Laryngotrachael Disorders Flashcards
1
Q
vocal production generator
result
A
- lungs
- power source
2
Q
vocal production oscillator
result
A
- larynx
- tone and pitch
3
Q
vocal production resonator
result
A
- pharynx/sinuses
- shape, resonate, and articulate sound into individual voice
4
Q
epithelial cover of the mucosa
A
- stratified squamous epithelium
5
Q
superficial layer of the mucosa
A
- lamina propria
6
Q
what comprises the vocal ligament
A
- intermediate lamina propria
- deep lamina propria
7
Q
what motion of the larynx allows for breathing
A
- abduction
8
Q
what motion of the larynx allows for sound production and swallowing
A
- adduction
9
Q
what produces the sounds of speaking or singing
A
- edges of larynx vibrating together
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
11
Q
hoarseness for greater than 2 weeks suggests
A
- another diagnosis than acute viral laryngitis
12
Q
common causes of hoarseness
A
- neurological injury
- alterations of vocal cord folding
13
Q
what nerve is injured to cause hoarseness
A
- recurrent laryngeal nerve injury
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
15
Q
alterations of vocal fold lining caused by
A
- non-lesion
- lesion
16
Q
non-lesion causes of alterations of vocal fold lining
A
- GERD
- sinus disease/allergic rhinitis
- dehydration
17
Q
symptoms of unilateral vocal fold paralysis
A
- breathy, weak hoarseness
- poor cough
- trouble swallowing
18
Q
the vast majority of laryngeal lesions that cause hoarseness involve
A
- superficial layers of the vocal fold
19
Q
what are the superficial layers of the vocal fold
A
- superficial lamina propria
- epithelial cover
20
Q
the most common cause of benign vocal fold lesions is
A
- phonotrauma (yelling)
21
Q
what is the most common benign neoplasm of the larynx in children
A
- recurrent respiratory papillomatosis
22
Q
etiology of recurrent respiratory papillomatosis
A
- HPV types 6 and 11
23
Q
recurrent respiratory papillomatosis childhood disease linked to
A
- mom’s with genital HPV
24
Q
adult onset of recurrent respiratory papillomatosis associated with
A
- oral-genital contact
25
best HPV vaccine
- gardasil-9
26
treatment of vocal fold lesions
- medical treatment
- speech therapy
- surgery
27
most common cause of unilateral vocal fold paralysis
- iatrogenic
28
90% of laryngeal carcinoma is
- squamous cell carcinoma
29
largest risk factor for laryngeal carcinoma
- smoking
30
effect of EtOH use on laryngeal carcinoma
- synergistic effect
31
tumor in laryngeal carcinoma arises from
- stratified squamous epithelium
| - respiratory epithelium that has undergone metaplasia
32
laryngeal tumors more prevalent at which age
- over 40
33
laryngeal tumors more prevalent in which gender
- males
34
laryngeal tumor more prevalent along which class
- lower SES
35
most common subtype of laryngeal cancer
- glottic - vocal folds
36
most common symptom of laryngeal tumors
- hoarseness
| - neck mass
37
important physical exam maneuver for laryngeal tumors
- good neck exam looking for lymphadenopathy
38
neck mass in an adult is _____ until proven otherwise
- cancer
39
lab workup for laryngeal tumors suspicion
- CT neck and chest
- PET/CT
- laryngoscopy, bronchoscopy, esophagoscopy
40
treatment of early laryngeal tumors
- single modality
- surgery
- or radiational therapy
41
treatment of advanced stage laryngeal tumors
- surgery with radiation
42
how long do we use radiation for laryngeal tumors
- 6-7 weeks daily
43
surgical therapy for advanced laryngeal cancer
- transoral laser microsurgery
- open partial laryngectomy
- total laryngectomy
44
what is a total laryngectomy
- complete separation of digestive and respiratory tracts
| - tracheal stump attached to the neck
45
can patients without a larynx or voice box speak?
- yes
46
how tracheoesophageal speech works
- divert exhaled air into pharynx by creation of tracheoesophageal fistula
- pharyngoesophageal segment above the fistula will vibrate and produce a voice
47
can we give patients without a voice box a breathing tube through the mouth?
- no
48
some symptoms of pediatric obstructive sleep apnea
- poor sleep
- kid wetting the bed
- poor attention
49
pediatric obstructive sleep apnea - dysphagia and choking on solid foods indicates
- obstructing tonsils
50
pediatric obstructive sleep apnea - hypo nasal speech suggests
- enlarged adenoid tissue
51
greater risk of pediatric obstructive sleep apnea in patients with
- decreased neuromuscular tone
| - craniofacial anomalies
52
definitive diagnosis for pediatric obstructive sleep apnea
- polysomnography
| - routine use for diagnosis NOT recommended
53
pediatric obstructive sleep apnea peaks at what age
- preschool age
54
pediatric obstructive sleep apnea higher in which children
- obese children
55
most common cause of upper airway obstruction in children with pediatric obstructive sleep apnea
- adenotonsillar hypertrophy
56
treatment of pediatric obstructive sleep apnea
- adenotonsillectomy
57
nonsurgical treatment of pediatric obstructive sleep apnea
- CPAP
| - weight loss
58
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
- stridor
59
what is used to describe airway noise from the nose, NASOPHARYNX and oropharynx
is low pitched, nonmusical, snoring
- stertor
60
which is a high pitched sound that indicates LOWER AIRWAY DISEASE
more commonly end expiratory noise
- wheezing
61
inspiratory stridor from
- supraglottis/glottis
62
biphasic stridor from
- subglottis
63
expiratory stridor from
- trachea
64
what is a big sign on Xray for epiglottitis
- thumb sign
65
typical bacterial for epiglottitis/supraglottitis
affects what age
- H. flu type b
| - 2-6
66
result of epiglottitis/supraglottitis
- airway emergency
67
treatment of epiglottitis/supraglottitis
- secure airway
- IV antibiotics
- steroids
68
laryngotracheobronchitis also known as
- croup
69
laryngotracheobronchitis most commonly caused by
which ones
- viral
| - parainfluenza
70
laryngotracheobronchitis result
- swelling from inflammation leads to airway narrowing
71
laryngotracheobronchitis affects what age group
- under 3
72
laryngotracheobronchitis symptoms
- barking cough
- stridor
- hoarseness
- difficulty breathing
73
X ray sign of laryngotracheobronchitis
- steeple sign
74
treatment of laryngotracheobronchitis
- steroids
- nebulizer epi (bronchodilates)
- cool mist
75
voice in epiglottitis
- muffled
76
voice in croup
- hoarse
77
most common cause of stridor in children
- laryngomalacia
78
laryngomalacia definition
- congenital abnormality of laryngeal cartilage
79
laryngomalacia presents around which age
- < 2 months
| - resolves by 18 months
80
laryngomalacia - floppy cartilage leads to
- collapse
| - inspiratory stridor
81
laryngomalacia worse when
- supine
- feeding
- exertion
82
most common treatment of laryngomalacia
- observation
| - sometimes supraglottoplasty
83
one thing you must avoid doing in a patient with epiglottiis/supraglottitis
- avoid agitating the patient
