Pediatric Airway

Question 0

Characteristics of the infant epiglottis

Answer 0

Longer
Omega shaped
stiffer
Horizontal

Question 1

What are the age classifications of infant,child, and adult?

Answer 1

Infant = < 1year

Child, development = 1-7 years

Child, growth = 8 – 15 years

adult = >16 years

Question 2

At what C-spine level does the infant glottis lie?

Answer 2

C3 – C4

Question 3

What plane do the infant vocal c0rds lie in?

Answer 3

Antero-inferior plane

Question 4

What is the narrowest point of the infants larynx

Answer 4

The cricoid Cartlidge

Question 5

What appears does the infant glottis take on?

Answer 5

Pursed mouth appearance. Insert picture here

Question 6

What shape is the larynx in an infant

Answer 6

Funnel shape

Question 7

True or false. vocal chords descend with age

Answer 7

True

Premature infant = vocal cord at C3

Full term infant = between C3-4

Adult = between C4-5

Question 8

What is the cross-sectional area(Diameter) of infant cricoid Cartlidge versus adult, In relation to the smallest point of the larynx

Answer 8

Infant (cricoid) = 4 mm diameter

Adult (vocal cord) = 12 mm diameter

Question 9

What is true of pediatric conducting airways

Answer 9

Shorter and narrower

right main stem has less cute angle

infant right mainstem angle = 30°
left mainstem angle = 47
adult right mainstem angle = 20
Adult left mainstem angle = 40-50

Question 10

What type of mask is this? Insert picture here

Answer 10

Rendell – Baker – soucek mask

Question 11

Pediatric LMA sizes

Answer 11

70 kg = 4

Question 12

ETT sizes for infants and children < 2 years

Answer 12

Premature
1000 g = 3.0 mm

neonates – 3 months = 3.0 mm

3 – 9 months = 3.5 mm

9 – 18 months = 4.0 mm

Question 13

What is the airway management for mediastinal masses

Answer 13

Identify the level

CT/MRI definition

post irradiation, hemorrhagic

tracheomalacia

pre-op Heliox

Any cardiovascular effects

Question 14

ETT sizing for children >2 years

Answer 14

Selecting ETT ID: (18+ age)/4

OETT insertion depth: (24+ age)/2

NETT insertion depth: (30+ age)/2

Question 15

In utero, when does the lip and palate develop?

Answer 15

10 – 12 weeks

Question 16

How does the list and hard palate develop?

Answer 16

The hard palate is formed by the uniting Of the Pallotine processes of the maxillary bone

The upper lip is formed from the fusing of the maxillary process with globular process

Question 17

What is the one-year mortality due to associated Cleft lip and cleft palate?

Answer 17

15%

Question 18

When is cleft lip and palate repaired

Answer 18

Lip repair at 3 – 6 months
Palate repair at 12 months

anesthetic management
oral airway, cleft pack, laryngoscope Blade of choice

Question 19

What is laryngomalacia?

Answer 19

immature development of laryngeal cartilage and supraglottic fiberous support, most common cause of stridor in infants

Strider is hallmark on inspiration
begins at birth - few weeks

Spontaneous Resolution At 2 – 3 years

Question 20

What is Pierre Robin syndrome

Answer 20

1:30,000 live birth
etiology uncertain

normal intelligence normal lost

1 micrognathia
2 glossoptosis (Down and backward displacement of tongue)
3 cleft palate

Question 21

Airway management of Pierre Robin syndrome

Answer 21

Airway Obstruction during first 4 weeks, elective tracheostomy

Question 22

What is Treacher Collins syndrome

Answer 22

1:10,000 live births

autosomal dominant

normal intelligence, Normal lifespan

Question 23

What is presentation of Treacher Collins syndrome

Answer 23

Hypoplastic zygoma and mandible

Macrostomia (Unusually wide mouth opening)

High (cleft) palate

Abnormal dentition

Question 24

At what age range is the peak incidence of foreign bodies in the airway?

Answer 24

2 - 3 years