Adult Dysphagia Midterm

David is 78 years old. He started to notice that he coughs more frequently during his mealtimes. Also, he sometimes has to swallow multiple times to clear his throat. He was referred to an SLP for a complete swallowing evaluation. The SLP noticed that there is a delayed pharyngeal response along with reduced hyoid elevation during swallowing. What are the symptoms? (multiple answers may apply) a. Delayed pharyngeal response b. Reduced hyoid elevation c. Multiple swallows per bolus d. Coughing

-multiple swallows per bolus -coughing

In general, thicker bolus viscosities will a. Create less effort and movement in the swallow and tend to slow it down b. Create less effort and movement in the swallow and tend to make it faster c. Create more effort and movement in the swallow and tend to slow it down d. Create more effort and movement in the swallow and tend to make it faster

Create more effort and movement in the swallow and tend to slow it down

The relaxation of this muscle opens the pharyngoesophageal segment during the esophageal phase of swallowing. A. Palatopharyngeus B. Criocopharyngeus C. Salpingopharyngeus D. Pharyngeal constrictors

Criocopharyngeus

Which statement is correct? a. Feeding disorder may be used interchangeably with swallowing disorders for infants or children b. Eating disorder refers to impairment of the food transport outside the alimentary canal c. Patients with eating disorders usually complain of swallowing problems d. Feeding disorder refers to changes in dietary selections, and problems with the oral transport of the bolus

Feeding disorder may be used interchangeably with swallowing disorders for infants or children

What is the most common respiratory pattern during swallowing? a. Inhale-brief exhale- swallow apnea- finish exhale b. Brief exhale-inhale-swallowing apnea- finish exhale c. Swallowing apnea- brief exhale -inhale- finish exhale d. Brief exhale- swallowing apnea-Inhale- finish exhale

Inhale-brief exhale- swallow apnea- finish exhale

Which of the following is among the psychosocial consequence of dysphagia a. Malnourishment b. Aspiration Pneumonia c. Dehydration d. Loss of quality of life

Loss of quality of life

In order to fully understand the underlying cause of the problem, David should be referred to a(n)_________ . a. ENT b. Psychologist c. Gastroenterologist d. Neurologist

Neurologist

"Based on the existing evidence, feeding tubes in advanced dementia " a. Prevent aspiration pneumonia b. Prolong survival c. Reduce pressure sores or infections d. None of the above

None of the above

All of these muscles are innervated by the trigeminal nerve except a. Temporalis b. Masseter c. Orbicularis oris d. Medial pterygoid

Orbicularis oris

Which muscle raises back of the tongue to keep the bolus in the mouth during chewing? a. Palatoglossus b. Digastric c. Buccinator d. Palatopharyngeus

Palatoglossus

All the following muscles are active during chewing EXCEPT A. Medial pterygoid B. Masseter C. Temporalis D. Palatopharyngeus

Palatopharyngeus

Which group of patients usually have good stamina for dysphagia treatment? a. Patients in Skilled Nursing Facility b. Patients in acute care c. Patients in rehab d. Patients in Home Healthcare

Patients in rehab

Aging can make the following changes on swallowing EXCEPT a. Reducing hyolaryngeal excursion b. Increasing pharyngeal pressures c. Reducing pharyngeal constriction d. Reducing PES opening and decreasing open time

Reducing pharyngeal constriction

Which one is NOT considered a clinical symptoms of dysphagia? a. Food sticking b. Reduction in tongue strength c. Coughing and choking during and/or after a meal d. Pain on swallowing

Reduction in tongue strength

Which statement is correct regarding the esophageal stage of swallowing? a. The Secondary peristalsis is the highest and therefore the strongest. b. Primary peristalsis initiated by bolus distention of esophagus at any location c. Secondary peristalsis often assists in primary transport of solid food boluses d. Tertiary contractions are often orderly and peristaltic

Secondary peristalsis often assists in primary transport of solid food boluses

A comprehensive definition of dysphagia should encompass a. Signs, medical history, and quality of life b. Sign, symptoms, and level of impairment c. Patient chief complains and related consequences d. Signs, symptoms, and consequences

Signs, symptoms, and consequences

The Physiologic reserve is a. The difference between maximum pressure and sub maximum swallowing pressures divided by tidal respiratory capacity b. The sum of maximum pressure and sub maximum swallowing pressures divided by tidal respiratory capacity c. The sum of maximum pressure and sub maximum swallowing pressures d. The difference between maximum pressure and sub maximum swallowing pressures

The difference between maximum pressure and sub maximum swallowing pressures

All the following statements regarding the neurological control of swallowing are correct EXCEPT A. Multimodal sensory impulses are sent to the nucleus tractus solitarius (NTS), which initiates the pharyngeal swallow B. The oral preparatory stage of swallowing is highly involuntary. C. Higher control centers may be involved in continuing, modifying, and monitoring swallowing and also responding to input variability D. Motor function of swallowing is mediated by the nucleus ambigus (NA) via multiple cranial nerves

The oral preparatory stage of swallowing is highly involuntary.

The oral stage of swallowing involves a. Transport of food from the pharynx to the esophagus b. Mastication of food in preparation for transfer c. Movement of food through the esophagus into the gastric cardia d. Transfer of food from the mouth to the oropharynx

Transfer of food from the mouth to the oropharynx

This cranial nerve plays a prominent role during pharyngeal swallowing. A. Trigeminal (V) B. Abducens (VI) C. Facial (VIII) D. Vagus (XII)

Vagus (XII)

Dysphagia in brainstem is characterized by a. Incoordination between stages and between swallowing and respiration b. Muscular weakness c. incomplete swallow d. All of the above

all of the above

Swallow-generated pressures are most sensitive to changes in _____________. a. Viscosity b. Temperature c. Taste d. Volume

viscosity

The coordination of swallowing gestures based on different bolus characteristics is called a. Sarcopenia b. Bolus accommodation c. Swallowing reflex d. physiologic reserve

bolus accommodation

What are the signs? (multiple answers may apply) a. Coughing b. Delayed pharyngeal response c. Multiple swallows per bolus d. Reduced hyoid elevation

-delayed pharyngeal response -reduced hyoid elevation

The highest prevalence of dysphagia is in the ______ phase of stroke. a. Rehabilitative b. Subacute c. Acute d. Long term

Acute

All the followings are mechanisms of the pharyngoesophageal segment opening EXCEPT a. Bolus driving forces b. Aerodynamic traction c. Mechanical traction d. Brainstem disinhibition

Aerodynamic traction

The Pharyngeal Stage begins when the a. Bolus arrives at valleculae b. Epiglottis inverts c. Hyoid bursts d. PES opens

Bolus arrives at valleculae

What is the best term to describe David's problem? a. Feeding disorder b. Anorexia c. Dysphagia d. Bulimia nervosa

Dysphagia