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Dysphagia Exam 2 CSD UMD Flashcards | StudBud
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Dysphagia Exam 2 CSD UMD
Dysphagia Exam 2 CSD UMD
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1
RSST: Repetitive Saliva Swallowing Test. Count # of dry swallows via palpatations, low probability of false positive.
True
False
2
When is imaging indicated?
After a screening is passed
It doesn't matter- always do imaging to be safe
After a screening is failed
3
Sensory aspects of adjusting diet
Texture/visual
Taste
Temperature
Thickness
4
To reduce residuals:
LSVT
Shaker
Mendelsohn
Masako
5
How much do you have to aspirate before getting aspiration pneumonia?
Based on IDDSI guidelines
1 fluid oz.
When fluid is detected in alveoli sacs
Based on judgement
6
Head tilt towards the weak side.
False
True
7
Lazenby article said there is conflicting evidence supporting thickened liquids due to surrogate and hard endpoints
True
False
8
Indirect treatment strategies: exercises in the field that positively affect the swallow (not done while eating)
False
True
9
What are some respiratory risk factors?
Reduced max isometric tongue to palate pressure
Low baseline O2 Sat. (~80%)
Increased bolus "dwell time" in pharynx before swallow trigger
Reduced anterior hyoid movement
10
MacRae:
False
True
11
Postural strategies are direct interventions.
True
False
12
What is the cause of aspiration in the pharyngeal phase? (during/after swallow)
Secondary to delayed swallow trigger
Secondary to poor vocal fold closure/laryngeal valving
Secondary to residuals (stasis)
13
Chin tuck: compensatory swallow maneuver that protects airway and reduces aspiration
False
True
14
How do you assess oral prep phase?
Assess chewing
Assess oral residue
Assess lip seal
Assess duration
15
Yale swallow protocol is:
High specificity and low sensitivity
Low specificity and low sensitivity
Fairly low specificity and HIGHLY sensitive
Fairly high specificity and HIGHLY sensitive
16
Intervention for vocal fold paralysis
EMST
LSVT
17
Why alter viscosity?
Less cohesion
More proprioception
Slower flow rate
decreased aspiraiton
18
Free water protocol candidates must have
good mobility
good hair
good cognition
good oral care
19
Huckabee/burnup:
True
False
20
What is the purpse of clinical dysphagia assessment?
Assess integrity of upper airway and digestive tract
To ensure independence
Assess overall health
To be highly sensitive and highly specific
21
Facilitative strategies are indirect interventions.
False
True
22
T or F: positive (false/true) results represent specificity
True
False
23
Coyle:
True
False
24
To promote airway protection...
Mendelsohn
Effortful swallow
LSVT
Supreglottic and super supraglottic
25
Sensory approaches
Bolus modification
Thermal/tactile stimulation
Bolus enhancement
Modified diets
26
To increase oral motor control
Bolus management
tongue base strength
Resistance exercises
Chin tuck
27
Murray: people on free water protocol drink more liquids
False
True
28
Shaker exercise: increases duration of UES opening
True
False
29
Laryngeal penetration is the same thing as aspiration.
True
False
30
What is one example of a postural strategy?
Tilt back
Head turn
Head tilt
Chin tuck
31
What screener has poor inter-rater reliability?
VFSS
CSE
FEES
MBS
32
What is aspiration pneumonia?
Alveoli sacs fill with gas, blocking gas
Infection in esophagus
Alveoli sacs fill with fluid block gas exchange
Alveoli sacs fill with gas, blocking liquid
33
EMST: glottal closure exercise practicing bearing down and forceful inspiration
False
True
34
Free water protocol can be assigned when there is low compliance.
True
False
35
Mendelsohn Maneuver: hold larynx up after it lifts, helps reduce laryngeal elevation
False
True
36
What is the goal of clinical dysphagia assessment?
To ensure independence
Based on judgement
To ensure true positives and true negatives
To be highly sensitive and highly specific
37
Screening protocol: positioning, oral mech/CN, effectiveness of strategies, presentation sequence (post NPO), imaging
False
True
38
What is one facilitative strategy?
Breath hold
Mendelsohn
Super supraglottic
Effortful swallow
39
According to lecture, which two assessments have highest inter-rater reliability?
VFSS
MBS
CSE
FEES
40
How do you assess the pharyngeal phase?
Palpate larynx
Assess chewing
Listen to voice quality
Stethescope
41
Masako Maneuver: tongue base retraction and tongue base strength
True
False
42
Labeit: VFSS and FEES can both adequately assess penetration, aspiration, and pharyngeal residue gold standards
True
False
43
IDDSI is based on foods and liquids, based on thickness and drip test.
False
True
44
Effortful swallow: compensatory strategy that protects the airway and increases posterior motion of the tongue
False
True
45
Leder (2011):
False
True
46
Why not alter viscosity
less aspiration
more cohesion
tongue to hard palate pressure
increased force on bolus required
47
In order to be diagnosed with dysphagia, you need to have imaging.
False
True
48
No aspiration at the time of imaging means no aspiration at time of fatigue.
True
False
49
Symptom specific strategies are indirect interventions.
False
True
50
Phases of the swallow
oral prep, oral, pharyngeal, esophageal
esophageal, oral prep, oral, pharyngeal
oral prep, pharyngeal, oral, esophageal
oral, oral prep, pharyngeal, esophageal
51
Thin liquids have low viscosity.
True
False
52
Fail Yale Swallow Protocol (3 oz water test)
Delayed cough
Throat Clear
Immediate cough
Stops drinking
53
Leder (2015):
False
True
54
Hydration characteristics: as we age, total body water content and thirst increases
True
False
55
Mann Assessment of Swallowing Ability (MASA) is: designed for use in BEDSIDE EVALUATIONS
False
True
56
What is a true negative?
Negative result, does not have condition
Negative result, has condition
Positive result, has condition
Positive result, does not have condition
57
You can penetrate on every swallow and not aspirate.
False
True
58
IOPI: strengthens pharyngeal muscles to assist in swallowing
False
True
59
What is a false positive?
Negative result, does not have condition
Negative result, has condition
Positive result, has condition
Positive result, does not have condition
60
Hamdy: bolus enhancement, warm and citrus increases sensitivity and sensory drives motor :)
True
False
61
Increase peristalsis
LSVT
Effortful swallow
Masako
EMST
62
What is the cause of aspiration before swallow?
Secondary to poor vocal fold closure/laryngeal valving
Secondary to residuals (stasis)
Secondary to delayed swallow trigger
63
For dysphagia treatment:
Aspirate
Maintain/improve overall health through nutrition
Least restrictive diet
Maintain quality of life
64
What is a true positive?
Positive result, has condition
Negative result, does not have condition
Positive result, does not have condition
Negative result, has condition
65
Presentation protocol: 5mL nectar-like liquids--> 5mL liquids--> 5mL pudding--> Repeat w/ 10mL--> Cup of thin liquid etc
False
True
66
When should you screen?
Coughing after the swallow
Weak cough on demand
Reduced laryngeal elevation
Wet vocal quality
67
What is one example of a symptom-specific strategy?
EMST
IOPI
Masako
Glottal closure
68
Thickened liquids have a trend of improving hydration
False
True
69
To promote tongue base strength
LSVT
IOPI
Masako
EMST
70
How do you assess esophageal phase?
Palpate sternum
Stethescope
Cannot assess
Palpate larynx
71
What is a false negative?
Negative result, has condition
Positive result, has condition
Negative result, does not have condition
Positive result, does not have condition
72
Aspiration perceptual characteristics
Clearing throat
Eye watering
Dry heaving
Gurgly, wet breath sounds
73
How do you assess oral phase?
Feel tongue movement
Palpate larynx
Check oral residue after swallow
Stethescope
74
Head turn towards the weak side.
True
False
75
What is the cause of aspiration in the esophageal phase? (after swallow)
Secondary to residuals (stasis)
Secondary to delayed swallow trigger
Secondary to poor vocal fold closure/laryngeal valving
76
T or F: negative (false/true) results represent specificity
False
True
77
Mancopes: clear evidence regarding EMST as a sufficient practice
False
True
78
Post NPO puree screen
1/2 tsp puree, 1 tsp puree, small amt. thickened liquids, etc.
1/2 tsp puree, if aspiration, small bite of cracker
79
Butler: correlation between hand-grip strength and a person's aspiration status
False
True
80
Silent aspiration is past the PES opening and not coughing.
False
True
81
Direct treatment strategies: exercises in the field that positively affect the swallow (not done while eating)
False
True
