Instrumental Procedure
The six (6) imaging Studies
What is 1.Ultrasound, 2.Videoendoscopy or Flexible Fiberoptic Examination of Swallowing (FEES), 3.Transnasal Flexible Fiberoptic Laryngoscopy (TFL), 4.Flexible Endoscopic Evaluation of Swallowing with Sensory (FEESST), 5.Videoflouroscopy of Modified Barium Swallow Study (MBSS), and 6.Scintigraphy?
What is very important during bedside examination?
What is posture (Best body position is 90 degrees if appropriate (at least 30 degrees)?
What is the imaging study that can observe tongue function & measures oral transit time & motion of the hyoid bone?
Ultrasound imaging
During what swallowing phase can bolus manipulation, oral transit times, and no oral residue or pocketing can be noted within normal limits?
Oral Phase
No radiation exposure (when using this imaging study)
What is using Videoendoscopy or Flexible Fiberoptic Examination of Swallowing (FEES)?
Purpose of Electroglottography (EGG)
What is tracks vocal fold movement by recording the impedance changes as the vocal folds move toward and away from each other during phonation and can track laryngeal elevation to determine the onset and termination of a pharyngeal swallow, and in providing biofeedback on extent and duration of laryngeal elevation during swallows.?
Signs and symptoms to look for to do the bedside evaluation
What is coughing/choking, pneumonia, weight loss, changes in diet, reflux, patient complaint, dehydration, drooling/increased secretions, and pocketing?
What is a flexible scope inserted through the nose, down the soft palate or below?
Videoendoscopy or Flexible Fiberoptic Examination of Swallowing (FEES)
During what swallowing phase can the SLP note that the patient exhibited aspiration with thin/nectar-thick/honey-thick liquids?
Pharyngeal phase
What suppresses lung difficulties?; can impact assessment results.
What is antibiotics?
The most frequently used technique
What is Videoflouroscopy of Modified Barium Swallow Study (MBSS)?
What other referrals might an SLP make?
What is 1.Dietary consult, 2. GI series, 3.neurological consult, 4.surgery, 5.radiation treatment, and 6.barium swallow?
What instrument is the standard for examining the larynx and vocal folds?
Transnasal Flexible Fiberoptic Laryngoscopy (TFL)
At what swallowing phase can aspiration be noted with all solids and thin liquids and vocal quality can be noted within normal limits?
Pharyngeal phase
Purpose of electromyography (EMG)
What is provides information on the timing and relative amplitude of selected muscle contractions during swallowing?
What can be used to listen to the sounds of swallowing on the surface of the patient’s neck and various locations?
What is Cervical Auscultation-Sounds of Swallowing?
Name three things an SLP would look to identify during the oral-motor examination
What is 1. Identification of optimal oral sensory stimuli and bolus types, 2. Identification of and compensation for swallowing apraxia, and 3. Identification of and compensation for abnormal oral reflexes?
What non-imaging instrument allows measurement of intrabolus pressures and the timing of the pharyngeal contractile wave?
Pharyngeal Manometry
At what swallowing phase can no anterior spillage by cup, straw and tsp be noted?
Oral phase
Purpose of scintigraphy
What is a nuclear medicine test in which the patient swallows measured amounts of a radioactive substance. *The bolus is imaged and recorded?
What is the reason for selecting rigid videoendoscopy for a patient?
What is to understand the patient's pharyngeal anatomy?
Name 3 things an SLP would to to check laryngeal elevation
What is 1. Place index finger immediately under the patient’s chin, 2. Place middle finger under the chin near the base of the tongue on the hyoid, and 3. Place ring and pinky fingers on the larynx?
What instrument provides information of bolus transit times, motility problems, and the amount and etiology of aspiration?
Videoflouroscopy of Modified Barium Swallow Study (MBSS)
Give an example of a BSE result for the oral and pharyngeal phase.
BSE indicated severe oral and pharyngeal dysphagia. Recommend diet of NPO with alternative means of nutrition/hydration/meds.
The only test that examines both the laryngeal reflexes for airway protection and bolus transport
What is Flexible Endoscopic Evaluation of Swallowing with Sensory (FEESST)?