Test on FEES for Neurogenic Dysphagia

Question 1: During the pharyngeal squeeze maneuver, the patient is primarily asked to perform a Valsalva maneuver.

A. Ano

B. Ne

Explanation: The study materials state that during the pharyngeal squeeze maneuver, the patient is asked to make an “eeeee“-Phonation. The Valsalva maneuver is a separate task mentioned for observing vocal cord closure.

Question 2: Is an algorithm proposed for the study materials for the evaluation of neurogenic dysphagia in a hospital setting?

A. Ano

B. Ne

Explanation: The study materials state, "We propose the following algorithm for the evaluation of neurogenic dysphagia in a hospital setting (Fig. 4) and a protocol for the FEES description (Table 3)."

Question 3: According to the FEES algorithm presented, which of the following scales are explicitly recommended for describing the pathological findings, including the grade of secretions, residues, and the presence of penetration/aspiration, after performing the procedure?

A. The Murray secretion scale

B. The Yale Pharyngeal Residue Severity Rating Scale

C. The Penetration Aspiration Scale (PAS)

D. The Volume-Viscosity Swallow Test (V-VST)

Explanation: The study materials state: 'After performing FEES, we recommend a protocol to describe the pathologic findings of the swallowing phases, using scales to describe the grade of secretions and residues, as well as the presence of penetra - tion and aspiration. In summary, we recommend a pathophysiological description of the affected swallowing phases, with an emphasis on aspiration risk.' It then explicitly names and details 'The Murray secretion scale', 'The Yale Pharyngeal Residue Severity Rating Scale', and 'The PAS' as validated instruments for this purpose. The Volume-Viscosity Swallow Test (V-VST) is mentioned as a bedside screening method, not a scale for describing post-FEES pathological findings.

Question 4: During a FEES procedure, which of the following food consistencies are recommended for observing the swallowing process?

A. Pureed and mashed fruits and vegetables

B. Thickened water (e.g., nectar)

C. Foods with solid consistency (e.g., toasted bread and banana)

D. Highly carbonated beverages to test protective reflexes

Explanation: The study materials explicitly list 'Pureed and mashed fruits and vegetables', 'Thickened water (e.g. nectar)', 'Fluids', and 'Foods with solid consistency (e.g. toasted bread and banana)' as the different food consistencies for observation during the FEES procedure. Highly carbonated beverages are not mentioned.

Question 5: The pharyngeal phase is the final stage of the swallowing process, concluding with the food bolus entering the stomach.

A. Ano

B. Ne

Explanation: The study materials state that swallowing is divided into four stages: Oral preparatory phase, Oral transport phase, Pharyngeal phase, and Esophageal phase. The Esophageal phase is described as the final stage, during which the food bolus enters the stomach via peristaltic pressure.