SLP Praxis 5331 Exam

CN that provides primary motor innervation to larynx & velum - ANSWER-X - Vagus Fela is a third-grade student in a public school. She is a speaker of African American Vernacular English (AAVE) who has difficulty with the Standard American English (SAE) dialect used in her classroom. Her teacher believes that Fela's language skills are affecting her academic performance and has referred her to the school's speech-language pathologist. Which of the following is an appropriate rationale for providing language intervention for Fela? A. Will likely foster better comm w/ling'ly & culturally diverse peers B. Will likely improve code-switching abil w/teacher & other adult spkrs for SAE C. May expand later aca & vocational opps D. Will likely lead to adopt SAE as prim dialect - ANSWER-A, B, C Speech recognition threshold (SRT) - ANSWER-Measured in dBs & corresponds to intensity lvl @which spondaic words cb recog'd approx'ly 50% of time; assesses how intense speech must be to be barely audible Best action to take initially w/client who presents w/poor oral control of liqs & solids, coughing & choking while eating & drinking, & hx of hospitalizations associated w/pneumonia A. Thickening liqs so client able to control oral mvmts for swallowing B. Obtaining MBSS to determ appro interventions C. Eval abil to eat variety of foods iot determ which foods safest D. Prescribing that client be NPO, since asp present - ANSWER-B Conclusion from studies describing poor aud mem in children w/lang impairments - ANSWER-Poor aud mem could be reflection/cause of lang impairment or could be related to some other factor, & further research needed to determ which is case 70y/o retired female, CVA; left-side neglect, anosognosia (denial of impairment), & visuospatial probs, incl'ing prosopagnosia (diffic recog'ing famil faces); aud comprh & rep skills good, exp'd diffic w/topic maintenance & turn taking; mostly likely dx: A. Wernicke's B. Conduction aphasia C. Cog-comm dis consistent w/R hemi dmg D. Cog-comm dis consistent w/L hemi dmg - ANSWER-C A client exhibits weakness, atrophy, and fasciculations of the right side of the tongue and lower face. The client also has right vocal-fold weakness and nasal regurgitation of fluid when swallowing. These problems are the result of damage to which part of the nervous system? A. Brain stem B. Cerebellum C. Left cerebral cortex D. Right cerebral cortex - ANSWER-A - weakness, atrophy, fasciculations, & other described symptoms all consistent w/LMN locus & suspected CN abnorms (prim'ly CNX & XII); CNs emerge directly from brain stem & help mediate transfer of messages from brain to brain stem and to strucs of head & neck Standard videofluoroscopic swallow study views A. Frontal B. Lateral C. Transverse D. Anterior-posterior - ANSWER-B, D HL in infants born w/cleft palate usually related to: A. Infant's inabil to create pos P in oral cav B. Malform of ME ossicles associated w/malform of palate C. Eustachian tube dysfx D. Cochlear dysfx - ANSWER-C Dialectical variation rather than artic error observed in spch of Af-Am child A. /f/ for /θ/ in postvocalic position B. /θ/ for /s/ in all positions C. Affricates for fricatives in word-final position D. Dentals for velars in word-initial position - ANSWER-A - use of VL labiodental fricatives for VL interdental fricatives is feat of AAVE Children dx'd as having specific language impairments likely to exhibit greatest defcs in: A. Production of sentences with appropriate inflectional morphology and syntax B. Acquisition of word meanings C. Comprehension of short sentences D. Motoric aspects of written expression - ANSWER-A - children w/SLI's typically have diffic producing utts that are morpho'ly & syntactically well formed A 70-year-old female has dysphagia characterized by poor posterior oral containment of the bolus during the oral preparatory stage, causing aspiration before the swallow. Cognition and the pharyngeal stage of the swallow are intact. Which of the following is the most appropriate treatment approach for the client? A. Providing a puree diet with thickened liquids B. Having the client flex her head forward (perform the chin-down posture) during oral preparation and transit stages of the swallow C. Having the client turn (rotate) her head to the right when swallowing D. Providing a diet that consists of thin liquids - ANSWER-B - tx alters oral config to place base of tongue sup to bolus inside oral cav; since liq cn flow uphill against gravity, intervention compensates for impaired palatoglossus contraction, which is causing impaired post oral containment A single exposure of several hours duration to continuous music with an overall level of 100 dB SPL will most likely produce A. tinnitus and a temporary threshold shift in high frequencies B. tinnitus and a distortion of speech perception C. a temporary threshold shift in the low frequencies D. a permanent threshold shift - ANSWER-A - single exposure of several hrs duration to cont music @lvl of ~100dB SPL will most likely produce tinnitus & temp thresh shift in H-freqs After sustaining a CVA, Ms. Williams, age 75, was referred to an SLP for a speech and language evaluation. While Ms. Williams was describing the cookie-theft picture, the SLP observed that her grammatical structure appeared to be intact and her prosody was normal but that many of her sentences were meaningless, did not fit the context, and included nonsensical paraphasic errors. Additional testing also revealed that Ms. Williams exhibited poor repetition and naming skills, did not respond appropriately to many simple commands, and had difficulty reading. Ms. Williams appeared happy and talked excessively. She did not appear to be aware of her communication deficits. What is the most likely location of the lesion? A. Left posterior superior temporal gyrus B. Left inferior frontal gyrus C. Left superior frontal gyrus D. Left inferior parietal gyrus - ANSWER-A - symptoms described consistent w/dmg to L post sup temp gyrus Excessive nasality is associated with inadequate velopharyngeal closure. An SLP is training a client to self-monitor nasality during speech. Which of the following tactics will best allow the speaker to determine whether there is excessive nasal airflow? A. Looking in a mirror while speaking B. Being aware of vowel-sound productions C. Speaking/phonating while alternately leaving the nostrils open and pinching them closed D. Monitoring production of consonant blends - ANSWER-C - speaking while alternately leaving nostrils open & pinching them closed = easy way for spkr to determ whether inappro nas airflow is occurring; this technq allows 1 to determ diff in airflow pattern when spch is produced w/nostrils occluded as compared w/spch produced when nostrils open; spkr w/velopharyng incompetence, closure of nostrils will elim nas airflow in production of /s/ An SLP who is treating an adolescent who stutters designs a treatment plan that includes three fluency management strategies: prolonged speech, cancellation, and pullout. Which of the following is true about the use of these treatment strategies? A. Use of prolonged speech is likely to reduce the frequency of part-word repetitions and sound prolongations significantly. B. Each of the three strategies entails deliberate regulation of speech motor movements. C. The client will seek to apply cancellation whenever he feels anxious about the possibility of stuttering overtly. D. The client will seek to apply pullout during the course of part-word repetition or sound prolongation. - ANSWER-A, B, D - prolonged spch, deliberate regulation of spch motor mvmts, & pullout could all be appro'ly applied A client with anomic aphasia is a native speaker of Spanish with fair proficiency in English. Production of the word "shoes" as [tʃuz] on a repetition task is most likely due to phonological interference from speaker's native language, why? - ANSWER-The Spanish language does not have /f/ in its phonemic inventory, and native speakers of Spanish typically substitute the affricate /t∫/ when producing English words with that phoneme. A native speaker of Spanish would most likely have made the substitution before acquiring an anomic aphasia. Immediately following removal of a benign tumor from the base of the brain, a 76-year-old client exhibits severe nasalization and a weak, breathy voice. A four-month postsurgical assessment reveals no improvement. At this time, the remediation strategy for this client should focus on A. evaluation for prosthetic or surgical intervention B. strengthening exercises for the oral articulators C. a trial period using the yawn-sign technique D. complete vocal rest - ANSWER-A - client has resonance & phonation dis indicative of velopharyng & laryng probs; velopharyng prob could be assisted by prosthetic/surgical intervention A 12-year-old native speaker of Spanish who has been studying English as a second language for three years is most likely to do which of the following when speaking English in casual conversation with teachers at school? A. Use the auxiliary "have" in place of "be" in progressive tenses B. Use incorrect word order within prepositional phrases C. Use conjunctions in place of prepositions D. Use multiple negation improperly - ANSWER-D - multi neg = gramm feat of Spanish but not of SAE; contract bw langs can cause multi neg to persist as spkr attempts to learn SAE Which of the following procedures would be effective in remediating a falsetto voice for an adult male with a severe bilateral hearing loss? A. Development of phonation from coughing B. Pushing exercises C. Manual depression of the larynx D. Manual elevation of the larynx - ANSWER-C - manual depression of larynx will serve to lengthen VFs, allowing them to vibrate @lower freq Cog thx for stuttering - ANSWER-Changing distorted beliefs about self-efficacy & need to speak w/comp fluency A prospective client is described as a man in his forties who is under chronic stress. He uses his voice extensively in daily life has a hard-driving personality, and exhibits glottal fry. The client has the classic profile of a person at high risk for: vocal nodules OR contact ulcers? - ANSWER-Contact ulcers Whispered speech - ANSWER-Composed largely of aperiodic sounds as VFs dn vibrate while whispering is taking place; speech produced without vocal fold vibration by causing air to pass along the edges of the tensed vocal folds, thus producing a friction sound source Which of the following actions will most effectively control the problem of overreferral in school screening programs that use impedance/immittance measurements? A. Obtaining the measurements in a professional sound-insulated room B. Including 500 Hz in the audiometric screening procedure C. Retesting immediately those who did not pass the first screening D. Waiting three to five weeks to retest those who did not pass the first screening - ANSWER-D - some children may have temp prob dt cold/ear infection which may resolve in few weeks Type of perturbation that can be measured to determine the amount of noise in the voice A. Changes in the frequency range between F1 and F2 over time B. Changes in the frequency range between F2 and F3 over time C. F3 cycle-to-cycle variations in sound energy over time D. F0 cycle-to-cycle variations in sound energy over time - ANSWER-D - perturbation = disturbance in qual of laryng tone or F0 of voice Dxtic distinction bw AOS & dysarthria - ANSWER-Strength and coordination of the speech musculature are intact in clients with apraxia of speech, whereas slowness, weakness, incoordination, or altered tone of the speech musculature are associated with dysarthria. Naturalistic teaching involves A. Establishing successful and useful communication B. Using multiple trials and training techniques C. Using more adult-initiated interactions than child-initiated interactions D. Using differential reinforcement, fading, and modeling - ANSWER-A - naturalistic teaching focuses on successful production of utts that are useful in context for communicating A 67-year-old male patient with no history of swallowing problems has undergone a cardiothoracic surgical procedure. Postoperatively, he is found to be aspirating while swallowing and is diagnosed with a left vocal-fold paralysis and left pharyngeal paresis. Is this damage to the RIGHT recurrent laryngeal nerve OR to the LEFT recurrent laryngeal nerve - ANSWER-The left recurrent laryngeal nerve courses under the aortic arch in its course back to innervate the left larynx and the inferior pharynx. The nerve can be damaged in cardiothoracic operations including aortic arch or valve repairs. Only the left (and not the right) recurrent laryngeal nerve has this course. Muscle that produces the opposing action to those that produce velopharyngeal closure A. Musculus uvulae B. Levator veli palatini C. Palatoglossus D. Stylopharyngeus - ANSWER-C - velopharyng closure largely produced by soft palate elev, & palatoglossus only musc that produces soft palate depression An otolaryngologist has referred a 45-year-old man for voice treatment following medialization thyroplasty for a paralyzed vocal fold. Which of the following is the most appropriate therapeutic strategy for the SLP to use? A. Assisting the patient to produce a soft glottal attack B. Digitally manipulation of the patient's neck to reduce strap-muscle tension C. Assisting the patient to produce a hard glottal attack D. Employing techniques aimed at increasing airflow - ANSWER-C - Medialization thyroplasty moves the paralyzed vocal fold closer to the mid-glottis to allow better compensation by the unaffected fold. Only the production of a hard glottal attack addresses the compensatory behavior. For a test of expressive morphology and syntax for speakers of African American Vernacular English (AAVE), the test item that would be considered LEAST biased against such speakers would be one requiring A. use of the auxiliary verb "be" in the present progressive tense B. use of the past-tense ending "-ed" C. use of sentences with multiple negation D. agreement of personal pronouns with their antecedents in gender and number - ANSWER-D - in AAVE does not differ from SAE Research regarding the use of intensive phonemic-awareness treatment for children who have difficulty learning to read has demonstrated that the treatment A. is effective only for children from 4 to 8 years old B. is effective mainly with children who have remediated all phonological process errors C. is effective only when combined with a supplemental literacy program D. might have no direct relationship to improvement in reading abilities - ANSWER-D - intensive phonemic-awareness tx progs thought to improve reading BUT research has not successfully separated effects of intensive intervention, so NO direct rx has yet been proved Most likely to help client who has aphonia A. Development of phonation through coughing or throat clearing B. Respiratory exercises C. Easy initiation of phonation - ANSWER-A - effective technq in tx of aphonia A child with discourse problems is most likely to need remediation directed at A. Morphology B. An initial lexicon C. Gestural communication D. Cohesive devices - ANSWER-D - cohesive devices e.g. prenominal references, coordinating conjunctions, & conjunctive adverbs, are used to link clausal & sentential elems to form coherent & unified message In terms of communication impairment, an adult with Alzheimer's-type dementia tends to differ from an adult with aphasia associated with a CVA in that A. repetition abilities are typically more seriously impaired in the adult with dementia B. the adult with dementia generally experiences greater dysfluency C. the adult with dementia is generally more aware of any disruptions in communication D. the capacity of the adult with aphasia to make appropriate comments about recent events is generally better - ANSWER-D - adults w/dementia typically have impaired short-term mem abils; adults w/aphasia m+ likely to recall recent events & consequently would be m+ likely to make appro comments about recent events when compared to those w/dementia An SLP is planning treatment for a 5-year-old child with multiple speech-production errors. The most effective strategy the clinician can use to treat the child is to A. arrange error sounds by developmental pattern and correct them sound by sound B. start with sounds the child can make and use them as bridges to error sounds C. teach sounds in isolation, then use nonsense syllables, and then build to words D. delineate phonological processes in operation and address them through minimal-contrast pairs - ANSWER-D - most efficient procedure > define phono processes in operation & address through minimal-contrast pairs Differential dx bw CAOS & flaccid dysarthria in child A. The child's articulation performance at the sentence level B. A history of the child's development of chewing, eating, and swallowing C. A history of the child's language development D. The child's willingness to function in sociocommunicative events - ANSWER-B - CAOS de/n have diffics w/chewing, eating, & swallowing, whereas child w/flaccid dysarthria likely to have such diffics Native speakers of a language possess several capacities or abilities that provide insight into their language competence. Sentences such as "Visiting friends can be a nuisance" are especially useful to test a person's ability to A. recognize syntactic ambiguity B. interpret metaphoric language C. distinguish homophones by means of syntactic cues D. recognize a semantically anomalous sentence - ANSWER-A - 2 ways to interp struc of sentence t/f sentence appro to test abil to recog syntactic ambiguity f/v - ANSWER-[f] substituted for[v] Utterance Gloss/Child's Intended Meaning No kitty It's not a kitty. My doggie This toy dog is mine. No goat It's not a goat. Kitty house The cat is in the house. Big kitty It's a big cat. Doggie ball The dog pushed the ball. What kind of semantic-syntactic constructions are used? A. Disappearance B. Denial C. Possessor + possession D. Attribute + entity E. Agent + action - ANSWER-B. "no kitty" C. "my doggie" D. "big kitty" E. "doggie ball" For which of the following conditions is it most appropriate for the SLP to recommend that the patient's primary-care physician refer the patient to a prosthodontist for construction of a palatal-lift appliance? A. Submucous cleft palate B. Unrepaired cleft of the secondary palate C. Flaccid paralysis of the soft palate D. Congenitally short palate - ANSWER-C - construction of palatal-lift appliance is appro for pt w/flaccid paralysis charac'd by intact palate that de/n fx Tx for AOS most appro'ly emphasizes - ANSWER-Aud-vis stim, oral-motor rep, & phonetic placement Typical symptom of cerebellar involvement - ANSWER-Over/undershooting intended target Doing which of the following would likely yield the most useful information about the effectiveness of an intervention strategy? A. Reviewing the results of standardized assessment instruments B. Utilizing a single-subject design (ABAB) or a reversal procedure (ABA) C. Utilizing the subjective, objective, assessment, and plan (SOAP) format D. Requesting that a colleague reevaluate the client - ANSWER-B - ABAB/ABA design shows changes when intervention is applied; single-subject design using ABAB/ABA is best method to determ whether intervention has succeeded Most helpful target for treatment for a child who repeatedly inserts an inappropriate sound in certain environments; for example, [fpɪʃ] for [fɪʃ] A. Bisyllabic words for which a minimal-contrast pair can be easily identified B. Words containing phonemes that have distinctive features in common with the sound the child inserts inappropriately C. Repeated practice with the combinations of phonemes that the child finds particularly easy to produce D. Words that contrast the child's error pattern with the target pattern in the word - ANSWER-D - words that contrast child's error pattern w/target pattern would be most helpful for child Although mental age should not be used to specify the need for treatment, mental age can legitimately be used as a performance criterion because using CA overidentifies or underidentifies language disorders? - ANSWER-Overidentifies Ratio of reinforcement that will most quickly cause newly acq'd behav tb habituated - ANSWER-Random ratio of tokens to correct responses; dec's client's dependence on token reward Mr. Charles, age 78, has had Alzheimer's disease for the past nine years. A recent speech and language evaluation at his nursing home indicated severe deficits in verbal reasoning, memory, word finding, discourse, pragmatics, phonology, semantics, and syntax. Which of the following should the speech-language pathologist do next? A. Recommend individual treatment to improve his receptive and expressive language skills, beginning with the areas where he is least deficient B. Recommend individual treatment to improve his receptive and expressive language skills, beginning with the areas where he is most deficient C. Initiate group treatment with other adults with language impairments to improve spontaneous conversational speech and pragmatic skills D. Examine his living conditions and, if necessary, educate the nursing staff concerning ways to help him communicate more effectively - ANSWER-D - best that cb done is help cf's improve conditions related to basic comm needs; spchlang tx itself very unlikely tb effective t/f not appro adult client exhibits visuospatial disorg, inabil to initiate interactions, L-side neflect, lack of facial exp; most likely associated with - ANSWER-R-hemi TBI A physician told the spouse of a client that melodic intonation therapy (MIT) would improve the client's speech considerably. The most appropriate next action by the SLP would be to A. consider the potential value of incorporating MIT into the client's treatment B. explain MIT to the client's spouse to assist in the decision-making process about the type of therapy to use - ANSWER-A - MIT = appro'ly used by SLPs to proomte certain results; SLP responsib for determ'ing value of procedure in relation to objv to spchlang tx prog Posterior cricoarytenoid - ANSWER-Abducts vocal folds; opens airway; CNX RLN; **only VF abductor UES opening - ANSWER-Not a true sphincter muscle Primary make-up is of the cricopharyngeus muscle Boundary between the pharynx and the esophagus Tonic in state, but relaxes when swallow is triggered Elevation of the hyolaryngeal process mechanically assists with opening of the UES Partial relaxation of cricopharyng portion of inf constrictor musc Sup & ant hyolaryng excursion provides mechanical op'ing Mendelsohn maneuver - ANSWER-Increased laryngeal movement stretches/opens the CP Prolonging hyolaryngeal elevation keeps the CP open longer Used for: (1) Decreased range/duration hyolaryngeal elevation; (2) Decreased range/duration cricopharyngeal opening; (3) Decreased pharyngeal swallow coordination Prolong duration & diameter of upper esophageal sphincter op'ing If a child's language exhibits the phonological process of gliding, the child might say [wɛd] for "red." When asked, "Do you mean wed?" the child may respond, "No! [wɛd]!" Such a response demonstrates which of the following? A. Phonological development lags behind semantic development. B. Semantic development lags behind phonological development. C. Linguistic competence lags behind linguistic performance. D. Linguistic performance lags behind linguistic competence. - ANSWER-D Interjudge reliability - ANSWER-Consistency of measurement when different people observe the same event or score the same test Results are replicable, even if different people administer the test E.g. asking 2 SLPs to ea independently rate 30 subjects Linguistic approaches to the treatment of sound-production errors in children are based on the notion that the errors are systematic and rule-based and that the goal of treatment is to modify a child's rule system to approximate the rule system used by adults. Which of the following is a treatment objective that reflects a linguistic approach to treatment? A. The child will contrast alveolar stops with velar stops in meaningful word pairs. B. The child will produce voiceless alveolar sibilants correctly in unstructured conversation. C. The child will coarticulate stop plus liquid clusters as easily as other children of the same age. D. The child will recognize and identify phonetic distortions of his or her error sound. - ANSWER-A - The objective refers to speech sounds in terms of general distinctive-feature classes, rather than in terms of isolated phonemes or overly specific classifications. Most reasonable standard to apply when judging whether a client has achieved generalization of a targeted skill A. The client uses the targeted skill under stimulus conditions that were not present during the training process and without reinforcement. B. The client maintains the correct production of the targeted skill when the reinforcement schedule is changed. C. The client correctly produces the targeted skill effortlessly and without hesitation. D. The client is able to monitor errors and correct them with only a minimal number of cues from the clinician. - ANSWER-A - When judging whether a client has achieved generalization of a targeted skill it is a reasonable standard to apply. It shows that the client is exhibiting the skill independently in situations not covered during training. Transcortial motor aphasia - ANSWER-Nonfluent aphasia, Difficulty initiating speech or writing, Impaired speech (especially in conversation) Good verbal imitative abilities, Mildly impaired auditory comprehension (?) Laborious, halting, dysfluent, telegraphic utterances Vowel formants F1, F2, F3 - ANSWER-F1: inversely associated w/tongue height e.g. H vowels tend to have L F1 frequences; higher the formant, lower the vowel height F2: frontness/backness of tongue; m+ front the vowel, higher the F2 F3: lower F3, rounder shape of lip; not used as freq'ly Recs to a parent of an infant with cleft lip and palate that an SLP should make to best optimize feeding for adequate nutrition and appropriate growth A. Providing a bottle rather than breast-feeding the infant B. Positioning the infant in a supine position during feeding times C. Allowing the infant to take as much time as needed to feed D. Using a bottle with a modified nipple during feedings - ANSWER-D - bottle w/ mod'd nip allows for greater control over quant of liq exp'd & pacing of feeding Shaker exercise (head lift) - ANSWER-- lay flat on floor - lift head up from floor without lifting trunk/shoulders from the floor - repeat slowly 3x; rest for 1 minute - repeat head lifts rapidly 30x - repeat entire series 3x/day for 6 weeks - increased anterior laryngeal excursion and upper esophageal sphincter opening during swallowing with healthy subjects - prolonged relaxation of cricopharyng portion of inf constrictor musc - demo'd inc in opening duration of UES Cerebral palsy (CP) & AAC - ANSWER-- Caused by a lack of oxygen to parts of the fetus' brain during birth - Result can include spastic muscles; lack of coordination in walking, eating, and talking; muscle paralysis; seizures; or mental retardation - when assessing abil of student w/CP to access AAC, trunk stability & control must be eval'd first bc will guide clinician in making appro rec for type of device client can access as it influences m+ distal mvmts An SLP provides home practice for a patient with aphasia as part of discharge plans. The patient is approximately six-months post left-hemisphere stroke that resulted in aphasia. Verbal output has improved significantly since the stroke; however, the patient is still very concerned that written expression is moderately impaired at the single-word level. The homework assignment is to implement copy-and-recall treatment to improve written expression, which involves practicing writing target words (from photographs) and then copying those words multiple times. However, during a follow-up phone call, the SLP determines that the patient is struggling to write the assigned target words because the patient "can't think of the correct letters." Although a model is provided on the back of each target photograph, the patient wants to find a way to practice without looking at the answer. The SLP's best course of action is to suggest that the patient A. try anagramming the words using letter tiles to form the target word B. practice writing the alphabet in order multiple times before beginning the homework again C. use a cell phone voice-to-text application as a compensatory strategy D. use drawing to convey messages instead of using written expression - ANSWER-A - anagramming words would give client best access to comp'ing hw; letter tiles would provide support for client to comp hw & reg part of this tx approach Acculturation - ANSWER-Simultaneous incorporation of host culture's perspective & values and values and maintenance of native culture's perspective & values The commonly used chin-down posture was initially developed to eliminate thin-liquid aspiration in people with delayed pharyngeal stage onset after having a stroke, and when its efficacy was investigated, it was found to be 50% effective. For whom is the chin-down posture ineffective at eliminating thin-liquid aspiration? A. People who have cricopharyngeal dysfunction B. People who aspirate residue from the pyriform sinuses C. People who have impaired lingual function D. People who aspirate residue from the valleculae - ANSWER-B - Shanahan et al. (1993) found that 50% of people with stroke- and swallowing-related aspiration due to delayed onset of the pharyngeal response continued to aspirate from the pyriform sinuses using chin-down posture. Moreover, Eisenhuber et al. (2002) found that people with a pyriform sinus residue with a height that was <50% of the pyriform sinus height aspirated significantly more than those with less or no pyriform sinus residue.