Respiratory: Laryngectomy & Tracheostomy

Question 1

A laryngectomy separates the airway from where?

Answer 1

The mouth, nose and oesophagus.

Question 2

What is the difference between a total and partial laryngectomy?

Answer 2

Total: entire larynx is removed.

Partial: only a portion of the larynx is removed.

Question 3

What is the name of the opening in the neck that a laryngectomee breaths from?

Answer 3

The Stoma

Question 4

When is a laryngectomy procedure usually performed?

Answer 4

In cases of laryngeal cancer.

Question 5

What is a stoma?

Answer 5

A healed hole that has been surgically put there.

Question 6

What are individuals termed after a total laryngectomy?

Answer 6

Total neck breathers.

Question 7

What are individuals termed after a partial laryngectomy?

Answer 7

Partial neck breathers. Because they can partially breath through the nose and mouth.

Question 8

Where is ventilation and resuscitation of total and partial neck breathers done?

Answer 8

Through their stoma.

Question 9

What is a tracheostomy?

Answer 9

A surgical procedure which consists of making an incision on the anterior aspect of the neck.

Opening a direct airway through an incision in the trachea.

Question 10

What is the anterior aspect of the neck?

Answer 10

Front

Question 11

How is a tracheostomy different to a laryngectomy?

Answer 11

In a tracheostomy there is no removal of the larynx.

Question 12

How can a resulting stoma be used?

Answer 12

Independently or as a site for a tracheostomy tube to be inserted.

Question 13

How could a patient communicate after a laryngectomy? (3)

Answer 13

Artificial larynx (darlic)
The oesophageal voice (burping)
Silent mouthing, writing and gestures. (Most do this)

Question 14

What should you do with a laryngectomy patient.

Answer 14

Plenty of time to speak
Ask them to repeat
Watch their lips
Ask about their voice prosthesis if poss.

Question 15

List 6 complications associated with laryngectomy and tracheostomy patients.

Answer 15

Fistula
Breakdown of wound
Dysphagia
Chest infection
Stoma shrinkage
Recurrence of cancer

Question 16

What don’t you do with a laryngectomee?

Answer 16

Hurry them
Pretend to understand
Avoid eye contact
Remove a voice prosthesis if they are unconscious (unless obvs full)

Question 17

What is a fistula complication?

Answer 17

Two cannulars, cannulars an artery, a vein and connect the two.

Easily blocked because it is up by the neck.

Question 18

When can the complication of ‘break down of wound’take place?

Answer 18

After radiotherapy, being used to treat cancer.

Question 19

What is dysphagia?

Answer 19

Difficulty swallowing due to oesophageal stricture.

Question 20

Why is chest infection a complication for laryngectomee?

Answer 20

Because the procedure this means the normal respiratory filters (e,g tonsils) are by passed, increasing the chance of infection.

Question 21

What do we use for oxygen therapy?

Answer 21

An adult tracheostomy mask.. This fits over the stoma instead.

Question 22

What is the % of oxygen used with the Venturi mask?

Answer 22

50%

Question 23

At what flow rate is oxygen given?

Answer 23

10 Lpm

Question 24

What is a Laryngectomy?

Answer 24

The removal of the larynx.