Module 4

Question 1

endotracheal tube considerations:

• mucosal
• injury to
• tracheal

Answer 1

injury
vocal folds
edema, ulceration and stenosis

Question 2

Clinical complications of cuff:
tracheal wall 
esophageal 
... 
laryngeal

Answer 2

injury
impingement
backflow
tethering

Question 3

Physiologic changes after tracheotomy: 
speech taste and smell 
-reduced PEEP negatively impacts
1. 
2. 
3. body 
4.

Answer 3

physiologic peep
swallow
body core and strength posture
cough

Question 4

physiologic changes after trach. 
inability to control secretions due to 
-decreased 
-pooling of 
-loss of

Answer 4

cough effort
secretions
pharyngeal and laryngeal sensations

Question 5

-

Answer 5

delays or decrease using PMV

• cooing
• babbling

Question 6

Benefits of closing the system: 
restores 
-improved
-improved
-decreased risk of

Answer 6

physiologic positive pressure

• gas exchange
• oxygen saturation levels
• risk of atelectasis

Question 7

Role of pressure: 
-
-
-
-
-
-..control 
-.. stability

Answer 7

breathing 
coughing 
swallowing 
voicing 
mobility 
-trunk control 
-postural stability

Question 8

Expedites weaning and decannulation:
rehabilitation
-for
-for

step toward ?

• less work of
• develops ?

Answer 8

tool

• respiratory muscles
• upper airway muscles
• decannulation
• breathing vs. capping
• confidence and motivaiton

Question 9

Pocket TOM: 
assess upper airway patency 
do what first 
ask patient to 
... next?

Answer 9

deflate cuff
inhale
finger occlude and speak or cough on exhalation

Question 10

Transitioning and troubleshooting: 
excesive 
air ? 
need for 
.. rehab 
..isues

Answer 10

coughing 
air trapping, back pressure 
retraining 
laryngeal/pharyngeal muscle rehab 
psychological issues

Question 11

Factors affecting expiraotry air flow: 
size or type of 
presence and degree of 
...
...
incomplete 
... cuff 
tube ?

Answer 11

trach tube 
obstruciton 
edema
secretions 
cuff defaltion 
foam filled cuff 
tube position

Question 12

Troubleshooting;

Answer 12

downsize or different brand tube

Question 13

Therapy goal areas: 
valve use during waking hours with? 
.. management 
reestablish 
speech and language 
...

Answer 13

spo2>90%
swallowing and secretion management

inta-oral airflow management

development

decannulation

Question 14

Trach and aspiration: 
does a cuff prevent aspiration
-incidence of aspiration
... apsirate 
silent aspiration up to ? 

high correlation of

Answer 14

45-86%
83%
aspiration around the cuff

secretions and aspiration

Question 15

Cuffed inflated condition:
-significantly greater frequency of ?
significantly less ?

higher the cuff pressure the more negative effect on?

research is ? and methods not ?

Answer 15

silent aspiration in cuff inflated condition
hyolaryngeal elevation during swallow

swallowing

variable/strong

Question 16

pharyngeal deficits: 
common interventions
..exercises
...maneuver 
...swallow 
...maneuver 
...swallow 
....

Answer 16

falsetto exercises 
mendelsohn maneuver 
supraglottic swallow 
shaker maneuver 
effortful swallow 
masako

Question 17

prior to covid patients were typically intubated ? but with covid ?

longer intubation leads to greater ?

Answer 17

7-10 days / intubated much longer

muscle disuse atrophy

Question 18

with endotracheal tube removed patient can move ? and.. can be provided more thoroughly

Answer 18

tongue

oral hygiene

Question 19

when is pediatric trach tube utilized ? rather than infant size

Answer 19

3 years

Question 20

check amount of cuff inflation with ?
goal is ?
who does this ?

Answer 20

manometer
20-30 cm of water
respiratory therapy

Question 21

PEEP: 
air in the lungs that remains ?
 PEEP... with cuff inflation 
can lead to some ? 
atelectasis: a condition where the

Answer 21

after exhalation (lungs never fully deflate)
levels drop
alveoli of lung not fully inflated

Question 22

when placing PMV apply and twist ? this serves to avoid ? and accidental removal of ?

Answer 22

1/4 to right

pressure on trach tube/trach tube if there is reusable inner cannula