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Stridor Updated 12/2010

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BASICS

  • Description
  • Etiology

DIAGNOSIS

  • Signs and Symptoms
  • Essential Workup
  • Tests
  • Differential Diagnosis

TREATMENT

  • Pre-hospital
  • Initial Stabilization
  • ED Treatment
  • Medication (Drugs)
  • In-patient Considerations
The following is an excerpt....
BASICS
Description

Impedance of air movement through the upper airway, which causes high-pitched audible wheezing and vibratory harsh sounds evident on auscultation over larynx during inspiration

Etiology
  • Congenital:
    • Laryngomalacia
  • Ectopic thyroid:
    • Laryngeal webs/rings
    • Vocal cord dysfunction
  • Infection:
    • Bacterial tracheitis
    • Epiglottitis
    • Viral croup
    • Peritonsillar abscess
    • Retropharyngeal abscess
    • Supraglottitis
    • Uvulitis (eg, Quincke disease)
    • Ludwig angina
    • Diphtheria
    • Tetanus
  • Extrinsic compression:
    • Trauma
    • Hematoma
    • Vascular anomalies (eg, rings)
  • Intraluminal obstruction of the trachea:
    • Foreign body
    • Cyst
    • Invasive tumors
    • Squamous cell
    • Lymphomas
    • Thyroid carcinomas
    • Laryngeal or tracheal papilloma
  • Subglottic stenosis:
    • Postoperative scarring
    • After radiation therapy
  • Angioedema
  • Vocal cord dysfunction:
    • Congenital
    • Surgical injury
    • Postintubation trauma
    • Thyroid malignancy
    • Mediastinal mass

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Diffuse alveolar damage (adult respiratory distress syndrome, ARDS). In ARDS, type I cells die as a result of diffuse alveolar damage. Intra-alveolar edema follows, after which there is formation of hyaline membranes composed of proteinaceous exudate and cell debris. In the acute phase, the lungs are markedly congested and heavy. Type II cells multiply to line the alveolar surface. Interstitial inflammation is characteristic. The lesion may heal completely or progress to interstitial fibrosis.Credit: Image from Rubin E MD and Farber JL MD. Pathology, 3rd Edition. Philadelphia: Lippincott Williams & Wilkins, 1999.
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