Oral Care

Oral Care

The First Thing.... When I assess a patient with dysphagia, my first plan of attack is to teach the patient about oral care and start an oral care plan with that patient! Aspiration Aspiration is defined as the inhalation of either oropharyngeal or gastric contents into the lower airways, that is, the act of taking [...]

Respiratory Muscle Strength Training

Respiratory Muscle Strength Training

Inspiratory Muscle Strength Training  Inspiratory strength training works on the muscles of inspiration the diaphragm, the intercostals. Inspiration involves contractions of the diaphragm and external intercostals, which increase intrathoracic volume and decreased volume in pressure.  Respiration is a recoil from inspiration. Exhalation involves relaxation of the inhalation muscles, recruitment of abdominal and internal intercostals to force [...]

Modified Barium Swallow Study: Gold Standard or Old News?

Modified Barium Swallow Study:  Gold Standard or Old News?

The Modified Barium Swallow Study, no matter what name is used, has been considered a gold standard for many years in the assessment of dysphagia.   Recently there has been a lot of debate about whether the MBSS continues to be the gold standard or if FEES (Flexible Endoscopic Evaluation of Swallowing) has taken the place [...]

What’s In A Name

What’s In A Name

Seriously, how many names can we have for one test? We typically do the same thing.....assess swallowing function, so why a million different names? In the early days, the swallowing assessment using x-ray was called a Cookie Swallow Test. You can read more about the history of the MBSS: The same test is more recently [...]

MBSImP

MBSImP

MBSImP For those of you that don't know what the heck the MBSImP is, it stands for the Modified Barium Swallow Impairment Profile.  What it is, an answer to everyone's prayers to FINALLY have a standardized method for swallow studies. Where Can I Find MBSImP This protocol for MBSS is based on more than 10 years [...]

The History of the Modified Barium Swallow Study

The History of the Modified Barium Swallow Study

No matter what you call it...there is a history behind the Modified Barium Swallow Study (MBSS). Gold Standard? The Modified Barium Swallow Study has long been called THE gold standard in dysphagia evaluation, however it does have its limitations.   The MBSS definitely continues to be A gold standard in swallowing evaluation. Early Days In the [...]

Laryngeal Palpation

Laryngeal Palpation

  Why Are You Strangling the Patient? Relax.....  You may walk in to observe a Clinical Swallow Evaluation and see an SLP with 3 fingers on a patient's neck as the patient is swallowing. What in the World are they Doing?? It's called laryngeal palpation.   The ring finger goes on the patient's cricoid notch, the [...]

Cervical Auscultation

Cervical Auscultation

  What is Cervical Auscultation? Using Cervical Auscultation (CA) involves the use of a stethoscope, placed on the throat to "listen" to the sounds of the swallow. Clinicians often use CA to assess swallow sounds and airway sounds.  Judgements are made on the normality of the swallow or the degree of impairment of swallowing. Cervical [...]