the swallow is likely to occur based on the following impairments: Poor bolus control and delayed trigger Reflux and reside Reduced laryngeal closure and airway protection
What are 2 contradictions for VFSS?
What are 2 contradictions for VFSS?
Facilitates utilize a uniform approach when administering PO trials.
Facilitates utilize a uniform approach when administering PO trials.
How much should the VFs rise during VFSS when looking at laryngeal elevation?
How much should the VFs rise during VFSS when looking at laryngeal elevation?
FEES involves passing a fiberoptic laryngoscope through the nasal cavity into the hypopharynx. We can view the larynx and surrounding structures from a superior view. This requires the clinician to be an expert in identifying the anatomical structures from a ______ view.
FEES involves passing a fiberoptic laryngoscope through the nasal cavity into the hypopharynx. We can view the larynx and surrounding structures from a superior view. This requires the clinician to be an expert in identifying the anatomical structures from a ______ view.
All stages of swallowing can be visualized during a FEES.
All stages of swallowing can be visualized during a FEES.
FEES is ⅓ to ¼ less than the cost of modified barium swallow.
FEES is ⅓ to ¼ less than the cost of modified barium swallow.
Early diagnosis of dysphagia (within a few days of admission) can increase daily reimbursement for management of this condition.
Early diagnosis of dysphagia (within a few days of admission) can increase daily reimbursement for management of this condition.
Provide 2 examples of disadvantages of VFSS
Provide 2 examples of disadvantages of VFSS
Who is present during the VFSS?
Who is present during the VFSS?
VFSS: Who provides the patient with the instructions? Who presents the PO trials?
o interprets the VFSS?
VFSS: Who provides the patient with the instructions? Who presents the PO trials? o interprets the VFSS?
Provide 3 benefits of using FEES vs VFSS
Provide 3 benefits of using FEES vs VFSS
When assessing the esophageal phase, it is okay for the SLP to write: “Zenker’s Diverticulum noted at the level of C5-C6
When assessing the esophageal phase, it is okay for the SLP to write: “Zenker’s Diverticulum noted at the level of C5-C6
Provide 3 possible contraindication for performing FEES
Provide 3 possible contraindication for performing FEES
Provide 3 possible adverse reactions to FEES
Provide 3 possible adverse reactions to FEES
What is an indicator of poor saliva management during a FEES assessment?
What is an indicator of poor saliva management during a FEES assessment?
What is the purpose of assessing laryngeal closure during a FEES assessment?
What is the purpose of assessing laryngeal closure during a FEES assessment?
Why is it important to assess sensation during a FEES assessment?
Why is it important to assess sensation during a FEES assessment?
What is the purpose of using green or blue dyed material during a FEES assessment?
What is the purpose of using green or blue dyed material during a FEES assessment?
What can happen to the lens during a FEES assessment?
What can happen to the lens during a FEES assessment?
What is the importance of positioning the scope to see the vocal folds and advancing bolus simultaneously during a FEES assessment?
What is the importance of positioning the scope to see the vocal folds and advancing bolus simultaneously during a FEES assessment?
What is the primary purpose of instrumental evaluation, including FEES?
What is the primary purpose of instrumental evaluation, including FEES?
What is the main limitation of FEES in terms of assessing swallowing phases?
What is the main limitation of FEES in terms of assessing swallowing phases?
What is the role of the distal tip of the endoscope in FEES?
What is the role of the distal tip of the endoscope in FEES?
Why has ASHA endorsed the practice of FEES?
Why has ASHA endorsed the practice of FEES?
What is the main advantage of FEES in terms of patient comfort?
What is the main advantage of FEES in terms of patient comfort?
What is the purpose of the thumb lever in FEES administration?
What is the purpose of the thumb lever in FEES administration?
What is the primary reason FEES is not intended to replace the fiberoptic exam done by ENT?
What is the primary reason FEES is not intended to replace the fiberoptic exam done by ENT?
According to Langmore et al. (1991), what is the significance of the comparison between FEES and MBS?
According to Langmore et al. (1991), what is the significance of the comparison between FEES and MBS?
When is it more appropriate to use MBS instead of FEES?
When is it more appropriate to use MBS instead of FEES?
What is a unique requirement for clinicians performing FEES?
What is a unique requirement for clinicians performing FEES?
What is a common goal of both MBS and FEES?
What is a common goal of both MBS and FEES?
In which situation would FEES be preferred over MBS?
In which situation would FEES be preferred over MBS?
What is the main advantage of using FEES over VFSS?
What is the main advantage of using FEES over VFSS?
What is the purpose of using blue or green dye during a FEES examination?
What is the purpose of using blue or green dye during a FEES examination?
What is the term used to describe the obliteration of the pharyngeal phase during a FEES examination?
What is the term used to describe the obliteration of the pharyngeal phase during a FEES examination?
What is the primary advantage of using FEES over VFSS in terms of cost?
What is the primary advantage of using FEES over VFSS in terms of cost?
What is the primary purpose of using FEES in the assessment of swallowing function?
What is the primary purpose of using FEES in the assessment of swallowing function?
What is the benefit of using FEES in patients with excessive oral secretions?
What is the benefit of using FEES in patients with excessive oral secretions?
What is the purpose of using topical anesthesia during a FEES examination?
What is the purpose of using topical anesthesia during a FEES examination?
What is the advantage of using FEES in terms of patient convenience?
What is the advantage of using FEES in terms of patient convenience?
What is the primary disadvantage of using FEES in terms of visualization?
What is the primary disadvantage of using FEES in terms of visualization?
What is the benefit of using FEES in terms of patient education and biofeedback?
What is the benefit of using FEES in terms of patient education and biofeedback?
What is the purpose of using barium with different consistencies in a VFSS?
What is the purpose of using barium with different consistencies in a VFSS?
What is the advantage of using commercially available pre-thickened barium in a VFSS?
What is the advantage of using commercially available pre-thickened barium in a VFSS?
What is the significance of understanding how the barium stimuli map to the different levels on the IDDSI Framework?
What is the significance of understanding how the barium stimuli map to the different levels on the IDDSI Framework?
What is the role of the IDDSI Testing Methods in a VFSS?
What is the role of the IDDSI Testing Methods in a VFSS?
What is the disadvantage of VFSS in terms of radiation exposure?
What is the disadvantage of VFSS in terms of radiation exposure?
What is the primary purpose of performing a videofluoroscopy swallow study (VFSS)?
What is the primary purpose of performing a videofluoroscopy swallow study (VFSS)?
What is the benefit of using VFSS in assessing swallowing function?
What is the benefit of using VFSS in assessing swallowing function?
Which of the following is a contraindication for VFSS?
Which of the following is a contraindication for VFSS?
What is the purpose of mixing food with barium during a VFSS?
What is the purpose of mixing food with barium during a VFSS?
Which of the following can be viewed during a VFSS?
Which of the following can be viewed during a VFSS?
What is the primary goal of using VFSS in assessing swallowing function?
What is the primary goal of using VFSS in assessing swallowing function?
What is the characteristic of oral-transit time in mild dysphagia?
What is the characteristic of oral-transit time in mild dysphagia?
When is non-oral supplement to oral feeding recommended?
When is non-oral supplement to oral feeding recommended?
What is the characteristic of oral residue in mild dysphagia?
What is the characteristic of oral residue in mild dysphagia?
What is the general rule for oral-pharyngeal transport?
What is the general rule for oral-pharyngeal transport?
When is oral feeding recommended?
When is oral feeding recommended?
What is the characteristic of severe dysphagia?
What is the characteristic of severe dysphagia?
When would you recommend NPO to a patient?
When would you recommend NPO to a patient?
What is a common misconception about G-tube feedings in patients with terminal illnesses?
What is a common misconception about G-tube feedings in patients with terminal illnesses?
What is a potential risk associated with tube feedings?
What is a potential risk associated with tube feedings?
What is the role of the speech-language pathologist in the assessment and treatment of medically fragile patients with swallowing difficulties?
What is the role of the speech-language pathologist in the assessment and treatment of medically fragile patients with swallowing difficulties?
What is a consequence of tube feedings, according to research?
What is a consequence of tube feedings, according to research?
What is a consideration that speech-language pathologists should take into account when making recommendations about tube feedings?
What is a consideration that speech-language pathologists should take into account when making recommendations about tube feedings?
Can view every phase of the swallow.
Can view every phase of the swallow.
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