Airway Obstruction

Question 1

What is classified as upper airways?

Answer 1

anything above the level of the vocal cords

Question 2

What is an alternative name for the upper airways?

Answer 2

UADT

Question 3

What forms the larynx?

Answer 3

-

Question 4

What is the only complete ring of cartilage on the airways?

Answer 4

the cricoid cartilage - so will determine the maximum dilation of the airways as cannot expand

Question 5

How do neonates breath?

Answer 5

nasally as have a relatively large tongue

Question 6

As airway diameter decreases airflow resistance ….

Answer 6

increases

Question 7

What will a reduction of airway diameter by 1 mm cause?

Answer 7

16 times increase in resistance

Question 8

What is the equation for airflow resistance?

Answer 8

1/r^4

Question 9

What are the signs of airway obstruction?

Answer 9

Stridor (high pitch harsh noise due to turbulent airflow from obstruction)
Stertor (low pitched sonorous arising from nasopharyngeal airways - snoring)

Question 10

What are some of the main causes of airway obstruction?

Answer 10

Inflammatory/infective causes
allergy
foreign bodies
physical compression (invasion of airways)
Trauma
neurological

Question 11

Is epiglottisis common? why/why not?

Answer 11

No as we receive the vaccine against haemophilus but can be caused by other viruses too

Question 12

What is a particularly bad foreign object to get trapped in the airways and why?

Answer 12

peanuts as the oil can trigger a terrible reaction so requires bronchoscopy on the same day of inhalation

Question 13

_____ can shift if there is obstruction of the left main bronchus

Answer 13

Mediastinum

Question 14

What is the most common malignant pathology in a child and how is it treated?

Answer 14

Lymphoma and treated with a large dose of steroids

Question 15

What is a recurrent benign tumour that occurs in the respiratory tract before the age of 12?

Answer 15

juvenile rigor respiratory papillomatosis (after 12 is adult onset)

Question 16

Why does recurrent respiratory papillomatosis require reconstruction?

Answer 16

as it can destroy the larynx

Question 17

What is the most common viral cause of recurrent respiratory papillomatosis?

Answer 17

HPV 16 and 18

Question 18

What is the main cause of neonatal subglottic stenosis?

Answer 18

have had incubatory tubes in for too long

Question 19

congenital subglottic stenosis is ___

Answer 19

extremely rare

Question 20

What are the two main causes of adult subglottic stenosis?

Answer 20

Reflux and GPA vasculitis

Question 21

How do you treat subglottic stenosis?

Answer 21

requires balloon dilation

Question 22

When should you intubate a burns victim (head and neck) and why?

Answer 22

ASAP as the swelling will come on fast and will cause compression of airways resulting in respiratory arrest - will be very difficult to intubate after swelling

Question 23

What 3 elements should you assess when it comes to airway obstruction?

Answer 23

Appearance - anxiety?
Work of breathing
Skin circulation

Question 24

What is the most common cause of cardiac arrest in kids?

Answer 24

Respiratory arrest

Question 25

Respiratory failure leads to ______ which then leads to ____ due to _____

Answer 25

Cardiac failure Neurological failure Prolonged lack of oxygen

Question 26

What is Heliox?

Answer 26

This is a gas mixture of helium and oxygen - as helium is lighter than oxygen it is easier to breath in when in respiratory distress

Question 27

Why should tracheostomy be avoided at all costs?

Answer 27

Because once it is given it is difficult to take out, has a high morbidity rate and risk of tracheal stenosis