Swallowing & Dysphagia Management Flashcards
7 cards from real SLP practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Swallowing & Dysphagia Management flashcards as text
A patient with Parkinson's disease presents with festinating swallowing and reduced tongue base retraction. Which compensatory strategy is MOST appropriate as a first-line intervention?
Answer: Effortful swallow
The effortful swallow increases tongue base retraction and posterior pharyngeal wall pressure, directly targeting the impaired biomechanics seen in Parkinson's disease.
During a Modified Barium Swallow Study (MBSS), penetration to the laryngeal vestibule is observed with thin liquids but the material is immediately expelled. How is this classified using the Penetration-Aspiration Scale?
Answer: Score of 2 — material enters the airway, remains above the cords, and is ejected
A PAS score of 2 indicates material enters the airway above the vocal folds and is successfully expelled, representing penetration without aspiration.
A 78-year-old patient post-CVA demonstrates silent aspiration of thin liquids on MBSS. Which thickened liquid consistency per IDDSI Level is typically trialed FIRST?
Answer: IDDSI Level 2 (Mildly Thick)
IDDSI Level 2 (Mildly Thick / nectar consistency) is typically the first thickened liquid trialed because it slows bolus flow while maintaining relative palatability.
Which pharyngeal phase landmark indicates the onset of the pharyngeal swallow response during videofluoroscopic study?
Answer: Velopharyngeal closure
Velopharyngeal closure marks the onset of the pharyngeal swallow response, as it prevents nasal regurgitation and signals the beginning of pharyngeal stage events.
A patient with head and neck cancer post-radiation presents with cricopharyngeal dysfunction. FEES reveals residue in the pyriform sinuses bilaterally after swallowing. Which intervention targets the cricopharyngeal muscle MOST directly?
Answer: Shaker exercise (head lift)
The Shaker (head-raising) exercise strengthens the suprahyoid musculature, which pulls the cricopharyngeus open during swallowing, directly targeting UES dysfunction.
On FEES, 'white-out' or loss of image occurs during which phase of swallowing?
Answer: Pharyngeal phase — at the moment of pharyngeal contraction
During the pharyngeal phase, the pharyngeal walls contact the endoscope causing a brief whiteout; clinicians assess residue immediately before and after this period.
A 65-year-old patient with ALS has intact cognition but progressive bulbar weakness. Diet modification alone is being considered. What is the PRIMARY long-term consideration that should be discussed proactively with this patient?
Answer: Candidacy for and timing of PEG tube placement
In ALS, bulbar dysfunction is progressive and irreversible; proactive discussion of PEG tube placement before nutritional or respiratory compromise is critical for patient safety and quality of life.