Dysphagia Midterm Practice Questions

What is the function of the buccal cavity in swallowing?

It helps prevent food and liquid from pocketing in the lateral sulci.

How does buccal tension contribute to swallowing?

It helps keep food from collecting in the lateral sulci by maintaining cheek tone.

What structure allows communication between the oral, nasal, and pharyngeal cavities?

The oropharyngeal isthmus.

Where does the pharyngeal cavity extend?

From the base of the skull to the level of C6 posteriorly and the cricoid cartilage anteriorly.

What are the three levels of airway protection in the laryngeal cavity?

True vocal folds (TVF), false vocal folds (FVF), and the epiglottis.

What is the function of the hyoid bone in swallowing?

It is the foundation for hyolaryngeal excursion, assisting in laryngeal elevation and airway protection.

What are the primary mandibular depressors?

Digastricus anterior, mylohyoid, geniohyoid, and lateral pterygoid.

What muscles form the floor of the mouth?

Mylohyoid, geniohyoid, and anterior belly of digastric.

What are the primary mandibular elevators?

Masseter, temporalis, and medial pterygoid.

Where does the oral tongue end?

At the circumvallate papillae

What is the difference between the oral tongue and pharyngeal tongue?

The oral tongue is voluntary, while the pharyngeal tongue is involuntary.

What muscle pulls the soft palate down and forward against the tongue?

The palatoglossus muscle.

What is the function of salivary glands in swallowing?

They maintain oral moisture, assist in digestion, and help with bolus formation.

Where are the valleculae located?

Between the base of the tongue and the epiglottis

What is the clinical significance of the pyriform sinuses?

Food or liquid residue may collect there, leading to aspiration risk.

What are the two names for the cricopharyngeus region?

Upper esophageal sphincter (UES) and pharyngoesophageal sphincter (PE).

What is the function of the cricopharyngeus muscle?

It prevents air from entering the esophagus during respiration and reduces backflow from the esophagus into the pharynx.

Where is the cricopharyngeus muscle located?

At C5 and C6.

What are the three components of the pharynx?

Nasopharynx, oropharynx, and laryngopharynx

What is the function of the superior, medial, and inferior pharyngeal constrictors?

They form the posterior and lateral pharyngeal walls and contract to propel the bolus into the esophagus.

When does the esophageal phase of swallowing begin?

When the bolus enters the UES.

What is the purpose of the labial seal in the oral preparatory phase?

To keep the bolus contained within the oral cavity.

What occurs during the oral transit stage?

The tongue moves the bolus posteriorly to initiate the pharyngeal stage.

What triggers the pharyngeal swallow?

When the bolus passes the anterior faucial pillars.

How does the soft palate contribute to swallowing?

It elevates to prevent nasal regurgitation.

What is the role of the true vocal folds in swallowing?

They adduct to prevent aspiration.

How does the larynx move during swallowing?

It elevates and moves forward as a unit.

How long does the esophageal stage typically last?

10-20 seconds.

What cranial nerves are primarily responsible for the pharyngeal swallow?

Cranial nerves IX (Glossopharyngeal) and X (Vagus).

What occurs if pharyngeal constriction is weak?

Residue may remain in the pharynx, increasing aspiration risk.

A patient demonstrates food falling out of their mouth. What might be the underlying issue?

Reduced lip closure

What disorder leads to food pocketing in the lateral sulcus?

Reduced buccal tension.

A patient presents with premature spillage of the bolus into the pharynx. What is the likely disorder?

Reduced linguavelar seal.

What symptom is associated with reduced tongue range of motion?

Residue on the tongue after swallowing.

A patient has nasal regurgitation during swallowing. What is the likely cause?

Reduced soft palate elevation.

What might be indicated by residue in the valleculae after swallowing?

Reduced tongue base retraction.

A patient exhibits unilateral residue in the pharynx. What could this suggest?

Unilateral pharyngeal weakness.

What disorder is associated with slow laryngeal elevation?

Aspiration during the swallow.

A patient shows aspiration after swallowing due to pharyngeal residue. What might be the cause?

Reduced pharyngeal constriction.

What symptom results from reduced airway closure?

Aspiration during the swallow.

What is the function of the glossopharyngeus muscle in swallowing?

It contributes to tongue base retraction and attaches to the tongue base.

How does the epiglottis protect the airway during swallowing?

It inverts over the laryngeal opening to prevent food and liquid from entering the trachea

What are the structures of the larynx involved in swallowing?

Aryepiglottic folds, arytenoid cartilages, false vocal folds, laryngeal ventricle, and true vocal folds.

What is the purpose of the aryepiglottic folds?

They form the lateral walls of the laryngeal opening and help direct food away from the airway.

Where is the laryngeal ventricle located?

Between the false vocal folds (FVF) and true vocal folds (TVF).

What are the three laryngeal sphincters that help prevent aspiration?

True folds, false folds, epiglottis

What is the primary function of the esophagus?

To transport the bolus from the pharynx to the stomach.

What is the anterior sulcus, and why is it significant in swallowing?

It is the space between the lower lip and the alveolar ridge; food may collect there with reduced labial tone.

What happens to respiration during the pharyngeal stage?

It ceases reflexively to prevent aspiration.

What is the function of the tongue during the oral preparatory phase?

It holds and manipulates the bolus for mastication and bolus formation

What action initiates the pharyngeal stage?

The bolus passing through the anterior faucial pillars.

What causes the epiglottis to invert during swallowing?

The elevation and forward movement of the hyoid and larynx.

What happens if the UES fails to relax?

The bolus may not enter the esophagus, leading to residue in the pyriform sinuses.

What is the function of the pharyngeal constrictors in swallowing?

They contract sequentially to propel the bolus through the pharynx.

What cranial nerves play a role in velopharyngeal closure?

Cranial nerves IX (Glossopharyngeal) and X (Vagus).

How does reduced pharyngeal constriction affect swallowing?

It may cause residue in the pharynx, increasing the risk of aspiration.

What happens to the oral and pharyngeal structures after the esophageal stage?

They return to rest or prepare for another swallow.

What symptom is associated with reduced lip closure?

Food falling anteriorly out of the mouth.

A patient has premature spillage of the bolus into the pharynx. What disorder might be present?

Reduced tongue shaping and/or reduced linguavelar seal.

What disorder results in food lodging in the anterior sulcus?

Reduced labial tension or tone.

What symptom results from reduced buccal tension?

Food collecting in the lateral sulcus.

What might cause a patient to have difficulty forming a cohesive bolus?

Reduced tongue motion or coordination.

A patient exhibits anterior bolus loss during swallowing. What is a likely cause?

Tongue thrust.

What happens if a patient has reduced tongue range of motion or strength?

Food residue remains on the tongue after swallowing

What is a common swallowing difficulty in patients with Parkinson's disease?

Repetitive lingual rocking or rolling

A patient with tongue scarring has bolus residue in a specific depression. Why?

Scar tissue is immobile, preventing complete bolus clearance.

What symptom occurs if there is a delayed trigger of the pharyngeal swallow?

The bolus may dwell in the pharynx before initiating the swallow.

What disorder results in nasal regurgitation during swallowing?

Reduced velopharyngeal closure.

What symptom occurs with reduced tongue base movement?

Vallecular residue, potentially leading to aspiration after swallowing.

A patient has unilateral pharyngeal weakness. What might be observed?

Residue on one side of the pharynx and in the pyriform sinus.

What symptom occurs when there is reduced laryngeal elevation?

Residue in the laryngeal vestibule, increasing aspiration risk.

What is a potential consequence of slow laryngeal elevation?

Penetration or aspiration during the swallow.

A patient demonstrates aspiration after the swallow. What disorder might be present?

Reduced pharyngeal constriction or reduced CP opening

What symptom results from incomplete airway closure?

Aspiration during the swallow.

What is the cause of piecemeal deglutition?

The patient swallows small portions of the bolus instead of a single cohesive swallow

A patient with a stroke presents with residue in both pyriform sinuses. What does this indicate?

Bilateral pharyngeal weakness

What swallowing disorder is common in patients with brainstem strokes?

Delayed pharyngeal swallow and reduced airway closure.

Why does a reduced linguavelar seal cause aspiration before the swallow?

The bolus spills into the pharynx before the airway is protected.

How does reduced hyoid elevation affect swallowing?

It impacts UES opening and increases aspiration risk.

What could cause residue in the pyriform sinuses?

Reduced anterior laryngeal motion or cricopharyngeal dysfunction.

A patient has slow pharyngeal transit and aspiration of residue after swallowing. What is the likely cause?

Reduced pharyngeal constriction.

A patient with ALS presents with reduced tongue strength. What swallowing symptoms might they exhibit?

Difficulty forming a cohesive bolus and oral residue.

What might cause silent aspiration?

Reduced airway sensation preventing cough reflex.

A patient presents with nasal regurgitation and pharyngeal residue. What might be impaired?

Velopharyngeal closure and pharyngeal constriction

A patient demonstrates food sticking in their throat. What might be the cause?

Reduced pharyngeal constriction or CP dysfunction.