Logemann Chapter 8

Front 1

Tumors in the larynx may be managed by__ or ___, with ___ as complement

Back 1

radiotherapy, surgery, chemo

Hint 1

p. 282

Front 2

__ is most frequent treatment for smaller tumors on vocal cord

Back 2

Radiotherapy

Hint 2

p. 282

Front 3

In larger tumors, ___ treatment using ___ or ___ is used

Back 3

combined treatment, radiotherapy+ surgery, high-dose chemotherapy plus radiation

Hint 3

p. 282

Front 4

__ of laryngeal tumors occur in glottic area, ___ occur in supraglottic area, and __ occur in subglottic area

Back 4

60%, 35%, 5%

Hint 4

p. 282

Front 5

Supraglottic tumor will not spread downward unless ____

Back 5

located at base of epiglottis

Hint 5

p. 283

Front 6

Supraglottic tumors occurring at: ___, ___, or ___ are often treated w/ supraglottic/horizontal laryngectomy

Back 6

epiglottis, aryepiglottic folds, false vocal fold

Hint 6

p. 284

Front 7

Standard supraglottic laryngectomy removes:

Back 7

hyoid, epiglottis, aryepiglottic folds, false vocal folds

Hint 7

p. 285

Front 8

In reconstruction, surgeon usually ___ larynx and ___

Back 8

elevates, tucks under tongue base

Hint 8

p. 285

Front 9

The ___maneuver can be used for these patients

Back 9

super-supraglottic swallow

Hint 9

p. 286

Front 10

What would the super-supraglottic maneuver do for these patients?

Back 10

1) serve as exercise for TB and arytenoid contact and 2) swallow maneuver

Hint 10

p. 286

Front 11

Patients with extended resections may experience ___ and ___

Back 11

reduced lingual control, bolus control

Hint 11

p. 287

Front 12

Patients with extended resections may also experience

Back 12

reduced laryngeal sensation, delayed pharyngeal swallow

Hint 12

p. 287

Front 13

One selection criterion for supraglottic laryngectomy is__

Back 13

ability to re-learn swallowing sequence

Hint 13

p. 288

Front 14

If possible, onset of radiotherapy should be delayed until ___

Back 14

oral intake is reinstated

Hint 14

p. 288

Front 15

In a hemilaryngectomy, __ and __ are usually left intact

Back 15

hyoid, epiglottis

Hint 15

p. 289

Front 16

Patients w/ hemilaryngectomies should have few problems with post-operative swallowing -- T or F?

Back 16

T

Hint 16

p. 289

Front 17

Why?

Back 17

Because of reconstructed tissue bulk that may help w/ swallowing

Hint 17

p. 290

Front 18

Patients/ w hemilaryngectomy may experience temporary__

Back 18

Aspiration during the swallow

Hint 18

p. 290

Front 19

Which two postures may help with this problem?

Back 19

Chin down, head rotate

Hint 19

p. 290

Front 20

IF leson is anteriorly on one vocal fold, hemilaryngectomy must include __

Back 20

some or all of anterior commissure

Hint 20

p. 290

Front 21

When arytenoids are removed in hemilaryngectomy, chances of returning to normal swallow are greatly reduced -- T or F?

Back 21

T

Hint 21

p. 291

Front 22

Patients w/ their arytenoids removed typically require

Back 22

adduction exercises, chin-down, head rotation

Hint 22

p. 292

Front 23

Large lesions (T3 or T4) usually require total laryngectomy or high-dose radiation with or without chemo -- T or F

Back 23

T

Hint 23

p. 292

Front 24

Patients w/ total laryngectomy cannot aspirate -- T or F?

Back 24

T -- total separation of GI and and respiratory tracts!

Hint 24

p. 293

Front 25

Swallowing problems in total laryngectomy include__ and __

Back 25

pseudo-epiglottis, tightness of surgical closure

Front 26

Both pseudo-epiglottis and stricture can result in __

Back 26

backflow

Hint 26

p. 295

Front 27

If a total laryngectomy patient has not returned to full pre-op. swallow within __ post-operation, there should be another MBS study of swallow

Back 27

2 months

Hint 27

p. 295

Front 28

If patient complains of dysphagia months or years after surgery, they should see a __ because ___

Back 28

surgeon, disease may recur

Hint 28

p. 295

Front 29

___ is most successful surgical prosthetic procedure to reconnect esophagus and airflow

Back 29

TEP (tracheo-esophageal puncture)

Hint 29

p. 295

Front 30

What does it do?

Back 30

Prevent backflow from esophagus into trachea

Hint 30

p. 295

Front 31

The two most successful techniques for rapidly restoring voice to post-operative laryngectomees are __ and __

Back 31

TEP and Panje procedure

Hint 31

p. 296

Front 32

TEP is also known as the

Back 32

Singer-Blom procedure

Hint 32

p. 296

Front 33

Neurectomy involves

Back 33

cutting the innervation to pharyngeal wall muscles, rather than muscles themselves

Hint 33

p. 296

Front 34

Pharyngospasm is

Back 34

contraction of pharyngeal muscles in response to airflow introduced below it

Hint 34

p. 296

Front 35

In total laryngectomy, patients increase lingual pressure to compensate for absence of larynx -- T or F?

Back 35

T

Hint 35

p. 296

Front 36

Radiotherapy for smaller tumors may result in

Back 36

temporary hoarseness or roughness, small changes in saliva flow

Hint 36

p. 296

Front 37

Patients who receive high-dose radiotherapy with or without chemotherapy, may experience___

Back 37

significantly reduced laryngeal elevation, pharyngeal wall motion

Hint 37

p. 296

Front 38

THese changes may be due to ___

Back 38

fibrosis due to damaged blood supply

Hint 38

p. 296

Front 39

Patients w/ reduced swallowing function due to fibrosis may be helped wth ___

Back 39

falsetto, Mendelsohn maneuver

Hint 39

p. 297

Front 40

Patient should begin ROM exercises ___

Back 40

before or at the beginning of radiotherapy, 5-10 times daily for 10 minutes each time

Hint 40

p. 297

Front 41

In patient after surgery, exercise can begin when___

Back 41

suture lines have healed

Hint 41

p. 297

Front 42

__ and __ will determine patient's functional capacity after surgery

Back 42

resection, reconstruction

Hint 42

p. 297

Front 43

Best therapy occurs when__

Back 43

single set of instructions is given to patient and reinforced by everyone inolved

Hint 43

p. 298