Introduction
Physical Examination
Differential Diagnosis
Specific Diseases
References
Other Lectures
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The diseases which cause upper respiratory tract (URT) obstruction account for a significant percentage of pediatric emergency visits. Some are very common and, ordinarily, quite benign, while others are much less common, yet are true pediatric emergencies.
The physical examination sign common to all causes of URT obstruction is inspiratory stridor. This is a harsh, raspy noise produced by the flow of air through a partially obstructed airway. Stridor on inspiration is indicative of obstruction at or above the larynx. Biphasic stridor, heard during expiration as well as inspiration, places the obstruction in the trachea, while expiratory stridor usually means obstruction below the carina.
According to the American Thoracic Society's definition of respiratory sounds, stridor is a type of wheezing, that is a continuous sound originating from the airway. In common usage, though, only isolated expiratory stridor is referred to as wheezing; isolated inspiratory stridor is simply called stridor. Throughout this lecture, the terms "stridor" and "wheezing" will refer, respectively, to inspiratory and expiratory sounds, usually associated with prolongation of inspiratory or expiratory phases of respiration.
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