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