DYSPHAGIA EXAM 2- EVALUATION OF DYSPHAGIA QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

DYSPHAGIA EXAM 2- EVALUATION OF DYSPHAGIA QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 what is the purpose of a clinical bedside swallow exam? - Answers determine the safety of PO intake and determine goals What 7 questions should be answered during a clinical bedside swallow exam - Answers 1. How is the patient receiving nutrition? 2. Is there a history of aspiration pneumonia? 3. What is the anatomic and functional status of the oral mechanism? 4. Is there a risk of aspiration given the present nutritional status and diet? 5. Should the patient be referred for further evaluation/instrumental assessment? 6. Is the patient cognitively capable of participating in instrumental testing and rehabilitation? 7. What changes in the treatment plan should be anticipated or planned given the diagnosis? What are the 3 major limitations of a CBSE - Answers We can only asses the oral phase, clinical evaluation of the pharyngeal phase requires clinical judgement and inferencing skills, incidence of aspiration is 40-60% What are clinical indicators of dysphagia (9) - Answers altered mental state, dysarthria speech, hoarse/breathy vocal quality, sialorrhea (drooling), coughing/choking, prolongation of meals, unexplained weight loss, effortful chew, globus The start of the CBSE is the objection info from the chart review which includes? (5) - Answers current diagnosis, past medical history, onset of the disorder (acute vs. chronic), reason for referral, and any imaging After the objective info review in the CBSE is the subjective info which includes? (7) - Answers orientation, GI imaging, nursing flow sheets, current level of nutritional status (diet), respiration status, alertness, and impressions of other staff What comes after the chart review in the CBSE? - Answers behavioral information What are the critical components of the clinical case history? (9) - Answers identify the chief complaint, onset/prognosis, time since onset, associated symptoms, present/past illness, surgery, trauma, medications, social history/habits, family history, and review of systems 9 components of the CBSE - Answers 1. oral physical evaluation 2. positioning 3. orientation 4. oral peripheral exam 5. baseline vocal quality 6. strength of cough 7. baseline pulse oximetry 8. assess laryngeal elevation on a dry swallow 9. administration of food trials oral physical evaluation - Answers overall body position, ability to hold head up, sit up, good balance, facial symmetry positioning - Answers sitting upright is ideal orientation - Answers baseline mental status 11 components of the oral peripheral exam - Answers 1. face at rest 2. lips 3. jaw 4. tongue 5. velum 6. larynx 7. respiration 8. gag 9. sensation 10. intra-oral observations 11. dentition What to look for in the face at rest (3) - Answers symmetry, spontaneous movement, mask face What to look for in the lips (8) - Answers retract smile, protrude to pucker, range of motion, alternating movements (coordination), puff cheeks, tongue depressor between lips, symmetry, DDK What to look for in the jaw (4) - Answers hold mouth positions at rest, open as wide as possible (symmetry), range of motion, pressure on the chin when open vs. closed What to look for in the tongue (9) - Answers should be at the bottom of the mouth during rest, fasciculations, protrusion, lateralization, elevation, retraction, depression, resistence to test strength, DDK How to test the tongues ability to lateralize - Answers push cheeks side to side and lateral sulci sweep What to look for in the velum (3) - Answers symmetry, myoclonus, symmetry during "ah" What to look for in the larynx (6) - Answers cough to see vocal fold movement, sharpness of the cough, vocalize, vocal quality, cricothyroid muscle test vagus nerve (varying pitch), breathing What to look for in respiration (5) - Answers whether it is labored or shallow, rapid (trachypnea), check O2 saturation, rate (12-20 bpm), HR (60-80 BPM) What to look for in gag reflex - Answers touch base of tongue and PPW (glossopharyngeal nerve [sensory], vagus nerve [motor]) What to look for in sensation - Answers ask to close eyes and touch different parts of the face to see if they know where it is What to look for in intra-oral observations - Answers health of the tissue in the mouth (zerostomia, excessive mucous, crusty tongue), clean if possible What to look for in the dentition - Answers missing teeth, dentures (how they fit), edentulous, cavities What is the gag reflex - Answers a protective response that prevents foreign objects or noxious material from entering the pharynx, larynx, and trachea what does the gag reflex look like - Answers lowering the mandible, forward and downward movement of the tongue, and pharyngeal and velar constriction What is more important the cough reflex or gag reflex - Answers cough Assessment of different textures of food - Answers 1. ice chips 2. thin liquids 3. thick liquids if necessary 4. puree texture 5. minced and moist 6. soft and bite sized 7. regular/solid texture argument to begin with thin liquids - Answers will not affixiate the patient argument to begin with thick liquids - Answers easiest to swallow What to look for during assessment of PO intake at the oral phase (6) - Answers 1. intra-oral management of the bolus 2. mastication skills 3. ability to propel the bolus out of the oral cavity 4. timing of the initiation of the oral swallow 5. oral residue (what they do with it)