Читать книгу Understanding Anatomy and Physiology in Nursing - John Knight - Страница 154

Phillip is 78 and was admitted to your ward following a stroke. While he could be roused, Phillip was experiencing a reduced level of consciousness. In line with current guidance from the National Institute for Health and Care Excellence (NICE, 2019b), the ward manager undertook a rudimentary swallowing assessment by giving Phillip a teaspoon of water to drink. Unfortunately, Phillip couldn’t swallow the water, and it trickled out of the side of his mouth. Therefore, he was referred to a speech and language therapist (SALT) for a specialist assessment the next morning. Phillip was kept nil by mouth until he was assessed by the SALT.

Difficulty in swallowing (dysphagia) is common following a stroke if the glossopharyngeal nerve (cranial nerve 9) which coordinates swallowing is damaged. Failure to recognise and adequately manage dysphagia can result in aspiration pneumonia, which can potentially lead to death.

Depending on the extent of Phillip’s dysphagia, a range of measures will be considered including thickened oral fluids and nasogastric or gastrostomy feeding. Hopefully, as Phillip begins to recover from his stroke, his swallowing will improve. His recovery can be supported by the SALT.

A common mistake is to confuse the pharynx with the larynx; this confusion largely arises because these two words sound similar and are spelt in a similar manner. Remember, the term pharynx is generally used interchangeably with throat, while the larynx is the voice box.

Now that we have explored the key components of the upper respiratory tract, we need to examine the nature of the lower respiratory tract and its role in conducting air to the alveolar air sacs and in gaseous exchange.