Ch. 32 - Pediatric airway disorders and parenchymal lung disease

Created by hkim1326 

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What structures make the children at risk for airway obstruction?

the narrow trachea, bronchi, and bronchioles.

What makes the larynx in the infant "hide" from view during direct laryngoscopy?

The infant's larynx is positioned higher in the neck (near C3-4)

How many generations of airway does the infant have?

16-17.

What attacks the respiratory bronchioles in children?

Respiratory syncytial virus.

How many generation of airways does the infant have?

16-17 at birth.

What area must be auscultated to determine the extent of air movement and obstruction?

Upper airway (over the trachea) and the lower airway (over the thorax)

What leads to decreased dynamic compliance and ineffective respiration?

Exhaustion of respiratory muscle.

How is the pitch of the stridor used to assess improvement or worsening of the obstruction?

Low-pitch signify mild obstruction, higher pitch indicates the child is in more distress and attempting to generate higher air flow rate.

Choanal Atresia

The stenosis or absence of the nasal passages, typically presents in the immediate postnatal period.

How is Pierre Robin Syndrome treated?

Temporary insertion of oral or nasal airways, placement of the infant in a prone position, and surgical repair.

Describe Pierre Robin Syndrome

Infants have extremely small mandibles and a small oropharynx that causes the tongue to occlude the airway.

What does tonsillitis, or streptococcal pharyngitis present?

exudative pharyngitis and cervical adenopathy.

What infectious agents are involved in retropharyngeal abscess?

Group A Streptococcus, Staphylococcus aureus, and occasionally anaerobic bacteria.

What is the preferred treatment in Retropharyngeal Abcess?

Surgical drainage along with administration of appropriate antibiotics based on culture results of the aspirated material.

What are some characteristics of Obstructive Apnea?

noisy snoring and air flow loss.
abnormally large adenoids or tonsils with or without abnormal positioning of the airway tissues.

Describe the treatment of Epiglottitis

-First, establish artificial airway under general anesthesia and place for 12-48 hrs.
-2 day course of ceftriaxone is administered.
-Arm restraints, and sedatives are used to prevent self-extubation.
-Extubation is considered when signs of toxicity diminish and when an air leak at 20 cm H2O pressure develops around the ETT.

Why would an ETT size smaller be used than the predicted size?

Because of considerable swelling to the upper airway structures.

What is the most common cause of Laryngotracheobronchitis?

Parainfluenza virus 1.

What does the viral infection in LTB cause?

mucosal edema and exudate formation in the glottic and subglottic areas, involving the airways from the larynx to the bronchus.

What does the steeple sign in the AP chest radiograph demonstrate?

Subglottic tracheal edema that extends from the larynx to the thoracic trachea.

When is ETT necessary in LTB?

If the child becomes exhausted or severe respiratory distress develops.

bronchiectasis

continuous infections.

RSV

commonly associated with acute bronchiolitis.

primary ciliary dyskinesia

cilia are not moving. increased secretions. Tx includes beta agonist.

mycoplasma pnemoniae

have a sense that they're going to die. "impending doom". unable to divert attention of the patient.

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