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Questions and Answers
What is the primary purpose of a tracheostomy?
What is the primary purpose of a tracheostomy?
Which type of tracheostomy involves complete removal of the larynx?
Which type of tracheostomy involves complete removal of the larynx?
Which complication is specifically associated with the misplacement of the tracheostomy tube?
Which complication is specifically associated with the misplacement of the tracheostomy tube?
What surgical preparation position is typically used for performing a tracheostomy?
What surgical preparation position is typically used for performing a tracheostomy?
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Which indication for tracheostomy relates to upper airway blockages caused by growths?
Which indication for tracheostomy relates to upper airway blockages caused by growths?
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What is the primary method used to clean a tracheostomy wound?
What is the primary method used to clean a tracheostomy wound?
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Which of the following is NOT a type of tracheostomy?
Which of the following is NOT a type of tracheostomy?
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Which component is essential for tracheostomy care to ensure proper air flow?
Which component is essential for tracheostomy care to ensure proper air flow?
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Study Notes
Tracheostomy
- Tracheostomy is a surgically created opening in the front of the neck into the trachea.
- It's also the creation of a stoma at the skin surface leading into the trachea.
- Tracheostomies can be temporary or permanent.
- Temporary tracheostomies can be elective or emergency.
- Permanent tracheostomies often follow a laryngectomy, where the larynx is removed and no connection between the upper airway and trachea remains.
Types of Tracheostomies
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Temporary: Can be elective (planned) or emergency (urgent).
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Permanent: Usually follows laryngectomy.
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Open: Surgical incision made in the neck to access the trachea.
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Percutaneous: Minimally invasive technique.
Indications for Tracheostomy
- Upper airway obstruction: Congenital, traumatic, or tumorous causes. Infections and vocal cord paralysis also factor.
- Prolonged ventilation: Patients needing long-term breathing support.
- Tracheobronchial toilet: Removal of accumulated secretions from the airways.
- Neurological diseases: Such as following trauma or coma.
- Head and neck surgery: Preemptive or post-op treatment where airway is compromised.
Surgical Technique
- The patient is positioned supine with a neck extension.
- A horizontal incision is made between the cricoid and sternal notch.
- Strap muscles are divided and retracted; the thyroid isthmus is divided.
- A window is created in the trachea, and a tracheostomy tube is inserted.
Surgical Technique (Specific steps)
- Anesthesia is administered.
- Position the patient for neck extension.
- Incise the skin and divide the strap muscles.
- Divide the thyroid isthmus to access trachea.
- Create a window in the trachea.
- Insert the tracheostomy tube, securing in place.
Relations (Anatomical structures near the trachea)
- The trachea is surrounded by critical structures, notably the:
- Thyroid cartilage
- Thyroid gland
- Carotid artery
- Vagus nerve
- Recurrent laryngeal nerve,
- Jugular vein
- Hyoid bone
- Superior laryngeal nerve
Complications
- Bleeding
- Pneumothorax
- Subcutaneous emphysema
- Tube misplacement or displacement
- Tracheo-esophageal fistula
- Tracheostomy tube obstruction
- Accidental decannulation
- Infection
- Tracheal Stenosis
- Tracheocutaneous fistula
Tracheostomy Care
- Humidification: Maintaining appropriate moisture in the airway.
- Suctioning: Removing excessive secretions.
- Wound cleaning: Maintaining the stoma area and tube connections.
- Changing/cleaning inner cannula: Ensuring the inner part is clean.
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Description
This quiz explores the concept of tracheostomy, a surgical procedure creating an opening in the trachea. It delves into the different types of tracheostomies, including temporary and permanent options, as well as their indications. Test your knowledge about this vital medical procedure and its applications.
