Upper airway Flashcards
(55 cards)
What are the signs/symptoms of upper airway obstruction?
stertor or stridor
What is stridor?
High pitched noisy breathing due to respiratory obstruction
What is stridor commonly caused by?
A respiratory obstruction such as:
croup
allergic reaction (anaphylaxis)
a foreign body
abscess
cancer
What is stertor?
Low pitched noise
on inspiration (ABOVE the larynx)
What is a common cause of stertor?
Enlarged tonsils
What is a tracheostomy?
A hole is made in the trachea and a breathing tube is inserted.
What are the functions regarding breathing of the nose?
Humidifying, filtering and warming the air
What are the indications for a tracheostomy?
Obstructive reason
-> Bypass an obstruction above the tracheostomy
Surgical reasons:
- > To prevent breathing problems from swelling of the larynx post surgery - > Post-laryngectomy
Lowered consious level reasons:
- > Aritificial respiration - > If there is substantial risk of aspiration
What are the two types of tracheostomy and what are their indications?
a) end tracheostomy – performed as part of a laryngectomy
b) side tracheostomy – here the larynx is left in place and an airway is put through the skin over the trachea. For shorter term reasons.
What are some early risks of tracheostomy?
Pneumothorax
Dysphagia
Surgical emphysema
tracheitis
What are some late risks of tracheostomy?
tracheocutaneous fistula on removing the tube
tracheaoesophageal fistula
tracheal stenosis
What causes snoring?
Vibration of one or more areas of the upper airway.
What is obstructive sleep apnoea hypopnoea syndrome (OSAHS)?
excessive daytime sleepiness
with repeated collapses of the upper airway
usually associated with desaturations
Describe what happens when a pt stops breathing due to sleep apnoea?
hypoxia occurs
a central impulse then causes a slight lightening of consciousness
and an increased respiratory effort
to overcome the obstruction.
What is the relationship between sleep apnoea and snoring?
Not all people who snore have sleep apnoea
but
all people who have sleep apnoea will snore
What is the diagnostic criteria for sleep apnoea?
30 or more episodes of cessation of breathing
each lasting at least 10 seconds
occurring over a 7 hour period of sleep.
How can one differentiate between sleep apnoea and snoring?
Snoring is disruptive snoring without any impact on:
sleep pattern or
daytime sleepiness
Are men or women more likely to develop snoring/sleep apnoea? (Why?)
Men are 2-5 times more likely.
Oestrogen is thought to be protective as risk increases post menopause
Which age groups are most at risk from snoring/sleep apnoea?
The risk constantly increases until 60 y/o
What is the link between obesity and snoring/sleep apnoea?
70% risk if BMI >40
What social habits can increase the risk of snoring/sleep apnoea?
Smoking + drinking
What are the consequences of sleep apnoea?
a) Neurocognitive effect – daytime sleepiness causes
a cognitive deterioration
and can increase the risk of an accident (e.g. RTA)
b) Cardiovascular – can contribute to
systemic hypertension
as well as pulmonary hypertension
and eventually ventricular failure (i.e. cor pulmonale)
How can snoring/sleep apnoea be assessed?
Sleep studies
Invasive endoscopies with vibration detector on them
When are sleep studies indicated in snoring/sleep apnoea?
Pt’s with COPD or resp problems
For truckers/heavy machinary workers
Pt’s being considered for surgery
