Studies
What do SLP's use an Endoscopy for?
SLP's use a type of Endoscopy, the Fiberoptic Endoscopic Evaluation of Swallowing (FEES), used to evaluate swallowing.
What reflexes persist through adulthood?
gag reflex and cough relfex
when examining the Hard Palate, what do you look for?
Arched/Vaulted (Vents), Cleft Palate
what are the alternative names for Videofluroscopic swallow study?
Modified Barium Swallow study
What do you look for when examining a patients current status?
-Current growth parameters
-Oral Motor Functioning
-Current Diet
-Eating behaviors
-GI Symptoms
What do SLP's use a Manometry for?
Can check for pressure as you swallow
What reflexes are do babies have between 0-4 months?
rooting, gag, transverse tongue, phasic bite, suck/swallow/breath, and cough reflex
when examining occlusion, what do you look for?
Inability to chew = choking, Microagnathia
Who participates in the modified barium swallow study?
SLP, Radiologist, Parent, intern (sometimes)
What are Moderate Autonomic Stress Cues?
Sighing, yawning, sneezing, sweating, hiccupping, tremoring, startling, gasping, straining
What do SLP's use an Ultrasound for?
Measures movement of the muscles of the neck/mouth. Good for articulation therapy.
At what age do babies transition from reflexive to volitional swallow? What is the suck/swallow ratio?
-4-6 months
-suck/swallow ratio changes from 2-3:1 to 3-4:1
when examining dentition, what do you look for?
Caries, Pain, Sensitivity, Crowding
Name four foods or liquids barium can be hidden or mixed into
Options talked about in class:
yogurt, pudding, chicken pate, goldfish, Cheetos, Oreos, cranberry juice, water, gummy worms, Reeses, jelly beans
What are Major Autonomic Stress Cues?
Coughing, Spitting up, Gagging, Choking, Color Change, Respiratory pauses, & irregular Respirations.
What do SLP's use a Cervical Auscultation for?
It can be used to listen for a swallow. Can't be used for diagnostic purposes.
What age does the transition period for self feeding start?
11-14 months
when examining Jaw Control, what do you look for?
Hypertonia (Tonic Bite), Hypotonia (Wide excursion)
What is Arvedson's 2 rules for radiation safety? (for the patient)
-make sure it's medically necessary
-make sure radiation is ALARA (As Low As Reasonably Achievable)
List 5 of Arvedson's common criteria for referral
-sucking/swallowing incoordination
-weak suck
-breathing disruptions during feeding
-excessive gagging/ coughing during feeding
-new onset of feeding difficulty
-DX associated w/ dysphagia/undernutrition
-weight loss/lack of weight gain for 2-3 months
-behavior issues during feeding
-history of pneumonia
-concern of aspiration
-lethargy during feeds
-feeding periods longer than 30-40 min.
-food refusal
-drooling after 5yo
-nasopharynx reflux when feeding
-delay in feeding milestones
-craniofacial anomalies
What are the Anthropometric Measures?
-growth curve
-Skin fold thickness
-muscle mass measurements
What are the seven main structures of early structural maturation?
-Nasal Cavity
-Oral Cavity
-Pharynx
-Larynx
-Trachea
-Esophagus
-Stomach
How do you determine Hyposensitivity?
lack of sensation/responsiveness, drooling, requires increased sensation to respond.
How can you reduce radiation exposure for the patient?
-shorten exposure time
-concentrate beam only in area of interest
-limiting radiographs taken
-using minimum necessary electronic magnification
list 5 warning signs for aspiration
Difficulty coordinating suck/swallow/breathe sequence.
• Turning away, crying, arching, &/or Fussy behaviors during feeds.
• Coughing, choking, or throat clearing: before/during/after swallow.
• Hoarse, breathy, whispered voice - ? TVC or airway involvement.
• Tracheostomy - Excessive secretions/congestion, or liquid/food in trach secretions.
• History of pneumonia. • Lung congestion with fever, or upper respiratory congestion.
• "Asthma" symptoms which don't respond to normal treatment.
• Wet vocal quality / audible pharyngeal pooling.
• Excessive drooling.
• Fluctuating level of alertness.
• Difficulty chewing - loss of bolus control.
• Complaint: food "stuck" in throat, or "multiple swallows / bolus".
• Regurgitation of food.