Peds Airway Flashcards
What differs in airway anatomy bet Adults and PEds?
1) Located high in the neck
2) Epig behind soft palate
3) Funnel shaped
4) Narrowest comp is cricoid
What is the purpose of anatomical differences in peds?
Allows infants to suckle continuously without holding breath =>
Obligate nose breathers
What is the critial narrowest part of adult airway?
Nose
You have a patient with an insp/exp sound that is biphasic, high pitched and harsh. What is it called?
Stridor
What aspect of the airway changes the air resistance the most?
Radius changes
What are the traits of an obstruction of the nasal cavity?
Life Threatening @ birth
Easy Dx
-Nasal cannulla passed @birth
-Relief w/ cry
List the types of congenital NAsal obstruction?
Choanal atresia
Nasal pyriforn aperture stenosis
nasal lacrimal duct cysts
Neoplastic: Encephalocele (neuroectoderm), Dermoid, Glioma
What are the traits of Choanal atresia?
Female > Male
Bony or membranous
Persistance of Bucopharyngeal membrane
What are the traits of Pyriform Stenosis?
form of Holoprosencephaly
Associated w/ central megaincisor
What are the traits of Rhinitis of infancy?
MOST COMMON
Persistent nasal congestion in first 6 mon w/ no etiology
Self resolving
What are the imaging options for the nasal passage?
Nasal endocopy and X-ray
List Causes of Oropharynx and Hypopharynx obstruction caused by tongue?
Macroglossia
Lingual Thyroid
Vallecular Cysts
Craniofacial anomaly
What are Causes of Oropharynx and Hypopharynx obstruction NOT caused by tongue?
Adenotonsillar Hypertrophy**
Pharyngeal wall infections
Neoplasms
Vascualr Malformation
What are the Traits of Retropharyngeal Abcesses?
Swelling behind Trachea caused by air causing bacteria => obstruction
Rapid progression
List the causes of Supraglottic Obstruction?
Laryngomalacia Laryngocele Epiglottis Foreign Body: latex baloon Neoplastic: Hemangioma, Vasc malf, Papilloma
What are the traits of LAryngiomalacia?
MOST COMMON cause of peds stridor Resolves by one year Sugical correction Abn at base of skull Redundant Aretynoid tissue
What is the technique used to Dx Laryngomalacia?
Laryngoscopy
What happens if infant can’t feed due to airway obstruction?
Failure to thrive
What is the Infectious etiology of Epiglottitis?
Haemophilus Influenza
Life threatening
Thumbprint sign
WHat is the most common cause of supraglottic airway obstruction? Most common airway obs in infancy?
Laryngomalacia
What are the Congenital Causes of Pediatric Laryngeal Obstruction?
Glottic Atresia/cleft
Glottic webs
Vocal fold paralysis
What malformation is assiciated with Congential vocal fold paralysis?
Chiari malformation
What are the traits of Recurrent Resp Papillomatosis?
MOST COMMON NP in children
Etiology is HPV 6 and 11 vertical transmission
Hoarseness and progresses to stridor/distress
20 surgeries to maint airway
Immunologically resolves with maturation
List the traits of Subglottic Airway obstruction?
Stenosis Cyst Hemangioma Foreign Body Infection/Croup
WHat are the traits of Subglottic Stenosis?
Iatrogenic
Scars down with freq Intubation?
What are the top 3 causes of Congenital stridor?
1) LM
2) Bilateral Vocal fold paralysis
3) Subglottic Stenosis
What are the traits of Subglottic Hemangioma?
2:1 female/male ratio
Asymptomatic @ birth
Cutaneous hemang. seen in 50%
What is the Most common neoplasm in kids
Most common neoplasm in infant airway
Hemangioma
List types of Tracheobronchial Obstructions?
Trachiomalacia \+/- TE Fistula, Ext compression: Vasc rings, mediastinal tumors Trachial Rings Asthma Foreign body
What are the traits of Tracheomalacia?
Confused w/ laryngiomalacia
Depends on location and extent
What are the traits of Foreign body Obstruction?
Most likley food particle
Coin in esophagus
