Quiz 2 Flashcards
long-term goal of any swallow treatment
safely swallow
maintain nutrition and hydration
evidence-based practice
evidence
experience
patient’s wishes
categories for adult treatment
- food modifications-thickened liquids
- pt. modifications-positions, maneuvers
- feeding modifications-rate, bite size
- exercises
adult treatment positions
chin tuck-for delayed swallow
head rotation-for unilateral pharyngeal weakness
head tilt-vocal fold paralysis or unilateral weakness
head extension-apraxia
lying down/side lying-bolus only goes down one side (laryngectomy, etc)
adult maneuvers definition
volitional techniques to put specific aspects of pharyngeal swallow under voluntary control. must be able to follow complex commands
common maneuvers
-supraglottic swallow-breath hold technique
-extended supraglottic swallow-dump and swallow
-super supraglottic swallow-breath hold
effortful swallow-increases lingual force
Hierarchy of adult treatment
- position first
- maneuver second
- modify viscosity last
cuff
inflate/deflate with syringe inflatable piece around tube in throat prevents air from escaping upper airway prevents leakage of air assures pt. is well-oxygenated when cuffed, cannot phonate can swallow but not a natural swallow because don't feel the pressure reduces risk of aspiration but can still aspirate around it
cricopharyngeus bar
hypertrophied cricopharyngeus. overworked muscle, aging, or dysfunctional UES. treated with myotomy or balloon dilation
affects of intubation
redness, odynophagia, edema, decreased sensation
purpose of cuff
prevents air from escaping upper airway, assures pt. is well oxygenated
how does trach affect swallowing
swallowing is pressure driven and trach causes reduction in sub glottal pressure as well as reduced smell and taste
order of trach progression
- trach cuff inflated
- deflated or cuff less
- passy muir speaking valve
- trach capped
- decannulated-trach out
alveoli
clusters of ducts in the lungs that contain air
which bronchi more prone to aspiration
right-shorter, wider, more forward
pleura
2 thin layers of tissue that surround lungs. like “saran wrap” protects and cushions lungs and helps them expand and contract
cilia
tiny hairs that line bronchi and move mucous
mucociliary clearance
moves foreign matter, dirt, and membranes. clears respiratory tract and prevents infections. Hydration is key **saliva
pulmonary toilet
body’s natural way of clearing secretions
- mucociliary clearance
- coughing
- spitting
adult treatment
can pt. follow directions
short term memory issues
fatigue/endurance
bedside order
intake/history
physical exam/oral mech
food/liquid swallow
report writing-4 main objectives
- diagnosis
- aspiration risk
- recommendations
- patient education
