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Specialty Medicine > Pediatric Airway > Flashcards

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
Q

What is lingual thyroid?

A

Thyroid does not descend into the neck, causing obstruction

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26
Q

What are vallecular cysts?

A

a rare type of laryngeal cyst seen in infants

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27
Q

What is a common cause of airway obstruction with Down syndrome?

A

Macroglossia

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28
Q

What is the sequelae of OSA in kids?

A

Right sided cardiomegaly

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29
Q

What is the prognosis for retropharyngeal abscesses?

A
  • Lethal in adults

- Airway obstruction is more concerning in kids

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30
Q

How do you diagnose retropharyngeal abscesses in kids?

A
  • Look

- CT if needed

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31
Q

What is the most common cause of a upper airway obstruction in the oro hypopharynx?

A

Tonsillar / adenoid hypertrophy

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32
Q

What is laryngomalacia? S/sx?

A

The soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction

33
Q

What is a laryngocele?

A

a congenital anomalous air sac communicating with the cavity of the larynx, which may bulge outward on the neck.

34
Q

What is the most common cause of stridor, period?

A

Laryngomalacia

35
Q

What are the neoplastic causes of obstruction in the supraglottic larynx? (3)

A
  • Hemangiomas
  • Vascular malformation
  • Papilloma
36
Q

What is the most common cause of pediatric stridor and airway problems?

A

Laryngomalacia

37
Q

What is the prognosis for laryngomalacia?

A

Usually resolves by one year of life

38
Q

True or false: laryngomalacia usually required surgery

39
Q

How do you diagnose laryngomalacia?

A

Laryngoscopy—NOT imaging studies

40
Q

When is laryngomalacia concerning?

A

If kid cannot eat

41
Q

What is the classic presentation of epiglottitis?

A

Sudden onset of stridor in a kid, with relief if tripods

42
Q

What is the classic x-ray sign for epiglottitis?

A

Thumb print sign

43
Q

How do you diagnose laryngeal problems?

A

Laryngoscopy

44
Q

What is glottic atresia?

A

Glottis does not form

45
Q

What are glottic webs?

A

Webs in the glottis

46
Q

What is the 2nd most common cause of stridor in a newborn?

A

Vocal cord paralysis

47
Q

What is the most common presentation of a posterior laryngeal cleft?

A

Recurrent aspiration

48
Q

What is the most common cause of congenital bilateral vocal cord paralysis?

A

Idiopathic

49
Q

What must be evaluated for, upon finding congenital bilateral vocal fold paralysis?

A

Foramen magnum for a chiari malformation

50
Q

What is the most common neoplasm of the vocal folds in children?

A

Recurrent respiratory papillomatosis

51
Q

What is the average onset of recurrent respiratory papillomatosis?

52
Q

What are the virus strains that cause recurrent respiratory papillomatosis?

A

HPV 6 and 11

53
Q

What are the HPV strains that cause cervical cancer?

A

16, 18, 33, 35

54
Q

What is the usual presentation of recurrent respiratory papillomatosis?

A

Presents with hoarseness and progresses to stridor/distress

55
Q

What is recurrent respiratory papillomatosis?

A

Recurrent HPV papillomas in the trachea 2/2 infection at birth from an infected mother

56
Q

Does respiratory papillomatosis cause throat cancer?

57
Q

What is the “great masquerader” of respiratory issues in children?

58
Q

How do you diagnose recurrent respiratory papillomatosis?

A

Laryngoscopy

59
Q

How do you treat recurrent respiratory papillomatosis?

A

Recurrent surgeries (20 is the average)

60
Q

What is the treatment for vocal cord paralysis?

A

Trach ‘em

61
Q

What are the common lesions in the subglottic area? (5)

A
  • Stenosis
  • Cysts
  • Hemangiomas
  • FBs
  • Croup
62
Q

What are the 1st, 2nd, and 3rd most common causes of congenital stridor in kids?

A
  1. Laryngomalacia
  2. Vocal cord paralysis
  3. Subglottic stenosis
63
Q

What is the most common cause of subglottic stenosis?

A

Iatrogenic

64
Q

What is the most common neoplasm of the infant airway? Where in the airway in particular do these usually arise?

A

Hemangiomas

Subglottic region

65
Q

Which gender is more affected with subglottic hemangiomas?

66
Q

What is the presentation of subglottic hemangiomas?

A

Asymptomatic at birth, but pituitary surge at 6 months causes biphasic stridor

67
Q

What percent of kids with subglottic hemangiomas have cutaneous hemangiomas?

A

50% (but the converse is not true)

68
Q

What are the external compression causes of tracheomalacia?

A
  • Vascular rings
  • Mediastinal masses
  • Tracheal rings
69
Q

What are causes of tracheobronchial obstruction?

A
  • Asthma
  • FBs
  • Complete tracheal rings
70
Q

What are the two major questions to ask when seeing a kid with tracheomalacia?

A
  • TE fistula?

- External compression?

71
Q

How do you diagnose tracheomalacia?

A
  • Endoscopy
  • Ba swallow
  • x-ray
72
Q

FB aspiration most commonly occurs under what age?

73
Q

At what age is FB aspiration most likely to occur?

A

6 months - 2 years

74
Q

Aspiration is most likely to be caused by swallowing what?

A

Food particles

75
Q

What is the cause of croup?

A

Parainfluenza virus type I

76
Q

What is the classic x-ray finding with croup?

A

Steeple sign

77
Q

What causes lacrimal duct cysts?

A

Lacrimal ducts fail to canulate

78
Q

What is tracheomalacia highly associated with?

A

TE fistulas

79
Q

What is the treatment for tracheomalacia?

A

Surgical fix

Specialty Medicine (36 decks)

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