Stridor and Sleep Apnoea Flashcards
What is stridor?
An inspiratory wheeze due to large airways obstruction (Larynx, trachea, major bronchi)
What are causes of stridor?
Infections (croup, epiglottis, retropharyngeal abscess, diphtheria)
Foreign body
Anaphylaxis
Others (burns, trauma)
What is a neoplasm?
a new and abnormal growth of tissue in a part of the body, especially as a characteristic of cancer.
What are some causes of stridor in ADULTS?
Neoplams - larynx, trachea, major bronchi Anaphylaxis Goitre Trauma Other ( wagerers, RA)
What are some investigations of stridor?
Laryngoscopy (not in acute epiglottis) Bronchoscopy Flow volume loop CXR Other imaging (CT, Thyroid scan)
What is the treatment of laryngeal obstruction?
Treat underlying cause (foreign body removal, anaphylaxis)
Mask bag ventilation with high flow O2
Cricothyroidotomy
Tracheostomy
What is the treatment for malignant airways obstruction?
Remove tumour - Laser, surgical etc
Tumour compression - intraluminal stent (too big or external to the airways)
Radiotherapy
Chemotherapy, corticosteroids
Describe acute anaphylaxis, type 1? (symptoms and signs)
Hypersensitivity IgE
Flushing (red), pruritus (itching skin), urticaria (hives, red raised itchy rash)
Angioneurotic oedema ( rapid swelling (edema) of the dermis, subcutaneous tissue, mucosa and submucosal tissues) (lips, tongue, face, larynx, bronchi)
Hypotension, shock
Stridor, wheeze, resp failure
What are some of the causes of anaphylaxis?
Latex Animal venom Food (peanuts) Dust Drugs (penicillin etc)
How do you treat anaphylaxis?
IV adrenaline
IV antihistamine IV corticosteroid high flow O2 Neublised bronchodilators Allergen avoidance
What is snoring and what is it caused by?
It is relaxation of the pharyngeal dilator muscles during sleep
Upper airways narrowing, turbulent airlift and vibration of soft palate and tongue base.
What is obstructive sleep apnoea?
intermittent closure/collapse of the pharyngeal airways causing apnoea episodes during sleep. Terminated by partial arousal.
What are the risk factors for sleep apnoea?
Enlarged tonsils/adenoids
Obesity
Retrognathia (abnormal posterior positioning of the maxilla or mandible, particularly the mandible, relative to the facial skeleton and soft tissues.)
Hypothyroidism
Neurological - stroke, MS
Drugs - benzodiazepines, opiates, alcohol
Post op after anaesthesia
What are the consequences of sleep apnoea?
Excessive daytime sleepiness Personality change Congnitive/functional impairment 7 fold increase in RTA driving stimulation Independent risk factor for hypertension Raised CRP Impaired glucose tolerance etc
What is the official diagnosis of obstructive sleep apnoea?
Snoring and a raised epworth score
