CVA-08 · Post-Stroke Dysphagia

Post-Stroke Dysphagia. Part of the Cerebrovascular / Stroke series of the Reflex PM&R Board Review podcast. Audio corrections: (1) In the audio: If the recurrent laryngeal nerve is damaged, the water crosses the true vocal folds, pools in the trachea — Correct: Stroke does not injure the recurrent laryngeal nerve; it impairs central processing of the signal. Silent aspiration reflects hemispheric or brainstem (NTS/nucleus ambiguus) injury, with the peripheral nerve intact. (2) In the audio: you can literally watch a pitch black liquid travel through the ghostly white outline of their throat. — Correct: Barium is radiopaque and appears bright white on videofluoroscopy; the air-filled pharynx is the dark background. The audio's description is inverted. (3) In the audio: hangs it down just above the soft palate looking straight down at the larynx. — Correct: For a swallow assessment the endoscope sits just above the epiglottis. Just above the soft palate is the nasopharynx, used for the separate velopharyngeal-closure view. (4) In the audio: gets ripped open wider and stays open longer, permanently curing that pyriform sinus residue, — Correct: The Shaker exercise improves laryngeal excursion and UES opening; it is not a permanent cure. Benefit is shown over six weeks and depends on continued conditioning. The written chapter is correct. Full correction register: https://www.reflexpmr.com/errata. The full companion chapter and a linked board-style Q-bank set for this topic are at https://www.reflexpmr.com/read/CVA-08.