FEES and treatmetn
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| ASHA recommends fiberoptic endospcopic evaluation of swallowing "genric identifier" | show 🗑
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| show | FEESST (Sensory Testing)
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| Why is it usually easier to see and try more therapeutic strategies with FEES than MBS? | show 🗑
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| show | FALSE, not the ONLY goal: also evaluate phsyiology of swallow, identify patterns of impairments, identify consequences of four phases, how does disorganized tongue affect etc. Predict outcome,determine whether and why pt is aspirating
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| show | Motivation, cognitive status, if phsiology will allow it, if pt is stimulable for correct or improved behavior.
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| show | FALSE. Opposite is true If you want to assess phases in action chose: MBS. IF you want to assess impact of swallow and therapy chose FEES.
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| show | Technique (no x-ray-FEES invasive with Camera, MBS invasive with x-ray beams)
Image perspective: view is not lateral or AP like MBS
POrtability (much easier to do at bedside)
Repeatability (can do many times, cheaper, easier)
Upper airway sensory asse
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| T/F. An FEESST gives direct information about CN function, MBS not as much | show 🗑
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| _______ happens when the vagus nerve is overstimulated, it can cause patient to pass out, vomit and can happen with anything in nose, or with laryngectomy patient, very dangerous because vagus nerve controls heartbeat | show 🗑
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| show | TRUE
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| show | False, a camera can be used to record, (most often) nice because can watch again, but you can also look with naked eye
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| What are some specific goals of FEES? | show 🗑
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| T/F it is best to have kids bring their own food, other foods tested include: thin liquid, thicker liquid, pudding, soft solid, solid | show 🗑
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| T/F Patient instruction is important so pt. realized the scope will be int he nose for awhile | show 🗑
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| T/F an SLP can administer anesthetic without medical supervision | show 🗑
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| All oral motor exercises should only be used if they are either, increasing strength, range of motion accuracy or _______ | show 🗑
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| What do we look for in a physical assessment using FEES? | show 🗑
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| show | Humming can get velum to drop
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| show | Falsetto, throat clearing, cough, valsalva maneuver, voicing, sniffing (maximal abduction) breath holds.
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| show | FALSE. WE describe but we DON'T DIAGNOSE.
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| show | FALSE. start with best texture, or standard protocol. Foods should be easily observable. (apple juice instead of water)
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| show | TRUE
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| What is observed when you blow air into larynx? | show 🗑
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| T/F with FEES may actually see aspiration penetration as it is happening | show 🗑
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| When choosing a technique we have to consider: | show 🗑
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| Management is _______ while rehabilitation is _______ | show 🗑
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| What are some therapy techniques? | show 🗑
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| A postural adjustment is a _____ technique | show 🗑
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| show | entire body or just head/shoulders, may redirect the swallow, may increase speed of swallow, no single posture change will help all patients
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| Type of Body posture which involves patient in the supine or side lying position | show 🗑
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| Head posture changes have 3 major changes: | show 🗑
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| T/F Thickening liquids decreases the chances of pneumonia | show 🗑
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| show | free water protocol
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| T/F. When we decrease to purees, we decrease quality of life and decreases nutritional benefit | show 🗑
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| show | TRUE, research shows we are overly restrictive with patients, modified diets need to be monitored and re-evaluated at regular intervals
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| T/F. Oral motor exercices should be used to strengthen artiulation muscles and are beneficial for children with apraxia of speech | show 🗑
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| show | Bruxism (teeth grinding), drooling (help increase lip closure), dysphagia (tongue strengthening) etc.
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| What are goals of OME's? | show 🗑
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| show | Direct: changes four phases and
Indirect: compensation/facilitation taht don't change the four phases, help person safe swallow but nothing to improve status of anatomy or physiology
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| Tube feeding recomendations, calorie and food intake measures, secretion management, structring the eating environment, safety precautions, diet modifications are types of __________ treatment | show 🗑
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| show | Direct Treatment
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| This type of direct treatment includes oral motor exercises, range of motion, coordingation, compensatory maneuvars, sensory stimulation, bolus modification, and devices | show 🗑
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| Thermal, gustaltory stimulation and bolus modifcations are exames of _______ direct therapy | show 🗑
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| show | Improve laryngeal closure
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| Chin-down posture (flexion), head-back posture (extension) and head tilt posture (rotation) are ________compensations and are a direct thearpy | show 🗑
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| show | TRUE
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| What does tilting head to stronger side do? | show 🗑
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| show | Double swallows, effortful swallow, supraglottic swallow, super-surpaglottic swallow, mendelssohn maneuvar.
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| show | Supraglotttic Swallow
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| This compensatory maneuver is identical to supraglottic swallow but uses incrased effort, valsavla and may not be used with patient who have cardiovascular disease or strokes | show 🗑
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| show | Efffortful swallow
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| show | double swallow
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| Designed to maintain elevation of larynx at highest point which decreses pooling in pyriform sinuses, improves extend and ROM of opening of cricopharhyngeus, icnrases stregnth and range o f elevation for tongue base retraction | show 🗑
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| Modifciations to bolus, can have definite affect on onset and duration of swallow events | show 🗑
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