SLP Swallowing & Dysphagia Management 3

Question 1

Which muscle is the PRIMARY contributor to upper esophageal sphincter (UES) opening during swallowing?

Accepted Answer

Geniohyoid

Answer

The geniohyoid, along with other suprahyoid muscles, pulls the hyolaryngeal complex anterosuperiorly, mechanically opening the cricopharyngeus/UES.

Question 2

A patient demonstrates 'premature spillage' of the bolus into the pharynx before the swallow trigger. Which oral stage impairment BEST explains this finding?

Accepted Answer

Impaired lingual control of the posterior oral seal

Answer

Premature spillage occurs when the posterior tongue fails to maintain a seal against the soft palate, allowing the bolus to enter the pharynx prematurely before pharyngeal swallow is triggered.

Question 3

When performing a FEES examination, which of the following BEST indicates laryngeal penetration rather than aspiration?

Accepted Answer

Material is visualized on the laryngeal surface of the epiglottis or in the laryngeal vestibule above the vocal folds

Answer

Penetration is defined as material entering the laryngeal vestibule above the level of the true vocal folds, whereas aspiration requires material to pass below the vocal folds.

Question 4

The Mendelsohn maneuver is designed to improve swallowing safety and efficiency primarily by:

Accepted Answer

Prolonging hyolaryngeal elevation to extend UES opening duration

Answer

The Mendelsohn maneuver teaches the patient to voluntarily sustain peak hyolaryngeal elevation, thereby prolonging UES opening and improving bolus clearance through the pharyngoesophageal segment.

Question 5

A 55-year-old patient post-total laryngectomy is being evaluated for tracheoesophageal puncture (TEP) voice and swallowing. Which swallowing concern is SPECIFIC to total laryngectomy patients?

Accepted Answer

Pharyngoesophageal (PE) segment spasm causing difficulty with esophageal insufflation and swallowing

Answer

After total laryngectomy, the PE segment (reconstructed from pharyngeal constrictors) may be hypertonic or spasmic, causing dysphagia and restricting voice prosthesis use — aspiration is not possible since the airway is separated.

(SLP) Speech-Language Pathologist Certified Practice Test

(SLP) Speech-Language Pathologist Certified Practice Test

SLP Swallowing & Dysphagia Management 3