Exam #1 True or False Questions

SLP 477-Swallowing Disorders

A normal swallow is possible even if all swallowing organs are not normal

True

Most people will occasionally aspirate some food or fluid.

True

Aspiration pneumonia is the result of a pulmonary infection

True

The normal individual does not require as much water as the neurologically impaired person.

False

All individuals require enough water and other fluids to prevent dehydration.

Chewing is more difficult for people who lack adequate hydration.

True

People at risk for aspiration should not take liquids.

False

Under controlled swallowing situations, it is possible for persons at risk for aspiration to learn to manage small sips with various exercises and postures

Malnutrition will decrease the speed of recovery in stroke patients.

True

Malnutrition can be found in all patients with a neurological disease.

False

With the aid of non-oral feeding and with proper nutrition management, they can maintain a healthy recovery

Unplanned weight loss is a welcome event for overweight people who are over the age of 60.

False

Unplanned weight loss in an otherwise healthy individual is a symptom of dysphagia and should be explored initially by the primary care physician.

The study of pneumonia rates pre and post early intervention by Odderson and collegues suggests that the cost of an early intervention program reduces the overall cost of treating pneumonia.

True

Hospitals will benefit from early intervention programs because the cost of non-oral feeding is more expensive than oral feeding.

True

Adult patients undergoing surgery to the kidneys, liver, or hips may experience dysphagia after these procedures.

True

The incidence of swallowing disorders in CVA patients is about 42%.

True

Cortical strokes result in dysphagia more than any other type of stroke

False

Brain stem strokes

Approximately 20% of stroke patients die due to aspiration pneumonia in the first year after the stroke.

True

Older adult individuals over the age of approximately 80 years are likely to have dysphagia even without knowing it.

True

The Lateral cricoarytenoid muscle is the major sphincter in the upper esophagus.

False, it is the cricopharyngeus muscle also known as the UES.

Failure of the velopharyngeal sphincter to close (contract) during a swallow is most likely to result in air or the bolus to leak into the airway.

**False;** failure to closure leaks into the nasopharynx

The most important sphincter for preventing the entrance of food or liquid into the subglottic \n airway is the vocal folds.

False; velopharyngeal sphincter

The upper esophageal sphincter is normally in a state of tonic contraction when the patient is \n not swallowing

True

The voluntary and involuntary phases of swallowing are partially ongoing in the same time frame when swallowing is normal.

True

All four phases of swallowing are amenable to treatment in a proper dysphagia management program.

True

Because of the overlapping of the actions during swallowing, it is not necessary for the larynx to elevate to have a normal swallow. 

False

The vocal folds do not have to close completely for the swallow to occur without aspiration or penetration.

True

Difficulty chewing or inability to chew various textures of food is a problem in the pharyngeal.

False, it is the oral preparatory and oral phase. 

A delayed cough or cough after the swallow is usually a sign of a pharyngeal phase swallow problem.

True

When food of liquid penetrates to the level of the vocal folds, the voice quality is most likely to change.

True

Despite modification of food textures or bolus size, a pharyngeal phase swallowing problem is unlikely to improve

False. Modification of food textures or bolus size CAN improve pharyngeal phase swallowing problems because it makes it easier for the brainstem coordinates with many muscles to push food down reflexively. Also, it may improve with improved laryngeal elevation or stimulation with cold as well as tongue strength exercises. 

The lack of coordination of the major sphincters in the swallowing mechanism is likely to lead to a problem when swallowing liquids.

true

The internal branch of the superior nerve is responsible for glottic closure during the passage of \n the bolus to the esophagus

False, this is the recurrent branch is the motor branch.

The superior laryngeal nerve has both sensory and motor functions

True

Cortical regulation of swallowing is represented in the LEFT hemisphere of the brain

**False**, it is represnted in both hemispheres

The central pattern generator for coordinating the act of swallowing is located in the brainstem.

True

The teeth are the primary manipulators of the bolus during the oral phase of swallowing

**False, the tongue.**

Bolus containment is the responsibility of the tongue.

**False, the tongue and the oral cavity (aside from the tongue also the lips and cheeks)  are the responsibility.**

\

To improve the pharyngeal phase of swallowing in the normal person, reducing the size of the bolus is the most important factor.

False; **Maintaining the consistency of the bolus is the most important**

The pharyngeal phase of swallowing is involuntary.

True

There is no sensory information occurring during the oral preparatory phase of swallowing.

**False; sensory information occurs in the oral preparatory phase**

The loss of the molar teeth will not affect the transfer stage of the oral preparatory phase

True

Chewing is part of the oral phase of swallowing.

False, chewing is part of the oral preparatory phase. 

Normal bolus movement is a combination of pressure and tongue posture

True

Inflammatory myopathies cause swallowing problems due to the fact that \n the muscle over acts during the act of swallowing.

**False, inflammatory myopathies cause swallowing problems due to the fact that the muscle is weak and causes fatigue during the act of swallowing**

Myasthenia gravis is a disorder that reduces the muscular activating \n network and results in muscle fatigue

true

Oral, pharyngeal, laryngeal but not esophageal problems usually lead to \n aspiration of foods and liquids in Parkinson's patients.

**False, Esophageal problems also lead to aspiration of foods and liquids in Parkinson's patients**

Parkinson's disease patients are more likely to have less oral phase problems \n of swallowing than patients who have had a stroke

**False, they often have drooling due to muscular weakness**

The risk of aspiration pneumonia in patients with Parkinson's disease \n increases over time

true

Tests of swallowing for patients with neurological disorders are usually

done in conjunction with a neurosurgeon.

False

Amyotrophic lateral sclerosis is a disorder of the upper and lower motor

neuron systems.

True

Lower motor neuron disease usually results in damage from the motor

nuclei in the cerebellum.

False, spinal cord and brainstem

The risk of aspiration pneumonia in patients with strokes increases over Time

False, it decreases over time