PAS Scale
Material remains above the vocal fold and is ejected
PAS 2 or false penetration
This cranial nerve provides innervation to all muscles of the tongue except for the palatoglossus
Hypoglossal or CN XII
IDDSI rating of 2
mildly thick or nectar thick
This posture is used to improve A-P transit and oral containment.
Head back posture
Reasons to palpate the thyroid prominence
-assess timing and coordination, amount of elevation, and number of swallows per bolus
Material contacts the vocal folds, but is not ejected
PAS 5, deep penetration
Trigeminal Nerve or CN V
IDDSI rating of 5
minced and moist
This posture is used to increase tongue base retraction and pharyngeal clearance.
Effortful swallow
4 ways to fail the 3 oz water test
2. coughs
3. chokes
4. wet voice
Material passes below the vocal folds, with no effort to eject
PAS 8 or silent aspiration
This cranial nerve provides sensory taste info to the anterior 2/3 of the tongue and motor info for hyolaryngeal elevation and facial expression.
Facial or CN VII
IDDSI rating of 7
includes both Regular and Easy to chew
This posture is used to reduce spillage to the pharynx
Clincial symptoms that may occur after a ACDF
multiple swallows, effortful swallows, reduced hyolaryngeal movement, globus, and immediate coughing
Material contacts the vocal folds but is ejected
PAS 4 or flash deep penetration
This cranial nerve provides tactile sensation for aspiration and airway clearance.
RLN of the Vagus/CN X
IDDSI rating of 4
pureed food or Extremely thick liquid
The maneuver involves holding the tongue between the teeth while swallowing.
Masako
3 symptoms of pharyngeal dysphagia that are not concerning for aspiration
absent/delay swallow initiation, globus, gagging, reduced pharyngeal movement, multiple swallows, audible swallows
Material passes below the vocal folds but is ejected
PAS 6 or flash aspiration
This cranial nerve provides tactile sensation for the tongue base, laryngeal closure, true and false vocal folds, pyriform sinuses and posterior pharyngeal wall.
IDDSI rating of 3
Liquidised Food, Moderately thick liquid or Honey Thick
Name 2 exercises that increase muscle contraction in suprahyoid region, increase laryngeal vestibule closure and UES opening.
Mendelsohn and Shaker
3 symptoms of pharyngeal dysphagia that are concerning for aspiration
wet voice/change in vocal quality,
throat clearing, increase in respiratory rate, oxygen desaturation, cyanosis or cough