trachea cholson banjo e. garcia. suspended from the cricoid cartilage by the cricotracheal ligament...
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TracheaCholson Banjo E. Garcia
Suspended from the cricoid cartilage by the CRICOTRACHEAL LIGAMENT
Length: 10-13 cmFrom C6-C7 to T4-T5Bifurcate at T4-T5 level into the right and
left main bronchi
Lumen maintained by 12-20 hyaline cartilage rings
Horseshoe shape interconnected by strong cartilagenous and elastic connective tissue fibers- Annular ligaments
Cervical part 6-7 cm long, 6-8 cartilaginous rings
Membranous posterior wall- foreign bodies and tumors of the esophagus may impinge upon the posterior surface of the trachea constricting the airway lumen
Transverse diameter 13-20 mm 13-16 mm women, 16-20 mm men
Lined by two rows of CILIATED EPITHELIUM with GOBLET CELLS
Blood Supply- Inferior Thyroid Artery and Superior thyroid artery
Lymphatic- Vertical lymphatic chain of the Neck and Paratracheal and Mediastinal group of LN
Nerve Supply- Vagus and Symphatetic trunk
Malformations
Symptoms: Airway obstruction with inspiratory and
expiratory stridor Wheezing Cyanosis Gasping for breath
Tracheal Tumors
Chondroma, Osteochondroma, Osteoma
Appear as thickening of trachel or bronchial cartilage
Grow slowly and cause extensive bronchopulmonary destruction
Tx: Surgical Removal
Tracheopathia osteochondroplasticaMalformation of the trachea and
bronchial cartilagesAbnormal deposits of cartilaginous
tissue in the endotracheal mucosacan cause progressive airway
obstructionWheezing, coughing, hemoptysis,
respiratory distress
Adenoid Cystic Carcinoma Tx: surgical, radiotherapy
and chemotherapy Palliative: tumor
debulking, stent insertion, tracheotomy
Infectious Diseases
Acute Subglottic Laryngitis Synonym: acute laryngotracheobronchitis Cause: Viral Infants and small childre 6 months- 3years Peaks spring and fall Develop 1-3 days during th course f UR viral
disease
Symptom Horse voice Dry, harsh barking cough Stridor loudest during inspiration
Dx Body temp- elevated or normal Leukocytosis- absent Laryngoscopy: inflammatory swelling below the vocal
cords and in the upper part of the cervical trachea
Treatment Airway humidification and fluid intake
Bacterial Laryngotracheatis Sporadically and without seasonal incidence Viral etiology with subsequent bacterial
superinfectionSymptoms and Dx
Gradual onset with rhinitis and pharyngitis + expiratory and inspiratory stridor, rales over the lungs, other pulmonary complications
Mucosal redness, vocal cords red and swollen on PETreatment
Antibiotic with mucolytic agents ( ambroxol) Airway humidification Adequate fluid intake
Foreign Body aspiration
Most prevalent in children under 3 years of age 2:1 boys over girls
Oropharyngeal swallowing abnormailitiesFound 4x more often on the right main
bronchusSymptoms depends on the size, shape and
compositionComplete obstruction: cyanotic, aphonic
patient with spasmodic breathing movements
Bolus death: acute cardiac arrest caused by a vasovagal reflex evoked by obstrction of upper airways
Radiographs: key in the diagnosis Heimlich maneuver