Flashcards in Pediatric Airway Deck (79):
What is the general shape of the pediatric airway?
Funnel shaped to the cricoid
What is the most narrow component of the pediatric airway?
The location of the pediatric oropharynx is the result of what?
Epiglottis sitting behind the soft palate
Where is the pediatric airway, relative to the adult? What is the functional significance of this?
More superior--allows kids to feed and breathe simultaneously
What is the narrowest part of the adult airway?
The higher location of the airway in infants allows for what, which cannot be done with adults
Breathing and eating at the same time
What is stridor?
Vibration of noise in the airway
What is the location of the lesion with an inspiratory stridor? Expiratory?
Inspiratory = external
Expiratory = Internal
Why are kids more susceptible to croup than adults?
Airway is much smaller in diameter
How can you assess for tracheoesophageal atresia in infants?
NC passed at birth
What is the most common type of tracheoesophageal atresia in infants?
EA with distal TEF
How do infants breathe?
Obligate nasal breather, with periodic apnea
What is choanal atresia?
A congenital disorder where the back of the nasal passage (choana) is blocked, usually by abnormal bony or soft tissue (membranous) due to failed recanalization of the nasal fossae during fetal development.
What is pyriform aperture stenosis?
The anterior nasal aperture (pyriform or pyriform aperture) is a heart- or pear-shaped opening in the human skull.
What are the three major neoplastic conditions that cause congenital airway obstruction at the level of the nasal cavity?
Where do the tear ducts drain?
What is the foramen that the thyroid descends into?
What gender has a higher incidence of choanal atresia?
What is the most likely cause of choanal atresia?
Persistence of buccopharyngeal membrane
What is pyriform stenosis usually associated with?
-Central mega incisor
What is the most common source of nasal obstruction in infancy?
Rhinitis of infancy
What is the prognosis for rhinitis of infancy?
What is rhinitis of infancy?
Persistent nasal congestion in the first 6 months of life, with no clear etiology
How do you diagnose rhinitis of infancy?
What is lingual thyroid?
Thyroid does not descend into the neck, causing obstruction
What are vallecular cysts?
a rare type of laryngeal cyst seen in infants
What is a common cause of airway obstruction with Down syndrome?
What is the sequelae of OSA in kids?
Right sided cardiomegaly
What is the prognosis for retropharyngeal abscesses?
-Lethal in adults
-Airway obstruction is more concerning in kids
How do you diagnose retropharyngeal abscesses in kids?
-CT if needed
What is the most common cause of a upper airway obstruction in the oro hypopharynx?
Tonsillar / adenoid hypertrophy
What is laryngomalacia? S/sx?
The soft, immature cartilage of the upper larynx collapses inward during inhalation, causing airway obstruction
What is a laryngocele?
a congenital anomalous air sac communicating with the cavity of the larynx, which may bulge outward on the neck.
What is the most common cause of stridor, period?
What are the neoplastic causes of obstruction in the supraglottic larynx? (3)
What is the most common cause of pediatric stridor and airway problems?
What is the prognosis for laryngomalacia?
Usually resolves by one year of life
True or false: laryngomalacia usually required surgery
How do you diagnose laryngomalacia?
Laryngoscopy---NOT imaging studies
When is laryngomalacia concerning?
If kid cannot eat
What is the classic presentation of epiglottitis?
Sudden onset of stridor in a kid, with relief if tripods
What is the classic x-ray sign for epiglottitis?
Thumb print sign
How do you diagnose laryngeal problems?
What is glottic atresia?
Glottis does not form
What are glottic webs?
Webs in the glottis
What is the 2nd most common cause of stridor in a newborn?
Vocal cord paralysis
What is the most common presentation of a posterior laryngeal cleft?
What is the most common cause of congenital bilateral vocal cord paralysis?
What must be evaluated for, upon finding congenital bilateral vocal fold paralysis?
Foramen magnum for a chiari malformation
What is the most common neoplasm of the vocal folds in children?
Recurrent respiratory papillomatosis
What is the average onset of recurrent respiratory papillomatosis?
What are the virus strains that cause recurrent respiratory papillomatosis?
HPV 6 and 11
What are the HPV strains that cause cervical cancer?
16, 18, 33, 35
What is the usual presentation of recurrent respiratory papillomatosis?
Presents with hoarseness and progresses to stridor/distress
What is recurrent respiratory papillomatosis?
Recurrent HPV papillomas in the trachea 2/2 infection at birth from an infected mother
Does respiratory papillomatosis cause throat cancer?
What is the "great masquerader" of respiratory issues in children?
How do you diagnose recurrent respiratory papillomatosis?
How do you treat recurrent respiratory papillomatosis?
Recurrent surgeries (20 is the average)
What is the treatment for vocal cord paralysis?
What are the common lesions in the subglottic area? (5)
What are the 1st, 2nd, and 3rd most common causes of congenital stridor in kids?
2. Vocal cord paralysis
3. Subglottic stenosis
What is the most common cause of subglottic stenosis?
What is the most common neoplasm of the infant airway? Where in the airway in particular do these usually arise?
Which gender is more affected with subglottic hemangiomas?
What is the presentation of subglottic hemangiomas?
Asymptomatic at birth, but pituitary surge at 6 months causes biphasic stridor
What percent of kids with subglottic hemangiomas have cutaneous hemangiomas?
50% (but the converse is not true)
What are the external compression causes of tracheomalacia?
What are causes of tracheobronchial obstruction?
-Complete tracheal rings
What are the two major questions to ask when seeing a kid with tracheomalacia?
How do you diagnose tracheomalacia?
FB aspiration most commonly occurs under what age?
At what age is FB aspiration most likely to occur?
6 months - 2 years
Aspiration is most likely to be caused by swallowing what?
What is the cause of croup?
Parainfluenza virus type I
What is the classic x-ray finding with croup?
What causes lacrimal duct cysts?
Lacrimal ducts fail to canulate
What is tracheomalacia highly associated with?