Msp Exam 3 With 100% Correct And Verified Answers 2024, Exams of Advanced Education

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Msp Exam 3 With 100% Correct And

Verified Answers 2024

signs and symptoms of dysphagia !!! - Correct Answer-- inability to recognize food

• inability to control food/saliva in the mouth
• coughing before/during/after swallowing due to aspiration
• frequent coughing towards the end or immediately after a meal
• feeling that food is sticking in the throat
• recurring pneumonia
• unexplained weight loss
• gurgly voice
• increase in secretions during/after eating
• prolonged meal length
• complaints of swallowing difficulties
• elevated temperature
• drooling/increased secretions
• weight loss
• coughing/choking
• pocketing
• pneumonia
• changes in diet
• dehydration
• reflux pneumonia risk factors - Correct Answer-- poor dental/oral hygiene
• bed-bound
• change in alertness
• poor laryngeal adductor reflexes diagnostic procedure/instrumental evaluation components -- symptoms observed - Correct Answer-aspiration, penetration, residue, backflow of food what to check in oral mech exam - Correct Answer-- lip closure
• hard palate configuration (height and width)
• soft palate dimensions
• lingual configuration
• any asymmetries IDDSI stands for - Correct Answer-International Dysphagia Diet Standardization Initiative IDDSI 7 - Correct Answer-regular

IDDSI 6 - Correct Answer-soft & bite-sized IDDSI 5 - Correct Answer-minced & moist IDDSI 4 (food) - Correct Answer-pureed IDDSI 3 (food) - Correct Answer-liquidised IDDSI 4 (liquid) - Correct Answer-extremely thick IDDSI 3 (liquid) - Correct Answer-moderately thick IDDSI 2 - Correct Answer-mildly thick IDDSI 1 - Correct Answer-slightly thick IDDSI 0 - Correct Answer-thin instrumental swallow eval purpose - Correct Answer-- further evaluate any patient who is suspected of aspirating

• identify aspiration
• provide a cause for aspiration
• examine effects of various treatment methods
• determine the best form of nutritional intake (oral/non-oral/both) why is swallowing and dysphagia management important? - Correct Answer-pneumonia malnutrition dehydration transitional food - Correct Answer-- foods that start as one texture but change to another when a liquid is added
• no biting, minimal chewing
• tongue pressure can help break down food
• can be used to teach chewing skills IDDSI #s of transitional foods - Correct Answer-5, 6, 7 4 stages of the swallow - Correct Answer-oral prep, oral, pharyngeal, esophageal oral prep phase - Correct Answer-- lip closure, cheek tone (resistance), rotary and lateral jaw/tongue movement
• posterior seal by tongue and palate
• anterior bulging of soft palate
• does not pull all the way down during mastication
• premature spillage for consistencies requiring mastication is normal

• food mixes with saliva
• tongue forms bolus oral phase - Correct Answer-- bolus is held between tongue and hard palate
• tongue elevates/retracts, squeezing bolus along palate, pushing bolus to back of the mouth
• tongue tip elevates, tongue blade pushes bolus posteriorly, triggers pharyngeal swallow
• if tongue control is poor, food may go into the pharynx and be aspirated pharyngeal phase - Correct Answer-- triggered when bolus reaches anterior faucial pillars
• velum closes, larynx elevates, epiglottis flips, true and false vocal folds come together
• tongue has major role in triggering pharyngeal swallow
• interactions of tongue, velopharynx, larynx -- temporal integration
• elevation and retraction of velum
• pharynx constricts and contracts
• hyoid moves anteriorly and superiorly (forward and up)
• elevation and closure of larynx (epiglottic inversion, F VFs, T VFs)
• but the sequence of closure in the opposite
• relaxation of cricopharyngeus muscle esophageal phase - Correct Answer-- 8-20 seconds
• peristaltic action when does the esophageal phase begin and end - Correct Answer-- begins when upper esophageal sphincter (UES) opens
• ends when lower esophageal sphincter (LES) opens components all swallows must have - Correct Answer-- oral propulsion of bolus into pharynx
• airway closure
• UES opening
• tongue base-pharyngeal wall propulsion what must happen during a swallow? - Correct Answer-larynx elevates, epiglottis inverts, VFs close ways swallowing disorders affect psychological well-being - Correct Answer-limited social functions surrounding meals ways swallowing disorders affect financial well-being - Correct Answer-- special foods, supplemental feeding
• dysphagia therapy, special appliances for meal prep or feeding
• cost of non-oral feeding may be up to 7x higher than oral feeding

2 instrumental evaluations - Correct Answer-FEES and MBSS MBSS stands for - Correct Answer-modified barium swallow study FEES stands for - Correct Answer-fiberoptic endoscopic examination of swallowing purpose of MBSS - Correct Answer-- identify any structural abnormalities

• observe oral and pharyngeal movement patterns
• compensatory strategies and therapy options purpose of FEES - Correct Answer-- to assess swallowing in pts who present with symptoms of oropharyngeal swallowing disorders
• to help manage and guide treatment of dysphagia with the goal that a pt will return to safe oral feeding advantages of MBSS !!! - Correct Answer-- see all phases of the swallow
• can often identify contributing impairments
• effectiveness of compensatory strategies disadvantages of MBSS !!! - Correct Answer-- radiation
• unnatural environment and consistencies
• skilled observations
• expensive advantages of FEES !!! - Correct Answer-- no radiation
• uses natural foods (dyed)
• can be conducted in clinic or bedside
• observe airway closure, arytenoid mobility, secretions, residue, aspiration before and after the swallow, altered anatomy disadvantages of FEES !!! - Correct Answer-- invasive
• cannot see larynx during swallow
• skill needed
• not easy with young kids and confused/combative pts what you see in MBSS vs FEES !!! - Correct Answer-FEES: true VFs, penetration before and after swallow (NOT during) MBSS: all stages of the swallow 4 main swallowing exercises - Correct Answer-- effortful
• masako maneuver
• supraglottic
• mendelsohn maneuver effortful swallow - Correct Answer-press tongue against roof of your mouth. hold tongue in place and squeeze all swallowing muscles. swallow hard.

masako maneuver - Correct Answer-stick tongue out of mouth and bite down to hold your tongue in place. swallow with your tongue held between your teeth supraglottic swallow - Correct Answer-hod your breath. swallow hard then cough right after the swallow mendelsohn maneuver - Correct Answer-(swallow hold) place fingers on adam's apple. swallow once to feel how it moves. swallow again and squeeze swallowing muscles when it reaches its highest position and hold for 5 seconds SOAP notes - Correct Answer-Subjective observations (opinion) Objective observations (fact) Assessment Plan info shown in a bedside exam - Correct Answer-- current medical diagnosis and medical history

• history, awareness, and understanding of the nature of the disorder
• medical, nutritional, and respiratory status
• oral anatomy
• respiratory function and how it relates to swallowing
• labial, lingual, and laryngeal control
• palatal function
• ability to follow directions and control behavior
• reaction to oral sensory stimulation
• reaction during swallowing attempts bedside swallow assessment components - Correct Answer-- chart review
• patient interview
• OME
• swallow assessment what causes dehydration - Correct Answer-- fever or infection
• high env temp/low env humidity
• dry oxygen therapy
• diuretic therapies
• vomiting
• diarrhea
• food/fluid malabsorption 4 forces that move a bolus - Correct Answer-- posterior tongue movement
• pharyngeal constriction
• negative pressure in esophagus
• gravity

do you identify areas sensitive to light touch in an oral mech exam? - Correct Answer- yes, shows awareness to touch and helps the clinician place foods into the oral cavity how to increase sensory awareness during swallowing - Correct Answer-- press spoon downward on the tongue

• bolus is: cold, sour, requires chewing, large volume
• thermal-tactile stimulation types of feeding tubes - Correct Answer-G, J, NG long term feeding - Correct Answer--gastrostomy (PEG or G-tube) -jejunostomy (J-tube) NG tube - Correct Answer-nasogastric tube dysphagia definition - Correct Answer-difficulty moving food from the mouth to the stomach goals of assessment - Correct Answer-- identification
• description
• etiology
• identification of compensatory strategies
• conditions under which pt may eat safely