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PRE-CLINIC ACTIVITY – OUTPATIENT CLINIC

The pre-clinic activity is designed to help you prepare for your clinical placement. Please e-mail your responses to your clinical educator(s) at least one week before commencing placement.

  1. List some characteristics of “normal” swallowing in the elderly.
  1. Your patient has been recently admitted with RLL pneumonia. They have a PHx of AF, IHD, CCF, COPD, HT, GORD, T2DM, PPM, CVA, UTI and AAA. They have been referred to Outpatients by the GP:
  • Translate the diagnosis
  • Translate the PHx
  • Why might the patient be referred for speech pathology ax?
  • Which conditions in the PHx are of relevance to us?
  1. List some of the causes of dysphagia.
  1. A 93 year old patient with a diagnosis of Alzheimer’s dementia is referred for swallowing ax. The pt is not able to follow instructions. How would you perform the ax and what could you expect to see regarding their swallowing function?

5. List the 5 parameters you are assessing in a motor speech exam. What tests might we use to assess presence of dysarthria?

6. What are some important questions in a swallowing case history?

7. Why is oral health important in swallowing? How might we assess this?

8. What are some clinical vs audible signs of aspiration? What are the limitations of doing a “bedside” examination in diagnosing dysphagia?

9. What are some reasons a speech pathologist might request an instrumental swallowing assessment?

10. Why do we work closely with a dietitian when managing dysphagia?

11. List the different terminology for modified fluids/diets (National Standards).

SUGGESTED REFERENCES
  • Duffy, J (2005) Motor Speech Disorders: Substrates, Differential Diagnosis and Management (2nd Ed) Elsevier Mosby: St Louis USA

Chapters: 2,3,15,17

  • Groher, ME (1997) Dysphagia Diagnosis and Management 3rd Edition, Butterworth-Heinemann: Boston, USA

Chapters: Chapter 2, 4, 5, 6

OR

  • Logemann, J (1998) Evaluation and Treatment of Swallowing Disorders (2nd Ed) College-Hill Press: San Diego, USA

Chapters: 1,2, 5, 6

  • Humbert IA & Robbins J. (2008). Dysphagia in the elderly. Phys Med Rehabil Clin N Am 19:853-866
  • Logemann JA. (2008). Treatment of oral and pharyngeal dysphagia. Phys Med Rehabil Clin N Am 19:803-816.
  • Martin-Harris B & Jones B. (2008). The videofluorographic swallowing study. Phys Med Rehabil Clin N Am 19:769-785

2017 Outpatients