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Pediatric Airway Flashcards

1
Q

What is the general shape of the pediatric airway?

A

Funnel shaped to the cricoid

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2
Q

What is the most narrow component of the pediatric airway?

A

Cricoid

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3
Q

The location of the pediatric oropharynx is the result of what?

A

Epiglottis sitting behind the soft palate

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4
Q

Where is the pediatric airway, relative to the adult? What is the functional significance of this?

A

More superior–allows kids to feed and breathe simultaneously

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5
Q

What is the narrowest part of the adult airway?

A

Nasopharynx

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6
Q

The higher location of the airway in infants allows for what, which cannot be done with adults

A

Breathing and eating at the same time

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7
Q

What is stridor?

A

Vibration of noise in the airway

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8
Q

What is the location of the lesion with an inspiratory stridor? Expiratory?

A 
Inspiratory = external
Expiratory = Internal
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9
Q

Why are kids more susceptible to croup than adults?

A

Airway is much smaller in diameter

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10
Q

How can you assess for tracheoesophageal atresia in infants?

A

NC passed at birth

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11
Q

What is the most common type of tracheoesophageal atresia in infants?

A

EA with distal TEF

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12
Q

How do infants breathe?

A

Obligate nasal breather, with periodic apnea

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13
Q

What is choanal atresia?

A

A congenital disorder where the back of the nasal passage (choana) is blocked, usually by abnormal bony or soft tissue (membranous) due to failed recanalization of the nasal fossae during fetal development.

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14
Q

What is pyriform aperture stenosis?

A

The anterior nasal aperture (pyriform or pyriform aperture) is a heart- or pear-shaped opening in the human skull.

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15
Q

What are the three major neoplastic conditions that cause congenital airway obstruction at the level of the nasal cavity?

A
  1. Encephalocele
  2. Dermoids
  3. Gliomas
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16
Q

Where do the tear ducts drain?

A

Inferior meatus

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17
Q

What is the foramen that the thyroid descends into?

A

Foramen cecum

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18
Q

What gender has a higher incidence of choanal atresia?

A

Females

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19
Q

What is the most likely cause of choanal atresia?

A

Persistence of buccopharyngeal membrane

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20
Q

What is pyriform stenosis usually associated with?

A
  • Holoprosencephaly

- Central mega incisor

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21
Q

What is the most common source of nasal obstruction in infancy?

A

Rhinitis of infancy

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22
Q

What is the prognosis for rhinitis of infancy?

A

Self resolving

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23
Q

What is rhinitis of infancy?

A

Persistent nasal congestion in the first 6 months of life, with no clear etiology

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24
Q

How do you diagnose rhinitis of infancy?

A

Otoscope

X-ray

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25
What is lingual thyroid?
Thyroid does not descend into the neck, causing obstruction
26
What are vallecular cysts?
a rare type of laryngeal cyst seen in infants
27
What is a common cause of airway obstruction with Down syndrome?
Macroglossia
28
What is the sequelae of OSA in kids?
Right sided cardiomegaly
29
What is the prognosis for retropharyngeal abscesses?
- Lethal in adults | - Airway obstruction is more concerning in kids
30
How do you diagnose retropharyngeal abscesses in kids?
- Look | - CT if needed
31
What is the most common cause of a upper airway obstruction in the oro hypopharynx?
Tonsillar / adenoid hypertrophy
32
What is laryngomalacia? S/sx?
The soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction
33
What is a laryngocele?
a congenital anomalous air sac communicating with the cavity of the larynx, which may bulge outward on the neck.
34
What is the most common cause of stridor, period?
Laryngomalacia
35
What are the neoplastic causes of obstruction in the supraglottic larynx? (3)
- Hemangiomas - Vascular malformation - Papilloma
36
What is the most common cause of pediatric stridor and airway problems?
Laryngomalacia
37
What is the prognosis for laryngomalacia?
Usually resolves by one year of life
38
True or false: laryngomalacia usually required surgery
False
39
How do you diagnose laryngomalacia?
Laryngoscopy---NOT imaging studies
40
When is laryngomalacia concerning?
If kid cannot eat
41
What is the classic presentation of epiglottitis?
Sudden onset of stridor in a kid, with relief if tripods
42
What is the classic x-ray sign for epiglottitis?
Thumb print sign
43
How do you diagnose laryngeal problems?
Laryngoscopy
44
What is glottic atresia?
Glottis does not form
45
What are glottic webs?
Webs in the glottis
46
What is the 2nd most common cause of stridor in a newborn?
Vocal cord paralysis
47
What is the most common presentation of a posterior laryngeal cleft?
Recurrent aspiration
48
What is the most common cause of congenital bilateral vocal cord paralysis?
Idiopathic
49
What must be evaluated for, upon finding congenital bilateral vocal fold paralysis?
Foramen magnum for a chiari malformation
50
What is the most common neoplasm of the vocal folds in children?
Recurrent respiratory papillomatosis
51
What is the average onset of recurrent respiratory papillomatosis?
2-4 years
52
What are the virus strains that cause recurrent respiratory papillomatosis?
HPV 6 and 11
53
What are the HPV strains that cause cervical cancer?
16, 18, 33, 35
54
What is the usual presentation of recurrent respiratory papillomatosis?
Presents with hoarseness and progresses to stridor/distress
55
What is recurrent respiratory papillomatosis?
Recurrent HPV papillomas in the trachea 2/2 infection at birth from an infected mother
56
Does respiratory papillomatosis cause throat cancer?
No
57
What is the "great masquerader" of respiratory issues in children?
Croup
58
How do you diagnose recurrent respiratory papillomatosis?
Laryngoscopy
59
How do you treat recurrent respiratory papillomatosis?
Recurrent surgeries (20 is the average)
60
What is the treatment for vocal cord paralysis?
Trach 'em
61
What are the common lesions in the subglottic area? (5)
- Stenosis - Cysts - Hemangiomas - FBs - Croup
62
What are the 1st, 2nd, and 3rd most common causes of congenital stridor in kids?
1. Laryngomalacia 2. Vocal cord paralysis 3. Subglottic stenosis
63
What is the most common cause of subglottic stenosis?
Iatrogenic
64
What is the most common neoplasm of the infant airway? Where in the airway in particular do these usually arise?
Hemangiomas | Subglottic region
65
Which gender is more affected with subglottic hemangiomas?
Female
66
What is the presentation of subglottic hemangiomas?
Asymptomatic at birth, but pituitary surge at 6 months causes biphasic stridor
67
What percent of kids with subglottic hemangiomas have cutaneous hemangiomas?
50% (but the converse is not true)
68
What are the external compression causes of tracheomalacia?
- Vascular rings - Mediastinal masses - Tracheal rings
69
What are causes of tracheobronchial obstruction?
- Asthma - FBs - Complete tracheal rings
70
What are the two major questions to ask when seeing a kid with tracheomalacia?
- TE fistula? | - External compression?
71
How do you diagnose tracheomalacia?
- Endoscopy - Ba swallow - x-ray
72
FB aspiration most commonly occurs under what age?
3 years
73
At what age is FB aspiration most likely to occur?
6 months - 2 years
74
Aspiration is most likely to be caused by swallowing what?
Food particles
75
What is the cause of croup?
Parainfluenza virus type I
76
What is the classic x-ray finding with croup?
Steeple sign
77
What causes lacrimal duct cysts?
Lacrimal ducts fail to canulate
78
What is tracheomalacia highly associated with?
TE fistulas
79
What is the treatment for tracheomalacia?
Surgical fix

Specialty Medicine (36 decks)

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