Post on 22-Jan-2016
Anne Connell Mater Children’s Hospital
2012 New Zealand
IMAGING THEPAEDIATRIC
AIRWAY
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
ADULT
CHILD
Anne Connell Mater Children’s Hospital
ADULT CHILD
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
BUTTON BATTERIES and COINS
Anne Connell Mater Children’s Hospital
Anne Connell
Anne Connell
21 Month old swallowed watch battery (10.30am)
Oesophageal mucosa burn12 noon
Anne Connell Mater Children’s Hospital
SORE THROAT ? TONSILITIS
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
SORE THROAT ? TONSILITIS
DROOLING, CHOKING ? FOREIGN BODY
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
Stylohyoid ligament calcification
Anne Connell Mater Children’s Hospital
SORE THROAT ? TONSILITIS
DROOLING, CHOKING ? FOREIGN BODY
NECK SWELLING ? RETROPHARYNGEAL ABCESS
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
SORE THROAT ? TONSILITIS
DROOLING, CHOKING ? FOREIGN BODY
NECK SWELLING ? RETROPHARYNGEAL ABCESS
BARKING COUGH, “HOOP” ? CROUP
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
SORE THROAT ? TONSILITIS
DROOLING, CHOKING ? FOREIGN BODY
NECK SWELLING ? RETROPHARYNGEAL ABCESS
BARKING COUGH, “HOOP” ? CROUP
STRIDOR ? EPIGLOTITIS
Anne Connell Mater Children’s Hospital
EPIGLOTITIS
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
? RETROPHARYNGEAL ABCESSSUPINENECK EXTENDED
Anne Connell Mater Children’s Hospital
Anne Connell Mater Children’s Hospital
Anne ConnellMater Children’s Hospital
PSEUDO SUBLUXATION
PSEUDO Dictionary definition
1. False not genuine
2. Resembling or Imitating
Appearance of subluxation
Created artificially
Pseudosubluxation
Anne ConnellMater Children’s Hospital
SWISCHUCK LINE
Posterior cervical line drawn
Posterior arch of C1 to
Posterior arch of C3
Should pass through or be less than 1mm anterior to posterior arch of C2
Spino-Laminar line
Anne ConnellMater Children’s Hospital
Pseudosubluxation True subluxation
Anne Connell
Anne Connell
Anne Connell
Article from Neurosurgery March 2002
MANAGEMENT OF THE PAEDIATRIC CERVICAL SPINE AND SPINE CORD INJURY
Conclusion
Thoracic elevation or occipital recess to prevent flexion of the head and neck when restrained supine on flat board allows better neutral alignment in children younger than 8 years.
Anne Connell
CORRECT NECK FLEXION SHOULD PRODUCE
NEUTRAL POSITION
Anne Connell
MATER RADIOLOGY QUEST
Produce the most effective “TED”
Thoracic elevation Device
Study by Nypaver & Treloar 1994
Evaluated 40 children younger than 8 years
Assessed their neutral position on backboard
All 40 required elevation of torso to eliminate
neck flexion
Mean amount of elevation required was 25mm
Anne Connell
Mater TED
Dimensions 30mm high
20cms wide
Placed under shoulders at level of acromioclavicular ligament
Anne Connell Mater Children’s Hospital
ELEVATION
EXTEND THE NECK
CONCLUSION
Anne Connell Mater Children’s Hospital
GRATEFUL THANKS
Dr Tony Lamont
Dr Gill Long
Adam Lack for photography
Gerard Duckworth for photography
Ivan Simic & my son Crawford for computer skills
Olivia & Madonna, Jordan & Sally for modeling
Kate Bilby for speech pathology assistance
Vic Summers for his image suggestion
Yourselves for listening
Anne Connell Mater Children’s Hospital
REFERENCES AND TEXTS
Pediatric Videofluoroscopy Studies Joan C. Arvendson
Maureen A. Lefton-Greif
Atlas of Human Body Professor Peter Abrahams
Eyewitness visual dictionary of human body Covent Garden Books
Internet article Bobby R. Alford Dept. of Otorhinolaryngology
Atlas of Human Anatomy Frank H. Netter