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Dysphagia Quiz/Exam > GER > Flashcards

GER Flashcards

1
Q

GER definition

A

the movement of partially digested food or acid up from the stomach into the esophagus and/or beyond into the larynx/oral cavity

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2
Q

GI tract is how many feet long?

A

30

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3
Q

esophagus is how many inches?

A

9

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4
Q

A&P of the esophagus

A

esophagus is a muscular tube which extends from the pharynx through the esophageal hiatus of the diaphragm

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5
Q

name the 3 layers of the esophagus

A

outer layer of fibrous tissue, a middle layer of smooth muscle, and an inner membrane containing tiny glands

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6
Q

innervation of the esophagus cranial nerve

A

X vagus

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7
Q

Laryngopharyngeal reflux vs GERD

A

LPR- backflow from stomach all the way into the throat
-50% report heartburn
-daytime reflux
GERD- backflow of stomach contents into the esophagus
-usually reports heartburn
-night-time reflux

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8
Q

LPR signs and symptoms

A
  • hoarseness
  • sinus congestion
  • excessive mucous in throat
  • chronic chest congestion
  • chronic cough
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9
Q

T/F we all experience GER with meals

A

true

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10
Q

When GER become pathologic, it is then known as ____

A

GERD

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11
Q

manifestations of GER are not effects of gastric acid, BUT…

A

abnormalities of motility and sphincter function cause GER

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12
Q

etiologies of GERD

A
  • esophageal influences
  • trauma/surgery influences
  • infections influences
  • food/liquid influences
  • other influences
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13
Q

esophageal influences

A
  • transient lower esophageal tone
  • decreased LES resting tone
  • ineffective esophageal clearing
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14
Q

trauma/surgery influences

A
  • gastric or duodenal surgeries
  • excessive vomiting (bulimia)
  • swallowed acid or foreign objects
  • smoking
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15
Q

infections influence

A
  • fungal (candida)

- viral (herpes simplex)

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16
Q

food/liquid influences

A
  • alcohol
  • caffeine (chocolate)
  • spicy foods
  • acidy foods
  • fatty foods
  • medications
17
Q

other influences

A
  • diminished salivation
  • prolonged NG intubation
  • overeating
  • obesity
18
Q

medications causing GERD

A

tranquilizers
birth control pills
respiratory meds

19
Q

severe reflux can lead to ____ where cells similar to cells in the stomach lining begin to line the lower esophagus and can become cancerous

A

Barrett’s esophagus

20
Q

assessing GER

A
  • reflux symptom index
  • VFSE/MBS
  • esophagram
  • UGI
  • EGD
21
Q

reflux symptom index

A

pt self-rating form, 5 point scale for nine symptoms

-if score is more than 13, then significant reflux is supsected

22
Q

VFSS/MBS is done in ___ with ___

A

radiology with ST

23
Q

esophagram is done by ____

esophagram aka Barium study

A

radiologist

-looks at swallow function from the pharyngeal phase through the esophageal phase and into stomach

24
Q

upper GI is done in ___ by ____

A

radiology by radiologist
-looks at swallow function from the pharyngeal phase through esophageal phase and into the stomach and then further into duodenum and possibly jejunum

25
Q

EGD is done by ___

A

a GI doctor

-endoscopy camera through the mouth and into the esophagus and further into the stomach

26
Q

Tx for GERD

A
  • behavioral modification
  • pharmacological intervention
  • surgery
  • exercises
27
Q

Tx for GERD: behavior modifications

A
  • elevate HOB 6-8 inches
  • instead of 3 large meals, try 6 smaller meals
  • don’t lay down at least 2 hours after eating
  • watch what you eat/drink
28
Q

Tx for GERD: pharmacological intervention

A
  • antacids
  • H2 receptor blockers
  • proton pump inhibitors
  • alginates
  • kinetic agents
29
Q

alginates

A

“raft” formulations

  • foam that floats to the top of the gastric contents
  • physical barrier to reflux
30
Q

alginate raft forms rapidly, often in a few ___ and stays intact for ___ hours or more

A

seconds, 3-4

31
Q

alginate advantages

A
  • no systemic absorption
  • can use during pregnancy
  • onset of action is almost immediate
  • symptom relief in minutes
  • no interactions with other meds
32
Q

alginates disadvantages

A
  • frequent dosing (4x/day)
  • taste/liquid formulation
  • sometimes difficult to obtain
33
Q

Tx for GERD: surgical interventions

A
  • esophageal dilatation
  • Fundoplication-Nissan (wraps part of stomach around the lower esophagus which places more pressure on LES to keep it closed)
  • stretta system
  • implantation of inert polymers
34
Q

esophageal dilation

A

for specific structures like Schatzki’s ring

35
Q

Nissan surgical procedure fixes reflux, but pt still has ___

A

globus sensation

36
Q

stretta

A

thin tube (catheter) is passed through esophagus to LES

  • balloon is inflated, exposing 4 sharp probes on the outside of balloon
  • probes insert into LES and discharge high-frequency radio waves
  • this causes LES to become tighter
37
Q

Exercise for GERD: DIEZ technique

A
  • place material into mouth
  • inhale through your nose using a diaphragmatic breath and hold
  • swallow
  • exhales SLOWLY

Dysphagia Quiz/Exam (7 decks)

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