Question 1

The hypoglossal nerve (XII)is active during what stages of the swallow?&#10;A) Oral preparatory and pharyngeal stages&#10;B) Oral preparatory and oral stages&#10;C) Oral and pharyngeal stages&#10;D) Pharyngeal and esophageal stages

Accepted Answer

B

Question 2

An individual who has moderate to severe oral stage dysphagia and who has a reduced ability to protect the airway would benefit from beginning oral feedings with which food consistency?&#10;A) Pur&#233;ed (Level 1)&#10;B) Mechanically soft (Level 2)&#10;C) Dysphagia advanced (Level 3)&#10;D) Only thin liquids

Accepted Answer

Puréed foods (Level 1) are recommended for individuals with moderate to severe oral stage dysphagia and a reduced ability to protect the airway because they are easier to swallow and pose less risk of aspiration compared to foods with more texture or thin liquids.

Question 3

To protect the airway during the swallow,an individual must have the following with the exception of _________________.&#10;A) Intact palatal reflex&#10;B) Elevation of the larynx&#10;C) Productive cough&#10;D) Full dentition

Accepted Answer

Full dentition is not necessary for protecting the airway during swallowing. The key mechanisms include intact palatal reflex, elevation of the larynx, and a productive cough to help prevent aspiration.

Question 4

Videofluoroscopy is an example of what type of swallowing assessment?&#10;A) Oral motor assessment&#10;B) Bedside sensory assessment&#10;C) Instrumental assessment&#10;D) Clinical assessment

Accepted Answer

Videofluoroscopy is an example of an instrumental assessment, which involves the use of specialized equipment to observe and evaluate the swallowing process in detail. This method uses X-ray technology to capture real-time images of a person's swallowing mechanism, allowing clinicians to identify any abnormalities or dysfunctions that may be affecting their ability to eat and drink safely.

Question 5

What is the cause of aspiration that occurs after the swallow has taken place?&#10;A) Poor tongue control of the bolus&#10;B) Delayed initiation of the swallow, and the bolus enters the airway&#10;C) Reduced laryngeal closure, allowing the bolus to enter the airway&#10;D) Pooled material in the pyriform sinuses overflows into the trachea

Accepted Answer

Pooled material in the pyriform sinuses that overflows into the trachea is a cause of aspiration that occurs after the swallow has taken place. This is because the material was not effectively cleared during the swallow and subsequently enters the airway.

Question 6

During which phase of the swallow is there closure of the glottic and supraglottic structures to cover the airway and provide protection from aspiration?&#10;A) Pre-oral&#10;B) Oral&#10;C) Pharyngeal&#10;D) Esophageal

Accepted Answer

During the pharyngeal phase of the swallow, there is closure of the glottic and supraglottic structures to cover the airway and provide protection from aspiration.

Question 7

A wet or gurgly vocal quality after an individual swallows is indicative of what?&#10;A) Poor vocal fold control when talking&#10;B) Poor respiratory support and a weak voice&#10;C) Material collecting in the larynx&#10;D) Nasal congestion

Accepted Answer

The wet or gurgly vocal quality after swallowing is indicative of material collecting in the larynx, which can be a sign of dysphagia or difficulty swallowing. This can be a serious medical issue and should be evaluated by a healthcare professional.

Question 8

Mattias is a 65-year-old man who experienced a right cerebrovascular accident resulting in left hemiplegia and dysphagia.During the occupational therapy assessment,Mattias had difficulties with chewing and swallowing of textured foods.He had frequent episodes of coughing and pocketing of food in the left cheek.He complains that he chokes on certain foods,including water.During the assessment Mattias's vocal quality was consistently clear,and no raspiness or gurgly quality was noted before,during,or after eating.These clinical signs indicate problems with which stages of the swallow?

A) Oral preparatory and esophageal stages
B) Oral preparatory and oral stages
C) Pharyngeal and esophageal stages
D) Esophageal and oral stages

Accepted Answer

Mattias's difficulties with chewing and swallowing textured foods and episodes of coughing and pocketing of food in the left cheek indicate dysfunction in the oral preparatory and oral stages of the swallow. These stages involve manipulating and preparing food in the mouth before initiating the swallow. The fact that his vocal quality was clear and no raspiness or gurgly quality was noted before, during, or after eating indicates that there are no issues with the pharyngeal and esophageal stages of the swallow, which involve the movement of food through the back of the mouth and throat and into the esophagus. The fact that he chokes on certain foods, including water, implicates the oral stages specifically.

Question 9

Mattias is concerned about his frequent drooling and difficulties controlling the food bolus within his mouth.His daughter's wedding is in 4 weeks,and he does not want to embarrass himself or his family by drooling or choking on food or liquids.Which strategies would be most appropriate?

A) His wife uses a side handgrip on Mattias to improve his head control, and he should only eat crumbly foods.
B) Mattias should frequently pat his mouth during the meal and alternate between cold and hot foods.
C) Mattias should lean back in his chair while eating to avoid drooling.
D) Mattias should only eat pureed foods and thin liquids while at the wedding.

Accepted Answer

DB) Frequently patting his mouth can help Mattias be more aware of drooling, and alternating between cold and hot foods can stimulate his oral sensory system, potentially improving control. D) Eating pureed foods and thin liquids can reduce the risk of choking and make it easier for him to control the food bolus, addressing his concerns about embarrassing himself or his family.

Question 10

During a swallowing evaluation the tongue is noted to be retracted.What would typically be the reason for tongue retraction?&#10;A) Abnormal tone or loss of range of motion as a result of soft-tissue shortening&#10;B) The oral cavity is too large and makes the tongue appear retracted within the oral cavity&#10;C) The tongue is abnormally small for the oral cavity&#10;D) Protective response seen with a hyperactive gag

Accepted Answer

Abnormal tone or loss of range of motion as a result of soft-tissue shortening can lead to tongue retraction. This can occur due to neurological conditions such as cerebral palsy, muscular dystrophy, or stroke. It can also result from surgical interventions in the oral or pharyngeal regions.

Deck 28: Eating and Swallowing