Medical SLP - Final

Question 1

Tracheotomy

Answer 1

emergency procedure; opening the trachea at any level.

Question 2

Flail Chest

Answer 2

1. When diaphragm contracts (muscles of respiration) without rigid framework of ribs/spine/sternum, they collapse the chest. Chest doesn’t expand it gets smaller; no air comes in. skeletal structure of respiration is destroyed.

Question 3

When do you need to insist an intubation tube is removed by?

Answer 3

Day 7

Question 4

Indications for tracheostomy

Answer 4

length of time on ventilator, difficulty mobilizing secretions, airway trauma that won’t resolve quickly.

surgical indications: skull/dural surgeries, head and neck cancers and TBI.

Question 5

Tracheostomy

Answer 5

create stoma/semi-permanent opening.

Question 6

O2 Saturation Levels

Answer 6

should be above 95%; if below, STOP WHAT YOU’RE DOING.

Question 7

Pulse Oximeter (pulse ox)

Answer 7

records how much red is in the blood going through your finger

Question 8

What is the biggest job you have in the hospital?

Answer 8

wash your hands

Question 9

Managing Secretions

Answer 9

suction, clean technique (doesn’t need to be sterile), doesn’t hurt, know size of catheters, CHART EVERYTHING.

Question 10

suitability for a speaking valve is determined by the patient’s ability to tolerate a speaking valve, which is judged by…

Answer 10

the patient’s ability to maintain reasonable oxygen saturation levels in the blood.

Question 11

Types of tracheostomy tubes

Answer 11

single cannula, cuffed
double cannula, cuffed
metal cannula, non-cuffed
single cannula, non-cuffed
fenestrated, cuffed

Question 12

Why does the cannula need to be smaller than the trachea?

Answer 12

So Air can go around cannula and get into the larynx so the patient can speak

Question 13

Branchoscopy

Answer 13

An examination of the inside of the trachea and of the large air passages leading to the lungs. Usually done as a way of assessing the degree of narrowing of the trachea and the overall general condition of the trachea and the air passageways.

Question 14

Why does the cannula need to be centered in the airway?

Answer 14

It lessens the risk of aspiration and it helps to keep the tube from rubbing the airway which can lead to tracheal deterioration.

Feeding/eating

Question 15

decannulation

Answer 15

removing the tracheostomy tube

Question 16

Dysphagia

Answer 16

swallowing disorder

Question 17

Extrinsic Muscles

Answer 17

one attachment is outside the larynx which supports larynx in its position
- suprahyoids and infrahyoids

Question 18

Suprahyoids

Answer 18

elevators; muscles attach to hyoid from above

• digastricus
• mylohyoid
• stylohyoid
• genoihyoid

Question 19

Digastricus

Answer 19

2 bellies (anterior & posterior)

elevates hyoid and larynx superiorly and anteriorly

Question 20

Mylohyoid

Answer 20

floor of mouth

elevates hyoid, tongue and floor of mouth. may depress mandible is hyoid is fixed.

Question 21

Stylohyoid

Answer 21

long and slender.
elevates and retrates hyoid and larynx.

same as digastricus posterior bellly.

Question 22

Geniohyoid

Answer 22

pulls hyoid superiorly and anteriorly, like anterior belly of digastricus

Question 23

Structures of the larynx (bottom to top)

Answer 23

true VFs, false VFs, aryepiglottic folds and epiglottis

Question 24

Spaces and places in the larynx

Answer 24

Valleculae, pyriform sinuses, aditus laryngeus (aditus or vestibule), anterior and posterior commissure.

Question 25

Pharyngeal constrictors

Answer 25

superior, middle and inferior

Question 26

Infrahyoid muscles

Answer 26

depressors, to hyoid from below - sternohyoid - omohyoid - thyrohyoid - sternothyroid

Question 27

Sternohyoid

Answer 27

pulls hyoid down or holds it in place when mandible is forcefully opened against resistance

Question 28

Omohyoid

Answer 28

On contraction it pulls the hyoid inferiorly and dorsally.

Question 29

Thyrohyoid

Answer 29

On contraction it raises the larynx and decreases the distance between the thyroid and hyoid.

Question 30

Sternothyroid

Answer 30

On contraction it depresses the thyroid cartilage.

Question 31

Risk for dysphagia

Answer 31

lack of muscle function, sensation or cough/clear reflex

Question 32

Aspiration

Answer 32

entry of food or liquid into the airway below the true vocal folds.

Question 33

Penetration

Answer 33

entry of food or liquid into the larynx down to but not below the level of the true vocal folds. Food or liquid in the additus.

Question 34

Residue

Answer 34

food or liquid that is left behind in the mouth or pharynx after the swallow.

Question 35

Backflow

Answer 35

food from the esophagus into the pharynx and/or from the pharynx into the nasal cavity.

Question 36

screening identifies ____ the patient is aspirating but not ___

Answer 36

that; why

Question 37

Signs and symptoms of aspiration

Answer 37

coughing after swallow history of pneumonia food squirting out the tracheostomy

Question 38

diagnoses that put patient at greater risk for dysphagia

Answer 38

laryngeal damage stroke head injury neurological disorder or disease that leads to paralysis/paresis and/or lessened sensation

Question 39

Videoflouroscopic procedure

Answer 39

modified barium swallow

Question 40

modified barium swallow focuses on...

Answer 40

oral structures, upper trachea and larynx

Question 41

barium swallow test goes all the way to...

Answer 41

the stomach

Question 42

2 purposes of the barium swallow test

Answer 42

determine the abnormalities in A and P causing patient's symptoms identify and evaluate treatment strategies

Question 43

3 consistencies of material used in barium swallow test

Answer 43

thin liquid, thick liquid, barium on a cracker.

Question 44

Laryngeal strategies/swallowing maneuvers

Answer 44

head positioning, laryngeal manipulation, food alterations, multiple swallows, swallow-cough, food then a sip of liquid to clear.

Question 45

Practicalities of treatment strategies for swallowing maneuvers

Answer 45

- Is your patient cognitively capable of following instructions? - If someone has to be there with the patient during feeding times, will the caregiver follow instructions? (Is mama a little senile too? Is the patient in a nursing home and the duty will fall to an aide, etc.)

Question 46

Multidisciplinary Dysphagia intervention team

Answer 46

``` SLP Physician Nursing staff Dietician OT PT Pharmacist Radiologist ```