SPA 6565 Final Exam revision test guide
with a complete solution
what is neurogenic dysphagia? - ANS any issue with swallowing safely or efficiently caused
by a neurogenic disease
what are the causes of neurogenic dysphagia? - ANS -Parkinson's
-Huntington's
-TBI
-CVA/stroke
-MS
-ALS
-Guillian-Barre Syndrome
-Alzheimer's
-Brain tumors
-Bulbar/Pseudobulbar Palsy
-Myathenia Gravis
-Neurotoxins
where can the location of the problem that causes dysphagia be (in neurogenic dysphagia) -
ANS brain or CNS
-cerebral cortex
-midbrain/subcortical
-corticobulbar tract
-brainstem
-cerebellum
-medulla
-meninges
-PNS/cranial nerves
what is an acute insult? - ANS it happened all of a sudden
example of acute insult? - ANS TBI/stroke
What are meninges? - ANS membranes that cover the brain and spinal cord; dura,
arachnoid, Pia
What flows between the meninges - ANS cerebral spinal fluid
,what is a leak that can make blood go into the CSF (the CSF is already full which creates more
pressure and the collection of blood SPREADS)? - ANS subarachnoid hemorrhage
What is bleeding of the arachnoid from up above that causes a collection of blood that stays in
just that area (easier to understand what the deficits might be)? - ANS subdural hematoma
what are the types of CVAs - ANS hemorrhagic, ischemic
what is the higher brainstem - ANS pons
what is the lower brainstem - ANS medulla
What are the subcortical structures? - ANS basal ganglia, thalamus, cerebellum
the basal ganglia is a key part of ______ motor control of swallow - ANS efferent
what does the basal ganglia do? - ANS modulates motor signals coming from the cortex and
cerebellum; connects the cortex and other subcortical structures
what controls posture, balance, and fine motor movement; motor movement - ANS
cerebellum
T/f a cerebral stroke would not directly damage a nerve because the nerves are not in the brain
- ANS true but it would impact them
how does the blood get from the heart to the brain? - ANS arteries
What is the PNS - ANS all of the nervous system that isn't in the brain or spinal cord
Are cranial nerves part of the CNS or PNS? - ANS PNS
What artery is most often involved in strokes? - ANS MCA
If the lesion is in the medulla/lower brainstem, what will the patient most likely have difficulty
with? - ANS swallowing
What is the sequelae mainly dependent on? (2 things) - ANS site of lesion; extent of lesion
(how bad it is)
In a stroke, what helps us to determine the sequelae? - ANS -hemiparesis?
-oral acceptance?
-lingual/labial/velum strength and coordination
-sensory impairment?
-pharyngeal swallow timing
, -reduced contraction
-reduced laryngeal excursion
-cognitive disturbances
would you do rehab, compensation, or both for a stroke victim ? - ANS both
what are the 2 types of strokes? - ANS -Hemorrhagic: bleeding in the brain
-Ischemic: blood vessel supplying the brain is blocked
______ is the #1 cause of neurologic dysphagia - ANS stroke
t/f most stroke patients impove swallowing function in about 6 months - ANS true
are brain injuries normally simple or complex? - ANS complex
what are the considerations of a brain injury? - ANS -severity of damage
-open/closed injury
-multi-system trauma (did multiple things happen or just one)
-type of force that caused the damage
TBIs are easy to predict the outcomes of T/F - ANS false- there is limited evidence to assist
in predictive outcomes
In a TBI, dysphagia is normally primary symptom T/F - ANS False - normally secondary to
respiratory status, behavioral issues, and impulsivity
When does treatment have to be the most adaptive? - ANS During the acute phases;
thinking about positioning, assistance and orthopedic injuries; diet modifications
What is more focal (specific), a TBI or stroke? - ANS stroke. A brain injury is usually more
spread out so its difficult to predict outcomes
treatment for a brain injury is mostly dependent on _____ and ______ - ANS -type of
damage (strengthening, sensory impairments especially with presence of partial/total nerve
damage)
-insight and cognitive abilities (supervision, impulsivity, ability to participate)
Which neurogenic disorder is described as demyelination (small scars on white matter) ,
immune-mediated disorder, inflammatory disease, genetics can have an impact, and nearly
30% exhibit dysphagia? - ANS MS- multiple sclerosis
What might you see in MS, dependent on site of lesion - ANS delay and incoordination of
laryngeal movement and pharyngeal constrictor dysmotility-Depends on site of lesion could be
with a complete solution
what is neurogenic dysphagia? - ANS any issue with swallowing safely or efficiently caused
by a neurogenic disease
what are the causes of neurogenic dysphagia? - ANS -Parkinson's
-Huntington's
-TBI
-CVA/stroke
-MS
-ALS
-Guillian-Barre Syndrome
-Alzheimer's
-Brain tumors
-Bulbar/Pseudobulbar Palsy
-Myathenia Gravis
-Neurotoxins
where can the location of the problem that causes dysphagia be (in neurogenic dysphagia) -
ANS brain or CNS
-cerebral cortex
-midbrain/subcortical
-corticobulbar tract
-brainstem
-cerebellum
-medulla
-meninges
-PNS/cranial nerves
what is an acute insult? - ANS it happened all of a sudden
example of acute insult? - ANS TBI/stroke
What are meninges? - ANS membranes that cover the brain and spinal cord; dura,
arachnoid, Pia
What flows between the meninges - ANS cerebral spinal fluid
,what is a leak that can make blood go into the CSF (the CSF is already full which creates more
pressure and the collection of blood SPREADS)? - ANS subarachnoid hemorrhage
What is bleeding of the arachnoid from up above that causes a collection of blood that stays in
just that area (easier to understand what the deficits might be)? - ANS subdural hematoma
what are the types of CVAs - ANS hemorrhagic, ischemic
what is the higher brainstem - ANS pons
what is the lower brainstem - ANS medulla
What are the subcortical structures? - ANS basal ganglia, thalamus, cerebellum
the basal ganglia is a key part of ______ motor control of swallow - ANS efferent
what does the basal ganglia do? - ANS modulates motor signals coming from the cortex and
cerebellum; connects the cortex and other subcortical structures
what controls posture, balance, and fine motor movement; motor movement - ANS
cerebellum
T/f a cerebral stroke would not directly damage a nerve because the nerves are not in the brain
- ANS true but it would impact them
how does the blood get from the heart to the brain? - ANS arteries
What is the PNS - ANS all of the nervous system that isn't in the brain or spinal cord
Are cranial nerves part of the CNS or PNS? - ANS PNS
What artery is most often involved in strokes? - ANS MCA
If the lesion is in the medulla/lower brainstem, what will the patient most likely have difficulty
with? - ANS swallowing
What is the sequelae mainly dependent on? (2 things) - ANS site of lesion; extent of lesion
(how bad it is)
In a stroke, what helps us to determine the sequelae? - ANS -hemiparesis?
-oral acceptance?
-lingual/labial/velum strength and coordination
-sensory impairment?
-pharyngeal swallow timing
, -reduced contraction
-reduced laryngeal excursion
-cognitive disturbances
would you do rehab, compensation, or both for a stroke victim ? - ANS both
what are the 2 types of strokes? - ANS -Hemorrhagic: bleeding in the brain
-Ischemic: blood vessel supplying the brain is blocked
______ is the #1 cause of neurologic dysphagia - ANS stroke
t/f most stroke patients impove swallowing function in about 6 months - ANS true
are brain injuries normally simple or complex? - ANS complex
what are the considerations of a brain injury? - ANS -severity of damage
-open/closed injury
-multi-system trauma (did multiple things happen or just one)
-type of force that caused the damage
TBIs are easy to predict the outcomes of T/F - ANS false- there is limited evidence to assist
in predictive outcomes
In a TBI, dysphagia is normally primary symptom T/F - ANS False - normally secondary to
respiratory status, behavioral issues, and impulsivity
When does treatment have to be the most adaptive? - ANS During the acute phases;
thinking about positioning, assistance and orthopedic injuries; diet modifications
What is more focal (specific), a TBI or stroke? - ANS stroke. A brain injury is usually more
spread out so its difficult to predict outcomes
treatment for a brain injury is mostly dependent on _____ and ______ - ANS -type of
damage (strengthening, sensory impairments especially with presence of partial/total nerve
damage)
-insight and cognitive abilities (supervision, impulsivity, ability to participate)
Which neurogenic disorder is described as demyelination (small scars on white matter) ,
immune-mediated disorder, inflammatory disease, genetics can have an impact, and nearly
30% exhibit dysphagia? - ANS MS- multiple sclerosis
What might you see in MS, dependent on site of lesion - ANS delay and incoordination of
laryngeal movement and pharyngeal constrictor dysmotility-Depends on site of lesion could be
