Tracheostomy, Head and Neck Cancer, and COPD Review

Vocabulary flashcards created from lecture notes covering Tracheostomy management, Head and Neck Cancer, and COPD pathophysiology.

Tracheostomy

A surgical creation of an artificial opening into the trachea through the neck to establish a patent airway, providing advantages over an endotracheal tube such as increased patient comfort, easier cleaning, better oral and bronchial hygiene, and reduced risk of long-term damage to vocal cords.

Obturator

A rounded guide placed inside a tracheostomy tube during insertion to facilitate smooth passage into the trachea, which is removed immediately after tube placement and kept at the bedside for emergency re-intubation.

Fenestrated Tracheostomy Tube

A tracheostomy tube featuring an opening on the dorsal surface of the outer cannula that permits air to flow upward over the vocal cords when the inner cannula is removed, cuff deflated, and decannulation cap attached.

Speaking Tracheostomy Tube

A specialized tracheostomy tube constructed with two external tubings—one for cuff inflation and one leading above the cuff to a low-flow air source—allowing patients at risk for aspiration to speak while the cuff remains inflated.

Tracheostomy Tube Components

The structural assembly of a cuffed tracheostomy system, including an outer cannula with flange, a hollow inner cannula, a cuff with inflation line and pilot balloon, tie strings, a $15\text{-mm}$ adapter, and an obturator.

Tracheostomy Cuff Inflation Pressure

The standard pressure range maintained in a tracheostomy balloon cuff, specifically $20\text{ to }25\text{ cm H}_2\text{O}$, monitored routinely to prevent tracheal mucosal damage, ischemia, and aspiration.

Speaking Valve

A removable one-way valve fitted onto the hub of a tracheostomy tube that opens during inhalation to admit air and closes upon exhalation, redirecting air through the larynx and mouth to enable phonation.

Head and Neck Cancer

Malignancies originating in the squamous cells of mucosal surfaces in structures such as the nasal cavity, paranasal sinuses, nasopharynx, oropharynx, larynx, oral cavity, or salivary glands, with $85$% of cases attributed to smoking.

Leukoplakia

A precancerous white patch on the oral mucosa identified during physical examination of patients suspected of head and neck cancer.

Erythroplakia

A precancerous red velvety patch on mucosal surfaces that carries a high risk of progression to squamous cell carcinoma in head and neck cancer.

Xerostomia

Severe dry mouth caused by radiation-induced damage to salivary glands in patients undergoing treatment for head and neck cancer.

Transesophageal Puncture (TEP)

A surgical creation of a small tract between the trachea and esophagus that allows insertion of a one-way valve (such as a Blom-Singer prosthesis) for voice restoration after a total laryngectomy.

Chronic Obstructive Pulmonary Disease (COPD)

A progressive, preventable, and treatable lung disease characterized by persistent airflow limitation, chronic airway inflammation, increased mucus production, airway narrowing, and loss of elastic recoil.

COPD Pathophysiological Changes

Structural alteration in chronic lung disease where bronchioles lose shape and become clogged with mucus, while alveolar walls are destroyed to form fewer, larger air sacs with diminished surface area.

Air Trapping

The retention of air inside the distal lungs during exhalation due to bronchial collapse and loss of elastic recoil, resulting in pulmonary hyperinflation and difficulty getting air out.

Alpha-1 Antitrypsin Deficiency

A genetic risk factor leading to deficient antiproteinase protection in the lungs, predisposing non-smokers or young individuals to early-onset panlobular emphysema and COPD.

Tripod Positioning

An posture assumed by patients experiencing dyspnea, characterized by leaning forward with hands or arms resting on knees or an overbed table to maximize accessory muscle mechanics.

Pursed-Lip Breathing

A technique where exhalation is prolonged through narrowed lips to create positive backpressure in the airways, preventing collapse and reducing air trapping.

Spirometry Diagnostic Criterion for COPD

A post-bronchodilator spirometry measurement confirming diagnosis when the ratio of forced expiratory volume in $1$ second to forced vital capacity ($\text{FEV}_1/\text{FVC}$) is less than $70$ %.

Cor Pulmonale

Right ventricular hypertrophy and subsequent right-sided heart failure resulting from elevated pulmonary vascular resistance and pulmonary hypertension secondary to chronic pulmonary disease such as COPD.

Polycythemia in COPD

An adaptive physiological response to persistent arterial hypoxemia in which erythropoietin stimulates increased red blood cell production, elevating blood viscosity and pulmonary resistance.

Huff Coughing

A breathing technique involving deep inhalation followed by forced exhalation while uttering the word 'huff', designed to loosen and mobilize airway mucus without excessive exertion.