Exam# 3 (Final) - T/F Questions

Lectures 7-9

A head-tilt strategy during swallow to the stronger side of the pharynx will direct a bolus down the weak side.

False. Head tilt strategy directs a bolus down the stronger side with the aid of gravity.

Implementing a swallow postural technique to dysphagic patients should be done after an instrumental swallow assessment is conducted to confirm its effectiveness.

True

Bolus modification has been shown to be a more effective method of preventing penetration and aspiration compared to the chin-tuck posture in the elderly.

True

All individuals who aspirate with liquids or solids develop aspiration pneumonia

False, not all individuals who aspirate will develop aspiration pneumonia, other facts such as amount aspirated and oral hygiene contribute as well.

Compensatory therapy aims to improve the long-term physiology of swallowing

**False. Compensatory therapy aims to ensure safe swallowing.**

Compensatory therapy is only effective for the oral preparatory and oral phases of swallowing

**False. Postural changes may also change the pharyngeal phase**

The supraglottic swallow maneuver is an effective technique for achieving vocal fold closure for a swallow

True

Nonsurgical treatments for swallowing disorders are for patients with strokes and neurological disorders exclusively

**FALSE, Treatment can be for any clinical population as well as patients with difficulty swallowing.**

Speech-language pathologists should follow the principles of \n evidence-based practice in making clinical decisions.

True

Nonsurgical dysphagia management is a team effort that is led \n by the SLP.

True

It is ethical to withhold (otherwise available) treatment program \n to patients for the sake of collecting scientific evidence

**False, because it is unethical**

Poor oral hygiene and dysphagia are both risk factors for \n aspiration pneumonia, especially in the elderly

True

Occasional aspiration is to be expected in patients undergoing rehabilitative swallowing therapy.

True

Practicing timing movements with placing an empty cup to the lips and removing it will not improve labial function in swallowing.

**False**, practicing this movement will improve labial function in swallowing which helps improve the strength and awareness of control of the swallowing mechanisms.

The Shaker exercise has been shown to increase the opening of the UES and decrease the hypopharyngeal bolus pressure.

True

Allowing a specified time to pass in post-cancer patients with head and neck cancer is preferred to immediate treatment.

**False**, treatment should be preventative and concurrent to medical therapy, and begin before surgical or radiation therapy is carried out.

**Swallowing cold water compared to body temperature water has been shown to increase the overall speed of swallowing.**

True

**Oral motor exercises can be used to increase endurance of lip seal.**

False, oral motor exercises target the tongue, not the lips.

**Currently, there is no evidence to support the use of lingual exercises for patients with swallowing disorders.**

False, a number of studies have found these exercises to be efficacious 

**LSVT may be useful for both swallowing and for speech improvement in patients who have Parkinson disease and other neurological disorders.**

True

Swallow safety is the top priority of the dysphagia management team, together with maintaining nutrition and quality of life of the patient.

True

Proper nutrition can be achieved by a combination of oral and non-oral diet.

True

As a fluid becomes more viscous, it is more easily deformed.

False, it becomes more difficult to deform

Most foods or fluids that are eaten are non-newtonian.

True

One of the purposes of the International Dysphagia Diet Standardization Initiative is to restrict the levels of consistencies for testing when doing fluoroscopic swallow studies.

False, IDDSI is to allow consistent testing and documentation for comparisons across time, patients, and studies.

Thickened fluids retain their consistency with time.

False. This depends on the type of thickener used.

Extremely thick (level 4) liquids are suggested for those with poor tongue control, but will increase the risk of post swallow residue.

True

SLPs should provide guidelines on modified food and drink preparation to other health care professionals only.

False, The patient and his/her family members should be given guidelines as well.

Food texture is not related to chemical senses of taste or odor.

True

All foods and drinks behave similarly in persons with different types and severity levels of dysphagia.

False, foods and drinks may behave differently.

Even when limits are set for an elderly patient's oral diet to ensure swallow safety, they should not be so restrictive as to discourage oral intake.

True

After the initial diagnosis and recommendation for safer feeding, the clinician no longer needs to see the patient again.

False. Regular follow-ups are necessary.

A gastrostomy is a permanent fixture once it is in place

False. A gastrostomy may be a temporary solution while the patient recovers and improves with therapy.

Nasogastric feeding tubes are usually used in patients who will be on longterm nonoral diets.

False. Nasogastric tubes can be uncomfortable and cosmetically undesirable for long-term use

Choice of a nonoral diet via feeding tube is made based on the findings of the instrumental swallow examination.

False. Other factors such as dentition, living situation, and physical disabilities should also be considered.

Once a feeding tube is in place in the elderly, it is best to discontinue swallow exercises as they only make the patient more frustrated because he/she cannot eat orally.

False. Even with elderly patients, all attempts to encourage oral feeding should be part of the swallow treatment plan.

Patients with degenerative neuromuscular diseases should be placed on a feeding tube after they can no longer eat anything by mouth and show signs of malnutrition.

False. They should be on a feeding tube when they have the desire to maintain nutrition and before they can no longer eat orally.

Getting the prescribed amount of calories will allow a patient to recover from malnutrition.

True

Malnutrition in hospital patients has comorbidities unrelated to the underlying diagnosis

True

A pH test of tube aspirate is recommended for all types of tube-feeding.

False. Only for nasogastric tubes.

Elderly patients should be allowed to eat a liberal diet in order to maintain their social status and outside living activities as long as safety of swallowing is preserved in the diet.

True

Compensatory swallow therapies can be used to increase protective valving of the vocal folds but not stimulation of pharyngeal stage of the swallow.

False

The supraglottic swallow is helpful in attaining laryngeal closure.

True

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

True

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

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

Preventive swallowing therapy is designed to target head and neck cancer survivors.

True

VitalStim uses electrical stimulation which passes a current through electrodes to stimulate the pharyngeal area via a transoral cathether.

False

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

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

True

Swallowing postures can help with oral but not the pharyngeal stages of the swallow.

False

Consistency relates to the firmness and thickness of foods.

True

IDDSI was established in 2013 and with an official launch date of in the United States in 2019.

True

The first four liquid levels of the IDDSI use a 5 ml syringe to measure the flow within 10 seconds

False, 10 ml

A food example of IDDSI level 4 is ground beef and marinara sauce.

False

Level 3 of the IDDSI shows has a bolus that drips slowly or in dollops/strands through the slots of a fork.

True

Parenteral feeding means feeding through a tube.

False

Nasogastric tubes (NGT) is usually for short term use.

True

J-tubes go directly into the stomach and are most commonly used.

False

NJ tubes need to changed each month.

True