Oropharyngeal Dysphagia || with Certified Answers.
1. Inability to hold/contain bolus in mouth anteriorly - cause correct answers Reduced lip closure
1. Inability to hold/contain bolus in mouth anteriorly - observations correct answers - Anterior
spillage
- Possible oral breathing
Material/bolus observed on upper lip correct answers Not an impairment! Related to mode of
administration
2. Inability to form/control bolus - cause correct answers - Reduced lingual strength (generating
pressure), coordination & control
- Reduced oral sensation (cannot sense bolus in oral cavity)
- Cannot shape tongue
2. Inability to form/control bolus can result in... correct answers - No cohesive bolus
- Premature loss of bolus into pharynx
- Posterior loss of bolus/premature spillage (falling back b/c tongue isn't holding bolus in oral
cavity)
What consistency is normal to see premature loss of bolus into pharynx? correct answers Solids -
normal for them to be held back in valleculae during chewing
*Atypical in liquids and purees*
3. Premature/posterior loss of liquid or pudding into pharynx - cause correct answers Reduced
lingual coordination
, 3. Premature/posterior loss of liquid or pudding into pharynx - observations correct answers -
Gets lodged in PS, valleculae, or airway
- Coughing before swallow if in airway
- Aspiration or penetration before swallowing
4. Materials in sulci or lingual surface after swallowing - cause correct answers - Reduced labial,
lingual, and buccal muscle tone/strength/ROM
- Reduced oral sensation
Reduced labial, lingual, and buccal muscle tone/strength/ROM correct answers - Usually tongue
deficit
- Buccinator may have less tone or strength
Reduced oral sensation correct answers - Patient doesn't know if bolus is in sulci
What exam will help determine if it is reduced oral sensation or tongue strength? correct answers
Oral motor exam
Treatment strategies for materials in sulci or lingual surface correct answers - Lingual sweep
(swipe tongue through sulci)
- Another dry swallow after initial swallow
4. Materials in sulci or lingual surface after swallowing - observations correct answers - Material
remains on lingual surface of tongue or falls into sulcus
- Indicate where and amount of oral residue
- Residue increases with thickness of bolus
5. Abnormal bolus position - observations and cause correct answers - Tongue thrust (forceful
protrusion of tongue beyond boundary of lower lips) usually due to neurological impairments
(Ex: CP)
1. Inability to hold/contain bolus in mouth anteriorly - cause correct answers Reduced lip closure
1. Inability to hold/contain bolus in mouth anteriorly - observations correct answers - Anterior
spillage
- Possible oral breathing
Material/bolus observed on upper lip correct answers Not an impairment! Related to mode of
administration
2. Inability to form/control bolus - cause correct answers - Reduced lingual strength (generating
pressure), coordination & control
- Reduced oral sensation (cannot sense bolus in oral cavity)
- Cannot shape tongue
2. Inability to form/control bolus can result in... correct answers - No cohesive bolus
- Premature loss of bolus into pharynx
- Posterior loss of bolus/premature spillage (falling back b/c tongue isn't holding bolus in oral
cavity)
What consistency is normal to see premature loss of bolus into pharynx? correct answers Solids -
normal for them to be held back in valleculae during chewing
*Atypical in liquids and purees*
3. Premature/posterior loss of liquid or pudding into pharynx - cause correct answers Reduced
lingual coordination
, 3. Premature/posterior loss of liquid or pudding into pharynx - observations correct answers -
Gets lodged in PS, valleculae, or airway
- Coughing before swallow if in airway
- Aspiration or penetration before swallowing
4. Materials in sulci or lingual surface after swallowing - cause correct answers - Reduced labial,
lingual, and buccal muscle tone/strength/ROM
- Reduced oral sensation
Reduced labial, lingual, and buccal muscle tone/strength/ROM correct answers - Usually tongue
deficit
- Buccinator may have less tone or strength
Reduced oral sensation correct answers - Patient doesn't know if bolus is in sulci
What exam will help determine if it is reduced oral sensation or tongue strength? correct answers
Oral motor exam
Treatment strategies for materials in sulci or lingual surface correct answers - Lingual sweep
(swipe tongue through sulci)
- Another dry swallow after initial swallow
4. Materials in sulci or lingual surface after swallowing - observations correct answers - Material
remains on lingual surface of tongue or falls into sulcus
- Indicate where and amount of oral residue
- Residue increases with thickness of bolus
5. Abnormal bolus position - observations and cause correct answers - Tongue thrust (forceful
protrusion of tongue beyond boundary of lower lips) usually due to neurological impairments
(Ex: CP)
