Screening Procedure

Question 1

Name some signs and symptoms of dysphagia.

Answer 1

Coughing behaviors, Hx of Pneumonia, Some Dxs, Food squirting out of the tracy, presence of residual food in the mouth

Question 2

What are some abnormal behaviors observed in infants, children, and developmentally delayed adults that are indicators for an in-depth study?

Answer 2

1. Rejection of Food
2. Food Selectivity
3. Gagging
4. Open-Mouth Posture

Question 3

What is involved in the Preparatory Exam?

Answer 3

1. Chart review
2. Observation when entering the patient’s room
3. Respiratory Status

Question 4

What do you look at during a bedside eval?

Answer 4

1. Medical history and status of swallowing
2. Nutritional & respiratory status
3. Oral mech (Oral anatomy, Lip closure, Lingual function, Palatal function, Pharyngeal wall contraction) <–oral mech
4. Laryngeal control

Question 5

What should you be assessing after the oral mech during a bedside?

Answer 5

1. Ability to follow directions
2. Reaction to oral sensory stimulation
3. Reactions/symptoms during swallowing
   
   • Preparatory exam (no swallows)
   • Initial evaluation

Question 6

What should you be looking at when you enter a patient’s room?

Answer 6

Alertness, reaction to your entrance, posture, ability to follow directions and answer questions

Question 7

What should you note regarding respiratory status?

Answer 7

1. Timing of saliva swallows in relation to respiratory cycle
2. The timing of any coughing in relation to respiration
3. The duration of comfortable breath fold if feasible
4. The patient’s rest breathing pattern, oral or nasal.

Question 8

What should you have information on with a careful hx?

Answer 8

1. Localization of the disorder in terms of oral or pharyngeal state of the swallow or both
2. Easiest and most difficult types of material for the patient to swallow
3. Nature of the swallowing disorder

Question 9

What will you check during the oral motor control exam?

Answer 9

1. Ability to Open the Mouth Voluntarily
2. ID of optimal oral-sensory stimuli and bolus types
3. ID of and compensation for swallowing Apraxia
4. ID of and compensation for abnormal oral reflexes
   - - labial function
   - - lingual function
   - - chewing function
   - - soft palate function and oral reflexes
   - - oral sensitivity exam

Question 10

What management information should you collect from the oral examination?

Answer 10

1. Facial paralysis
2. Problem maintaining lip closure when food is placed in the mouth
3. Lingual function (propelling the food back; hold bolus)

Question 11

What should you assess during a laryngeal function exam?

Answer 11

1. Voice baseline, voice change after swallow
2. “He” several times (neurological impairments)
3. Pitch Glide (SLN; could imply reduced sensitivity within and surrounding the larynx)
4. Cough (make sure they have adequate pressure to clear the airway)