Upper Airway

Question 1

symptoms of UAO

Answer 1

noisy breathing
increasing SOB
hoarse voice
local pain/dysphagia (less common

Question 2

Signs of UAO

Answer 2

stridor
SOB: RR, retraction, acc mm, restless
voice change, drooling, subcut emphysema

Question 3

UAO Management

Answer 3

ABCDE: heliox easier to breathe
airway adjuncts
intubation
needle cricothyroidecctomy
percutaneous cricothyroidectomy
tracheostomy: under LA;

Question 4

causes of UAO

Answer 4

infection
neurological
angioedema: allergy
tumour
foreign body
trauma

Question 5

snoring vs. sleep apnoea

Answer 5

snoring: common, vibrations

SA: UA resistance; 30+ apnoea >10s during 7h

• RF: age, male, obesity, obstruction, smoking/alcohol, FHx, sedating drugs, neuromusc, CLD
• Sx: sleepy, snoring, unrefreshed, choking, irritability, nocturia, low libido

Question 6

sleep apnoea Mx

Answer 6

sleep studies and endoscopies

behavioural and lifestyle
CPAP: gold standard
intra-oral appliances (drooling SE)
pharma: resp effect, less REM
surgery: tracheostomy, nasal, uvulopalatopharyngeal, RF ablation, tonsils

Question 7

stridor

Answer 7

inspiratory (laryngeal), expiratory (wheeze), mixed (both)
aetio: laryngomalacia, palsy, syenosis, trauma, FB, angioedema, infection, Ca, polyps, compression

Rx: assess and secure airway; treat underlying cause

severity: appearance, speech, resp distress, when present (constant/exertion/deep inspiration)

Question 8

stertor

Answer 8

low pitched noise

can be upper airway obstruction

Question 9

tracheostomy BG info

Answer 9

bypasses warm/humidify and cords (speech)

end (laryngectomy) or side (larynx present)

tube: cuff, fenestrations, reservoir, inner tube, speaking valve

Question 10

Trachy indications

Answer 10

obstruction: cancer, infection, anaphylaxis, FB, OSA
post-op swelling
secretion removal/scar prevention: long-term ventilation
secretion/asp pneumonia
post-laryngectomy

Question 11

trachy complications

Answer 11

tube displacement, dried secretions, PTX, infection, surgical emphysema, dysphagia

late: fistula (tracheocutaneous or tracheo-oeso); stenosis

Question 12

Foreign bodies

Answer 12

Ear: deaf, d/c, blood, pain;
Rx: hooks (hard), forceps (soft), irrigate + suction/flush (insects)

nose: foul unilateral d/c, obstruction, vestibulitis, epistaxis
- Rx: blow out, forceps, rounded probes; check 2nd FB; EUA posterior nose

throat/swallow: discomfort/pain, odyno, otalgia, saliva
-Rx: visualise and remove
-corrosive: neutralise; strictures
need dilatation

bronchi/inhaled: dsypnoea, cough, wheeze, bloody sputum;

• Rx: bronchoscopy + remove
• total obstruction: cough, forceps, back blow/heimlich, cricothyroidectomy