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Kendigs > Aspiration > Flashcards

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
Q

second most common symptom of laryngomalacia

A

Feeding problems

26
Q

variant of layngo that makes aspiration worse post op

A

neurologic variant laryngo

27
Q

Independent congenital cause for aspiration

delayed passage of food bolus into the esophagus

A

CricoPharyngeal achalasia

28
Q

most common cause of death in cns px

A

aspiration

29
Q

children and adults initiate swallowing during _______ phase
with OBLIGATORY deglutition apnea

A

MID Ex piration

30
Q

Term
less than 6 months of age swallow at

A

VERY end of INspiration
and onset of EXpiration

31
Q

Standard evaluation for direct aspiration for children

A

VideoFLUOROSCOPIC Swallow

32
Q

directly evaluate oral and pharyngel phase

A

Modified barium swallow
Fiberoptic endoscopy

33
Q

Advantage of FEES

A

Evaluates functional ANATOMY of swallow
airway protective ability (even no food)

portable
good feedback

34
Q

Advantage of VSS

A

evaluates ALL phases

widely available

35
Q

disadvantage of VSS

A

LIMITED Anatomy eval
lack sensitivity if less eaten

radiation exposure
not portable

36
Q

disadvantage of FEES

A

BLIND to actual moment of swallow
not widely available
invasive

37
Q

comparison of Vss and fees

A
38
Q

allows superior visualization of laryngeal anatomy

evaluation of laryngeal cleft for aspiration

surgery planning

A

FEES-ST

observes laryngeal adductor response

39
Q

ideal for assessing excessive pooling of oral secretions

vocal cord function

few drops of colored food dye

A

FEES

40
Q

Most extensive studied biomarker in BAL fluid suggesting aspiration
Overall sensitivity and specificity is POOR

A

Lipid-laden macrophage Index

41
Q

Biomarker of aspiration in INTUBATED premature , critical care px, lung transpalant
Most extensively evaluated of gastric origin
High association to Severe BPD

A

GASTRIC PEPSIN

42
Q

Only respi disease correlated to BAL Pepsin

A

Asthma

43
Q

Why is acid suppression not advisable

A

Risk of higher bacterial density
by colonization of the proximal GI tract

44
Q

Most commonly utilized surgical procedure
Successful in resolving reflux
Not advisable in neuro impaired px

A

Fundoplication

45
Q

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

A

JJ
Jejunostomy feedings

46
Q

Diagnostic

A

Gastrojejunostomy

47
Q

Least commonly recognized form of aspiration

A

CHRONIC ASPIRATION OF SALIVA

48
Q

Syndrome assoc with saliva aspiration

A

CHARGE
Mobius
CHAOS
VCP

49
Q

These conditions aspirate at night because of decreased protective reflexes during sleep and absence of gravity assistance

A

Cricopharyngeal achalasia
Severe esoph dysmotility, stricture or diverticulum

50
Q

One way to evaluate aspiration in patients with tracheostomy
1-2 drops of green food dye in buccal space

A

Radionuclide salivagrams

51
Q

Decreases salivation but thickens secretions causing mucus plugging

A

Oral anti cholinergic medications

52
Q

Responsible for most baseline saliva production

A

SUBmandibular glands

53
Q

MAJOR secretors of saliva in anticipation of eating

A

Parotid glands

54
Q

Limited duration of effect in management of saliva aspiration

A

Botlinum toxin injection

55
Q

Long lasting management of saliva aspiration

A

Excision of salivary gland
Duct ligation

56
Q

Chest radio fx in aspiration

A

Hyperaeration
Peribronchial thickening
Segmental or subsegmental infiltrates

MULTIPLE LOBES and dependent distribution

57
Q

Best evaluation for laryngeal cleft, H type fistula, cricopharyngeal achalasia
Can manipulate tissue
Approach posterior larynx, circoid and PROXimal trachea

A

RIGID bronchoscopy

58
Q

Evaluates entire airways from nose to distal bronchi
Allows BAL

A

Flexible bronchoscopy
(Laryngomalacia, bronchomalacia, tracheomalacia)

59
Q

Static and dynamic airway anatomy
Status of lower airways

A

COMBINED FB and RB
Plus awake flexible laryngoscopy

Kendigs (24 decks)

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