Airway Obstruction Flashcards
how does the larynx move on swallowing?
up and forward
allows food to pass into oesophagus
what divides the upper and lower resp tract?
larynx
where is the subglottis?
below the glottis (vocal cords together as a pair)
describe the vocal cords in respiration vs phonation?
respiration = open phonation = closed
describe the special features of the respiratory system in neonates?
large head small nares obligate nasal breather (only breathe through nose to allow breastfeeding) large tongue small, soft larynx higher position of larynx (C1) weak neck muscles; floppy head narrow subglottis (3.5mm at cricoid)
what is the resistance to air flow equal to?
1/R to the power 4
- i.e a 2mm radius reduced by 1mm will produce a X16 increase in resistance and a 75% decrease in cross sectional area
stridor vs stertor?
stridor = high pitched, harsh noise due to turbulent airflow resulting from airway obstruction stertor = low pitched sonorous sound arising from nasopharyngeal airway
signs of acute epiglottitis?
very breathless
drooling
cherry red epiglottis on investigation
how is acute epiglottitis managed?
intubation
antibiotics
what is the danger of inhaled foreign bodies?
very inflammatory
can quickly cause an infection or serious pneumonia
effective management of laryngeal lymphoma?
high dose steroids
then normal cancer treatment
how can HPV affect the larynx?
can cause recurrent respiratory papillomatosis
follicular growths on the larynx
what is subglottic stenosis?
narrowing of the vocal cords
can be congenital (rare)
can be inflammatory (e.g after long period of intubation/ventilation)
how can burns affect the airway?
inhalation can cause the larynx to melt
swelling
3 components of assessment of airway?
appearance
work of breathing
skin circulation
how can respiratory problems present in infants?
recession in the chest
air in the abdomen
discomfort and swelling visible in the face
how can respiratory problems progress in infants?
respiratory distress > respiratory failure > cardiovascular failure > neurological failure (brain damage, irreversible)
general management of airway obstruction?
ABCDE - resuscitation oxygen heliox (oxygen and helium) steroid adrenaline flexible fibre-optic endoscopy secure airway with ET tube/tracheostomy treat underlying pathology
how is an airway endoscopy performed?
rigid vs flexible examination without the ET tube in is the best option general anaesthetic given medications given to assist breathing during - heliox - budesonide nebuliser - dexamethasone - adrenaline nebuliser
what are the 4 options for methods of airway endoscopy?
direct laryngoscopy
microlaryngoscopy
examination with Hopkins rods
laryngoTracheoBronchoscopy
how often is tracheostomy performed?
last resort
should be avoided at all possibilities
