Introduction
Physical Examination
General
Cyanosis
Labored respirations
Tachypnea
Chest wall retractions
Nasal Flaring
Coughing/Sneezing
Grunting
Stridor
Differential Diagnosis
Specific Diseases
References
Other Lectures
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Stridor is similar to grunting in its significance as a sign of respiratory distress. It appears early and correlates with disease severity. It is specific not only for the airway but also for the URT; that is, patients with stridor have URT obstruction. Patients with pneumonia, asthma or bronchiolitis do not have stridor.
Stridor and grunting, then, are the most important signs of respiratory distress in the pediatric patient. When seeing a child who has either stridor or grunting, you can be confident that the disease is localized, not only to the respiratory tract, but to a specific part of the respiratory tract. Since stridor and grunting are confined, respectively, to inspiration and expiration and are associated with prolongations of those parts of the respiratory cycle, it follows that an essential part of the physical exam is deciding which phase of respiration your patient is having difficulty/making noise in.
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