CSG Dysphagia & Swallowing Disorders 1 — Questions and Answers
Question 1: Which phase of swallowing is most commonly impaired in older adults with neurological conditions such as stroke or Parkinson's disease?
- Oral preparatory phase
- Oral transport phase
- Pharyngeal phase (Correct answer)
- Esophageal phase
Correct answer: Pharyngeal phase
The pharyngeal phase is most commonly impaired in neurological dysphagia because it depends on coordinated cranial nerve signaling that is frequently disrupted by stroke or Parkinson's disease.
Question 2: The International Dysphagia Diet Standardisation Initiative (IDDSI) framework categorizes foods and liquids into how many levels?
- 5 levels (0–4)
- 6 levels (0–5)
- 7 levels (0–6)
- 8 levels (0–7) (Correct answer)
Correct answer: 8 levels (0–7)
IDDSI uses 8 levels (0–7), ranging from thin liquids (Level 0) to regular foods (Level 7), providing a universal standard for dysphagia diet textures.
Question 3: Which condition is the single most common cause of oropharyngeal dysphagia in older adults in the United States?
- Parkinson's disease
- Stroke (Correct answer)
- Dementia
- Head and neck cancer
Correct answer: Stroke
Stroke is the most common cause of oropharyngeal dysphagia, affecting approximately 50–80% of acute stroke patients due to disruption of cortical and brainstem swallowing centers.
Question 4: The 'chin tuck' compensatory maneuver during swallowing is designed primarily to:
- Narrow the laryngeal vestibule to reduce aspiration risk (Correct answer)
- Prevent gastroesophageal reflux
- Strengthen the tongue base musculature
- Reduce cricopharyngeal muscle tension
Correct answer: Narrow the laryngeal vestibule to reduce aspiration risk
The chin tuck positions the epiglottis more posteriorly and narrows the laryngeal vestibule, increasing airway protection and reducing the risk of aspiration during the pharyngeal phase.
Question 5: Aspiration pneumonia secondary to dysphagia in older adults is most commonly caused by which source of organisms?
- Environmental gram-negative rods
- Staphylococcus aureus from skin flora
- Mixed anaerobes from oropharyngeal flora (Correct answer)
- Streptococcus pneumoniae from community exposure
Correct answer: Mixed anaerobes from oropharyngeal flora
Aspiration pneumonia in dysphagia results primarily from aspiration of oropharyngeal secretions containing mixed anaerobes and gram-negative bacteria colonizing the mouth and throat.
Question 6: A patient with mild dysphagia has difficulty with thin liquids but tolerates soft foods. Which intervention is the most appropriate first step?
- Initiate enteral tube feeding
- Recommend thickened liquids per SLP guidance (Correct answer)
- Restrict all oral intake pending VFSS
- Start a pureed diet with no liquids
Correct answer: Recommend thickened liquids per SLP guidance
Thickening liquids slows their transit, providing more time for airway closure and reducing aspiration risk while maintaining oral intake for patients with mild dysphagia.
Question 7: Sarcopenic dysphagia refers to swallowing difficulty caused by:
- Esophageal stricture from long-term GERD
- Radiation-induced fibrosis of the pharynx
- Age-related loss of swallowing muscle mass and strength (Correct answer)
- Neurological damage from Parkinson's disease
Correct answer: Age-related loss of swallowing muscle mass and strength
Sarcopenic dysphagia results from whole-body sarcopenia extending to the swallowing musculature, causing reduced muscle mass and force generation in the tongue, pharynx, and larynx.
CSG Dysphagia & Swallowing Disorders 1
Which phase of swallowing is most commonly impaired in older adults with neurological conditions such as stroke or Parkinson's disease?