Swallowing Disorders Exam 3

T/F: Compensatory swallow therapies can be used to increase protective valves of the vocal folds but not stimulate the pharyngeal stage of the swallow.

false

T/F: The supraglottic swallow is helpful in attaining laryngeal closure

true

A squeeze may help in propelling the bolus into the oropharynx due to weakness in the tongue is one of the purposes of the:

effortful swallow

This type of therapy is easiest for patients who have trouble with multiple-stage commands, children, or patients with significant sensory loss:

effortful swallow

Which of the following techniques helps open the upper esophageal sphincter by holding the larynx in an elevated position?

Mendelsohn Maneuver

Swallowing postures can be identified as:

head back, chin down/tuck, head rotation, and head tilt

Head back posture helps, improves or is used to/for

People with tongue paralysis or partial or total removal of the tongue due to oral cancer may benefit from this posture

Chin down posture/chin tuck helps, improves or is used to/for…

airway protection by moving the tongue base and epiglottis posterior toward the posterior pharyngeal wall

Which of the following postures is used to facilitate the flow of the bolus to the unaffected side of the pharynx in patients with impaired function on one side?

Head rotation

T/F: The head tilt posture involves tilting the head to the stronger side so that gravity carries the bolus in the direction

true

T/F: Thermal tactile oral stimulation has ample research to support the extensive use of cold stimulation to the oral-pharyngeal mucosa to improve swallow function.

false

How does the sensory process known as "chemesthesis," which detects carbonation, contribute to improving swallowing?

It helps detect carbonation in beverages, which enhances the sensation and control of the swallow

Which of the following methods, when combined with temperature stimulation, is commonly used to improve sensory awareness and enhance swallowing function?

Pressure - Applies tactile input to the oral cavity or pharynx, increasing awareness of the bolus and promoting improved swallowing coordination.

Refers to exercises and techniques that aim to achieve long-term improvement in neuromuscular control of swallowing:

Rehabilitative swallow therapy

The principles of "use it or lose it" and "use it and improve," which focus on the idea that practice helps improve function, are most closely related to the rehabilitation of which system?

Neuromuscular system

Which of the following types of exercises are specifically used to improve strength and awareness of control of the swallowing mechanism?

Labial exercises - Strengthen the muscles of the lips, enhancing their control during swallowing, including sealing and bolus manipulation.

T/F: The practice of inhaling/exhaling through the nose is a type of labial exercise to improve strength and awareness of control of the swallowing mechanism.

true

Which of the following phonemes are commonly used in therapeutic exercises to enhance posterior tongue contact with the soft palate, thereby improving swallowing function and velopharyngeal closure?

/k/ and /g/ - Voiceless and voiced velar plosives that both involve posterior tongue elevation against the soft palate, promoting improved velopharyngeal closure during swallowing

Which of the following devices is specifically designed to increase mandibular movement and improve mouth opening, commonly used in rehabilitation for conditions like trismus or temporomandibular joint dysfunction?

TheraBite 7 - A device that uses passive motion to stretch and strengthen the muscles of the jaw, improving the range of motion and mouth opening.

T/F: One well known vocal fold closure and laryngeal elevation technique that helps with oral and pharyngeal transit times is the Lee Silverman Voice Treatment.

true

If a person has not had a Modified Barium Swallow Study, but has pooling of saliva or food in their throat, which might be noticed by a “wet” or “gurgly” voice quality what treatment method would work best?

Masako exercise

What is specifically used to address fibrosis, scarring, and stiffness resulting from radiation therapy for head and neck cancer, aiming to improve swallowing and reduce restrictions in the upper aerodigestive tract?

Shaker exercise - A technique that involves head lifting exercises to strengthen the suprahyoid muscles and improve the ability to open the upper esophageal sphincter(UES) during swallowing.

Which of the following devices utilizes resistance training to strengthen expiratory muscles, improving both ventilatory and non-ventilatory functions, such as respiratory performance and swallowing coordination, in patients with impaired swallowing?

EMST150

T/F: Preventive swallowing therapy is designed to target head and neck cancer survivors.

true

T/F: VitalStim uses electrical stimulation which passes a current through electrodes to stimulate the pharyngeal area via a transoral catheter.

false

This type of procedure helps with laryngeal elevation and is kind of like acupuncture.

Intramuscular stimulation

T/F: Repetitive transcranial magnetic stimulation (rTMS) modulates the excitability threshold of targeted neurons by passing a low-intensity electrical current between two electrodes that are carefully placed at a predefined area of the head.

false

T/F: Both Transcranial direct current stimulation (tDCS) and Repetitive transcranial magnetic stimulation (rTMS) show potential for improved swallowing function in poststroke individuals.

true

In thermal tactile oral stimulation therapy, two types of materials—cold and _________—are commonly used to elicit sensory responses that enhance oral awareness and swallowing function. Which material is typically used alongside cold for this purpose?

sour

T/F: Swallowing postures can help with oral but not the pharyngeal stages of the swallow

false; its both

Consistency relates to:

The firmness and thickness of foods

The National Dysphagia Diet (NDD) implemented two main principles:

Recommended terminology and viscosity ranges

The International Dysphagia Diet Standardization (IDDSI) has how many levels of foods and drinks?

8

IDDSI was established in:

2013 and launched in 2019

In the IDDSI framework, the level that has drinks as moderately thick has foods as:

Liquidized

The first four liquid levels of the IDDSI use what size syringe to measure flow?

10 ml syringe

Level 3 of the IDDSI diet corresponds to what level of the NDD?

Honey thick

Which food is an example of IDDSI level 4?

Mashed potatoes

Level 3 of the IDDSI is characterized by food that:

Drips slowly through fork slots

Level 4 of the IDDSI diet has food that:

Forms a mound above the fork

Foods that change consistency with moisture or temperature are called:

Transitional

The IDDSI level that requires blanching the thumbnail is:

Soft and bite-sized

The recommended consistency for slightly reduced tongue control is:

Mildly thick

The consistency mainly used in pediatrics as a thickened drink is:

Slightly thick

When the flow test leaves 1-4 ml in the syringe after 10 seconds, this is:

Slightly thick

The medical acronym for "nothing by mouth" is:

NPO

Parenteral feeding means:

Intravenous nutrition

Feeding tubes can be placed in the:

Nose

Nasogastric tubes (NGT) are typically used for:

Short-term temporary feeding

A nasoduodenal tube is placed into the:

Duodenum

J-tubes are placed in the:

Jejunum

NJ tubes are used for patients with:

Chronic vomiting, respiratory problems from reflux and poor stomach function

The gastrostomy type used when patients can't open their mouth wide is:

Surgical gastrostomy

NJ tubes typically need to be changed:

Monthly

For long-term use (>2-3 months), instead of an NJ tube, a child should get a:

G-tube

How do compensatory therapies differ from rehabilitative therapies in managing dysphagia symptoms?

Compensatory therapies help make swallowing safer in the moment, while rehabilitative therapies focus on long-term improvement of swallowing function

What is the primary goal of rehabilitative therapies in treating dysphagia compared to compensatory therapies?

To improve the strength, coordination, and function of swallowing muscles over time

Which of the following best describes compensatory swallowing strategies?

They are designed to provide immediate symptom relief without permanently changing swallowing function.

Which of the following best describes the function and purpose of the Chin Tuck/ChinDown strategy in swallowing therapy?

It is a compensatory strategy used to reduce the risk of aspiration and improve airway protection during swallowing

What is the primary role of the Head Tilt strategy in dysphagia therapy?

To be a compensatory strategy that helps direct the bolus to the stronger side of the mouth during swallowing

The Head Back strategy is primarily used for which of the following purposes in dysphagia treatment?

It is a compensatory strategy used to assist in swallowing by allowing gravity to help clear the throat, especially in cases of poor oral transit

What is the role of the Head Rotation strategy in managing dysphagia?

It is a compensatory strategy aimed at redirecting the bolus away from the weak side of the throat, improving swallowing efficiency

What is the purpose of using the Lying Down (Postural Adjustment) technique in swallowing therapy?

It is a compensatory strategy used to reduce the effects of gravity on the bolus and improve swallowing safety, especially in cases of aspiration

What is the primary purpose of the Supraglottic Swallow in dysphagia management?

It is a compensatory swallowing maneuver aimed at protecting the airway by holding the breath before swallowing to prevent aspiration

How does the Super-Supraglottic Swallow differ from the Supraglottic Swallow?

The Super-Supraglottic Swallow is a compensatory maneuver that enhances airway protection by adding a "bearing down" technique to the Supraglottic Swallow

What is the overall purpose of swallowing postures in compensatory therapies?

To modify the position of the head or body during swallowing in order to enhance safety and efficiency by protecting the airway and improving bolus coordination

Which of the following best describes the primary function of swallowing maneuvers in compensatory therapies?

To temporarily modify the swallowing process to enhance safety and efficiency by improving airway protection, bolus control, and swallowing timing

Which principle of swallowing rehabilitation therapy emphasizes the need for regular practice to prevent further loss of swallowing function?

Use it or Lose it

According to the principle of "Specificity" in swallowing rehabilitation therapy, exercises should:

Target the specific swallowing difficulties a patient faces

How does the Mendelsohn Maneuver contribute to improved swallowing safety and efficiency in patients with dysphagia, particularly in the context of laryngeal elevation and airway protection?

It prolongs the laryngeal elevation, which enhances airway protection by improving the timing and coordination of the pharyngeal swallow, thereby reducing the risk of aspiration

In patients with dysphagia, what specific swallowing dysfunction does the Effortful Swallow technique most effectively address, and how does it improve bolus clearance during the pharyngeal phase?

It enhances the strength and coordination of the tongue base and pharyngeal muscles by increasing the force of the swallow, improving bolus clearance and reducing post-swallow residue

What is the primary purpose of the Shaker Exercise in swallowing rehabilitation for patients with dysphagia?

To strengthen the suprahyoid muscles, improve laryngeal elevation, and enhancing the pharyngeal swallow

The Masako (tongue-hold) exercise primarily targets which aspect of swallowing in patients with dysphagia?

It strengthens the pharyngeal muscles, particularly the tongue base, to improve bolus clearance and reduce residue

Throat or laryngeal exercises, such as the effortful swallow, are most beneficial for patients with dysphagia who have difficulty with:

Laryngeal elevation and closure, which are essential for airway protection during swallowing

What is the primary function of tongue resistance exercises in the context of swallowing rehabilitation for dysphagia?

To increase the strength and endurance of the tongue muscles, improving bolus propulsion and overall swallowing efficiency

What is the primary purpose of Falsetto (High Pitch) exercises in swallowing rehabilitation for patients with dysphagia?

To improve vocal fold strength and elasticity, aiding in better airway protection during swallowing

Pitch Glides are most beneficial for patients with dysphagia who experience difficulty with:

Vocal fold tension and coordination, which can affect airway protection and swallowing efficiency

What is the primary purpose of the "Pucker and Hold" exercise in swallowing rehabilitation?

To improve lip closure and control, preventing bolus leakage during the oral phase of swallowing

How does the "Pucker and Smile" exercise contribute to swallowing function in patients with dysphagia?

It targets the lips to enhance control, aiding in better bolus containment and reducing spillage

The "Lip Pucker Against Resistance" exercise is primarily used to:

Improve lip strength and closure, which helps with bolus containment and prevents leakage during swallowing

What is the function of the "Lip Smile" exercise in swallowing rehabilitation?

To enhance lip strength and control, improving bolus retention and reducing spillage during the oral phase

How does the "Alternating Pucker and Smile" exercise help patients with dysphagia?

It strengthens the lip muscles, improving control over bolus containment and preventing oral spillage

The "Lip Press with a Tongue Depressor" exercise is designed to:

Increase lip strength and closure, which helps with bolus control and reduces leakage during swallowing

What is the significance of the "Lip Closure with Resistance Bands" exercise in dysphagia rehabilitation?

It strengthens lip closure by providing resistance, which improves bolus containment and prevents leakage during swallowing

How does "Balloon Blowing (with Resistance)" contribute to swallowing function in patients with dysphagia?

It strengthens the lips and facial muscles, improving lip closure and control during swallowing

What is the primary purpose of "Resistance Tube Exercises" in swallowing rehabilitation?

To enhance lip and facial muscle strength, improving bolus control and reducing spillage during the oral phase

Blowing through a straw is primarily beneficial for improving:

Lip strength and coordination, which helps with bolus containment and reduces leakage during the oral phase

How does the use of Tactile Thermal Oral Stimulation (TTOS) contribute to improving swallowing function in individuals with delayed swallowing reflexes or reduced oral sensitivity?

TTOS enhances the swallowing reflex initiation by stimulating the brain and oral structures and increases sensory awareness to aid in more controlled and efficient swallowing

How do sensory techniques such as the Cold Spoon Technique, Ice Chips, and Sour Flavored Stimulation facilitate improved swallowing function in individuals with dysphagia, particularly those with delayed swallowing reflexes or reduced oral sensitivity?(pst- mention nerves)

By activating sensory receptors in the oral cavity, these techniques enhance sensory awareness, stimulate the trigeminal and glossopharyngeal nerves, and facilitate quicker initiation of the swallowing reflex, improving overall swallow safety and efficiency

How does the EMST150 (Expiratory Muscle Strength Training) device help individuals with dysphagia by improving the coordination of breathing and swallowing?

It strengthens the expiratory muscles, improving respiratory support and the coordination between the respiratory and swallowing phases, which reduces aspiration risk and enhances swallow safety

How does a palatal lift prosthesis contribute to swallowing function in individuals with dysphagia?

It elevates the soft palate to improve velopharyngeal closure, preventing nasal regurgitation and promoting safer swallowing

How does a palatal obturator support individuals with dysphagia?

It fills in gaps in the palate, preventing nasal regurgitation and improving the effectiveness of the swallow

How does repetitive transcranial magnetic stimulation (rTMS) support swallowing rehabilitation for dysphagia?

It stimulates neuroplastic changes in the brain to improve the motor pathways involved in swallowing, leading to better coordination and muscle function

Which of the following best describes how electrical stimulation (neuromuscular electrical stimulation or NMES) helps in dysphagia therapy?

It activates muscles involved in swallowing by stimulating nerve pathways, promoting muscle strength, coordination, and re-education of the swallowing reflex

Which of the following is the primary benefit of using the VitalStim therapy system in dysphagia management?

It uses electrical stimulation to enhance neuromuscular function and improve the strength, coordination, and efficiency of swallowing muscles

What was one of the primary flaws in the original National Dysphagia Diet (NDD)?

It lacked reliable solid food terminology

Which of the following IDDSI levels represents food that holds its shape and requires no chewing?

Level 4 - Pureed

What is the purpose of the IDDSI Flow Test?

To determine liquid thickness using a 10 ml syringe

Which IDDSI level corresponds to liquids that drip slowly through fork prongs?

Level 3 - Liquidized

According to the NDD, which viscosity range is defined as "nectar-thick"?

51-350 mPa·s