Larynx

Question 1

Acute laryngitis types

Answer 1

Infectious
Non-infectious

Question 2

Aetiology of acute laryngitis

Answer 2

Infectious type (viral in origin)
Follows Upper RTI
Bacterial invasion (strep. Pneumoniae, H. Influenzae, S. Aureus)
Exanthematous fever

Non-infectious (causes)
Vocal abuse
Allergy
Thermal / chemical burns
Laryngeal trauma (ET intubation)

Question 3

Symptoms of Acute laryngitis (usually abrupt)

Answer 3

Hoarseness (lead complete vocal loss)
Throat (pain + discomfort)
Cough (dry + irritating)
Heat cold / rawness / dryness of throat (viral infection)
Malaise
Fever

Laryngeal appearance
Early stage
Vocal cords (white)
Erythema + edema (Epiglottis, aryepiglottic folds, arytenoids, ventricular bands)
Later stage
Hyperemia
Swelling
Vocal cords (red + swollen)
Involves subglottic region
Sticky secretions
Submucosal haemorhhage (vocal abuse)

Question 4

Treatment of acute laryngitis

Answer 4

Vocal rest
Avoid smoking / alcohol
Steam inhalation (eucalyptus +pine oil)
Cough sedative
Antibiotics (secondary infection)(purulent expectoration)
Analgesics
Steroids (thermal / chemical burns)

Question 5

Acute Epiglottitis / Supraglottic laryngitis

Answer 5

Inflammation of epiglottis, aryepiglottic folds, arytenoids.

Question 6

Aetiology of acute epiglottitis

Answer 6

Children 2-7 years (common) + adults
Mostly by H. Influenzae type B

Question 7

Clinical features of acute epiglottitis

Answer 7

Symptoms abrupt and rapidly progress.

Sore throat + Dysphagia (adults)
Dyspnoea + stridor (children)
Fever (septicaemia)

Question 8

Examination of acute epiglottitis

Answer 8

Depressing tongue
Red + swollen epiglottis
Indirect laryngoscopy
Edema + congestion (supraepiglottic structures)
Lateral soft tissue X-Ray (neck)
Swollen epiglottis (THUMB SIGN)

Question 9

Treatment of Acute epiglottitis

Answer 9

Hospitalization + intubation/ tracheostomy ( respiratory obstruction)

Antibiotics (Ampicillin)
Steroids (Hydrocortisone / Dexamethsone)
Hydration fluids
Humidigication
Oxygen

Question 10

Acute laryngo-tracheo-bronchitis

Answer 10

Inflammation of larynx, trachea, bronchi.

Viral (parainfluenza Type I and II)
Children (3months -3 years)
Male commonly
Secondary bacterial infection

Question 11

Pathology of acute laryngo-tracheo-bronchitis

Answer 11

Loose areolar tissue (subepiglottic region) swells.
Respiratory obstruction +stridor
Thick Tenacious secretions + crusts

Question 12

Symptoms of acute laryngo-tracheo-bronchitis

Answer 12

Upper RTI
Hoarseness
Croupy cough
Fever
Difficult breathing
Stridor (inspiratory type)
Upper airway obstruction (supraster + intercostal recession)

Cough (BARKING SEAL LIKE)
X-Ray AP view (STEEPLE SIGN)

Question 13

Treatment of acute Laryngo-tracheo-bronchitis

Answer 13

Hospitalisation (inhalation anaesthesia + intubate)
Antibiotics (ampicillin)
Humidification (soften crusts)(tenacious secretion)
Fluids
Steroids (edema)
Adrenaline (bronchodilator)
Intubation/ tracheostomy

Question 14

Laryngeal diphtheria

Answer 14

Below 10 years
Secondary to faucial diphtheria

Question 15

Pathology of laryngeal diphtheria

Answer 15

Tough pseudomembrane (complete airway obstruction)
Exotoxin (myocarditis + neurological complications)

Question 16

Clinical features of laryngeal diphtheria

Answer 16

General
Fever (low)
Sore throat
Malaise
Toxaemic (tachycardia +thready pulse)
Laryngeal
Hoarse voice
Croupy cough
Stridor (inspiratory)
Dyspnoea (increasing)
Upper airway obstruction

Membrane
Greyish-white (tonsil+pharynx+palate)
Adherent (bleed)

Cervical lymphadenopathy (BULL NECK)

Question 17

Treatment of laryngeal diphtheria

Answer 17

Diphtheria antitoxin
Antibacterial
Benzyl penicillin
Amoxicillin
Erythromycin
Airway maintainance (tracheostomy, laryngoscopy, removal of membrane, intubation)
Bed rest (2-4 weeks)(against myocarditis)
Immunization

Question 18

Complications of laryngeal diphtheria

Answer 18

Asphyxia
Toxic myocarditis

Palatal paralysis + nasal regirgitation

Laryngeal + pharyngeal paralysis

Paralysis of extraocular muscles + diaphragm