*Stridor and Sleep Apnoea Flashcards Preview

Study notes - Respiratory > *Stridor and Sleep Apnoea > Flashcards

Flashcards in *Stridor and Sleep Apnoea Deck (18):
1

What is stridor?

Predominantly inspiratory wheeze due to large airway (larynx, trachea, major bronchi) obstruction (wheeze is an expiatory noise)

2

Causes of stridor in children?

Infections (croup, epiglottitis, pseudomembranous croup, retropharyngeal abscess, diphtheria, infectious mononucleosis)
Foreign body
Anaphylaxis/ angioneurotic oedema
Other e.g. burn

3

What is croup?

Inflammation of the larynx and trachea in children

4

Causes of stridor in adults?

Neoplasms (larynx, trachea, major bronchi)
Anaphylaxis
Goitre
Trauma
Other e.g. bilateral vocal cord palsy

5

Investigations of stridor? (4)

Laryngoscopy (beware in acute epiglottitis)
Bronchoscopy
Flow volume loop
Chest x-ray (other imaging e.g. CT)

6

Treatment of laryngeal obstruction?

Treatment of underlying cause e.g. foreign body removal, anaphylaxis
Mask bag ventilation with high flow O2
Cricothroidotomy
Tracheostomy

7

Treatment of malignant airway obstruction?

Tumour removal (laser, photodynamic therapy, cryotherapy, diathermy, surgical resection)
Tumur compression e.g. intraluminal stent (if tumour out with the airway)
Radiotherapy
Chemotherapy

8

What type of hypersensitivity reaction is acute anaphylaxis?

Type 1 (immediate) hypersensitiviy IgE

9

What is the name for swelling of the mouth, etc. during anaphylaxis?

Angioneurotic oedema

10

Why does anaphylaxis cause hypotension?

Vasodilation and plasma exudation

11

Treatment of anaphylaxis?

IV adrenaline (epinephrine)
IV anti-histamine
IV corticosteroid
High flow O2
Nebulised bronchodilator
Endotracheal intubation if necessary

12

What scale can be used to assess a patients sleepiness and therefore likelihood to have sleep apnoea?

Epworth sleepiness scale = normal = score of less than 10

13

What is snoring?

Relaxation of pharyngeal dilator muscles during sleep leading to upper airway narrowing, turbulent airflow and vibration of soft palate and tongue base

14

What is sleep apnoea?

An extension of snoring where the throat gets so relaxed that it flops all the way in causing of obstruction of upper airways - O2 levels will dip after the apnoea as by the time they dip you are breathing again (in brief it is intermittent upper airway obstruction in sleep)

15

What are risk factors for sleep apnoea?

Enlarged tonsils/ adenoids
Obesity
Retrognathia (abnormal posterior positioning of the mandible)
Acromegaly, hypothyroidism
Oropharyngeal deformity
Neutrological conditions such as MS
Drugs e.g. opiates, alcohol
Post-operative period after anaesthesia

16

Consequences of sleep apnoea?

Excessive daytime sleepiness
Personality change
Risk factor for hypertension
Raised CRP
Impaired endothelial function, etc.

17

Diagnosis of sleep apnoea?

Snoring and raised Hepworth scale
Overnight sleep study

18

Treatment of sleep apnoea?

Remove underlying causes
CPAP