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Aspiration Flashcards

1
Q

2 aspiration syndromes

A

acute event progressing to acute pneumonitis

chronic repeated aspiration of small volumes leading to chronic lung disease

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2
Q

non volitile lipid containing and aspiration leads to lipoid pneumonia

A

mineral oil

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3
Q

most predictive symptoms of aspiration

A

wet vocal quality or wet breathing

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4
Q

leading cause of dearh in neuro px

A

chronic pulmonary aspiration

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5
Q

histopath of chronic aspiration

A

Bronchiolo centric organizing pneumonia
giant cells
granuloma formation

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6
Q

gold std

A

identification of vegetable matter o

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7
Q

chest ct scan findings of chronic aspiration

A

tree in a bud
bronchiectasis

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8
Q

this phase includes voluntary
sucking/chewing

A

oral phase

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9
Q

spillage goes to

A

hypopharynx

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10
Q

phase wherein trigger is bolus delivery followed by airway protection

A

Pharyngeal phase

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11
Q

events in pharyngeal phase

A

Cessation of respiration
ADDUCTION of TRUE vocal cords (assoc horizontal approx or arytenoid)

FALSE vocal cord closure
Retroversion of the epiglottis

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12
Q

what makes the epiglottis a gutter

A

elevation of the larynx

contraction of INtrinsic laryngeal muscles

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13
Q

what happens after elevation of larynx

A

CRICOpharyngeus muscle STRETCHES and OPENS

pharyngeal constrictors SHORTEN the pharynx

propel the bolus through upper esophageal sphincter

passage of bolus

larynx returns to resting position

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14
Q

central source of respiration coordinated with deglutition

A

brainstem

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15
Q

pharyngeal swallowing occurs duting _______ weeks age of gestation

A

10-14 weeks

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16
Q

non nutritive sucking and swallowing

A

15 weeks

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17
Q

sucking with AP TONGUE movemenT

A

18-24 weeks

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18
Q

reflexes on taste buds and facial muscles
NON nutritive sucking on a PACIFIER

A

26-29 weeks

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19
Q

some feed by mouth

A

32-33 weeks

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20
Q

earliest infants can sustain full nutrition
organized sucking becomes rhythmic

A

34 weeks

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21
Q

lateral tongue movement

A

3-4 months

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22
Q

Swallowing development

A
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23
Q

swallowing dysfunction resolves between

A

2 - 3 yo

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24
Q

Typical symptons of LaryngotracheoEsophageal CLEFT

A

aspiration of thin liquids drunk QUICKLY

25
second most common symptom of laryngomalacia
Feeding problems
26
variant of layngo that makes aspiration worse post op
neurologic variant laryngo
27
Independent congenital cause for aspiration delayed passage of food bolus into the esophagus
CricoPharyngeal achalasia
28
most common cause of death in cns px
aspiration
29
children and adults initiate swallowing during _______ phase with OBLIGATORY deglutition apnea
MID Ex piration
30
Term less than 6 months of age swallow at
VERY end of INspiration and onset of EXpiration
31
Standard evaluation for direct aspiration for children
VideoFLUOROSCOPIC Swallow
32
directly evaluate oral and pharyngel phase
Modified barium swallow Fiberoptic endoscopy
33
Advantage of FEES
Evaluates functional ANATOMY of swallow airway protective ability (even no food) portable good feedback
34
Advantage of VSS
evaluates ALL phases widely available
35
disadvantage of VSS
LIMITED Anatomy eval lack sensitivity if less eaten radiation exposure not portable
36
disadvantage of FEES
BLIND to actual moment of swallow not widely available invasive
37
comparison of Vss and fees
38
allows superior visualization of laryngeal anatomy evaluation of laryngeal cleft for aspiration surgery planning
FEES-ST observes laryngeal adductor response
39
ideal for assessing excessive pooling of oral secretions vocal cord function few drops of colored food dye
FEES
40
Most extensive studied biomarker in BAL fluid suggesting aspiration Overall sensitivity and specificity is POOR
Lipid-laden macrophage Index
41
Biomarker of aspiration in INTUBATED premature , critical care px, lung transpalant Most extensively evaluated of gastric origin High association to Severe BPD
GASTRIC PEPSIN
42
Only respi disease correlated to BAL Pepsin
Asthma
43
Why is acid suppression not advisable
Risk of higher bacterial density by colonization of the proximal GI tract
44
Most commonly utilized surgical procedure Successful in resolving reflux Not advisable in neuro impaired px
Fundoplication
45
Transpyloric feeding without the concerns for gas bloating or retching But with risk of Intus, and displacement Do not allow bolus feeding and prevent reflux
JJ Jejunostomy feedings
46
Diagnostic
Gastrojejunostomy
47
Least commonly recognized form of aspiration
CHRONIC ASPIRATION OF SALIVA
48
Syndrome assoc with saliva aspiration
CHARGE Mobius CHAOS VCP
49
These conditions aspirate at night because of decreased protective reflexes during sleep and absence of gravity assistance
Cricopharyngeal achalasia Severe esoph dysmotility, stricture or diverticulum
50
One way to evaluate aspiration in patients with tracheostomy 1-2 drops of green food dye in buccal space
Radionuclide salivagrams
51
Decreases salivation but thickens secretions causing mucus plugging
Oral anti cholinergic medications
52
Responsible for most baseline saliva production
SUBmandibular glands
53
MAJOR secretors of saliva in anticipation of eating
Parotid glands
54
Limited duration of effect in management of saliva aspiration
Botlinum toxin injection
55
Long lasting management of saliva aspiration
Excision of salivary gland Duct ligation
56
Chest radio fx in aspiration
Hyperaeration Peribronchial thickening Segmental or subsegmental infiltrates MULTIPLE LOBES and dependent distribution
57
Best evaluation for laryngeal cleft, H type fistula, cricopharyngeal achalasia Can manipulate tissue Approach posterior larynx, circoid and PROXimal trachea
RIGID bronchoscopy
58
Evaluates entire airways from nose to distal bronchi Allows BAL
Flexible bronchoscopy (Laryngomalacia, bronchomalacia, tracheomalacia)
59
Static and dynamic airway anatomy Status of lower airways
COMBINED FB and RB Plus awake flexible laryngoscopy

Kendigs (24 decks)

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