Assessment of Stridor in Children- CJ- 1/8/2013
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| Explain how stridor is produced | Areas of low pressure distal to narrowed airways cause airway to collapse and vibrate
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| Stridor is described as | A high pitched, musical sound made while breathing
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| What is the narrowest part of the trachea? | Subglottis
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| Croup, epiglottitis, retropharyngeal abscess and diphtheria all cause | Extrathoracic obstructions
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| The supraglottic area includes the | Nasopharynx, epiglottis, larynx, aryepiglottic folds and false vocal cords
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| The upper airway is divided into two regions, they are | Extrathoracic and intrathoracic
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| What is the most common cause of extrathoracic airway obstruction in infants? | Croup (Laryngomalacia)
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| Larynogomalacia is commonly known as | Croup
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| Stridor from extrathoracic obstruction is heard in | Inspiration
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| Stridor from intrathoracic obstruction is heard in | Expiration
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| Stridor heard in both inspiration and expiration is coming from | Glottis or a fixed and critical obstruction
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| Narrowing of nasal, nasopharyngeal or oropharyngeal areas leads to | Snoring
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| Stridor in a patient ages birth-toddler, Consider a | Congenital disorder
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| Stridor in 6-36months, consider | Croup or foreign body aspiration
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| Stridor in less than 4 years old, consider | Retropharyngeal abscess
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| Stridor in older than 10, consider | Peritonsillar abscess
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| In abrupt onset stridor, consider | Allergic reaction, foreign body or infection
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| If patient presents with respiratory distress+drooling+gasping+fever, consider | Bacterial tracheitis (Emergency)
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| If stridor presents with a steady, progressive onset, consider | Viral croup (90% of stridor!!)
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| Delayed airway burns can result from | Steam, smoke, or microwaved liquids (Emergency)
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| In chronic stridor, consider | Foreign body, tumor, subglottic stenosis, or vascular rings
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| If patient presents with a change in voice, consider | Laryngeal lesion or paralysis
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| Evaluate the patient 2 times | Rest and after
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| Which factors are important to inspect for a stridor patient | Height/weight, size of tonigue, craniofacial malformation, surgical scars, neck edema, fever, cyanosis, nasal flaring, retractions, lymphadenopathy, clubbing, hemangiomas, cafe au lait spots
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| Which side of the stethoscope to use for stridor | The bell
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| In a patient with a steeple sign, consider | Croup
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| What radiographic test is give to a patient with an intrathoracic problem? | Chest xray
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| What radiographic test is given to a patient with swallowing problems? | Barium swallow
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| What radiographic test is given to a patient with tracheomalacia | Airway fluoroscopy
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| What radiographic test is given to a patient with mediastinum, tracheal stenosis or obstruction | MRI
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| what test will give a definitive diagnosis for epiglottitis or bacterial tracheitis? | Airway exam
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| What scope would you use for a stable airway? | Nasopharyngoschopy
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| What scope would you use for an unstable airway? | Laryngoscopy or bronchoscopy
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| Gold standard scope for subglottic, tracheal and central airway lesions, biopsies, foreign bodies, and to dilate stenosed airways | Rigid laryngoscopy
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| Extrathoracic obstructions are found | Above the thoracic inlet (Supraglottic, glottic and subglottic area)
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| Intrathoracic obstructions are found in | The portion of the trachea in the thoracic cavity and the mainstem bronchi
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