Traumatic/Mechanical disorders upper airway Flashcards
Epistaxis
Nosebleed
Types of epistaxis
Anterior
Posterior
Most common form of epistaxis
Anterior
Which type of epistaxis is associated with atherosclerosis or bleeding disorders?
Posterior
Origin of the bleed in anterior epistaxis
Plexus of vessels in the antero-inferior septum
(Kiesselbach’s area)
Origin of the bleed in posterior epistaxis
Posterior septum overlying the vomer bone, or laterally on the inferior or middle turbinate.
Causes of Epistaxis
Local trauma (e.g. nose blowing and picking)
Drying of the nasal mucosa
Less common: Local infections, foreign bodies,
arteriosclerosis, septal perforation, coagulopathy
Particular attention for in epistaxis
Signs of hypovolaemia or haemorrhagic shock
Anticoagulant drug use
Cutaneous signs of a bleeding disorder
Bleeding not stopped by direct pressure
Multiple recurrences, with no clear cause
Tissue injury caused by a pressure related
change in body compartment gas volume
Barotrauma
Affected organs in barotrauma
Lungs
Ear
Sinuses
GI tract
Risk conditions in barotrauma
Those interfering with equilibration of pressure
Pathogenesis of barotrauma
Entrapment of air or other gas within
the lungs → Over-inflation of them → Pulmonary
barotrauma
Symptoms of barotrauma
Immediate occurrence, after pressure changes
Ear pain
Vertigo
Hearing loss
Sinus pain
Epistaxis
Abdominal pain
Alveolar rupture and pneumothorax → Dyspnoea
and loss of consciousness
Tx of barotrauma
Symptomatic treatment and outpatient follow-up
Life threatening conditions: Alveolar or GI rupture
Abnormal vital signs →
epistaxis
High flow 100% O2
In case of respiratory failure →
epistaxis
Endotracheal intubation
Neurologic symptoms →
epistaxis
Recompression chamber
Pneumothorax →
epistaxis
Chest decompression with a large bore needle (2nd intercostal space, midclavicular line) & subsequent thoracostomy
Blockage of upper airway, occurs when the upper
breathing passages become narrowed or blocked →
Impairment of breathing
Laryngeal/Pharyngeal Obstruction
Affected parts in laryngeal obstruction
i. Trachea, ii. Larynx, iii. Pharynx
Causes of laryngeal obstruction
Allergic reactions to various agents and substances
Chemical burns and reactions
Epiglottitis
Fire or burns from breathing in smoke
Injury or infections of the upper airways
Peritonsillar or retropharyngeal abscess
Laryngeal cancer
Symptoms of laryngeal obstruction
Agitation or fidgeting
Cyanosis
Changes in consciousness → Unconsciousness
Choking
Confusion and panic
Difficulty in breathing and gasping for air
Unusual breathing noises: Wheezing, crowing, whistling
TX of laryngeal obstruction
Removal of stacked objects with special instruments
Insertion of a tube into the airway (endotracheal tube)
Tracheostomy or cricothyrotomy
