2: Airway obstruction Flashcards

1
Q

What is the boundary between the upper and lower airways?

A

Vocal cords

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2
Q

What direction does the larynx move on swallowing?

A

Upwards THEN downwards

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3
Q

The larynx is made up of ___ and ___.

A

cartilages and membranes

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4
Q

What is the only complete ring in the airway?

A

Cricoid cartilage

doesn’t expand, determines diameter of airway

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5
Q

What do the vocal cords do in

a) phonation
b) respiration?

A

a) Close

b) Open

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6
Q

Which muscles close the vocal cords?

A

Lateral crico-arytenoids

Arytenoids

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7
Q

Which muscles open the vocal cords?

A

Posterior arytenoid muscles

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8
Q

Neonates are obligate nasal breathers.

Why?

A

Larynx is raised too high (C1)

Subglottis is narrow

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9
Q

Air flow resistance is heavily dependant on ___ of the airway.

A

radius

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10
Q

Air flow resistance is directly proportional to what?

A

1 / (radius)4

So a 1 cm decrease in radius has a massive effect on air flow resistance

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11
Q

What is the difference between stridor and stertor?

A

Stridor - high pitched noise due to turbulent airflow

Stertor - low pitched sound for nasopharynx (snoring)

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12
Q

If you suspect a child has acute epiglottitis, what shouldn’t you do?

A

Examine the throat

You will exacerbate inflammation and cause respiratory obstruction > arrest

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13
Q

What can become lodged in the airway causing obstruction?

A

Foreign bodies

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14
Q

What is an insidious cause of dyspnoea and airway obstruction?

A

Malignancy

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15
Q

What is the commonest type of malignancy in children?

A

Lymphoma

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16
Q

recurrent respiratory papillomatosis

juveline < 12

adult onset > 12

hugely destructive to larynx, requiring loads of surgery

HPV 6, 11 (papillomas) 16 and 18 (carcinomas), also cervical cancer in women

A
17
Q

What can develop in a baby secondary to inflammation around a tube in the larynx?

A

Subglottic stenosis

ACQUIRED, CONGENITAL is extremely rare

18
Q

What are the commonest causes of subglottic stenosis in adults?

A

Vasculitis - granulomatosis with polyangiitis (GWP)

GORD

19
Q

What should you do immediately for someone with facial / neck burns?

A

Assess airway and INTUBATE

because subsequent swelling will make it impossible

20
Q

How is respiratory distress managed?

A

ABCDE

21
Q

What is used to examine the airway?

A

Laryngoscope

  • tracheo
  • broncho
22
Q

Should tracheostomy be done on kids?

A

No

Very difficult to take back