12.2 - Non-Oral Feeding Methods + Surgical Options Flashcards

1
Q

What are three different non-oral feeding methods?

A

NG tube

PEG tube

J-tube

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2
Q

What is an NG tube?

2

A

Nasogastric tube

It is passed through the nose and down through the nasopharynx and esophagus into the stomach

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3
Q

When is an NG tube chosen?

A

As a short term strategy

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4
Q

What is a PEG tube?

2

A

Percutaneous endoscopic gastrostomy

It bypass the mouth and esophagus and leads directly to the stomach

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5
Q

What sort of food is used with PEG tubes?

A

Special formula

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6
Q

What is a J-tube?

2

A

Percutaneous endoscopic jejunostomy tube (PEJ)

A soft, plastic tube placed through the skin of
abdomen into the midsection of the small intestine.

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7
Q

When is a J-tube utilized?

A

Stomach malfunction

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8
Q

What sort of food is used with J-Tubes?

A

Specialized, predigested formulas

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9
Q

What are the benefits of NG Tubes?

5

A

Easy insertion

No anesthesia is needed

Generally well tolerated

Good short nutrition

Does not prevent patient from eating normally

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10
Q

What are the risks of NG Tubes?

7

A

Can be uncomfortable

Visible tube

Can distends PES and UES

May promote reflux

May promote nasal ulceration

May promote sinusitis

May delay swallow

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11
Q

What are the benefits of PEG tubes?

5

A

Can be used long-term

Tube is not visible

Patient can eat with tube in place

Inserted under local anesthesia,

Generally well tolerated

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12
Q

What are the risks of PEG Tubes?

5

A

Requires surgical placement

Infection can occur

Tube may fall out

Can cause reflux

Diarrhea

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13
Q

What are the benefits of J-tubes?

3

A

May reduce reflux

Tube is not visible

Provides nutrition even if stomach not available

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14
Q

What are the risks of J-Tubes?

4

A

Requires surgical placement

Needs continuous drip feeding

Requires hospital visits if dislodged

Special formula may not be tolerated

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15
Q

What are the three most common reasons for placing a feeding tube?

A

Inability to sustain nutrition orally (even with safe swallow)

Recovery from a short-term acute medical problem requires sufficient calories

Patient aspirates during eating

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16
Q

What are two surgical methods to improve Glottal Closure?

A

Medialization thyroplasty

Injection of biomaterials

17
Q

What are five surgical methods to improve Airway Protection?

A

Stents

Laryngotracheal separation

Laryngectomy

Tracheostomy tubes

Feeding tubes

18
Q

What are three surgical methods to Improve UES Opening?

A

Dilation

Myotomy

Botox injections

19
Q

What is Medicalization Thyroplasty?

2

A

Surgical technique where a small piece of plastic is place behind the VF

This moves the VF closer to midline allowing for easier adduction

20
Q

Is general anesthesia required for Medicalization Thyroplasty?

21
Q

How does the Injection of Biomaterials improve glottal closure?

A

They are injected directly into a weakened vocal fold to “bulk-up” the tissue to improve glottal closure.

22
Q

Which surgical method is used for smaller gaps?

Which is used for larger ones?

A

Injection of biomaterials

Medialization thyroplasty

23
Q

What is a Laryngeal Stent?

What does it require?

A

A laryngeal “plug” preventing material from entering the airway.

A tracheostomy because glottis is blocked.

24
Q

What is Laryngotracheal Separation?

A

The trachea is surgically separated from the larynx

25
Are Laryngeal Stent and Laryngotracheal Separation permanent solutions?
Not usually
26
What is a Total Laryngectomy? | 2
The complete removal of the entire larynx Patient now breathes through a stoma.
27
Is a Total Laryngectomy a permanent solution? What is a major benefit of this procedure?
Yes It may allow the individual to ingest food and liquid safely
28
What is the goal of Tracheostomy & Feeding Tubes? What is a risk of Trachs?
Protection of the airway Tracheostomy tubes can further impair swallowing in some patients
29
What are the three goals of surgical interventions to improve UES opening?
Stretching Cutting Paralysis
30
What is Dilation? When is it often used?
It stretching the lumen of the UES If the UES is restricted due to scarring
31
What are risks of Dilation? | 2
The tear may extend beyond esophageal tissue The benefits are often temporary, requiring repeated procedures
32
What is Myotomy?
A surgical technique in which cuts the fibers of the cricopharyngeal muscle within the PES to separate them
33
How is Botox used to improve UES opening? When should this procedure not be used?
It is injected into the muscles around the UES in order to paralyze and relaxing them If patient has significant esophageal reflux