MBS

Question 1

MBS is a ?

also called

Answer 1

videofluorographic evaluation

• modified barium swallow
• cookie swallow study
• videofluoroscopic swallow study (VFSS)

Question 2

Rationale: 
to identify ? 
the evaluate ? 
to develop an ?
to implement and evaluate ? 
the provide ?

Answer 2

normal and abnormal anatomy and physiology of swallow

integrity of airway protection before during and after swallowing

effective dysphagia treatment plan for the patient

effectiveness of postures, maneuvers, bolus modification, and sensory augmentations in improving swallowing safety efficiency

recommendations regarding optimum delivery of nutrition and hydration

Question 3

Why?
a radiographic study SHOULD NOT be conducted for ?

rather the major question to be answered from the radiographic study is:

Answer 3

sole purpose of determining whether or not the patient aspirates

what is the anatomical or physiologic cause of the patient’s apsiration

Question 4

Indications:

Answer 4

neurological impairment

• congenital
• acquired (acute, progressive, traumatic)

structural/mechanical impairment

• head and neck cancer
• treatment of head and neck cancer via surgery, radiation therapy, and or chemotherap

Question 5

Indications:

structural mechanical continued

Answer 5

• tracheostomy and or ventilator dependence
• vocal fold paralysis
• cervical spine repair
• craniofacial anomalies
• velopharyngeal incompetence
• pharyngeal stenosis
• pharyngeal diverticulum

Question 6

Contraindications:
patient is

patient is unable

patient is unable

size of patient prevents

allergy to

Answer 6

medially unstable

to cooperate or participate in instrumental exam

be adequately positioned

adequate imaging or exceeds limit of positioning devices

barium

Question 7

Limitations of videofluorographic swallowing evaluation:
-
-procedure only 
-... issues 
-....issues 
-... with potential for

Answer 7

time restraints due to radiation exposure

• samples swallow function
• contrast issues
• viscosity issues
• barium, unnatural food bolus / refusal

Question 8

MBS:

Viscosity and consistency
-
-
-
-
-
-

mixed ?

other?

… tablets ?

.. and .. projections

Answer 8

thin liquid

nectar-like liquid

honey-like liquid

puree

soft solid

hard solid

mixed consistencies

other consistencies

barium tablets

lateral and A-P projections

Question 9

13mm barium tablet :utilized to assess

Answer 9

narrowing or strictures in esophagus

Question 10

Porjectsion

Answer 10

lateral (side )

a-p (front /back)

Question 11

Videofluorographic swallowing eval.: 
bolus volumes: 
?
discrete ? 
... cup sips 
sequential ? 
... drinking 

evaluate method of?

• fed by
• … fed
• … vs. ….
• alternating

Answer 11

controlled, graduated bolus volumes and rate of presentation

cup sips

sequential

swallows during bottle feeding

straw drinking

presentation effects on swallowing 
-examiner 
-self fed 
spontaneous versus instruction to swallow 
liquids and solids

Question 12

Videofluorographic swallowing evaluations: 
swallowing physiology and coordination: 
-...closure 
-mandibular ? 
-tongue ? 

• oral ?
• elevation of
• bolus?
• … of bolus

Answer 12

lip closure

• motiona nd efficiency (lateral tongue range of motion and control )
• base retraction (strength and range of motion)
• tongue strength, range of motion and control during;
• bolus to palate
• seal against palate
• anterior to posterior propulsion of bolus

Question 13

Swallowing physiology and coordination continued: 
-... closure
-timing of 
-.. transport time 
-... and ... 
-pharyngeal ? (what and what ) 
... movement 
airway ?

Answer 13

velopharyngeal closure

• swallow initiation
• oral and pharyngeal transport time
• range of motion and timing of velar movement
• muscle contraction (strength and degree and symmetry)
• epiglottic movement
• airway protection : supraglottic to glottic level

Question 14

Swallowing Physiology and coordination continued:

• .. motion
• … mobility
• …. opening
• coordination of?
• .. of movement

Answer 14

hyolaryngeal motion ( vertical and anterior)

• vocal fold mobility (anterior to posterior view)
• UES opening (amplitude duration timing)
• coordination of pharyngeal structural movement during swallow
• asymmetry of movement

Question 15

Penetration/Aspiration:
was it

-

during the swallow:

• reduced
• reduced
• … closure

after the swallow:
… pharyngeal walls
-… from ?
-… from ?

Answer 15

premature spillage into pharynx (reduced sensation)
-poor oral handling

• laryngeal elevation
• epiglottis inversion/coverage of laryngeal vestibule
• VF closure
• residue from pharyngeal walls
• residue from valleculae/pyriforms
• backflow from esophagus

Question 16

VFFS: identify impact of abnormal physiology:
residue:

-effectiveness of ? (eg: reduction in ? effectiveness of ?

Answer 16

etiology, approx. percentage and location

reaction to residue , penetration, and or aspiration ( percent residue, cough and expectoration f material from airway)