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Swallowology > Respiratory Illnesses/Passy-Muir > Flashcards

Respiratory Illnesses/Passy-Muir Flashcards

1
Q

What is pneumonia?

A

inflammation of the lungs

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2
Q

What causes pneumonia?

A

bacterial or viral infection

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3
Q

What are symptoms of pneumonia?

A

chest pain, fever, shaking, chills, shortness of breath

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4
Q

Which population is at greater risk for penumonia?

A

the elderly, 75 y/o and over

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5
Q

What does nosocomial refer to?

A

acquired in the hospital

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6
Q

T/F there is a vaccine for pneumonia

A

T

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7
Q

How is pneumonitis different from pneumonia?

A 
pneumonitis = aspirating gastric contents from vomiting
pneumonia = aspirated bacteria/virus
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8
Q

Which patients are at more risk for pneumonitis?

A

post-surgery with decreased level of alertness

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9
Q

Between pneumonitis and pneumonia, which is the illness that is usually witnessed?

A

pneumonitis

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10
Q

Which muscles are used for respiration?

A

diaphragm (primary), intercostals, abdominal

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11
Q

Phases of swallow according to Passy Muir:

A

anticipatory, oral prep, oral, pharyngeal, esophageal

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12
Q

What is the pattern in healthy adults for timing swallows?

A

at mid-exhalation; follow each swallow with exhalation

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13
Q

Why do normal, healthy individuals follow a respiration pattern?

A

the pattern assures there is sufficient air pressure below the VFs during swallow to inhibit aspiration of food residue after the swallow

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14
Q

How are breathing and swallowing related?

A

they are considered a “shared system” in terms of anatomy, timing, pressures, and CNS control

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15
Q

How can normal breathing be interrupted?

A

by illness, medications, tracheostomy, and mechanical ventilation

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16
Q

Individuals with which illnesses are more at risk for respiration interruption?

A

neuromuscular, COPD, restrictive disease

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17
Q

What are some diagnostic tools to document aspiration?

A

bedside eval, FEES, MBS

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18
Q

What are the signs and symptoms of aspiration?

A

wet sounding voice, drooling, multiple swallows, coughing while eating, recurrent RLL pneumonia

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19
Q

What are some goals that RCP and SLPs share?

A

communicate, manage secretions (oral and tracheal), tolerate cuff deflation, swallow without signs and symptoms of aspiration, participate in weaning and rehab efforts, be liberated from continuous mechanical ventilation, decannulate

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20
Q

What does it mean to decannulate?

A

to remove the tracheostomy

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21
Q

What does a Passy-Muir valve do?

A

restore normal physiology by reconnecting the upper and lower airway and closed system

22
Q

What are some clinical benefits of the Passy-Muir valve?

A

restoration of speech/com, secretion management, taste/smell, oxygenation/reduce atelectasis, weaning/decannulation time, infection control, QOL

23
Q

What can the SLP suggest to improve her client’s swallow on Passy-Muir?

A

cuff deflation, diet mod (textures, method), posture/position during and after eating, timing of the swallow, strengthening maneuvers

24
Q

With whom is the SLP co-treating clients using Passy-Muir valve?

A

RCP

25
Q

In what percentage of healthy individuals does aspiration occur?

A

50%

26
Q

When does aspiration typically happen?

A

at night

27
Q

In what portion of the lungs does aspiration pneumonia most commonly occur?

A

lower right lobe

28
Q

What percentage of acquired pneumonia is considered “aspiration pneumonia”?

A

15%

29
Q

What is the leading cause of death in individuals with dysphagia?

A

aspiration pneumonia

30
Q

What are some risk factors to acquiring aspiration pneumonia?

A

poor oral health, reduced swallowing frequency and cough effectiveness, decreased physical condition, undernutrition, illnesses

31
Q

What is COPD?

A

chronic obstructive pulmonary disease

32
Q

What is an open tracheostomy tube?

A

there is no obstruction

33
Q

What are the physiologic changes in tracheotomy?

A

no activation of smell/taste without air flow, sensation/secretion management

34
Q

How do you explain the normal airway?

A

closed and pressurized system

35
Q

Where is the cuff?

A

below the level of the VFs

36
Q

What is the incident of individuals with a cuff that aspirate?

A

45-65%

37
Q

What are some complications that can occur with a tracheotomy?

A

tracheal wall injury, esophageal impingement (reflux), laryngeal tethering

38
Q

Who invented the Passy-Muir valve?

A

a patient named David Muir

39
Q

The external diaphragm is closed at rest, when does it open?

A

when air is taken in

40
Q

What are benefits of “no-leak”?

A

restores voice and ability to communicate, restores airflow and sensation/sense of taste and smell, impacts swallowing and may reduce aspiration, restoring physiologic positive pressure (improved gas exchange, o2 sat levels), improves secretion management, facilitates effective cough, reduce suction needs

41
Q

What are the patient selection guidelines?

A

awake and alert, medically stable, manage complete cuff deflation, thin and easily suctioned secretions, patent airway (when the cuff is deflated there needs to have enough room for the air to move around and out)

42
Q

What are some important pre-placement considerations?

A

have a plan, block the time, reassure the patient, pick a good time, paint control, reduce interference

43
Q

When does the cuff have to be deflated?

A

when it is being placed

44
Q

How should the patient be positioned when placing a valve?

A

as straight up as possible (45-90 degrees)

45
Q

How do you assess airway patency?

A

deflate cuff, ask patient to inhale, finger occlude and speak or cough on exhalation

46
Q

How can you tell is there is breath stacking?

A

when you hear a whoosh out of the tracheostomy tube when you take it off

47
Q

Why does breath stacking happen?

A

something happened with the airflow that it didn’t get out of the mouth or nose

48
Q

How can you troubleshoot breath stacking?

A

downsizing valve, using a different brand

49
Q

What is a foam cuff?

A

they can re-inflate on their own; you can’t use a valve on them

50
Q

What is endotracheal tube?

A

the tube that goes into your mouth and through the vocal folds

51
Q

How long should you where an endotracheal tube?

A

no more than 14 days

Swallowology (15 decks)

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