Specific information regarding the Communication Sciences and Disorders' Acute Care Speech Language Pathology practicum led by Carley Evans MS CCC SLP. Carley is a medical speech pathologist at the Evelyn Trammell Institute for Voice and Swallowing of the Medical University of South Carolina in Charleston. If you are new to this practicum, start with the oldest post listed in Archive.

Friday, August 29, 2008

Ascites - CSD Student Contribution


What is ascites? Ascites (AKA peritoneal cavity fluid, peritoneal fluid excess, hydroperitoneum, or abdominal dropsy) is an accumulation of fluid in the peritoneal cavity (space between the tissues lining the abdomen and abdominal organs). It is most commonly due to cirrhosis and severe liver disease, and can present other significant medical problems. It can be treated with medications (diuretics), paracentesis or other treatments directed at the particular cause. Mild ascites can be hard to notice, but severe ascites leads to abdominal distension. Fluid accumulation in the abdominal cavity can lead to additional fluid retention by the kidneys due to the stimulatory effects on blood pressure hormones (i.e. aldosterone). Ascites can also produce spontaneous bacterial peritonitis (SBP) due to the decreased antibacterial agents in the fluid. Patient complaints include progressive abdominal heaviness and pressure, and shortness of breath due to stress on the diaphragm. Other signs of ascites may be present due to its underlying etiology. For instance, in portal hypertension (perhaps due to cirrhosis or fibrosis of the liver) patients may also complain of leg swelling, bruising, gynecomastia, hematemesis, or mental changes due to encephalopathy. Those with ascites due to cancer (peritoneal carcinomatosis) may complain of chronic fatigue or weight loss. Those with ascites due to heart failure may also complain of shortness of breath as well as wheezing and exercise intolerance.

So what is ascites’ impact on speech? Ascites can affect respiratory support to due stress placed on the diaphragm which can lead many signs, such as: short breath groups, decreased loudness, reduced fluency (effect on prosody), inspiratory stridor, and difficulty coordinating breathing with swallowing due to reduced lung volumes on inhalation and expiration.

Encephalopathy may cause “mental” changes which can result in deficits in cognition, speech, and language, depending on which areas of the brain are affected.

Cholangitis - CSD Student Contribution


What is cholangitis? Cholangitis is an inflammation of the bile duct. It is usually caused by a bacterial infection which causes an ascending cholangitis. However, there are other types of cholangitis as well. In acute cholangitis, the bacterial infection is secondary to biliary tract obstruction which is commonly caused from a gallstone, but may also be associated with neoplasm, elevated intraluminal pressure, bile infection, or stricture of the biliary tract. This infection diminishes antibacterial defenses, which causes immune dysfunction, and thus small bowel bacterial colonization and further possible infection (such as into the biliary canaliculi, hepatic veins, and perihepatic lymphatics).

Thursday, August 28, 2008

Fall Practicum 2008 - September

September schedule:

Off September 1st (Monday)

Off September 10th (Friday)

Off September 17th - 18th (Wednesday - Thursday)

Off September 22nd - 23rd (Monday - Tuesday)


Another term to quickly look up and define for us.

Ascites and Its Impact on Speech Pathology

Look up 'ascites' and give us a quick medical dictionary definition. What impact might ascites have on us as speech language pathologists?

Sunday, August 17, 2008

Fall 2008 Practicum

is fast approaching...