Airway Trauma and Lesions

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Questions and Answers

What is a sign of partial displacement of the airway out of the trachea?

Increased ability to ventilate the patient

Increased breath sounds

Decreased airflow through the tube (correct)

Easy passage of a catheter past the end of the tube

What should be done in case of accidental extubation?

Reintubate the patient immediately

Provide ventilatory support by manual resuscitator and mask as needed (correct)

Call for emergency assistance

Try to reinsert the tube without checking the patient's airway

What is one of the roles of RTs in airway maintenance?

Performing tracheostomies

Providing medication to patients

Assisting with surgeries

Securing the tube and maintaining placement (correct)

Why is it important to place the ETT or Trach tube 3-6 cm above the carina in adults?

To minimize tube migration during neck flexion or extension Signup and view all the answers

What is the normal mean range of movement of ETT during neck flexion?

1.9 cm up Signup and view all the answers

What is the main challenge in patient communication when an Endotracheal tube (ETT) is used?

Prevention of vocal cord movement and airflow Signup and view all the answers

What is the purpose of a speaking valve?

To allow phonation during exhalation Signup and view all the answers

What is an alternative method to using tape to secure the tube?

Endotracheal tube holders or stabilizers Signup and view all the answers

Why is skin preparation important before using tape to secure the tube?

To ensure proper adhesion of the tape Signup and view all the answers

When should a speaking valve not be used?

If the patient has a high risk for aspiration Signup and view all the answers

What is a benefit of using endotracheal tube holders or stabilizers?

Less skin damage Signup and view all the answers

What is the role of a Speech-language therapist in this context?

To assess the patient's ability to communicate using a speaking valve Signup and view all the answers

Why may a tracheostomy tube need to be changed into a smaller size?

If the tracheal pressure is more than 5 cm H2O Signup and view all the answers

What is the purpose of a Trach tube holder?

To maintain tube placement Signup and view all the answers

What is the advantage of a Talking Tracheostomy tube?

It allows for phonation Signup and view all the answers

What is a common problem that can occur when a patient is unable to communicate?

Agitation and stress Signup and view all the answers

What is the typical outcome of vocal cord paralysis following extubation?

It usually resolves spontaneously within 24 hours Signup and view all the answers

What is the main characteristic of laryngeal stenosis?

It is a chronic condition that requires surgical correction Signup and view all the answers

What is tracheomalacia?

Softening of tracheal cartilages rings leading to collapse of the trachea during inspiration Signup and view all the answers

What is the most common site of tracheal stenosis?

At the stoma site Signup and view all the answers

What is the typical symptom of tracheomalacia and tracheostenosis?

Shortness of breath Signup and view all the answers

What is the investigation of choice for tracheomalacia and tracheostenosis?

Tomography Signup and view all the answers

What is the treatment of choice for small tracheal lesions?

Laser therapy Signup and view all the answers

What is tracheo-oesophageal fistula?

Direct communication between trachea and oesophagus Signup and view all the answers

What is the primary reason for ensuring adequate humidification in airway maintenance?

To promote mucociliary clearance of airway secretions Signup and view all the answers

What is the recommended goal for absolute humidity in airway maintenance?

30mg/L Signup and view all the answers

Which humidification device is used in non-ventilated patients with tracheostomy?

Large-volume jet nebulizer Signup and view all the answers

What is a sign of infection in a patient, according to the text?

Change in sputum color Signup and view all the answers

What is the primary purpose of using a closed suction technique in airway maintenance?

To reduce the risk of nosocomial infections Signup and view all the answers

What is the benefit of using an ETT with a high-volume, low-pressure (HVLP) cuff?

Decreasing the incidence of ventilator-associated pneumonia (VAP) Signup and view all the answers

What is the recommended position of the patient's head of the bed to decrease reflux?

Elevated 30 degrees or more Signup and view all the answers

What is the purpose of chest physiotherapy in airway maintenance?

To reduce the risk of nosocomial infections Signup and view all the answers

What is the primary reason tracheal airways increase the incidence of pulmonary infections?

Bypass of upper airway filtration Signup and view all the answers

What is the main function of a cuff in tracheal airways?

To provide a seal for mechanical ventilation Signup and view all the answers

What is the main drawback of using high-pressure cuffs in tracheal airways?

Tracheal stenosis Signup and view all the answers

What is the pathogenesis of tracheal stenosis and tracheomalacia?

Excessive cuff pressure leading to ischemia Signup and view all the answers

What is the advantage of modern cuff designs compared to initial cuff designs?

Lower pressure and lower residual volume Signup and view all the answers

How often should cuff pressure be monitored in tracheal airways?

Every 4 hours Signup and view all the answers

What is the goal of cuff pressure adjustment in tracheal airways?

To ensure a secure airway Signup and view all the answers

Why is it important to use a manometer to measure cuff pressure in tracheal airways?

To monitor cuff pressure accurately Signup and view all the answers

ما هو الغرض من استخدام الفروع والجذوع في النباتات؟

لكي تتصل بالضوء اللازم لعمليه التمثيل الضوئي Signup and view all the answers

ما هو مصدر غذاء النباتات؟

الهواء والماء معاً Signup and view all the answers

ما هو دور الماء في نمو النباتات؟

يلعب دوراً في تكوين أغذية النبات Signup and view all the answers

ما هو الغرض من وجود الفروع في النباتات؟

لكي تتلقي الضوء اللازم لعمليه التمثيل الضوئي Signup and view all the answers

ما هو دور النباتات في البيئة؟

تتجزئة الأوكسجين في الهواء Signup and view all the answers

ما هو مصدر الأوكسجين في الهواء؟

النباتات فقط Signup and view all the answers

ما هو دور الأوكسجين في البيئة؟

يساعد على дыхة الكائنات الحية Signup and view all the answers

ما هي المادة التي تُسْتَخْدَمُ في عمليه التمثيل الضوئي؟

الماء والكربون ثاني أوكسيد معاً Signup and view all the answers

ما هو دور النباتات في Hệème ecstasy؟؟

تنتج الأوكسجين في الهواء Signup and view all the answers

Study Notes

Airway Trauma

Vocal cord paralysis usually resolves spontaneously within 24 hours of extubation, but may persist, requiring tracheostomy if obstruction is persistent.

Laryngeal Stenosis

Laryngeal stenosis occurs when normal tissue in the larynx is replaced by scar tissue, causing hoarseness and stridor, and does not resolve spontaneously, often requiring surgical correction and sometimes permanent tracheostomy.

Tracheal Lesions

Tracheal lesions can occur with any type of tracheal tube and may include granulomas, tracheomalacia, tracheal stenosis, and tracheoesophageal and tracheoinominate artery fistulas.

Tracheomalacia and Tracheostenosis

Tracheomalacia is the softening of tracheal cartilage rings, leading to collapse of the trachea during inspiration.
Tracheostenosis is the narrowing of the tracheal lumen due to fibrosis or scarring, often occurring at the ETT cuff site.
Many factors can lead to stenosis at the stoma site, including large stoma, infection, movement of the tube, frequent tube changes, and advanced age.
Symptoms of tracheomalacia and tracheostenosis include shortness of breath, stridor, and difficult expectoration.
Treatment for tracheomalacia and tracheostenosis depends on the severity and length of damage, and may include laser therapy, resection and end-to-end anastomosis, or staged repair or stent.

Tracheo-Oesophageal Fistula

Tracheo-oesophageal fistula is a direct communication between the trachea and oesophagus, often caused by accidental extubation.
Signs of partial displacement of the airway include decreased breath sounds, decreased airflow through the tube, and decreased ability to pass a catheter past the end of the tube.

Airway Maintenance

Role of Respiratory Therapists

Secure and maintain tube placement
Provide for patient communication
Ensure adequate humidification
Minimize the possibility of infection
Aide in secretion clearance
Provide appropriate cuff care
Troubleshoot airway-related problems

Securing Tube and Maintaining Placement

The most common way is to use tape, ensuring proper placement of the ETT or trach tube 3-6 cm above the carina in adults or between the 2nd and 4th tracheal rings.
Tracheal tube holders or stabilizers can also be used.

Providing for Patient Communication

Methods of communication include lip reading, writing, letter or phrase boards, talking tracheostomy tubes, and speaking valves.

Ensuring Adequate Humidification

Decreased humidity impairs ciliary function and mucociliary clearance, leading to infection and retention of airway secretions.
Methods of humidification include heated humidifiers, large-volume jet nebulizers, and heat and moisture exchangers (HME).

Minimizing Nosocomial Infections

Signs of infection include changes in sputum, breath sounds, and chest radiograph, as well as fever, tachycardia, and leukocytosis.
Methods to minimize nosocomial infections include sterile technique, aseptic equipment, hand hygiene, secretion clearance, and chest physiotherapy.

Providing Cuff Care

The importance of cuff care includes sealing the airway for mechanical ventilation and preventing aspiration.
High-pressure cuffs can lead to tracheal stenosis and tracheomalacia.
Modern cuffs are designed with low pressure and high residual volume to minimize damage to the tracheal wall.
Cuff pressure should be monitored regularly, with a goal of 30 mmHg.

Plant Communities

Plant communities increase in tropical regions and decrease in polar regions
The variation in plant communities is affected by the thermal gradient, with more diversity near the equator and less diversity near the poles

Animal Roles

Animals represent the second element in the ecosystem
They play a crucial role in the ecosystem, influencing the distribution and diversity of plant species

Organic Matter

Organic matter is essential for the survival of living organisms
It is a fundamental component of life, supporting the growth and development of plants and animals

Characteristics of Living Organisms

Living organisms have the ability to grow and develop
They exhibit variation in their physical characteristics, such as size, shape, and color
They are capable of responding to their environment and adapting to changes

Migration and Species Development

Migration can prevent the separation of different populations and the development of new species
However, when migration is restricted, separate populations can evolve into new species
This process is known as adaptive radiation, resulting in the formation of new species, such as:
- Birds (e.g., American birds)
- Fungi (e.g., fungi species)
- Plant species (e.g., succulent plants)

Plant Adaptations

Plants have adapted to their environment in various ways, such as:
- Using their roots and stems to reach light and water
- Developing specialized structures to conserve water and energy

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Description

This quiz covers the different types of airway trauma, including vocal cord paralysis, laryngeal stenosis, and tracheal lesions, and their respective treatments and outcomes.