Swallowing Questions

What are the two normal hold positions during the oral phase of the swallow?

During what phase is it essential to have an intact labial musculature?

The term peristalsis is used during which phase?

Ossification affects which parts of the swallowing mechanism?

The apneic period is ______________.

Reserve is defined as what according to Logemann?

The lateral view of the oral cavity and pharynx permits examination and measurement of ______ and ________ transit times.

When material falls into the anterior sulcus it is considered to be a disorder due to:

  1. reduced labial tension/tone
  2. reduced buccal tension/tone
  3. reduced tongue control
  4. reduced range of motion/coordination
Reduced velopharyngeal closure results in:
  1. residue on one side of the pharynx
  2. collection in the pyriform sinus
  3. nasal penetration during swallow
  4. vallecular residue after swallow
The term stasis refers to:
  1. peristalsis
  2. transit time
  3. residue
  4. delay
The percentage of people in which the bolus divides equally and passes down the two sides of the pharynx and into the esophagus is:
  1. 90%
  2. 80%
  3. 70%
  4. 60%
Residue in one pyriform sinus is an indication of:
  1. unilateral dysfunction in posterior movement of the tongue base
  2. unilateral dysfunction of pharynx
  3. unilateral dysfunction of velum
  4. unilateral dysfunction of the tongue
What is the first issue to address in a bedside examination?
  1. interview
  2. chart review
  3. trial swallows
It is more important to do an oral mech. exam first than get a patient's history.

True
False

If a person had reduced range of tongue motion the easiest food consistency to handle is thick liquid consistencies.

True
False

Where is the index finger placed during the 4-point swallow?

  1. Top of the tyroid cartilage
  2. Hyoid bone
  3. Behind the mandible anteriorly
  4. Bottom of the thyroid cartilage
Which swallow maneuver is termed the "safe" swallow?
  1. Mendelsohn
  2. Masako
  3. Chin tuck
  4. Supraglottic
Which is not an advantage of a Modified Barium Study?
  1. You can see the whole swallow
  2. You are able to see penetration, aspiration, and retention
  3. The underlying impairment is identifiable
  4. It is inexpensive
Which can not be used to image the oral region?
  1. ultrasound
  2. videoendoscopy
  3. videofluoroscopy
Which procedure is the best to use with a post surgical oropharyngeal cancer patient?
  1. FEES
  2. Videofluroscopy
  3. Ultrasound
If defining the presence of aspiration of saliva is your goal, which procedure should you use?
  1. FEES
  2. Videofluroscopy
  3. EGG
Which is designed to track vocal fold movement by recording impedance changes as vocal folds move toward and away from each other during phonation?
  1. FEES
  2. EGG
  3. Videofluroscopy
  4. EMG
In staging of laryngeal tumors:
  1. the T is followed by a # (1-4)
  2. T1=largest
  3. T4=smallest
  4. All of the above
Tumors located on the free margin of one vocal fold with only local extension are usually treated with a:
  1. vertical laryngectomy
  2. horizontal laryngectomy
  3. hemi-laryngectomy
  4. A and C
  5. B and C
A supraglottic laryngectomy is a procedure used when lesions are found on the supraglottic larynx, predominately involving which structures?
  1. anterior surface of epiglottis
  2. posterior surface of epiglottis
  3. aryepiglottic fold
  4. false vocal folds
  5. true vocal folds
  6. all of the above
  7. a,b,c,d
Large lesions on those involving more than one region of the larynx usually require which of the following:
  1. total laryngectomy
  2. high doses of radiation
  3. chemotherapy
  4. A and C
  5. All of the above
Which of the following impairments affect the oral phase of the swallow?
  1. reduced range of tongue movement vertically
  2. reduced tongue strength
  3. reduced tongue movement laterally
  4. reduced tongue protrusion
  5. A and B only
  6. B and C only
  7. A, B, and C only
  8. None of the above
A physiologicas and anatomical assessment should be completed for any patient in acute care with suspected swallowing disorder.

True
False

A patient who is aspirating ____% of every bolus, regardless of consistency of food, should not be feeding orally.

  1. 5
  2. 10
  3. 15
  4. 20
  5. 50
During a MBS, your patient, exhibits 1)delayed pharyngeal swallow 2) reduced laryngeal closure at the entrance, and 3) reduced laryngeal closure throughout. Which food consistencies are most appropriate for this patient?
  1. thin liquids
  2. thickened liquids
  3. purees
  4. thick foods
  5. A,B,C,D
  6. B,C,D
  7. C and D only
If you have a patient who has a delay in triggering the pharyngeal swallow reflex, the purpose of thermal stimulation is to:
  1. heighten the sensitivity for the swallow and trigger the pharyngeal swallow at the time of stimulation
  2. permanently heighten sensitivity
  3. both
The most frequent problem in stroke patients is:
  1. decrease in pharyngeal constriction
  2. decrease in oral control
  3. delay in triggering the pharyngeal swallow
  4. reduced epiglottic inversion
In most patients with a neurologic disorder, sensitivity to aspiration
  1. is heightened, resulting in a nonproductive cough
  2. is heightened, resulting in a productive cough
  3. remains normal
  4. is decreased
Which of the following is not characteristic of a patient who has had a brainstem (pontine) stroke:
  1. relatively normal pharyngeal swallow
  2. severe hypertonicity
  3. decreased laryngeal elevation
  4. unilateral spastic pharyngeal wall paresis or paralysis
Patients with injuries to cervical vertebrae _________ may have no sensory awareness of their swallowing difficulty.
  1. 3 or 4
  2. 1 or 2
  3. 6 only
  4. 5 or 6
Which of the following is rarely a characteristics of CP clients with dysphagia:
  1. decreased lip closure and tongue thrust
  2. reduced tongue coordination
  3. cricopharyngeal dysfunction
  4. pharyngeal delay
In patients with ALS (predominantly corticospinal involvement), swallowing impairment
  1. doesn't develop for several years after initial diagnosis
  2. often begins with delayed pharyngeal swallow
  3. often begins with a decrease in tongue mobility
  4. often begins with decreased velopharyngeal closure resulting in nasal regurgitation
Which of the following statements is not true of Werdnig-Hoffman Disease (pediatric motor neuron disease):
  1. management strategies basically involve compensatory strategies
  2. will result in paralysis form the shoulder down by 8 to 8 ½ years of age
  3. is diagnosed when the infant begins missing major motor milestones around 12-18 months of age
  4. will eventually result in the child being fed non-orally
Ocular muscles are most often affected first causing ptosis, with
  1. MS
  2. Postpolio syndrome
  3. Myasthenia Gravis
  4. Muscular Dystrophy
A tensilon test is used in a diagnostic evaluation to identify
  1. Dermatomyositis
  2. Muscular Dystrophy
  3. MS
  4. Myasthenia Gravis
Patients with ________ typically exhibit rocking-rolling tongue motion.
  1. Parkinson's
  2. Muscular Dystrophy
  3. ALS
  4. Myasthenia Gravis
Which of the following remarks is not true in regards to Postpolio syndrome:
  1. the typical impairments leave the client at risk of aspiration after the swallow
  2. many patients do not perceive the improvements in their swallowing efficiency following intervention
  3. compensatory strategies are usually the procedures of choice
  4. aggressive exercise in frequently utilized during treatment
Cervical osteophytes are boney outgrowths on the cervical vertebra that displaces the:
  1. posterior pharyngeal wall
  2. velum
  3. anterior pharyngeal wall
  4. UES
Surgically raising the larynx to improve cricopharyngeal opening and airway entrance closure is done occasionally in which patients:
  1. neurologic
  2. head and neck cancer patients
  3. infants
  4. all of the above
Which of the following is not a procedure used to improve vocal fold closure:
  1. vocal fold medialization
  2. Teflon injections
  3. Glycerin injections
  4. Botulinum Toxin injections
Cricopharyngeal myotomy should not be performed early in the recovery course of a patient who has suffered:
  1. a stoke
  2. head injury
  3. spinal cord injury
  4. all of the above
Which of the following structures is not involved in an epiglottic pull-down procedure?
  1. epiglottis
  2. aryepiglottic folds
  3. larynx
  4. arytenoids
The clinician should terminate swallowing therapy when a patient's function plateaus for:
  1. 2 weeks
  2. 4 weeks
  3. 12 weeks
  4. 2 years
The first decision the swallowing therapist must make upon being consulted to see a patient who may be dysphagic is whether the patient is at risk for:
  1. esophageal fistulas
  2. oropharyngeal dysphagia
  3. cervical osteophytes
  4. all of the above
Swallowing therapy is usually designed to:
  1. retain muscle function
  2. teach a new sequence of muscle activity
  3. stimulate increased sensory awareness
  4. all of the above
The staff who serve as feeders for dysphagic patients should
  1. inspect the food on the patient's tray to be sure the correct foods are presented
  2. make sure the food is within the patient's visual field
  3. be under the supervision of the swallowing therapist
  4. discontinue feeding and notify the swallowing therapist if the patient shows any signs of distress during a meal
  5. all of the above
  6. a, c,&d
When a multidisciplinary team for dysphagia is established the following department(s) is/are usually targeted first
  1. internal medicine
  2. neurology
  3. otolaryngology
  4. rehabilitation medicine
  5. gastroenterology
  6. all of the above
  7. c & d
  8. a,b,&c
Areas of research which may prove to be productive in the next ten years include
  1. sensory input and recognition in normal subjects
  2. sensory input and recognition in dysphagic patients
  3. coordination of respiration and swallowing
  4. all of the above
Which is NOT a symptom of Werdnig-Hoffman disease, an aggressive from of pediatric motor neuron disease?
  1. disordered articulation
  2. delayed pharyngeal swallow
  3. normal oromotor function
  4. paralysis
Which of the following does NOT describe the swallowing anatomy in children?
  1. tongue fills the oral cavity
  2. velum hangs lower
  3. hyoid and larynx are lower
  4. more tongue pumps
Which of the following is a reflex seen in infants?
  1. rooting
  2. phasic bite
  3. supraglottic swallow
  4. both a & b
A full oral feeding for an infant should normally last:
  1. 45 minutes
  2. until they stop sucking
  3. less than 30 minutes
  4. none of the above
The pharyngeal delay time is the same for infants as for adults.

True
False

A modified barium swallow can be administered to an infant

True
False

Preoperative counseling for head and neck cancer patients should NOT:

  1. include a swallowing screening
  2. include a dental consultation
  3. inform the patient of possible post-operative rehabilitation services available
  4. give detailed information of patient's treatment
Patients who have small surgical resections of the tongue typically have what kind of swallowing problems?
  1. decreased laryngeal elevation
  2. reduced epiglottal inversion
  3. difficulties triggering pharyngeal swallow
  4. vallecular retention
When deciding on resecting due to cancer or tumors in the oral cavity, the doctor does not take into consideration:
  1. surrounding structures being affected
  2. size of tumor
  3. numbers of nodes affected
  4. maintaining normal function in patient
A radical neck dissection removes the following structures:
  1. submandibular lymph nodes
  2. lymph nodes in the neck
  3. sternocleidomastoid muscle
  4. vocal cords
What do the T, N, and M stand for when talking about the stages of cancer?