Passy Muir

Question 1

Restrictive Disorders:
reduced ?
decreased ?

inability to take?

• connective tissue ?
• … deformities?
• pneumonia:

Answer 1

lung volumes
compliance (stiff lungs)

deep breaths
-disorders - fibrotic changes (scleroderma, lupus, pulmonary fibrosis)

-thoracic deformities: reduced volumes (arthritis, scoliosis, kyphosis, rib fractures)

infection and inflammation (bacterial, viral or aspiration)

Question 2

Obstructive disorders: 
CO?
-irreversible 
-caused by ?
-chronic? 
-chronic? 
-...
-....
-deterioration in ? 
loss of? 
-flat ?

Answer 2

COPD (chronic obstructive pulmonary disease)

• airway obstruction
• damaged lung tissue
• chronic bronchitis
• cough, mucus production, narrow airways secondary to irritation
• bronchosapsm
• emphysema
• alveolar walls
• elastic recoil
• flat diaphram

Question 3

Diseases:
cardiopulmonary conditions: poor?

right heart failure ?

left heart

Both sides ?

Answer 3

circulation of blood to lungs/body (cardiac cripple)

dependent edema

CHF

total failure

Question 4

ARDS:

Damage to ?

multi-factorial:

Answer 4

adult respiratory distress syndrome
-alveolar capillary membrane resulting in severe impairment of gas exchange

-stroke, trauma, infection, sepsis, severe pneumonia, inhalation injury

Question 5

Cuff over-inflation:

Answer 5

esophageal impingement
reflux
necrosis and trauma

Question 6

Inflated cuffs can ?
larynx does not ?

larynx does not move ?
-esophagus does not ? creating ?

Answer 6

tether larynx
-elevate: epiglottis doesn’t project down to protect airway

anteriorly
-increase in diameter, creating the vacuum environment for food bolus transition

Question 7

Tracheostomy and Aspiration:
does a cuff prevent aspiration ?

incidence of aspiration:
… rate for trach and vent patients ?

…silent aspiration

aspiration around ?

Answer 7

no

50-87%

75%

the cuff

Question 8

Clinical complication:
lack of ?
psychological ?
decreased

removal of ?

cycle of ?

Answer 8

vocal production - communication
agony, fear, panic, frustration

sense of smell/taste

natural filtration and humidification system

irritation and secretion production

Question 9

decreased effectiveness of ?
patient unable to ?
patient requires frequent ?

Answer 9

cough

mobilize secretion

tracheal suction and oral care

Question 10

Decreased PEEP ?

decreased ?
decreased
possible?

Answer 10

positive end expiratory pressure

gas exchange due to less surface area

oxygenation

atelectasis

Question 11

inability to ?
.. and …
examples:

Answer 11

valsalva
balance and equilibrium

ADLs
transfers
toileting
exercise

Question 12

Passy Muir clinical benefits: 
restoration of ?
100% airflow through ? 
improved sense of ? 
eliminates ?

Answer 12

voice and comm.
vocal tract on exhalation provides superior vocal quality

smell and taste

finger occlusion and chin dropping

Question 13

passy muir clinical benefits continued: 
improves ? 
-laryngeal 
-improved 
-vocal cord? 
-restored ? 

= reduced

Answer 13

swallowing

elevation
sensation
closure
subglottic pressure

aspiration

Question 14

passy muir clinical benefits continued: 
expedites ? 
rehabilitation tool for? 
rehab tool for  ?
reduces ? 
easier to tolerate than 
develops ?

Answer 14

weaning and decannulation

respiratory muscles 
upper airway muscles 
decannulation time 
capping/corking 
confidence and motivation