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Head And Neck > 10.2 Conditions Involving The Larynx And Airway Management > Flashcards

10.2 Conditions Involving The Larynx And Airway Management Flashcards

1
Q

Give examples of conditions that affect the larynx

A 
Laryngitis
Laryngeal nodules
Laryngeal cancer
Laryngeal oedema
Epiglottitis
Croup
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2
Q

What is laryngitis?

A

Inflammation of the larynx, often involving the vocal cords ( become oedematous and less pliable)

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3
Q

How is laryngitis diagnosed?

A

Clinical history

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4
Q

How does laryngitis present?

A

Hoarse / weak voice and sore throat

History of URTI

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5
Q

What causes laryngitis?

A 
Viral infection ( rhinovirus, influenza, adenovirus, coronavirus)
Non- infectious aetiology ( irritating substances, overusing voice)
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6
Q

How is laryngitis treated?

A

Self-limiting - fully resolves in 2-3 weeks

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7
Q

What causes laryngeal nodules?

A

Acute trauma

Chronic irritation of vocal cords

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8
Q

What are laryngeal nodules?

A

Benign growths on the vocal folds

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9
Q

How do laryngeal nodules present?

A

Hoarseness of voice ( longer than 3 weeks)

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10
Q

How are laryngeal nodules treated?

A

Visualisation of cords (laryngoscope/nasal endoscopy)

Biopsy to exclude laryngeal cancer

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11
Q

What is stridor?

A

A harsh, shrill grating sound on inspiration or expiration.

Usually due to upper respiratory tract pathology

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12
Q

How will a patient with a compromised upper airway present?

A 
Stridor
Raised respiratory rate
Distress
Hypoxia
Cyanosis
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13
Q

What causes laryngeal oedema?

A 
Allergic reaction (anaphylaxis)
swallowed foreign body
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14
Q

What is epiglottitis?

A

Inflammation usually secondary to infection. Causes swelling of epiglottis and supraglottis tissues.

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15
Q

Why is epiglottitis a medical emergency?

A

Rapid swelling can cause immediate threat to airway

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16
Q

Who is likely to present with epiglottitis?

A

Children/ infants

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17
Q

How might epiglottitis present?

A 
Stridor
Difficulty breathing
Difficulty swallowing
Pooling as saliva pools in mouth
Fever
Sat in Sniffing position
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18
Q

What is sniffing position?

A

Head extended at neck to maintain airway patency

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19
Q

What is epiglottitis usually caused by?

A

Bacterial infection - haemophilus influenzae

20
Q

How is epiglottitis usually treated?

A 
Secure airway (intubation/tracheostomy) 
Antibiotics
21
Q

What is croup?

A

Inflammation of the larynx in children

22
Q

How does an infant with croup present?

A

Characteristic barking cough
Symptoms worsen with agitation
Stridor

23
Q

Who is typically affected by croup?

A

Children/infants (6months to 3 years)

24
Q

How is croup usually treated?

A

Usually managed at home with single does of corticosteroid medication (dexamethosone/prednisolone)

Severe - emergency intervention, nebulised adrenaline and oxygen, course of corticosteroids to reduce inflammation

25
Q

What are the protective reflexes involved in protecting the airways?

A

Gag
Cough
Swallow

26
Q

Why are the airways at risk in decreased consciousness?

A

As there is decreased tone and suppression of reflexes
In supine position the tissues surrounding the airways have a tendency to fall back, occluding the air from entering from the nasopharynx/oropharynx

27
Q

What are the 2 broad categories of airway management?

A

Planned

Emergency

28
Q

Why might we plan to manage an airway?

A

In preparation for surgery involving general anaesthetic

29
Q

Why might emergency airway management be necessary?

A

acute/immediate threat to airway
conscious = laryngeal oedema/occlusion of airway
unconscious patient = cardiac arrest

30
Q

What are simple manoeuvres used to open up the airway?

A

Head tilt

Chin lift

31
Q

When is a head tilt/chin lift used?

A

Emergency airway management - unconscious/cardiac arrest

When putting in endotracheal tube

32
Q

What are airway adjuncts?

A

Devices used to support simple airway manoeuvre and maintain patent upper airway.

33
Q

What are the 2 airway adjuncts used?

A 
Oropharyngeal airway ( guedel)
Nasopharyngeal airway
34
Q

What are the disadvantages of using airway adjuncts?

A

Dont protect lower respiratory tract from vomit/secretions

Oropharyngeal airway can illicit gag reflex if minimal depression of consciousness

35
Q

IGel is an example of what?

A

A supraglottic airway

36
Q

What is a supraglottic airway used for?

A

To secure the airway.
Maintains airway and provides some protection for the lower respiratory tract
Often first line in cardiac arrest
NOT used for long-term ventilation such as in ITU

37
Q

What is an example of a definitive airway?

A

Intubation

38
Q

What is intubation

A

When an endotrachel tube is placed through the oral cavity, through the oropharynx, through larynx and into the trachea.
Cuff is inflated at the end of the endotracheal tube to secure in the trachea.

39
Q

What is the advantages of intubation?

A

Can be used long term for airway management as secures and protects (vomit/secretions) lower respiratory tract

40
Q

Why is intubation more complicated than a supraglottic airway ?

A

Requires used of laryngoscope
Technical skill
Patient needs to be anaesthetised before insertion

41
Q

What is a laryngoscope?

A

A device used to visualise the larynx. Inserted into oral cavity. Curved ‘blade’ with torch on the end. Sits in the vallecular

42
Q

When inserting a endotracheal tube, when structures does the tube pass through?

A

Oral cavity
Oropharynx
Laryngeal inlet
Glottis

43
Q

What is the endotracheal tube connected to?

A

Ambu bag

Ventilator

44
Q

What is the name of the 2 airway adjuncts?

A

Orophryngeal airway

Nasopharyngeal airway

45
Q

What is the role of airway adjuncts

A

To keep the tongue and tissues of the larynx off of the oropharynx. Keeps airway patent

46
Q

In terms of placement how does a supraglottic airway from an ET tube?

A

Supraglottic surrounds the laryngeal Tube sits at the top of the trachea.

Head And Neck (13 decks)

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