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Stridor

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by

Abdessalam Ewais

on 25 December 2012

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Transcript of Stridor

Stridor Definition Inspiratory Expiratory a high-pitched, musical sound made when breathing, which is usually superimposed on the normal breath sounds. Stridor is caused by the oscillation of a narrowed airway, and its presence suggests significant obstruction of the large airways It is a symptom, not a disease Causes Croup Epiglottitis Trauma Laryngomalacia Vocal Cord Paralysis Biphasic Obstructive lesions of supraglottis or pharynx Lesions of thoracic trachea and bronchi Lesions of glottis, subglottis and cervical trachea Abdessalam Ewais laryngotracheobronchitis caused by acute infection
"barking" cough, stridor and hoarseness
most common acute cause in children
viral: parainfluenza
self-limited; steroids, epinepherine, antibiotics Venturi's & Bernoulli's principles Linear motion of inspired air decreases pressure laterally which causes narrowing of the flexible airway; this results in vibrations of the wall producing an audible sound Types weakness of one or both vocal cords caused by anything that disturbs the nervous supply or limits vocal fold movement symptoms: hoarseness; lowered volume; pain in speech; aspiration; treatement: surgery by medialization "soft larynx" which collapses inward during inhalation shortened aryepiglottic folds cause epiglottis to be furled into an omega symptomatic after first weeks of life; high pitched stridor; rarely life threatening takes care of itself; surgery in rare cases - cutting the folds Investigations Radiography Laryngeal Cancer typically affects children
Difficulty breathing (80 percent),Stridor (80%),Muffled or hoarse voice (79%),Pharyngitis (73%),Fever (57%),Sore throat (50%),Tenderness of anterior neck (38%),Cough (30%),Difficulty swallowing (26%),hange in voice (20%)
may affect adults:
Sore throat or odynophagia (90 to 100%) fever 37.5ºC (26 to 90%) Muffled voice (50 to 80%) Drooling (15 to 65%) Stridor or respiratory compromise ( 33%) Hoarseness (20 to 40%)
H. influenzae most common
medical emergency
tracheal intubation and antibiotics (Ceftriaxone 50-75 mg/kg/day for 7-10 days). Primarily maintaining airway; patient is kept NPO
Manage according to trauma
Cessation of stridor - warning sign
Clear foreign bodies from airway
Provide oxygen
Endotracheal intubation or tracheostomy mostly squamous cell carcinoma and in the glottis
smoking; alcohol; hx of cancer
hoarseness, lump, sore throat, cough
hx, physical, CT/MRI, indirect laryngoscopy, biopsy
surgery; chemotherapy; radiotherapy Diagnosis History Physical Endoscopy most common cause of stridor in children Anatomy Acute Croup.
Acute epiglottitis.
Acute bacterial tracheitis.
Foreign body.
Angioneurotic edema.
Diphtheria.
Tetany.
Laryngeal burns.
Secondary to mediastinal tumor. Chronic Laryngomalacia.
Vocal cord paralysis.
Laryngeal papilloma.
Sub-glottic hemangioma.
Sub-glottic stenosis.
Vascular ring The End
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