Swallowing & Dysphagia Management Flashcards

Which cranial nerve provides sensory innervation to the valleculae and epiglottis, making it critical for triggering the pharyngeal swallow response?

Answer: CN X (Vagus) — internal branch of the superior laryngeal nerve

The internal branch of the superior laryngeal nerve (CN X) provides sensory innervation to the supraglottic larynx and epiglottis, playing a key role in triggering the pharyngeal swallow.

A patient with Zenker's diverticulum undergoes successful surgical repair. Post-operatively, the SLP's PRIMARY swallowing concern during the early recovery period is:

Answer: Risk of fistula formation from premature oral feeding before tissue healing

After Zenker's diverticulum repair, early oral feeding before pharyngeal tissue heals raises the risk of anastomotic leak or fistula formation, so the SLP must coordinate timing of diet initiation with the surgical team.

Which of the following BEST describes 'delayed pharyngeal swallow trigger' on MBSS?

Answer: The bolus passes the posterior faucial arches before pharyngeal swallow onset, pooling in the valleculae or pyriform sinuses

A delayed pharyngeal trigger is defined as the bolus advancing past the posterior faucial arches — the traditional trigger zone — before pharyngeal swallow onset, increasing aspiration risk before airway protection occurs.

Surface electromyography (sEMG) biofeedback is MOST appropriate as an adjunct treatment for which of the following swallowing deficits?

Answer: Impaired hyolaryngeal elevation during the Mendelsohn maneuver

sEMG biofeedback over the submental/suprahyoid region provides real-time visual feedback of muscle activity during maneuvers like the Mendelsohn, helping patients learn to sustain and increase hyolaryngeal elevation.

A patient with myasthenia gravis is most likely to demonstrate which characteristic dysphagia pattern?

Answer: Progressive deterioration of swallowing function across a meal due to fatigable neuromuscular transmission

Myasthenia gravis causes fatigable weakness at the neuromuscular junction, so swallowing typically deteriorates across a meal as the muscles fatigue with repeated use.

During a clinical swallowing evaluation (CSE), which finding is the STRONGEST predictor of silent aspiration requiring instrumental assessment?

Answer: Dysphonia (wet/gurgly vocal quality) after swallowing

A wet or gurgly vocal quality after swallowing (wet voice) suggests pooling of material at or near the vocal folds and is the strongest clinical indicator of aspiration or penetration, particularly silent aspiration.

A clinician is documenting MBSS findings and notes that barium passes below the vocal folds but is cleared by cough before additional swallows. What PAS score does this represent?

Answer: PAS 6

PAS 6 describes material passing below the vocal folds (aspiration) that is ejected from the subglottis by coughing, indicating retained protective reflexes.