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