Pediatric Airway Flashcards
Characteristics of the infant epiglottis
Longer
Omega shaped
stiffer
Horizontal
What are the age classifications of infant,child, and adult?
Infant = < 1year
Child, development = 1-7 years
Child, growth = 8 – 15 years
adult = >16 years
At what C-spine level does the infant glottis lie?
C3 – C4
What plane do the infant vocal c0rds lie in?
Antero-inferior plane
What is the narrowest point of the infants larynx
The cricoid Cartlidge
What appears does the infant glottis take on?
Pursed mouth appearance. Insert picture here
What shape is the larynx in an infant
Funnel shape
True or false. vocal chords descend with age
True
Premature infant = vocal cord at C3
Full term infant = between C3-4
Adult = between C4-5
What is the cross-sectional area(Diameter) of infant cricoid Cartlidge versus adult, In relation to the smallest point of the larynx
Infant (cricoid) = 4 mm diameter
Adult (vocal cord) = 12 mm diameter
What is true of pediatric conducting airways
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
What type of mask is this? Insert picture here
Rendell – Baker – soucek mask
Pediatric LMA sizes
70 kg = 4
ETT sizes for infants and children < 2 years
Premature
1000 g = 3.0 mm
neonates – 3 months = 3.0 mm
3 – 9 months = 3.5 mm
9 – 18 months = 4.0 mm
What is the airway management for mediastinal masses
Identify the level
CT/MRI definition
post irradiation, hemorrhagic
tracheomalacia
pre-op Heliox
Any cardiovascular effects
ETT sizing for children >2 years
Selecting ETT ID: (18+ age)/4
OETT insertion depth: (24+ age)/2
NETT insertion depth: (30+ age)/2
In utero, when does the lip and palate develop?
10 – 12 weeks
How does the list and hard palate develop?
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
What is the one-year mortality due to associated Cleft lip and cleft palate?
15%
When is cleft lip and palate repaired
Lip repair at 3 – 6 months
Palate repair at 12 months
anesthetic management
oral airway, cleft pack, laryngoscope Blade of choice
What is laryngomalacia?
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
What is Pierre Robin syndrome
1:30,000 live birth
etiology uncertain
normal intelligence normal lost
1 micrognathia
2 glossoptosis (Down and backward displacement of tongue)
3 cleft palate
Airway management of Pierre Robin syndrome
Airway Obstruction during first 4 weeks, elective tracheostomy
What is Treacher Collins syndrome
1:10,000 live births
autosomal dominant
normal intelligence, Normal lifespan
What is presentation of Treacher Collins syndrome
Hypoplastic zygoma and mandible
Macrostomia (Unusually wide mouth opening)
High (cleft) palate
Abnormal dentition
At what age range is the peak incidence of foreign bodies in the airway?
2 - 3 years
