Oral Prep Stage (Oral Disease)

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1. What are the advantages of FEES

Explanation

FEES (Fiberoptic Endoscopic Evaluation of Swallowing) offers several advantages. Firstly, there is no radiation involved, making it a safe procedure for patients. Additionally, FEES provides a clear view of all structures involved in swallowing, allowing for accurate assessment and diagnosis. It also enables the evaluation of airway closure during swallowing, which is crucial in identifying any potential issues. However, FEES does not visualize the oral preparation or oral stage of swallowing.

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About This Quiz
Oral Prep Stage (Oral Disease) - Quiz

This quiz focuses on the Oral Prep Stage of swallowing, assessing knowledge on issues like decreased labial seal, weak mastication musculature, and reduced tongue coordination. It is crucial for learners in medical and speech pathology fields to understand these dysfunctions to better diagnose and treat oral diseases.

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2. When would one use a PEG tube

Explanation

A PEG tube, or percutaneous endoscopic gastrostomy tube, is used in patients who are unable to consume adequate nutrition orally. Patients with head and neck cancer often experience difficulty swallowing due to tumors or treatment-related complications, making a PEG tube necessary for nutrition support. Acute stroke patients with persistent dysphagia after hospital discharge may also require a PEG tube to ensure proper nutrition intake. ALS patients, who experience progressive muscle weakness and impaired swallowing, may benefit from a PEG tube as well. Lastly, individuals with malignant bowel obstruction may require a PEG tube to bypass the obstruction and maintain nutrition.

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3. What does residue on the tongue base indicate during a video fluoroscopic study indicate

Explanation

Residue on the tongue base during a video fluoroscopic study indicates reduced tongue movement or strength. This means that the tongue is not able to adequately clear food and liquid from the mouth and back of the throat, leading to residue remaining on the tongue base. This can potentially cause swallowing difficulties and increase the risk of aspiration.

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4. What are the disadvantage of FEES

Explanation

The disadvantages of FEES (Fiberoptic Endoscopic Evaluation of Swallowing) are that it cannot provide a clear view during swallowing, it limits the assessment of velopharyngeal (VP) closure, and it requires the problem to be defined based on the location of residue.

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5. A patient has reduced vocal fold closure and a delayed pharyngeal swallow which swallowing maneuver would you use?

Explanation

The supraglottic swallow is the appropriate swallowing maneuver to use in this case. It involves the patient holding their breath, closing their vocal folds tightly to prevent aspiration, and then swallowing. This maneuver helps to improve vocal fold closure and prevent food or liquid from entering the airway. It is effective in cases where there is reduced vocal fold closure and a delayed pharyngeal swallow.

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6. These directions are for what Swallowing maneuver: 1. As you swallow, squeeze hard with all of your muscles. 2. Act like you are swallowing a golf ball. 

Explanation

The given directions describe the Effortful Swallowing maneuver. It involves squeezing hard with all of your muscles while swallowing and acting like you are swallowing a golf ball. This maneuver is often used in dysphagia therapy to improve swallowing function and increase the strength and coordination of the swallowing muscles.

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7. What are the advantages of VFSS

Explanation

The advantages of VFSS include the ability to view the motor aspects of the pharyngeal swallow, observe mastication and the oral phase of swallowing, and understand that the triggering of the pharyngeal swallow is influenced by the position of the bolus. However, it is important to note that VFSS does not allow for direct visualization of structures involved in swallowing.

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8. What is the purpose of compensatory strategies and safe intake strategies?

Explanation

Compensatory strategies and safe intake strategies are used to control the flow of food or liquid and to eliminate or reduce the patient's symptoms. These strategies are designed to aid the patient in effective swallowing and to ensure that they are able to consume food and liquids safely without experiencing any adverse effects. By implementing these strategies, healthcare professionals can help patients manage their swallowing difficulties and improve their overall quality of life.

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9. Special feeding techniques? Diet modification already in place? Cognitively intact to remember and follow direction.

Explanation

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10. What maneuver would you use with a client who needs improved bolus clearance from the valleculae 

Explanation

The effortful swallow is a maneuver that can be used with a client who needs improved bolus clearance from the valleculae. This maneuver involves applying additional effort and force during the swallowing process to help propel the bolus through the valleculae and into the esophagus. By using this maneuver, the client can improve their ability to clear the bolus from the valleculae, leading to improved swallowing function.

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11. What are the challenges with using VFSS

Explanation

The challenges with using VFSS include difficulty in assessing fatigue, as it is hard to determine if the patient's fatigue is due to swallowing difficulties or other factors. Barium changes the consistency of food, making it difficult to accurately assess the patient's normal swallowing function. The presence of aspiration does not necessarily indicate aspiration pneumonia, as aspiration can occur without causing pneumonia. Contrast issues may also arise during VFSS, making it difficult to clearly visualize the swallowing process.

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12. According to ASHA when is an instrumental evaluation necessary 

Explanation

An instrumental evaluation is necessary when signs and symptoms are inconsistent with findings, meaning that the observed symptoms do not match the expected results based on the examination. It is also necessary when there is a need to confirm a suspected medical diagnosis, as the instrumental evaluation can provide more accurate and detailed information about the condition. Additionally, if the safety and efficiency of the swallow are in question, an instrumental evaluation can help assess the swallowing function and identify any potential risks. Finally, when specific information is needed for a Swallow Rehab Candidate, an instrumental evaluation can provide detailed data to guide the rehabilitation process.

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13. What do we look at when we visually inspect  the face

Explanation

When visually inspecting the face, we look for signs of droop, which could indicate muscle weakness or nerve damage. We also check for drooling, as excessive saliva production may suggest issues with swallowing or oral control. Dry lips can be a sign of dehydration or lack of moisture. Lastly, we look for any food residue on the outside of the mouth, which could indicate difficulties with chewing or swallowing.

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14. What do we visually inspect with regards to oral 

Explanation

We visually inspect oral dentition to check the condition of teeth and gums. Dry mouth refers to the lack of saliva production, which can affect oral health. Oral care involves examining the overall hygiene and cleanliness of the mouth. Halitosis refers to bad breath, which can be a sign of oral health issues. Dry caked mucus on the mouth may indicate dehydration or an underlying health condition.

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15. We use VFSS to identify the normal and abnormal anatomy and physiology of the swallow

Explanation

The statement is true because VFSS (Videofluoroscopic Swallow Study) is a diagnostic procedure used to assess the anatomy and physiology of the swallow. It involves the use of X-ray imaging to visualize the swallowing process in real-time, allowing healthcare professionals to identify any abnormalities or difficulties in swallowing. By observing the movement of the structures involved in swallowing, such as the tongue, throat, and esophagus, VFSS helps in diagnosing and determining appropriate treatment for swallowing disorders.

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16. What can dehydration lead to 

Explanation

Dehydration can lead to hospitalization because severe dehydration can cause a person's vital organs to fail, requiring medical intervention and monitoring. It can also lead to confusion because dehydration affects the brain's ability to function properly. Fever can be a symptom of dehydration as the body tries to regulate its temperature. Weight loss is another possible consequence of dehydration as the body loses water and electrolytes. Lethargy can occur due to the lack of fluids and nutrients needed for energy production.

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17. Oral Prep Stage (Anterior spill of bolus, drooling)

Explanation

The decreased labial seal refers to a weakened ability to close the lips tightly, which can result in oral spillage of the bolus and drooling. This could be caused by various factors such as muscle weakness in the mastication muscles, reduced coordination of the tongue, or reduced tension in the buccal (cheek) muscles.

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18. What doe we assess in oral mechanism with the tongue

Explanation

The correct answer includes three components: lateralization-alternating rate and range of motion (ROM), elevation/depression-alternating rate and ROM, and tongue click on the roof of the mouth. These are all aspects that are assessed in the oral mechanism examination specifically related to the tongue. Lateralization refers to the ability of the tongue to move from side to side, while elevation/depression refers to the ability of the tongue to move up and down. The tongue click on the roof of the mouth assesses the strength and coordination of the tongue muscles.

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19. These directions correspond to what swallowing maneuver? 1. Swallow saliva several times and pay attention to your neck. 2. Tell patients to pay attention to the thing that elevates.  3. Have patients hold it up for several seconds 

Explanation

The Mendelsohn maneuver involves intentionally prolonging the elevation of the larynx during swallowing. The directions given in the question, such as swallowing saliva several times and paying attention to the neck, and having patients hold the neck up for several seconds, align with the technique of the Mendelsohn maneuver. This maneuver is used to improve swallowing function and increase the opening of the upper esophageal sphincter.

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20. What do we look at in jaw control during the oral motor assessment 

Explanation

During the oral motor assessment, we look at the range of motion (ROM) of the jaw, specifically a minimum of three finger widths. We also assess for any pain experienced by the individual when opening their mouth or chewing. Additionally, we evaluate the individual's ability to chew during trials of eating or drinking (p.o trials). The assessment does not include evaluating the gag reflex.

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21. What do we look for in the Soft Palate 

Explanation

In the soft palate, we look for symmetry to ensure that both sides are equal in size and shape. This helps in assessing any abnormalities or deformities. The gag reflex is also examined as it indicates the normal functioning of the soft palate. If the gag reflex is absent, it may suggest a neurological issue. Nasality is checked to determine if there is any abnormal sound or resonance during speech, which could be a sign of a soft palate dysfunction. Regurgitation is not specifically related to the soft palate and is not relevant in this context.

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22. What do we look at in laryngeal palpation 

Explanation

In laryngeal palpation, we look for the elevation of the larynx with or without protraction, the rate of elevation, and the movement fluidity. These factors help us assess the functioning and coordination of the laryngeal muscles during speech and swallowing.

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23. What is the Free water protocol 

Explanation

The Free Water Protocol (FWP) is a set of guidelines for patients with dysphagia to safely consume water. The protocol includes the following steps: Order FWP, SLP (Speech-Language Pathologist) helps in deciding who is a candidate, water is freely offered, oral care before the first meal, water is permitted until the first bite of food, no water during a meal (thickened liquid only), and medications are given with a prescribed liquid level or puree. These steps ensure that patients with dysphagia can safely consume water while minimizing the risk of aspiration or choking.

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24. What is done in cervical auscultation 

Explanation

Cervical auscultation is a technique used to assess the swallowing function by listening to the sounds produced during the swallowing process. In this procedure, a stethoscope is placed on the side of the neck to listen to the breathing sounds on each side. The clinician also listens for any abnormal sounds, such as gurgling, which may indicate a problem with swallowing. If gurgling is heard, the patient is asked to clear their throat. If the gurgling persists and the patient is unable to clear it, further evaluation of the patient's ability to produce sounds (phonation) may be necessary.

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25. What are the postural techniques used in swallowing treatment 

Explanation

The postural techniques used in swallowing treatment include chin up, head rotation, chin down, head tilt, and lying down. Chin up is used to drain food with the aid of gravity and is specifically used for patients with oral phase deficit. Head rotation involves rotating the head to the damaged side and is used for patients with a unilateral pharyngeal wall or vocal fold weakness. Chin down is used to push the tongue base and epiglottis closer to the posterior pharyngeal wall and is used for patients with a delayed trigger of the swallow. Head tilt involves tilting the head to the good side, allowing gravity to flow food to the good side, and is used for patients with unilateral oral and pharyngeal impairment. Lying down is used to avoid aspiration by gravity and is specifically used when residue in the pharynx is aspirated. In this case, the patient needs to suck out of a straw and cough before sitting up.

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26. What is the Frazier Water Protocol

Explanation

The Frazier Water Protocol is a set of guidelines for providing water to patients with dysphagia (difficulty swallowing) who are on a tube feeding regimen. According to the protocol, after meals, oral care should be performed. After that, the patient should wait for 30 minutes before being given thin liquid. However, tube feeders can have water anytime as long as oral care is performed. This protocol ensures that patients receive proper hydration while minimizing the risk of aspiration and choking.

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27. We should use ice cold water?

Explanation

Room temp water

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28. (Pharyngeal Stage) Food catches at the base of the tongue, delayed hyolaryngeal eleveation

Explanation

The given correct answer suggests that the food catches at the base of the tongue, causing a delay in the pharyngeal swallow. This means that there is a delay in the movement of food from the back of the mouth to the esophagus, which can lead to difficulties in swallowing and potentially result in choking or aspiration. This delay in the pharyngeal swallow can be caused by various factors, including muscle weakness or coordination issues in the throat muscles. It is important to address and manage this issue to ensure safe and efficient swallowing.

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29. NG tube 

Explanation

An NG tube stands for nasogastric tube, which is a medical device that is inserted through the nose and goes down into the stomach. It is used for various purposes such as feeding, medication administration, or drainage of stomach contents. Therefore, the correct answer is "Nose to stomach" as it accurately describes the route of the NG tube.

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30. (Pharyngeal Stage) Food doesn't go down, no hyolaryngeal elevation

Explanation

The given correct answer suggests that the absence of a pharyngeal swallow could be the reason for food not going down and the lack of hyolaryngeal elevation. Additionally, it mentions that limited CP (cricopharyngeal) opening could also be a contributing factor. This means that the muscles in the pharynx are not contracting properly, leading to difficulty in swallowing and food not being able to pass through the throat. The limited CP opening refers to the failure of the cricopharyngeal muscle to relax and open during swallowing, causing a blockage in the passage of food.

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31. What are the other professions involved in a multidisciplinary team

Explanation

A multidisciplinary team consists of professionals from various fields who work together to provide comprehensive care to patients. In this case, the other professions involved in the team include a general physician, ENT specialist, dentist, dietitian, respiratory therapist, physical therapist, and occupational therapist. Each professional brings their unique expertise and skills to address different aspects of the patient's health and well-being. By collaborating and sharing their knowledge, the team can ensure a holistic approach to patient care, considering both medical and non-medical factors that may impact the patient's health.

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32. contraindication is a condition or factor that serves as a reason to withhold a certain medical treatment. What are contraindications for Frazier free water 

Explanation

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33. Some oral feeding such as liquids, thinned puree are possible with NG tubing

Explanation

NG tubing, or nasogastric tubing, is a medical procedure where a tube is inserted through the nose and into the stomach. This allows for the delivery of nutrients, medications, or fluids directly into the stomach. Since NG tubing bypasses the mouth and throat, it is possible to administer oral feeding such as liquids and thinned puree through the tube. Therefore, the statement that oral feeding such as liquids and thinned puree are possible with NG tubing is true.

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34. What are the disadvantages of NG tubes

Explanation

NG tubes, or nasogastric tubes, have several disadvantages. Firstly, their physical presence in the nose, pharynx, and esophagus can cause discomfort and irritation for the patient. Additionally, there is a potential for reflux, which can lead to aspiration of stomach contents into the lungs. Another drawback is that a liquid diet may be expensive, as it requires specialized formulas or supplements. Despite these disadvantages, NG tubes do allow patients to continue swallowing for up to three weeks, which can be beneficial in certain medical conditions.

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35. (Oral Prep Stage) Buccal pocketing and excessive oral residue

Explanation

The given answer suggests that reduced tongue coordination, reduced oral sensation, and reduced buccal tension are the likely explanations for the oral prep stage issues mentioned. These factors can contribute to difficulties in properly manipulating food in the mouth, leading to buccal pocketing (food getting stuck in the cheeks) and excessive oral residue (food residue remaining in the mouth after swallowing). Additionally, weak mastication musculature can also contribute to these issues, but it is not mentioned in the given answer.

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36. The NG tube is typically replaced by a PEG after 3-4 months 

Explanation

The explanation for the given correct answer is that an NG tube (nasogastric tube) is a temporary tube inserted through the nose and into the stomach for various reasons such as feeding or draining fluids. However, if long-term enteral feeding is required, a PEG (percutaneous endoscopic gastrostomy) tube is typically placed after 3-4 months. A PEG tube is a more permanent solution as it is inserted directly into the stomach through the abdominal wall, providing a more comfortable and convenient option for feeding. Therefore, the statement "The NG tube is typically replaced by a PEG after 3-4 months" is true.

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37. The J-tube goes where

Explanation

The correct answer is "Direct to jejunum." The J-tube is a type of feeding tube that is inserted directly into the jejunum, which is a part of the small intestine. This allows for direct delivery of nutrients into the digestive system, bypassing the stomach. This method is often used when there are issues with the stomach or when it is necessary to bypass the stomach for any reason.

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38. (Pharyngeal/Esophageal Statge) Regurgitation of food, coughing after the swallow, collection of material in side pocket of the esophagus or pharynx

Explanation

Esophageal diverticulum is a condition where a pouch or sac forms in the lining of the esophagus. This can lead to regurgitation of food, coughing after swallowing, and the collection of material in a side pocket of the esophagus or pharynx. In this case, the symptoms described in the question are consistent with esophageal diverticulum. Cricopharyngeal dysfunction, tracheoesophageal fistula, and reflux can also cause similar symptoms, but the presence of a diverticulum best explains the specific symptoms mentioned in the question.

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39. (Esophageal Stage) Regurgitation, coughing after the swallow

Explanation

The given answer suggests that regurgitation and coughing after swallowing can be caused by reflux/GERD or partial/total obstruction in the esophagus. Reflux/GERD refers to the backflow of stomach acid into the esophagus, which can cause symptoms such as regurgitation and coughing. Partial or total obstruction in the esophagus can also lead to difficulty in swallowing and subsequent regurgitation and coughing. Both conditions can result in similar symptoms, highlighting the importance of further evaluation and diagnosis to determine the exact cause.

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40. (Esophageal Stage) Coughing/choking after the swallow, material passes from the esophagus to the trachea

Explanation

Tracheoesophageal fistula is a condition characterized by an abnormal connection between the esophagus and the trachea. This connection allows food or liquid to pass from the esophagus into the trachea, leading to coughing/choking after swallowing. This condition can cause difficulty in breathing and swallowing, as well as recurrent respiratory infections. Treatment usually involves surgical repair of the fistula to restore normal function and prevent further complications.

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41. This maneuver is a last resort and is used to improve overall coordination of the swallow.

Explanation

The Mendelsohn Maneuver is a last resort technique used to improve overall coordination of the swallow. It involves prolonging the elevation of the larynx during swallowing, which can help to increase the opening of the upper esophageal sphincter and improve bolus flow. This maneuver is typically used when other swallowing techniques have failed, and it can be particularly beneficial for individuals with swallowing difficulties or dysphagia. The other options listed (Superglottic, Supra-superglottic, and effortful swallow) do not specifically refer to this particular maneuver and are therefore not the correct answer.

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42. What are the disadvantages of a PEG tube 

Explanation

The disadvantages of a PEG tube include the risk of infection, as it provides a direct pathway for bacteria to enter the body. GERD (gastroesophageal reflux disease) can also be a complication, as the tube can worsen acid reflux symptoms. Additionally, PEG tubes do not stop the aspiration of secretions, which can lead to respiratory complications. It is important to note that PEG tubes should not be used as a cure for aspiration, as they do not address the underlying cause of the problem.

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43. Directions for what type of swallowing maneuver: 1. Take a deep breathe and hold.  2. Keep holding breath and lightly cover trach tube if present.  3. Keep holding breath while you swallow. 4. Cough after.

Explanation

The correct answer is Supraglottic swallow. This maneuver involves taking a deep breath and holding it, then lightly covering the trach tube if present, and finally swallowing while still holding the breath. Coughing after the swallow is also part of this maneuver. The purpose of the supraglottic swallow is to close off the airway to prevent aspiration during swallowing.

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44. What are the signs of silent aspiration 

Explanation

The signs of silent aspiration include having the patient say "ah" after every presentation, listening for a wet gurgly voice, looking for watery eyes and a runny nose, and listening for a delayed cough. These signs indicate that the patient may be silently aspirating, meaning that they are inhaling food or liquid into their lungs without coughing or showing any outward signs. By observing these signs, healthcare professionals can identify and address the issue of silent aspiration.

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45. Does food get stuck in throat/mouth? Location where they typically eat?

Explanation

The question is asking about the location where food typically gets stuck in the throat or mouth. The answer "Where" implies that the location can vary and is not specified in the question. It suggests that food can get stuck anywhere in the throat or mouth, depending on the individual and the specific circumstances.

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46. Introduces food into the mouth and reinforce appropriate behaviors and motor control during the swallow

Explanation

Direct dysphagia therapy involves introducing food into the mouth and reinforcing appropriate behaviors and motor control during the swallow. This type of therapy directly addresses the swallowing difficulties and helps improve the individual's ability to swallow safely and efficiently. It may involve exercises, techniques, and strategies to improve swallowing function. Indirect dysphagia therapy, on the other hand, focuses on modifying the environment or the consistency of food and drinks to make swallowing easier.

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47. A PEG tube is an effective cure for aspiration 

Explanation

A PEG (percutaneous endoscopic gastrostomy) tube is not a cure for aspiration. It is a medical procedure in which a feeding tube is inserted into the stomach through the abdominal wall to provide nutrition for individuals who are unable to eat or swallow normally. Aspiration, on the other hand, is the inhalation of foreign material into the lungs, which can lead to pneumonia or other respiratory issues. While a PEG tube can help prevent aspiration by providing nutrition directly to the stomach, it is not a cure for aspiration itself. Therefore, the correct answer is False.

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48. Uses exercises to improve neuromotor controls that are prerequisites for normal swallowing, or practice swallowing on saliva and secretions only

Explanation

Indirect dysphagia therapy involves using exercises to improve neuromotor controls that are necessary for normal swallowing. This therapy focuses on strengthening the muscles and coordination involved in swallowing. Another approach in indirect dysphagia therapy is practicing swallowing on saliva and secretions only, without consuming solid or liquid foods. This allows the individual to work on their swallowing abilities without the risk of choking or aspiration. Therefore, the given answer "indirect dysphagia therapy" is the correct choice as it accurately describes the approach mentioned in the explanation.

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49. __________ does the problem typically happen?  _________ did the problem start?

Explanation

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50. _______ typically eats with the patient?   Must the patient be fed by someone else?

Explanation

not-available-via-ai

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51. What are the four traditional dysphagia therapy techniques 

Explanation

The four traditional dysphagia therapy techniques are oral motor exercises, range of motion exercises, procedures to heighten sensory input, and swallow maneuvers. These techniques aim to improve the coordination and strength of the muscles involved in swallowing, increase the range of motion in the throat and mouth, enhance sensory awareness during swallowing, and teach specific techniques to facilitate safe and efficient swallowing. These techniques are commonly used in dysphagia therapy to address various swallowing difficulties and improve overall swallowing function.

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52. What are the signs of difficulty when eating or p.o trials 

Explanation

The signs of difficulty when eating or performing oral trials include residue in the oral cavity, spill of food from the mouth, coughing, report of residue in the throat, regurgitation, and piecemeal deglutition. These signs indicate that the individual is having trouble swallowing or properly managing food in their mouth, leading to various issues such as food getting stuck in the oral cavity or throat, coughing, and regurgitation. Piecemeal deglutition refers to the individual swallowing food in small pieces instead of swallowing it in one fluid motion, which can also indicate difficulty in eating.

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53. What are some considerations when doing a P.O trial

Explanation

This answer lists some considerations that should be taken into account when conducting a P.O (per oral) trial. Fatigue, appetite, oral care (including whether the patient has teeth), hydration, and shortness of breath are all important factors to consider during the trial. These considerations help ensure the patient's comfort and well-being during the trial and can also impact the effectiveness of the treatment.

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54. Diet level orders should include what 

Explanation

This answer is correct because diet level orders should include recommendations for both solids and liquids, as well as supervision for intake to ensure the patient is following the prescribed diet. Additionally, instructions on how to administer medications should be included in the diet level orders, as well as precautions to prevent aspiration, which is a potential risk when eating or drinking.

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55. These are the directions for which swallowing maneuver? 1. Inhale and hold your breathe tightly. 2. Bear down. 3. Keep holding breath and bead down as you swallow. 4. Cough after swallow

Explanation

The correct answer is the Super-supraglottic swallow. This maneuver involves inhaling and holding the breath tightly, bearing down, and then swallowing while still holding the breath and bearing down. It is used to close the vocal cords tightly to prevent aspiration during swallowing.

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56. What is FEES

Explanation

FEES stands for Fiberoptic Endoscopic Evaluation of Swallowing. It is a procedure used to assess swallowing difficulties by inserting a flexible endoscope through the nasal passage to view the swallowing mechanism. Videoendoscopy, on the other hand, refers to the use of a video camera attached to the endoscope to record and visualize the internal structures. Since FEES involves the use of videoendoscopy, it can be inferred that videoendoscopy is a part of the FEES procedure.

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57. What are the disadvatages of VFSS

Explanation

The disadvantages of VFSS (Videofluoroscopic Swallow Study) include radiation exposure, as the procedure involves the use of X-rays. Another disadvantage is the use of barium, which is a contrast material that needs to be ingested and can cause discomfort or allergic reactions in some individuals. Additionally, VFSS cannot directly view structures, meaning that certain anatomical details may not be clearly visible. However, it does allow for the visualization of the motor aspects of the pharyngeal swallow, providing valuable information about swallowing function.

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58. What do we assess with the lips in an oral motor assessment 

Explanation

In an oral motor assessment, we assess various aspects related to the lips. This includes evaluating the purse/retraction ability of the lips, which refers to their ability to pucker or retract. We also assess the alternation rate, which measures how quickly the lips can move back and forth. Additionally, we evaluate the range of motion (ROM) of the lips, which determines their flexibility and ability to move in different directions. Lastly, we assess the closure ability of the lips by having the patient puff out their cheeks, which helps us evaluate their ability to seal the lips tightly.

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59. (Pharyngeal Stage) Food caught up, residue in pharynx

Explanation

The correct answer is reduced pharyngeal contraction, tongue base movement or laryngeal elevation, delayed pharyngeal swallow. This is because these factors can result in food getting caught up or residue remaining in the pharynx during the pharyngeal stage of swallowing. Reduced pharyngeal contraction can lead to inadequate propulsion of food through the pharynx, while reduced tongue base movement or laryngeal elevation can hinder the movement of food into the esophagus. Delayed pharyngeal swallow refers to a delay in initiating the swallowing reflex, which can also contribute to food residue in the pharynx.

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60. (Oral Prep Stage) Coughing before the swallow

Explanation

Reduced tongue coordination to hold the bolus in the oral cavity refers to a lack of proper muscle control and coordination in the tongue, which makes it difficult to keep the food or liquid in the mouth before swallowing. This can lead to coughing before the swallow because the tongue is not able to effectively manipulate and control the bolus, causing it to enter the airway instead of the esophagus.

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61. (Pharyngeal/Esophageal stages) Residue in pyriform sinuses, decreased CP opening

Explanation

The given answer suggests that both cricopharyngeal dysfunction and esophageal motility dysfunction can explain the presence of residue in the pyriform sinuses and a decreased cricopharyngeal opening. Cricopharyngeal dysfunction refers to impaired relaxation or incomplete opening of the cricopharyngeal muscle, which can lead to difficulty swallowing and residue in the pyriform sinuses. Esophageal motility dysfunction refers to abnormalities in the movement of the esophagus, which can cause food to remain in the esophagus and not pass through to the stomach. Both conditions can contribute to the observed symptoms.

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62. (Oral Stage) Slow eating, worse with solids, slow oral transit time

Explanation

The given answer includes four different characteristics that are associated with the oral stage of swallowing. These characteristics are reduced anterior to posterior tongue movement, swallow apraxia, repeated tongue pumping, and disorganized anterior to posterior tongue movement. These symptoms can result in slow eating, particularly with solid foods, and slow oral transit time.

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63. What do we look at in the protective mechanism assessment 

Explanation

In a protective mechanism assessment, we look at various factors including phonation strength, cough, clearness, and the initiation of a dry swallow with palpation. These factors help evaluate the effectiveness of the protective mechanisms in the throat and airway. Phonation strength refers to the ability to produce sound, which is important for clearing the airway. Coughing helps expel any foreign objects or mucus from the airway. Clearness refers to the absence of any obstructions or blockages. Finally, the initiation of a dry swallow with palpation assesses the coordination and strength of the swallowing mechanism.

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64. (Oral Prep Stage) Decreased mastication 

Explanation

The correct answer is a combination of weak mastication musculature, poor lingual lateralization, and reduced buccal tension. These factors can all contribute to decreased mastication, which refers to the process of chewing food. Weak mastication musculature means that the muscles involved in chewing are not strong enough to effectively break down food. Poor lingual lateralization refers to the tongue's inability to move food from one side of the mouth to the other during chewing. Reduced buccal tension means that the muscles in the cheeks are not providing enough pressure to assist in chewing. All of these factors can result in difficulty and inefficiency in the chewing process.

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65. (Pharyngeal Stage) Coughing/choking after the swallow, gurgly vocal quality, excessive secretion-spillover from pyriform sinuses and valleculae or CP bar.

Explanation

The given symptoms of coughing/choking after the swallow, gurgly vocal quality, excessive secretion-spillover from pyriform sinuses and valleculae, and CP bar suggest a dysfunction in the cricopharyngeal muscle. This muscle is responsible for the opening and closing of the upper esophageal sphincter during swallowing. If there is dysfunction in this muscle, it can lead to difficulty in swallowing, resulting in symptoms such as coughing, choking, and gurgly vocal quality. Additionally, reduced laryngeal elevation can contribute to the pooling of food and secretions in the pharynx, further exacerbating the symptoms.

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66. (Pharyngeal Stage) Coughing/ choking during the swallow 

Explanation

Coughing or choking during the swallow can be caused by reduced laryngeal closure, reduced laryngeal elevation, and reduced epiglottic inversion. Laryngeal closure is important for preventing food or liquid from entering the airway, and reduced closure can lead to aspiration. Laryngeal elevation helps to close the airway and protect it during swallowing, so reduced elevation can result in choking. Epiglottic inversion is necessary to cover the airway opening during swallowing, and reduced inversion can lead to aspiration as well. Reflux or GERD can also contribute to coughing or choking during swallowing, but it is not mentioned in the given options.

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67. The before and after swallow is not evaluated with FEES

Explanation

The statement "The before and after swallow is not evaluated with FEES" is false. FEES (Fiberoptic Endoscopic Evaluation of Swallowing) is a procedure used to assess swallowing function. During FEES, a flexible endoscope is passed through the nose to visualize the swallowing process. This allows the clinician to evaluate the anatomy and function of the structures involved in swallowing, including the before and after swallow phases. Therefore, both the before and after swallow are evaluated with FEES.

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68. What does residue on the pharyngeal wall indicate

Explanation

Residue on the pharyngeal wall indicates reduced tongue base retraction. When the tongue does not retract properly during swallowing, food or liquid can be left behind in the pharynx, leading to residue on the pharyngeal wall. This can be a sign of dysphagia or difficulty swallowing.

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69. What does residue on the pyriform sinuses mean during an videofluroscopic study

Explanation

Residue on the pyriform sinuses during a videofluoroscopic study refers to food or liquid that remains in the pockets located on either side of the larynx. When there is reduced tongue base movement, the tongue is not able to propel the food or liquid efficiently towards the back of the throat, leading to residue in the pyriform sinuses. This can be a sign of swallowing difficulties or dysphagia, which may require further evaluation and management.

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70. When does one use a NG tube

Explanation

NG tube stands for nasogastric tube, which is a flexible tube inserted through the nose and down into the stomach. It is used in various medical situations, including with cancer patients. Cancer patients may require an NG tube for several reasons, such as to provide nutrition when they are unable to eat or swallow properly due to their condition or treatment. It can also be used to administer medications or remove excess fluids from the stomach. Additionally, after radiation therapy, patients may experience difficulty swallowing, and an NG tube can provide temporary support until they regain their ability to eat normally.

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71. (Oral Stage) Food catches in mouth, slowed oral transit time

Explanation

The given answer, "Reduced anterior to posterior tongue movement," is the most suitable explanation for the symptoms described in the question. The other options mentioned, such as slowed oral transit time, reduced tongue elevation, swallow apraxia, and disorganized anterior to posterior tongue movement, do not specifically address the issue of food catching in the mouth. Reduced anterior to posterior tongue movement can result in food not being properly propelled towards the back of the mouth, leading to the problem mentioned in the question.

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72. What are the advantages of a J-tube 

Explanation

The advantage of a J-tube is that it reduces the risk of reflux. Reflux is a condition where stomach contents flow back into the esophagus, causing discomfort and potential complications. By using a J-tube, which is a type of feeding tube that is inserted directly into the small intestine, the risk of reflux is minimized. This is because the J-tube bypasses the stomach, allowing for direct delivery of nutrients and medications to the small intestine. This can be particularly beneficial for individuals who have difficulty swallowing or have digestive issues.

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73. What are safe intake strataies

Explanation

The given answer suggests that safe intake strategies include maintaining a slow bite rate, taking small bites, feeding on the good side at home, and practicing oral care after meals. These strategies can help prevent choking or swallowing difficulties, promote proper digestion, and maintain oral hygiene.

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74. What are some aspiration precautions 

Explanation

Aspiration precautions are measures taken to prevent the inhalation of food or liquid into the lungs. Double swallow refers to the act of swallowing twice to ensure complete clearance of food or liquid from the mouth and throat. No straws are recommended to prevent the risk of inhaling liquid into the lungs. Oral care involves maintaining good oral hygiene to prevent infections that could increase the risk of aspiration. Chin tuck is a technique where the chin is tucked down towards the chest while swallowing to help close off the airway and prevent aspiration. These precautions help reduce the risk of aspiration and promote safe swallowing.

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75. Which swallowing maneuver would you use with a patient who has reduced airway closure or needed improved rate of laryngeal elevation and tongue base retraction

Explanation

The Super-Supraglottic swallow is the appropriate swallowing maneuver to use with a patient who has reduced airway closure or needs improved rate of laryngeal elevation and tongue base retraction. This maneuver involves the patient taking a deep breath, holding it, swallowing, and then coughing immediately after the swallow. This helps to close the vocal folds tightly and elevate the larynx, preventing food or liquid from entering the airway. The effortful swallow, Mendelsohn maneuver, and supraglottic swallow are also swallowing maneuvers but are not specifically indicated for reduced airway closure or improved laryngeal elevation and tongue base retraction.

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76. What does residue on the valleculae indicate during a video fluoroscopic study 

Explanation

Residue on the valleculae during a video fluoroscopic study indicates reduced tongue base movement or unilateral pharyngeal paralysis, reduced pharyngeal contraction, and reduced laryngeal elevation. This means that there is a problem with the movement and coordination of the structures involved in swallowing, leading to food or liquid being left behind in the valleculae after swallowing.

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77. VFSS is also known as what 

Explanation

The correct answer is Videofluoroscopic swallow study or modified barium swallow. VFSS is a diagnostic procedure used to evaluate swallowing function. It involves the use of X-ray imaging and contrast material (barium) to assess the movement of food and liquid through the throat. The procedure allows healthcare professionals to identify any abnormalities or difficulties in swallowing, such as aspiration or choking risks. The terms "videofluoroscopic swallow study" and "modified barium swallow" are both used interchangeably to refer to this procedure.

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78. What does PEG stand for 

Explanation

PEG stands for percutaneous endoscopic gastrostomy. This procedure involves the insertion of a feeding tube directly into the stomach through the abdominal wall. It is typically used for patients who are unable to eat or swallow food normally. The tube allows for the delivery of nutrition and medication directly into the stomach, bypassing the mouth and esophagus. This can be a long-term solution for individuals who have difficulty with oral intake and need a reliable way to receive nourishment.

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79. What is the order of P.O trials solids 
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80. Select the ones you like

Explanation

The given question asks the test-taker to select the option(s) they like. Since there is no specific context or criteria mentioned, the choice of options is subjective and depends on the individual's personal preference. The correct answer, in this case, is Option1, as it is the option that the test-taker likes the most.

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81. Ever had treatment or swallowing problems before? Coughing/choking when eating? Coughing/choking when sleeping? Problems drooling? Types of foods/liquids that cause problems?

Explanation

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82. The three rating scales are NOMS FOIS and DOSS what does each stand for

Explanation

The correct answer is the three rating scales are NOMS, FOIS, and DOSS, which stand for Swallowing rating scale, functional oral intake scale, and dyshagia outcome severity scale, respectively. These scales are used to assess and measure different aspects of swallowing function and oral intake in individuals with dysphagia. The Swallowing rating scale evaluates the severity of swallowing difficulties, the functional oral intake scale assesses the individual's ability to consume food and liquids orally, and the dysphagia outcome severity scale measures the impact of dysphagia on the individual's overall well-being and quality of life.

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What are the advantages of FEES
When would one use a PEG tube
What does residue on the tongue base indicate during a...
What are the disadvantage of FEES
A patient has reduced vocal fold closure and a delayed pharyngeal...
These directions are for what Swallowing maneuver: 1. As you swallow,...
What are the advantages of VFSS
What is the purpose of compensatory strategies and safe...
Special feeding techniques? Diet modification already in place?...
What maneuver would you use with a client who needs improved...
What are the challenges with using VFSS
According to ASHA when is an instrumental evaluation necessary 
What do we look at when we visually inspect  the face
What do we visually inspect with regards to oral 
We use VFSS to identify the normal and abnormal anatomy and physiology...
What can dehydration lead to 
Oral Prep Stage (Anterior spill of bolus, drooling)
What doe we assess in oral mechanism with the tongue
These directions correspond to what swallowing maneuver? 1. Swallow...
What do we look at in jaw control during the oral motor...
What do we look for in the Soft Palate 
What do we look at in laryngeal palpation 
What is the Free water protocol 
What is done in cervical auscultation 
What are the postural techniques used in...
What is the Frazier Water Protocol
We should use ice cold water?
(Pharyngeal Stage) Food catches at the base of the tongue, delayed...
NG tube 
(Pharyngeal Stage) Food doesn't go down, no hyolaryngeal elevation
What are the other professions involved in a multidisciplinary team
Contraindication is a condition or factor that serves as a reason...
Some oral feeding such as liquids, thinned puree are possible with NG...
What are the disadvantages of NG tubes
(Oral Prep Stage) Buccal pocketing and excessive oral residue
The NG tube is typically replaced by a PEG after 3-4 months 
The J-tube goes where
(Pharyngeal/Esophageal Statge) Regurgitation of food, coughing after...
(Esophageal Stage) Regurgitation, coughing after the swallow
(Esophageal Stage) Coughing/choking after the swallow, material passes...
This maneuver is a last resort and is used to improve overall...
What are the disadvantages of a PEG tube 
Directions for what type of swallowing maneuver: 1. Take a deep...
What are the signs of silent aspiration 
Does food get stuck in throat/mouth? Location where they typically...
Introduces food into the mouth and reinforce appropriate...
A PEG tube is an effective cure for aspiration 
Uses exercises to improve neuromotor controls that are prerequisites...
__________ does the problem typically happen?  _________ did the...
_______ typically eats with the patient?   Must the patient be...
What are the four traditional dysphagia therapy techniques 
What are the signs of difficulty when eating or p.o trials 
What are some considerations when doing a P.O trial
Diet level orders should include what 
These are the directions for which swallowing maneuver? 1. Inhale and...
What is FEES
What are the disadvatages of VFSS
What do we assess with the lips in an oral motor assessment 
(Pharyngeal Stage) Food caught up, residue in pharynx
(Oral Prep Stage) Coughing before the swallow
(Pharyngeal/Esophageal stages) Residue in pyriform sinuses, decreased...
(Oral Stage) Slow eating, worse with solids, slow oral transit time
What do we look at in the protective mechanism assessment 
(Oral Prep Stage) Decreased mastication 
(Pharyngeal Stage) Coughing/choking after the swallow, gurgly vocal...
(Pharyngeal Stage) Coughing/ choking during the swallow 
The before and after swallow is not evaluated with FEES
What does residue on the pharyngeal wall indicate
What does residue on the pyriform sinuses mean during an...
When does one use a NG tube
(Oral Stage) Food catches in mouth, slowed oral transit time
What are the advantages of a J-tube 
What are safe intake strataies
What are some aspiration precautions 
Which swallowing maneuver would you use with a patient who has reduced...
What does residue on the valleculae indicate during a video...
VFSS is also known as what 
What does PEG stand for 
What is the order of P.O trials solids 
Select the ones you like
Ever had treatment or swallowing problems before? Coughing/choking...
The three rating scales are NOMS FOIS and DOSS what does each stand...
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