A nurse is caring for a patient who is struggling to manage her type 2 diabetes mellitus. Which social determinant would the nurse predict is most likely influencing this client’s choices? 

A 65 year-old male presents to the Emergency Department (ED) following a fall at home. Two days following admission you receive a consult for a bedside evaluation of speech-language and swallowing function. Based on chart review, his neurological exam is significant for: Adequate force through the orofacial structures. Reduced speed of appendicular and axial movement, reduced range of motion, and difficulty initiating movements across orofacial structures. B. What are some important questions to answer during the collection of your case history to confirm your suspicions? (2 points).

A patient with a movement disorder presents to your clinic with a unilateral lingual paralysis.  Which of the following would you expect to be his/her most noticeable dysphagic symptom?

Put the following statements in the correct order (first to last, 1-5) describing the initiation of phonation based on the myoelastic aerodynamic theory: _______     Intrinsic laryngeal muscles adduct the vocal folds _______     Phonation threshold pressure is reached _______     Vocal folds are blown apart _______     Vocal folds are “sucked” back together _______    Subglottal pressure builds up

A 65 year-old male presents to the Emergency Department (ED) following a fall at home. Two days following admission you receive a consult for a bedside evaluation of speech-language and swallowing function. Based on chart review, his neurological exam is significant for: Adequate force through the orofacial structures. Reduced speed of appendicular and axial movement, reduced range of motion, and difficulty initiating movements across orofacial structures. A. Based on this limited case history, name the lesion and associated disorder (2 points).  

A 63 year-old female presents to your clinic complaining of a hoarse vocal quality, resonance imbalance (i.e. hypernasality, nasal emissions) and difficulty swallowing. An oral mechanism examination reveals appropriate function of the masticatory, facial, and lingual muscles; however, you note markedly reduced soft palate elevation. C. What type of dysarthria do you suspect this patient has? (1 point).

The expiratory muscles (i.e. the rectus abdominus and transverse abdominus) become active:  

Contraction of the posterior cricoarytenoid (PCA) muscle results in abduction of the vocal folds; innervation to the PCA is provided by the recurrent laryngeal branch of CN X.

The basal ganglia and cerebellum contain large numbers of nuclei that modify movement on a minute-to-minute basis.

A 63 year-old female presents to your clinic complaining of a hoarse vocal quality, resonance imbalance (i.e. hypernasality, nasal emissions) and difficulty swallowing. An oral mechanism examination reveals appropriate function of the masticatory, facial, and lingual muscles; however, you note markedly reduced soft palate elevation. A. Based on this limited case history, name the lesion (1 point).