Aspiration Flashcards
(81 cards)
gastric aspiration
stuff that comes out of stomach (acid, stomach contents) and travels up esophagus into lungs
aspiration pneumonitis - result of?
result of what happens after the gastric aspiration
- pulmonary aspirations syndrome
pulmonary aspiration
gastric aspiration
pneumonia
occurs in pts that aspirate infectious material (ex: from small bowel obstruction) or immunocompromised
pneumonitis - what is it?
chemical injury results from acid or particulates in stomach coming in contact with lung tissue and damaging the tissue.
aspiration pneumonitis- when ingested highly acidic particulate?
may cause severe reap damage with infectious component, possible to show no signs of infection and later develop pneumonia overtime DT lung injury and prolonged resp support. 1/2 of aspirations lead to pneumonia.
ppl more disposed to aspiration
OB, peds, trauma with low GCS = 33% aspirate
Mortality rates are dependant on?
amount and characteristics- Ph? is it a liquid or solid
Swallowing - sensory innervation
CN V, IX, X. to brainstem in medulla. Afferent
5 - trigeminal,
9 - glossopharyngeal
10- Vagus
swallowing- motor innervation
CN V, VII, IX, X, XII Efferent 5- trigeminal 7- fascial 9- Glossopharyngeal 10- Vagel 12- Hypoglossal
3 stages of swallowing
- oral cavity= where you chew the food
- pharyngeal= where soft palate moves upward and back sealing off the nasopharynx, vocal cords close. epiglottis covers laryngeal opening.
- esophagus= paristalic waves generated by musculature in the hallow esophagus moves food into the stomach
Upper esophageal sphincter (UES)/ Lower esophageal sphincter (LES)
Thickening of the muscle that helps prevent aspiration of stomach contents
- not true sphincters
- helps food pass down into stomach and with increased tone they help food from regurgitation back into esophagus
- relax in general anesthesia and increase risk of aspiration
UES
in the upper airway
LES
right above stomach
stomach
- Rugae= muscular ridges allowing stomach to expand allowing to hold more food and fluid
- increased amount of food = increased gastric pressure = increased risk for regurgitation
- inferior to diaphragm
3 functions of the stomach
1- storage
2- mixing
3- propulsions
3 functions of the stomach
mixing
Mixing- with hydrochloric acid (pH 1-2)
- with food or fluid, very acidic and if it regurgitates and goes to lungs it can do a huge amount of damage to the lung being so acidic –> creating a burn
3 functions of the stomach
propulsions
propulsion- time is dependent on what is in the stomach and drugs can increase or decrease gastric transit time.
- stomach contracts from top to bottom –> moving food from stomach and into small intestine. H2O leaves stomach quick, fried food takes longer to move. Time is a factor.
Gastric emptying time is dependent on:
- type of food
- amount of food
- state of being
- presence of pathophysiological conditions
Gastric emptying time is dependent on:
type of food
clear liquid or solid, high fat
Gastric emptying time is dependent on:
amount of food
increased amount = longer it takes to leave stomach
Gastric emptying time is dependent on:
state of being
- depending on the PNS and SNS and which one is in charge.
Balance each other out
Gastric emptying time is dependent on: PNS
increased tone of PNS helps facilitate process.
- gastric digestion is going at a regular rate and things are moving out of stomach. Increase of PNS tone
Gastric emptying time is dependent on: SNS
digestion is not a priority, decreased gastric emptying
- increased SNS= decreased gastric emptying.
pH may be low
- surgical pts, trauma, anxiety, fear