Dysphagia 1
A patient demonstrates reduced tongue base retraction and mild pharyngeal residue. The SLP wants to use a maneuver that increases pressure generation throughout the swallow by instructing the patient to “squeeze hard” during the swallow.
Which technique is MOST appropriate?
A. Supraglottic swallow
B. Effortful swallow
C. Masako maneuver
D. Chin‑tuck posture
B. Effortful swallow
The effortful swallow increases oropharyngeal pressure, improving bolus clearance.
During a therapy session, the clinician instructs a patient: “Take a deep breath, hold it, swallow, then cough.” This sequence is MOST appropriate for a patient with:
A. Reduced UES opening
B. Poor laryngeal elevation
C. Reduced airway closure at the level of the vocal folds
D. Impaired oral bolus formation
C. Reduced airway closure at the level of the vocal folds
The supraglottic swallow increases volitional airway closure and helps clear penetrated material with a cough.
Which patient would MOST benefit from an effortful swallow?
A. A patient with delayed swallow initiation
B. A patient with reduced pharyngeal pressure and residue
C. A patient with poor airway closure
D. A patient with reduced hyolaryngeal elevation
B. Reduced pharyngeal pressure and residue
The effortful swallow enhances pressure generation, improving bolus propulsion.
Which patient would NOT be an appropriate candidate for the Masako maneuver?
A. A patient with reduced pharyngeal constriction
B. A patient with significant vallecular residue
C. A patient with poor airway protection
D. A patient with reduced tongue base retraction
C. A patient with poor airway protection
The Masako maneuver is not performed with food and may increase aspiration risk if airway protection is already compromised.
A patient with reduced airway protection demonstrates penetration during the swallow due to delayed vocal fold closure. The SLP wants to teach a maneuver that includes volitional airway closure before and during the swallow, followed by a cough to clear any residue.
Which technique should the SLP use?
A. Mendelsohn maneuver
B. Supraglottic swallow
C. Shaker exercise
D. Chin‑tuck posture
B. Supraglottic swallow
A patient demonstrates delayed swallow initiation during FEES. The SLP wants to use a technique that provides heightened sensory input to the anterior faucial pillars to help trigger a faster pharyngeal swallow.
Which intervention is MOST appropriate?
A. Effortful swallow
B. Thermal‑tactile stimulation
C. Masako maneuver
D. Shaker exercise
B. Thermal‑tactile stimulation
A 72‑year‑old patient with reduced hyolaryngeal elevation demonstrates vallecular residue and delayed opening of the upper esophageal sphincter (UES) during a FEES exam. The SLP wants to use an exercise that increases the duration of laryngeal elevation and prolongs UES opening.
Which maneuver is MOST appropriate?
A. Effortful swallow
B. Mendelsohn maneuver
C. Masako maneuver
D. Supraglottic swallow
Mendelsohn maneuver
During a therapy session, the clinician instructs the patient: “Hold your tongue gently between your teeth and swallow.” This exercise is MOST appropriate for improving:
A. Hyolaryngeal elevation
B. Base‑of‑tongue retraction
C. Pharyngeal wall contraction
D. Airway closure
C. Pharyngeal wall contraction
The Masako maneuver increases posterior pharyngeal wall movement, compensating for reduced tongue base pressure.
A patient demonstrates reduced opening of the upper esophageal sphincter (UES) due to decreased anterior laryngeal excursion. The SLP wants to use an exercise that strengthens the suprahyoid muscles through sustained and repetitive head‑lifting.
Which exercise is MOST appropriate?
A. Mendelsohn maneuver
B. Shaker exercise
C. Effortful swallow
D. Supraglottic swallow
B. Shaker exercise
The Shaker targets suprahyoid strength to improve UES opening.
During therapy, a patient is instructed to “hold your larynx up at the peak of the swallow for a few seconds before letting it drop.” The SLP is MOST likely targeting improvement in:
A. Base‑of‑tongue retraction
B. Airway closure at the level of the true vocal folds
C. Duration of hyolaryngeal elevation
D. Oral transit time
C. Duration of hyolaryngeal elevation
The Mendelsohn maneuver specifically increases hyolaryngeal elevation duration, which supports improved UES opening.
During therapy, the clinician instructs the patient: “Swallow hard — like you’re trying to swallow a large pill.” This instruction is MOST likely intended to improve:
A. UES opening duration
B. Airway closure
C. Tongue base retraction and pharyngeal pressure
D. Laryngeal elevation
C. Tongue base retraction and pharyngeal pressure
The effortful swallow increases tongue base movement and pharyngeal constriction, reducing residue.
During therapy, the clinician strokes the patient’s anterior faucial pillars with a cold laryngeal mirror immediately before presenting a bolus. This technique is MOST appropriate for a patient with:
A. Reduced tongue base retraction
B. Delayed pharyngeal swallow
C. Reduced laryngeal elevation
D. Poor airway closure
B. Delayed pharyngeal swallow
Thermal‑tactile stimulation is specifically used to improve timing of the pharyngeal swallow.
A patient demonstrates reduced pharyngeal constriction and significant vallecular residue on FEES. The SLP wants to use an exercise that increases pharyngeal wall movement by having the patient swallow while the tongue is held between the teeth.
Which exercise is MOST appropriate?
A. Mendelsohn maneuver
B. Masako maneuver
C. Effortful swallow
D. Shaker exercise
B. Masako maneuver
The Masako maneuver targets pharyngeal wall contraction by restricting tongue base movement during the swallow.
During therapy, the clinician instructs the patient to lie flat and lift their head to look at their toes, holding the position for a set duration. This exercise is MOST appropriate for improving:
A. Airway closure
B. Hyolaryngeal elevation and UES opening
C. Pharyngeal constriction
D. Oral bolus formation
B. Hyolaryngeal elevation and UES opening
The Shaker increases anterior laryngeal excursion, improving UES function.
Which patient would NOT be a good candidate for the Shaker exercise?
A. A patient with reduced UES opening
B. A patient with weak suprahyoid musculature
C. A patient with cervical spine limitations or neck pain
D. A patient with pharyngeal residue
C. Cervical spine limitations or neck pain
The Shaker requires significant neck flexion and may be contraindicated for patients with cervical issues.