Upper Respiratory System Flashcards
What are the 4 sinuses?
Frontal - Don’t develop till 8-10 yrs.
Ethmoid
Maxillary
Sphenoid
What are the 5 steps for performing a thorough oral examination?
- Use gloves
- Establish good view oral mucosa & gingiva
- Palpate the oral mucosa & gingiva
- Check ventral aspect of tongue
- Grip tongue with gauze - check lateral borders
Is pharyngitis always strep?
NO!
What is pharyngitis? Most likely infectious causes?
Inflammation of the pharynx with resulting sore throat.
Causes:
- Viral (Adenovirus, Rhinovirus, Coronavirus, Enterovirus, etc.
- Bacterial (GABHS, Chlamydia Pneumoniae)
What are common symptoms of viral pharyngitis?
Coryza - inflamed mucus membrane Conjunctivitis Malaise / Fatigue Hoarseness Low grade fever Nausea
Why might patients report nausea with pharyngitis?
Pharynx next to intra abdominal organs on homunculus.
What would increase the likelihood of GABHS (Group A Beta Hemolytic Streptococci)?
- Children age 5-15
- Winter or early Spring
- Absence of cough
- Tender anterior cervical lymphadenopathy
- Tonsillar exudates
- Fever
What is the Centor Score System?
Used to assess testing/treatment for GABHS Pharyngitis.
- With score 2-3, perform Rapid Test; IF sibling is sick, start on empiric antibiotics.
- With score > 4, consider treatment with empiric antibiotics.
What is assessed with the Rapid Strep Antigen Test?
Presence of Group A Streptococcal
How is a throat culture obtained?
Obtain specimen from posterior tonsillopharyngeal area & inoculate onto agar plate.
What is a monospot test?
Rapid slide agglutination test for Mononucleosis by looking at Epstein-Barr Virus.
What causes acute otitis media?
Inflammation caused by bacteria or viruses.
What is acute suppurative otitis media?
Acute otitis media WITH purulent material in middle ear.
What is otitis media with effusion (serous otitis media)?
Inflammation and fluid build up WITH NO infection.
What is chronic otitis media with effusion?
Fluid remains in middle ear MORE THAN 6 WEEKS.
Makes children susceptible to new ear infections.
What is chronic suppurative otitis media?
Persistent ear infection results in tearing or perforation of eardrum.
With otitis media, what happens to the mobility of the tympanic membrane (TM)?
TM Mobility is reduced when using a pneumotic otoscope.
What may cause otitis externa?
Associated symptoms?
Bacteria entering small break in skin
Associated Symptoms:
Report drainage from ear
Pain upon touching external ear
What is otosclerosis? What are the 2 types?
Progressive hearing loss beginning age 10-30. Marked hearing loss during middle age.
Two types:
Conductive - ossicle sclerosis into single immovable mass.
Sensory - otic capsule sclerosis.
What is rhinosinusitis/sinusitis?
What are the signs & symptoms?
Mucosal lining paranasal sinuses/nasal cavity inflamed.
Signs/Symptoms: Nasal discharge Cough Sneezing Nasal Decongestant Fever Headache Pain Facial Pressure
What are the symptomatic treatments of sinusitis?
Analgesics, intranasal corticosteroid, nasal saline irrigation, decongestants, and antihistamines.
What are the signs/symptoms of bacterial sinusitis?
Double sickening, purulent rhinorrhea, elevated ESR
Suspicion of acute bacterial sinusitis
What is croup? What are causes?
Signs/Symptoms? Treatment?
Croup (Laryngotracheitis)
- Swelling of the larynx, trachea, bronchi causing inspiratory stridor & barking cough in children age 6 months to 3 years.
Causes: Parainfluenza virus, influenza, respiratory syncytial virus
Signs/Symptoms: Fever, nasal flaring, respiratory retractions, stridor
Treatment: O2 and Nebulized Epinephrine
What is Epiglottitis?
History?
Presentation?
Treatment?
Inflammation of the epiglottis.
History: Rapid onset symptoms, sore throat, muffled voice, drooling
Presentation: High grade fever, toxic appearance, child sitting/leaning forward
Treatment: Protect airway, broad spec antibiotics
