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ECU Dysphagia > 5.1 - RESPIRATORY AND IATROGENIC CAUSES OF DYSPHAGIA > Flashcards

5.1 - RESPIRATORY AND IATROGENIC CAUSES OF DYSPHAGIA Flashcards

1
Q

What does “iatrogenic” mean?

A

Due to treatment/medical intervention

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2
Q

What are the two types of artificial airways?

A

Endotracheal Tube (through the mouth/nose)

Tracheostomy Tube (hole created in the trachea)

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3
Q

What are the two types of trach tubes?

A

Cuffed

Uncuffed

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4
Q

What is a cuffed trach tube?

What does it do? (2)

A

It has an inflatable cuff on the end

//

Does not allow air or other substances to pass the tube

Forces air through the tube

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5
Q

What are the inner and outer tubes of a trach called

A

Outer Cannula

Inner Cannula (2nd cannula)

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6
Q

What is the progression of trach use to removal?

A

(1) Cuffed trach
(2) Cuffless trach (allows for natural mouth breathing)
(3) Removal

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7
Q

What is a Passy-Muir Valve?

Can it be used with a cuffed trach?

Why or why not?

A

A one-way value that allows for natural exhalation and speech

Yes, but only if the cuff has been deflated.

Your patient will suffocate because they won’t be able to exhale.

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8
Q

What are the four factors that increase the risk of aspiration?

A

Poor sub-glottic pressure.

Poor/disrupted laryngeal elevation

Reduced upper airway sensitivity

General muscle weakness.

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9
Q

How might surgery cause dysphagia? (3)

What type of surgery carries a high risk for dysphagia?

A

Damage to nerve endings (peripheral nerves, LMN)

Damage to brainstem during skull base surgeries.

Edema (temporary)

//

Surgery for cancers

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10
Q

What is a Thyroidectomy?

A

Removal of the thyroid gland

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11
Q

What are the dysphagia risks for Thyroidectomies?

2

A

Impairment of the Vagus nerve endings

This could cause VF paralysis

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12
Q

What is a Carotid Endarterectomy?

A

Removal of plaques from arteries

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13
Q

What are the dysphagia risks for Carotid Endarterectomies?

A

Vagus nerve impairment

Pharyngeal constrictor action, VF actions impaired

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14
Q

What are the dysphagia risks for Cervical Spine Procedures? (2)

What is one example?

A

Impairment of CN IX (glossopharyngeal) and X (vagus)

Could also impair brainstem connections to peripheral nerves

//

Anterior Cervical Fusion

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15
Q

What is an Anterior Cervical Fusion?

A

Decompression of Spinal cord/nerve roots

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16
Q

What are the dysphagia risks for Skull Base Surgeries?

A

Brain stem impairment

17
Q

What do we call the removal of thyroid gland?

A

Thyroidectomy

18
Q

What do we call the surgical removal of plaques from arteries?

A

Carotid Endarterectomy

19
Q

What do we call the Decompression of Spinal Cord/Nerve Roots?

A

Anterior Cervical Fusion

20
Q

What kinds of medications might cause dysphagia?

6

A

Antipsychotics

Anti-convulsants

Depressants

Respiratory medications

Cardiac medications

Cholesterol controllers

21
Q

What kinds of side effects may be seen with Anti-Psychotics + Depressants?

(2)

A

Tardive dyskinesia (isolated dysarthria of oral cavity.)

Xerostomia

22
Q

What kinds of side effects may be seen with Respiratory + Cardiac Medications

(2)

A

LES impairment

Subsequently GERD

23
Q

What kinds of side effects may be seen with Cholesterol Controllers?

A

Generalized myopathies

24
Q

Among healthy adults, ___% of swallowing occurs during the exhalation stage.

A

80%

25
Q

Patients with Chronic Obstructive Pulmonary Disease are more likely to swallow at times during the ______ cycle when they have low ___________.

A

Breathing

Sub-glottic air pressure

26
Q

Patients with Chronic Obstructive Pulmonary Disease often swallow ____________ or inhale _________________. This means __________ could be drawn into the airway

A

During inhalation

Immediately after a swallow

Residue in the pharynx

27
Q

How might we be able to gauge DECREASED sub-glottic pressure in a patient?

A

Decreased loudness

28
Q

How might we be able to gauge INCREASED sub-glottic pressure in a patient?

(2)

A

Pain + discomfort

Pulse changes

29
Q

What causes a patient with a trach to have reduced upper airway sensitivity?

A

Lack of use

ECU Dysphagia (31 decks)

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