Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Respiratory > Upper Airway > Flashcards

Upper Airway Flashcards

1
Q

Stridor

A

Primary airway noise in upper airway disease. Airflow is forced through a narrowed airway segment. Local area of low pressure creates a vacuum effect distal to the narrowing. Airway walls collapse and vibrate. Generates a high pitched sound. Most prominent symptom of airway obstruction in infants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Steeple sign

A

AP and lateral x-ray. Classic with CROUP (Laryngotracheobronchitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Thumb print sign

A

AP and lateral x-ray. Classic with EPIGLOTTITIS.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Definition/Etiology of Croup (Laryngotracheobronchitis)

A
  • Infection involving subglottic airway, larynx, trachea and bronchi
  • Most commonly caused by parainfluenza type 1 &type 2
  • Less commonly caused by adenovirus, RSV, influenza type A and B, parable type 3
  • Infrequently caused by Mycoplasma pneumoniae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms of Croup (Laryngotracheobronchitis)

A

Barky or brassy cough, inspiratory stridor, retractions, persistent low grade fever, worsens at night and on day 2-3, hoarseness, wheezing, prolonged expiratory phase, Frequently begins 12-48 hours after non-specific upper respiratory tract symptoms

**Typically symptoms are worse at night

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Croup (Laryngotracheobronchitis) diagnostic studies

A
  • Diagnosis generally baed on H&P
  • Viral studies may be sent to identify pathogen
  • Lateral neck X-ray. STEEPLE SIGN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Treatment of Croup (Laryngotracheobronchitis)

A

Dexamethasone as single dose outpatient. Maybe 24 hour dose inpatient. Racemic epinephrine but controversial due to ineffectiveness over time.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Etiology of Tracheitis

A

Haemophilus-influenza (H-flu), Strep pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Symptoms of Tracheitis

A

Stridor, tripod position, dysphagia, drooling, high fever >103. Ill appearing. Toxic appearing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tracheitis diagnostic studies

A

Lateral neck xray- THUMB SIGN = Epiglottitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tracheitis Treatment

A

Broad spectrum antibiotics, such as ceftriaxone or clindamycin. Symptom management. Steroids (dexamethasone).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Foreign Body Etiology (age)

A

Toddler age or infant with older sibling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Foreign body Symptoms

A

Acute cough, onset of choking, difficulty breathing, cyanosis, severe wheezing and/or stridor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Foreign body diagnostic studies

A

Inspiratory films, fluoroscopic evaluation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Foreign body treatment

A

Caution with transport, as object could progress and obstruct airway. Surgical emergency for bronchoscopy in the OR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Laryngotracheomalacia Etiology (age)

A

Infant age, previous injury or intubation, presence of lesion. Differentiate from vascular ring

17
Q

Laryngotracheomalacia Symptoms

A

Chronic stridor, mild respiratory distress with exertion or illness

18
Q

Laryngotracheomalacia Diagnostic Studies

A

Direct visualization with bronchoscopy

19
Q

Laryngotracheomalacia Treatment

A

If lesion, surgical removal or repair

20
Q

Retropharyngeal Abscess Etiology

A

Most commonly affects children less than 3-4 years. Group A strep, oropharyngeal anaerobic bacteria, Staph aureus.

Abscess in the retropharyngeal space following trauma or primary infection

Most common in children 1-5 years

Infections are polymicrobial

Common pathogens include Strep pyogenes, Staph aureus and Haemophilus species

21
Q

Retropharyngeal Abscess Symptoms

A

Fever, malaise, decreased oral intake, neck stiffness, torticollis, sore throat and neck pain, stridor, respiratory distress, dysphagia, muffled voice, vertical adenopathy, retropharyngeal bulge, drooling

History may include recent intubation, oral foreign object, dental procedure, infection of structure draining into retropharyngeal space

22
Q

Retropharyngeal Abscess Diagnostic Studies

A

H&P
CMC w/ dif –> leukocytosis
Soft tissue neck x-ray, CT

23
Q

Retropharyngeal Abscess Treatment

A

Avoid noxious stimuli
Supplemental oxygen
Assure secured airway
Incision and Drainage by ENT, Culture for ID if abscess >2cm and failure to improve on IV abx in 24 hrs

24
Q

Peritonsillar Abscess Etiology

A

Adolescent age, most common with history of acute pharyngitis, Group A Strep and mixed oropharyngeal anaerobes

A local cellulitis that progresses first to phlegm, then abscess; suppurative adenines is most common

Infections are polymicrobial

Common pathogens include Strep pyogenes, Staph aureus and Haemophilus species

25
Q

Peritonsillar Abscess Symptoms

A

Recent history of pharyngitis, nonspecific symptoms, including lethargy and fever, sore throat, dysphagia, truisms (spasm of the jaw muscles, causing the mouth to remain tightly closed)

Sore throat, radiates to ear
Tender glands of throat and/or jaw
Chills
Facial swelling
Difficulty/discomfort with opening mouth, refusing to eat or drink
Halitosis
Voice may be muffled or difficult to understand - hot potato voice
Swollen tonsils with uvula deviation
Swollen tissues may obstruct the airway which can lead to a life threatening emergency

26
Q

Peritonsillar Abscess Diagnostic Studies

A

CT scan w/ IV contrast – evlauate extent of infection and differentiate from cellulitis
Exam of throat, often displacement of uvula to opposite side
CBC w/ diff –> leukocytosis
Throat culture –> check for Group A strep

27
Q

Peritonsillar Abscess Treatment

A

Incision and Drainage for ID
—-Consider surgical drainage if abscess is >2cm or if failure to respond to antibiotic therapy
Avoid noxious stimuli
-Abx: amp-sulbactam or clinda and consider vance for resistant organisms
-Analgesics
-IV hydration if needed

28
Q

Acute respiratory distress and wheezing or stridor, always consider ___

A

Foreign body airway obstruction

29
Q

Incidence of Croup (Laryngotracheobronchitis)

A
  • Most commonly affects children 3 months-5 years of age

- Northern hemisphere, most common between October and March

30
Q

Epiglottitis - Definition

A
  • Acute severe inflammation of epiglottis
  • Results in displacing epiglottis posteriorly
  • May obstruct breathing
  • Airway emergency!
31
Q

Epiglottitis - Etiology

A
  • Haemophilus influenzae, has decreased since Hib vaccine

- May be caused by other bacteria or viruses; Staph Aureus, Strep pneumo, Group A Strep

32
Q

Epiglottitis - age of patient

A

Children 1-5 years

33
Q

Epiglottitis - Clinical manifestations

A
  • Sudden onset of symptoms
  • Sore throat
  • High fever
  • Resp distress
  • Difficulty swallowing/drooling/dysphagia
  • Muffled voice/”Hot potato” voice
  • Tripod position
  • Anxious appearing child
  • Stridor
34
Q

Epiglottitis - Diagnosis

A
  • Lateral neck radiograph: Enlarged epiglottis and distended hypopharynx (“thumb print sign”)
  • Direct laryngoscopy: Beefy red, swollen epiglottis
  • Blood and/or throat culture may reveal offending pathogen; obtained after airway is secure or no longer critical
  • CBC may reveal leukocytosis (non-specific)
35
Q

Epiglottitis - Management

A
  • Noxious stimuli must be avoided
  • Let child assume position of comfort
  • Consult otolaryngology or anesthesia for possible intubation
  • If not intubated, provide humidified oxygen
  • Antibiotics: Third generation cephalosporin or third generation cephalosporin plus vancomycin if penicillin-resistant pneumococci or MRSA is suspected. 7-10 days of therapy.
  • Consider systemic steroids
  • IV fluids to prevent dehydration
36
Q

Which organisms are common pathogens in epiglottis (since the inception of the Hib vaccine)

A

S. aureus
S. pneumo
Group A strep

37
Q

Antibiotics for Retropharyngeal Abscess

A

Broad spectrum
Coverage for aerobic and anaerobic organisms
If patient afebrile and improving, can change to enteral antibiotic to complete 14 day course

38
Q

Croup - dexamethasone dose

A

0.6 mg/kg IV/IM

39
Q

Peritonsillar Abscess - Antibiotics

A

IV abx

  • Ampicillin-sulbactam or Clindamycin
  • Consider Vancomycin for resistant organisms

Respiratory (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions