Praxis SLP Licensure Exam

During a patient's bedside swallowing evaluation, the SLP notices copious amounts of lingual residue in the patient's oral cavity following their swallow. Which part of the oral phase is the patient MOST LIKELY having difficulty with?

1. Bolus formation

2. Anterior-posterior movement

3. Labial seal

4. Mastication

The correct answer is: Bolus formation

The patient is most likely experiencing difficulty with bolus formation if there is copious amounts of lingual residue noted in the oral cavity after swallowing. Proper bolus formation is crucial for a successful swallow, as it involves the cohesive gathering of food and saliva into a manageable mass that is ready to be propelled to the pharynx. When the formation of the bolus is compromised, it can lead to inadequate preparation of the food. This would explain why there is excess residue left in the oral cavity following the swallow. A well-formed bolus is not only about the physical gathering of food but also relies on sufficient strength and coordination of the tongue to maintain the structured formation before transport. Although anterior-posterior movement and mastication are also vital components of swallowing, they are more directly involved in the transport and manipulation of the food within the mouth rather than the initial gathering into a bolus. Similarly, a labial seal primarily relates to maintaining the integrity of the mouth during the swallow process rather than the formation of the bolus itself. Hence, the presence of significant lingual residue strongly indicates a challenge specifically with bolus formation.