Dysphagia Book Quiz 3

Front 1

The physiologic hierarchy includes _____, ______, and _____. (in order)

Back 1

respiration, swallowing, and speech.

Front 2

***three types of respiration

Back 2

ventilation- the movement of air back and forth between the outside atmosphere and the inner spaces od the lungs

external respiration - exchange of gases between walls of lung spaces and the transporting blood

internal respiration- gases are exchanged between blood and cells ofthe body

Front 3

large alveolus = ____ collapsing pressure

Back 3

low

Front 4

small alveolus = ____ collapsing pressure

Back 4

high

Front 5

The small size of alveoli present a problem in keeping them open. ________ generates a pressure that can collapse alveoli

Back 5

surface tension

Front 6

Law that explains that the collapsing pressue on alveolus is equal to 2 times the surface tension divided by the radius of the alveolus

Back 6

Law of LaPlace

Front 7

****what combats the fact that small alveolus have a tendency to collape? how?

Back 7

Surfactant-- Without surfactant, the Law of LaPlace says that small alveolus will collapse. With surfactant, the small alveolus remain open.

Front 8

*** What is it called when small alveolus will collapse?

Back 8

atelectasis

Front 9

What is the space between 2 pleura?

Back 9

pleural cavity or intrpleaural space

Front 10

The thorax houses which system? what does this include?

Back 10

Pulmonary system- includes the trachea, bronchi, and lung structures themselves

Front 11

What is a collapsed lung called?

Back 11

Pneumothorax

Front 12

what are the 3 pumping actions of respiration?

Back 12

1) quiet inhalation- few muscles are used

2) forced inhalation- muscles enlarge volume of thorax and decrease pressure within the thorax so air will flow in the lungs

3) exhalation- compressive pumping action decreases volume of thorax and increases pressure on air within

Front 13

Main way to increase vertical space in the thorax

Back 13

by way of diaphragm muscle

Front 14

respiratory physiology at rest

Back 14

1) quiet inhalation- active muscles expand thoracic volume to decrease internal air pressure

2) quiet exhalation- relaxation of muscles of inhalation so ribs and or diaphragm can return to their rest position, decreasing thoracic volume and increasing pressure

Front 15

Most common pattern of coordination of respiration and swallowing: ____% do what?

Back 15

60-80% inhale, start to exhale, stop exhale, swallow and airway closes, return to exhalation thought to be protective, prevents residual food in the airway. Other method - begin on inhalation and return on inhalation

Front 16

An acute lung injury caused by acidic and particulate gastric contents such as reflux

Back 16

pneumonitis

Front 17

What is COPD? 2 types

Back 17

Chronic Obstructive Pulmonaty Disease: emphysema and chronic bronchitis

Front 18

** how fatal is aspiration pneumonia?

Back 18

fatal in 20-50% of the cases. Acute inflamnation caused by infection; reaction to acgteria and bacterial byproducts

Front 19

6 valves involved in swallowing

Back 19

1) lips
2) velar-lingual
3) tongue oral and base
4) velopahryngeal
5) laryngeal
6) cp muscles.UES

Front 20

apnea

Back 20

pause during the swallow, 1/3 to 2/3 of a second; longer apneic pause with larger thicker boluses also longer with straw/cup drinking

Front 21

upper airway versus lower airway

Back 21

upper airway includes the oral, nasal, pharyngeal, and laryngeal tract. The lower airway includes the trachea, bronchi, and lungs
the larynx is the boundary between the upper and lower airway

Front 22

main valves in the upper airway:

Back 22

oral- secondary airpway- use tp inhale or exhale if the nasal cavity is blcoked
nasal- primary airway
pharyngeal tube- in swallowing, its open except for closing at certain points
laryngeal tube- protection of airway, clears secretionsd, valve for throcic fixation so abdominal pressure can be accomplished (for heavy lifting)

Front 23

setting of valves in upper airway during respiration depends on activity. how would you set them for quiet breathing?

Back 23

lips together, velopharyngeal port open, glottis open

Front 24

exerted breathing?

Back 24

lips open, VP closed, glottis open

Front 25

speech breathing?

Back 25

lips open,vp closed, larynx rapid movement

Front 26

swallowing?

Back 26

depends on phase

Front 27

normal respiration rate young

Back 27

16 per minute

Front 28

normal respiration rate elderly

Back 28

20 per minute

Front 29

4 structural esophageal dysphagia etiologies

Back 29

1) schatzki's ring
2) peptic stricture
3) hiatal hernia
4) esophageal diverticula

Front 30

categories of esophageal dysphagia

Back 30

1) structural (the biggie!!)
2) motility
3) infectious
4) neoplastic (cancer)
5) inflammatory
6) iatrogenic

Front 31

prevelance of schiatzki's ring. population.

Back 31

2nd most common cause of structual esophageal dysphagia. found in 4-15% of radiographic studies. autopsy shows 9%. typical age is 50-70 yo. ring size important. dysphagia common in rings greater than 13 mm.

Front 32

where is schiatzki's ring localized?

Back 32

to esphageal squmocolumnar junction and almost invariably coexist with a hiatal hernia which is most present in the Western population and about 60% of elderly

Front 33

"Steakhouse Syndrome"

Back 33

Schiatzki's ring

Front 34

what is a peptic stricture

Back 34

alergenic; mucosal rings that line esophagous and resemble the tracha, now the most common cause of esphageal dysphagia. treatable with meds, dietary restrictions, steroids and dialation

Front 35

hierarchy of GERD to major problems:

Back 35

1) 38% of people in US have heartburn at least once a month. 11% on daily basis
2) 1/3 of people seeking medical attention for symptoms of GERD have esophagitis
3) approx. 10-20% of people with esophagitis develop serious complications

Front 36

name some local complicationd of esophagitis reflux

Back 36

erosive esophagitis
bleeding
esoph. ulcers
esoph. stricture
barret's esophagus
esophageal adenocarcinoma