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Respiratory Exam 1 > Laryngotrachael Disorders > Flashcards

Laryngotrachael Disorders Flashcards

1
Q

vocal production generator

result

A
  • lungs

- power source

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2
Q

vocal production oscillator

result

A
  • larynx

- tone and pitch

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3
Q

vocal production resonator

result

A
  • pharynx/sinuses

- shape, resonate, and articulate sound into individual voice

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4
Q

epithelial cover of the mucosa

A
  • stratified squamous epithelium
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5
Q

superficial layer of the mucosa

A
  • lamina propria
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6
Q

what comprises the vocal ligament

A
  • intermediate lamina propria

- deep lamina propria

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7
Q

what motion of the larynx allows for breathing

A
  • abduction
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8
Q

what motion of the larynx allows for sound production and swallowing

A
  • adduction
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9
Q

what produces the sounds of speaking or singing

A
  • edges of larynx vibrating together
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10
Q

indications for referral to an ENT in regard to hoarseness

A
  • hoarseness for 2 weeks

- with ear pain, trouble swallowing, or difficulty breathing

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11
Q

hoarseness for greater than 2 weeks suggests

A
  • another diagnosis than acute viral laryngitis
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12
Q

common causes of hoarseness

A
  • neurological injury

- alterations of vocal cord folding

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13
Q

what nerve is injured to cause hoarseness

A
  • recurrent laryngeal nerve injury
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14
Q

most common injury to the recurrent laryngeal nerve that causes hoarseness

other causes

A
  • iatrogenic (injury during a medical procedure)
  • neoplasm
  • viral neuropathy
  • idiopathic
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15
Q

alterations of vocal fold lining caused by

A
  • non-lesion

- lesion

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16
Q

non-lesion causes of alterations of vocal fold lining

A
  • GERD
  • sinus disease/allergic rhinitis
  • dehydration
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17
Q

symptoms of unilateral vocal fold paralysis

A
  • breathy, weak hoarseness
  • poor cough
  • trouble swallowing
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18
Q

the vast majority of laryngeal lesions that cause hoarseness involve

A
  • superficial layers of the vocal fold
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19
Q

what are the superficial layers of the vocal fold

A
  • superficial lamina propria

- epithelial cover

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20
Q

the most common cause of benign vocal fold lesions is

A
  • phonotrauma (yelling)
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21
Q

what is the most common benign neoplasm of the larynx in children

A
  • recurrent respiratory papillomatosis
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22
Q

etiology of recurrent respiratory papillomatosis

A
  • HPV types 6 and 11
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23
Q

recurrent respiratory papillomatosis childhood disease linked to

A
  • mom’s with genital HPV
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24
Q

adult onset of recurrent respiratory papillomatosis associated with

A
  • oral-genital contact
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25
Q

best HPV vaccine

A
  • gardasil-9
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26
Q

treatment of vocal fold lesions

A
  • medical treatment
  • speech therapy
  • surgery
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27
Q

most common cause of unilateral vocal fold paralysis

A
  • iatrogenic
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28
Q

90% of laryngeal carcinoma is

A
  • squamous cell carcinoma
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29
Q

largest risk factor for laryngeal carcinoma

A
  • smoking
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30
Q

effect of EtOH use on laryngeal carcinoma

A
  • synergistic effect
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31
Q

tumor in laryngeal carcinoma arises from

A
  • stratified squamous epithelium

- respiratory epithelium that has undergone metaplasia

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32
Q

laryngeal tumors more prevalent at which age

A
  • over 40
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33
Q

laryngeal tumors more prevalent in which gender

A
  • males
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34
Q

laryngeal tumor more prevalent along which class

A
  • lower SES
35
Q

most common subtype of laryngeal cancer

A
  • glottic - vocal folds
36
Q

most common symptom of laryngeal tumors

A
  • hoarseness

- neck mass

37
Q

important physical exam maneuver for laryngeal tumors

A
  • good neck exam looking for lymphadenopathy
38
Q

neck mass in an adult is _____ until proven otherwise

A
  • cancer
39
Q

lab workup for laryngeal tumors suspicion

A
  • CT neck and chest
  • PET/CT
  • laryngoscopy, bronchoscopy, esophagoscopy
40
Q

treatment of early laryngeal tumors

A
  • single modality
  • surgery
  • or radiational therapy
41
Q

treatment of advanced stage laryngeal tumors

A
  • surgery with radiation
42
Q

how long do we use radiation for laryngeal tumors

A
  • 6-7 weeks daily
43
Q

surgical therapy for advanced laryngeal cancer

A
  • transoral laser microsurgery
  • open partial laryngectomy
  • total laryngectomy
44
Q

what is a total laryngectomy

A
  • complete separation of digestive and respiratory tracts

- tracheal stump attached to the neck

45
Q

can patients without a larynx or voice box speak?

A
  • yes
46
Q

how tracheoesophageal speech works

A
  • divert exhaled air into pharynx by creation of tracheoesophageal fistula
  • pharyngoesophageal segment above the fistula will vibrate and produce a voice
47
Q

can we give patients without a voice box a breathing tube through the mouth?

A
  • no
48
Q

some symptoms of pediatric obstructive sleep apnea

A
  • poor sleep
  • kid wetting the bed
  • poor attention
49
Q

pediatric obstructive sleep apnea - dysphagia and choking on solid foods indicates

A
  • obstructing tonsils
50
Q

pediatric obstructive sleep apnea - hypo nasal speech suggests

A
  • enlarged adenoid tissue
51
Q

greater risk of pediatric obstructive sleep apnea in patients with

A
  • decreased neuromuscular tone

- craniofacial anomalies

52
Q

definitive diagnosis for pediatric obstructive sleep apnea

A
  • polysomnography

- routine use for diagnosis NOT recommended

53
Q

pediatric obstructive sleep apnea peaks at what age

A
  • preschool age
54
Q

pediatric obstructive sleep apnea higher in which children

A
  • obese children
55
Q

most common cause of upper airway obstruction in children with pediatric obstructive sleep apnea

A
  • adenotonsillar hypertrophy
56
Q

treatment of pediatric obstructive sleep apnea

A
  • adenotonsillectomy
57
Q

nonsurgical treatment of pediatric obstructive sleep apnea

A
  • CPAP

- weight loss

58
Q

which is high pitch breathing from turbulent airflow through the LARYNX OR TRACHEA that is caused by narrowing or obstruction outside of chest cavity

it can be inspiratory, expiratory, or bisphasic

mostly high pitched

A
  • stridor
59
Q

what is used to describe airway noise from the nose, NASOPHARYNX and oropharynx

is low pitched, nonmusical, snoring

A
  • stertor
60
Q

which is a high pitched sound that indicates LOWER AIRWAY DISEASE

more commonly end expiratory noise

A
  • wheezing
61
Q

inspiratory stridor from

A
  • supraglottis/glottis
62
Q

biphasic stridor from

A
  • subglottis
63
Q

expiratory stridor from

A
  • trachea
64
Q

what is a big sign on Xray for epiglottitis

A
  • thumb sign
65
Q

typical bacterial for epiglottitis/supraglottitis

affects what age

A
  • H. flu type b

- 2-6

66
Q

result of epiglottitis/supraglottitis

A
  • airway emergency
67
Q

treatment of epiglottitis/supraglottitis

A
  • secure airway
  • IV antibiotics
  • steroids
68
Q

laryngotracheobronchitis also known as

A
  • croup
69
Q

laryngotracheobronchitis most commonly caused by

which ones

A
  • viral

- parainfluenza

70
Q

laryngotracheobronchitis result

A
  • swelling from inflammation leads to airway narrowing
71
Q

laryngotracheobronchitis affects what age group

A
  • under 3
72
Q

laryngotracheobronchitis symptoms

A
  • barking cough
  • stridor
  • hoarseness
  • difficulty breathing
73
Q

X ray sign of laryngotracheobronchitis

A
  • steeple sign
74
Q

treatment of laryngotracheobronchitis

A
  • steroids
  • nebulizer epi (bronchodilates)
  • cool mist
75
Q

voice in epiglottitis

A
  • muffled
76
Q

voice in croup

A
  • hoarse
77
Q

most common cause of stridor in children

A
  • laryngomalacia
78
Q

laryngomalacia definition

A
  • congenital abnormality of laryngeal cartilage
79
Q

laryngomalacia presents around which age

A
  • < 2 months

- resolves by 18 months

80
Q

laryngomalacia - floppy cartilage leads to

A
  • collapse

- inspiratory stridor

81
Q

laryngomalacia worse when

A
  • supine
  • feeding
  • exertion
82
Q

most common treatment of laryngomalacia

A
  • observation

- sometimes supraglottoplasty

83
Q

one thing you must avoid doing in a patient with epiglottiis/supraglottitis

A
  • avoid agitating the patient

Respiratory Exam 1 (27 decks)

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