Respiratory: Laryngectomy & Tracheostomy Flashcards
A laryngectomy separates the airway from where?
The mouth, nose and oesophagus.
What is the difference between a total and partial laryngectomy?
Total: entire larynx is removed.
Partial: only a portion of the larynx is removed.
What is the name of the opening in the neck that a laryngectomee breaths from?
The Stoma
When is a laryngectomy procedure usually performed?
In cases of laryngeal cancer.
What is a stoma?
A healed hole that has been surgically put there.
What are individuals termed after a total laryngectomy?
Total neck breathers.
What are individuals termed after a partial laryngectomy?
Partial neck breathers. Because they can partially breath through the nose and mouth.
Where is ventilation and resuscitation of total and partial neck breathers done?
Through their stoma.
What is a tracheostomy?
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.
What is the anterior aspect of the neck?
Front
How is a tracheostomy different to a laryngectomy?
In a tracheostomy there is no removal of the larynx.
How can a resulting stoma be used?
Independently or as a site for a tracheostomy tube to be inserted.
How could a patient communicate after a laryngectomy? (3)
Artificial larynx (darlic) The oesophageal voice (burping) Silent mouthing, writing and gestures. (Most do this)
What should you do with a laryngectomy patient.
Plenty of time to speak
Ask them to repeat
Watch their lips
Ask about their voice prosthesis if poss.
List 6 complications associated with laryngectomy and tracheostomy patients.
Fistula Breakdown of wound Dysphagia Chest infection Stoma shrinkage Recurrence of cancer
What don’t you do with a laryngectomee?
Hurry them
Pretend to understand
Avoid eye contact
Remove a voice prosthesis if they are unconscious (unless obvs full)
What is a fistula complication?
Two cannulars, cannulars an artery, a vein and connect the two.
Easily blocked because it is up by the neck.
When can the complication of ‘break down of wound’take place?
After radiotherapy, being used to treat cancer.
What is dysphagia?
Difficulty swallowing due to oesophageal stricture.
Why is chest infection a complication for laryngectomee?
Because the procedure this means the normal respiratory filters (e,g tonsils) are by passed, increasing the chance of infection.
What do we use for oxygen therapy?
An adult tracheostomy mask.. This fits over the stoma instead.
What is the % of oxygen used with the Venturi mask?
50%
At what flow rate is oxygen given?
10 Lpm
What is a Laryngectomy?
The removal of the larynx.
