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24 Cards in this Set
- Front
- Back
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What are possible symtpoms of a tumor?
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1. pain, bleeding, non-healing sore/ulcer
2. lump/thickening in the throat 3. Dysphagia 4. hoarseness, sore throat |
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What is involved in a diagnosis of head & neck cancer?
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history
identification of risk factors physical examination more clinical assessments: endoscopy, biopsy, CT scan, MRI, chest films, blood chemistry tests |
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Describe TMN staging for head & neck cancer.
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T: size and/or extent of tumor following by "is" & a number 1-4
N: number, size, & location of local lymph nodes involved in the disease number 1-3 M: describe metistasis to body regions (can be followed by X to indicate it cannot be assessed, 0 indicating none, 1 indicating distant metistasis) |
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What are some symptoms of oral carcinoma seen in swallowing?
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-difficulty masticating, forming a bolus, and retention/transit
-aspiration -delayed oral transit time -drooling -bolus collection in sulci/palate |
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What are some symptoms of oropharyngeal carcinoma seen in swallowing?
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-nasal regurgitation
-decreased bolus transit -aspiration -PE dysfunction -loss of tongue propulsion & lip sensation |
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What are some symptoms of dysphagia s/p laryngeal carcinoma?
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-inadequate airway closure (aspiration)
-loss of normal pharyngeal contraction -loss of tongue base for glottal protection during LE -loss of SLN function (may impair pharyngeal swallow) -cricopharyngeal dysfunction, benign stricture, fistula |
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What are some effects of radiation therapy?
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-oral & pharyngeal inflammation
-pain in bone & soft tissue -drying of the mucosal tissues -xerostomia -loss of saliva flow -thicker saliva -change in taste sensation/loss of appetite |
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What are the physiologic effects of tracheostomy tubes?
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-loss of subglottic air flow & pressure
-decreased reflexive cough -loss of phasic laryngeal closure -loss of VF mobility -incoordination of swallow & breathing |
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List the assessment procedures for tracheostomy.
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-Clinical Swallowing Evaluation
-Blue Dye Screen (Modified Evans Blue Dye Test) -FEES -VFSS |
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List the 3 intubation & tracheostomy tubes.
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-endotracheal tube
-nasotracheal tube -tracheostomy tube |
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This is a long, plastic, flexible tube that is inserted through the mouth, VF, and into the trachea to aid the patient with respiratory distress/breathing
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tracheostomy tube
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When is a tracheotomy tube used?
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When multiple reintubations leads the team to consider this long-term approach
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T/F: Endotracheal tubes allow the pt to eat/swallow.
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F. VF/oral cavity/pharynx are not available for the swallow function if a endotracheal tube is in place.
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What are the advantages and disadvantages to tracheotomy tube?
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ADVANTAGES:
1. possibilty for swallowing/speaking 2. less trauma to VF 3. patient comfort DISADVANTAGES 1. decreased smell & taste 2. possible infection 3. increased secretion (body's response to foreign object) |
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Breakdown of tissue on posterior pharyngeal wall as a result of constant irritation: _____________________________.
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tracheomalacia
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Describe the 2 types of tracheotomy tubes.
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1. cuffed: portion on the end of the tube can be inflated with air by using a syringe; when inflated it seals the entrance to the lungs to prevent aspiration
2. non-cuffed |
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What are the advantages/disadvantages of cuffed tracheotomy tubes?
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ADVANTAGES: protects the lungs from secretions/food
DISADVANTAGES: restricts voice/limits swallow by anchoring larynx |
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What is a fenestrated tracheotomy tube?
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it has a hole placed in the top to allow for more airflow to the upper airway, primarily for speaking
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What are the 2 factors that make patients tracheotomy tubes more prone to aspiration?
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1. loss of subglottic air pressure
2. poor laryngeal elevation because of the tube |
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Bony changes in the vertebrae of the cervical spine that can push on the posterior pharyngeal wall/esophagus: _________________________.
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osteophytes
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This is a procedure where the esophagus is removed and replaced with tissue from the stomach/jejunum: _______________________. What is the most common cause for this procedure?
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esophagectomy
esophageal cancer |
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How can dental trauma affect the swallow?
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1. oral surgery can result in a temporary loss of normal swallow function caused by pain
2. removal of teeth affects oral preparation 3. ill-fitting dentures can sustain trauma to mandibular/maxillary arches |
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What are some possible effects of medication on swallowing?
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1. cognition/motor performance
2. xerostomia 3. effect on gastrointestinal function |
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How is swallowing impacted by COPD?
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reduced hyoid bone elevation, compromises the respiratory system
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