Stridor Flashcards
(22 cards)
Causes of Stridor in children <6 mo of age
LAVaVoS
Laryngotracheomalacia
Airway hemangioma
Vascular ring/sling
Vocal cord paralysis
Subglottic stenosis
Causes of Stridor in children >6 mo of age
CEB ForeignR
Croup
Epiglottitis
Bacterial tracheitis
Foreign body aspiration
Retropharyngeal abscess
Partial obstruction of the upper airway at the nasopharynx and/or oropharyngeal level produces sonorous sounds
Stertor
Define stridor
high-pitched, harsh, monophonic sound produced by turbulent airflow through a partially obstructed airway
accounts for 60% of all neonatal laryngeal problems and results from a developmentally weak larynx.
Collapse occurs with each inspiration at the epiglottis, aryepiglottic folds, and arytenoids.
stridor worsens with crying and agitation but often improves with neck extension and when the child is prone
Laryngomalacia
True or false
Laryngomalacia usually manifests shortly after birth, which is a key diagnostic feature, and generally resolves by 18 months of age.
True
Vocal cord paralysis Diagnosis is by _____________.
flexible nasolaryngoscopy
diagnosed when there is a narrowing of the laryngeal lumen
usually diagnosed in the first few months of life when the child is noted to have “persistent inspiratory stridor”
Subglottic stenosis
Consider in new-onset stridor beginning after the first month of life without another explanation; definitive diagnosis requires airway visualization through endoscopy
airway hemangioma
are rare congenital anomalies of the aortic arch and pulmonary artery in which anomalous vessels can compress the trachea or esophagus. Examples include a double- or right-sided aortic arch
Vascular rings and slings
Other name for Croup
viral laryngotracheobronchitis
most common cause of stridor outside the neonatal period, commonly affecting children 6 months to 3 years old
Croup (viral laryngotracheobronchitis)
symptoms typically begin after 1 to 3 days of nasal congestion, rhinorrhea, cough, and low-grade fever.
“harsh barking cough”, hoarse voice, and stridor
worse at night
self-limited and short in duration, resolving spontaneously within 3 days
Croup (viral laryngotracheobronchitis)
Steeple sign
Croup
Management of croup
Give nebulized epinephrine for moderate to severe croup, primarily those with stridor at rest; mild croup generally does not require epinephrine
All patients with croup, whether mild, moderate, or severe, benefit from the administration of oral steroids as a one-time dose
Disposition for croup
Children who have received nebulized epinephrine should be observed in the ED for 3 to 4 hours after administration.
Children with persistent stridor at rest, tachypnea, retractions, and hypoxia or those who require more than two treatments of epinephrine should be admitted to the hospital.
Widespread administration of Haemophilus influenzae type B vaccine has significantly reduced the number of cases
EPIGLOTTITIS
Most children appear toxic and anxious and may assume a tripod or sniffing position with the neck hyperextended and the chin forward to maintain the airway
EPIGLOTTITIS
Thumb sign EPIGLOTTITIS
True or false
 diagnosis of retropharyngeal abscess/ cellulitis is suggested when the retropharyngeal space at C2 is twice the diameter of the vertebral body or greater than one half the width of the C4 vertebral body
True
True or false
Peritonsillar abscess, also known as a quinsy, is a posterior oropharyngeal infection.
occurs in adolescents and young adults
polymicrobial infections
True
potentially life-threatening, rapidly expanding infection of the submandibular space
The submandibular space is composed of two spaces subdivided by the mylohyoid muscle into the sublingual and submylohyoid space (submaxillary space) and extends from the floor of the mouth to muscular attachments at the hyoid bone.
Infectious expansion into this space spreads superiorly and posteriorly and often involves the entire submandibular space
Most cases arise from an odontogenic source, often from the spread of periapical abscesses of mandibular molars.
polymicrobial involving oral flora.
LUDWIG’S ANGINA
