Choanal atresia is a congenital condition where the passageway between the nose and throat (choana) is blocked or narrowed at birth. It can affect one or both sides and causes respiratory issues for infants. The exact cause is unknown but it occurs when tissue meant to separate the nose and mouth during fetal development remains after birth. Diagnosis involves physical exam, imaging tests, and nasal endoscopy. Treatment is surgical removal of the blockage, which usually cures the problem. Nursing care focuses on respiratory support, monitoring for complications, teaching parents postoperative care, and ensuring an open airway during feeding.
Choanal atresia is a rare condition that affects babies. It is a congenital defect that affects respiratory function and caused by blockage of the choana, which is a passageway that connects each side of the nose to the throat. To know more visit here: www.lazoi.com
A Tracheoesophageal fistula (TEF) is an abnormal connection (fistula) between the Oesophagus and the trachea. TEF is a common congenital abnormality.
Oesophageal atresia is failure of oesophagus to form a continuous passage from the pharynx to the stomach
TEF is an abnormal connection between the trachea and the oesophagus
Choanal atresia is a rare condition that affects babies. It is a congenital defect that affects respiratory function and caused by blockage of the choana, which is a passageway that connects each side of the nose to the throat. To know more visit here: www.lazoi.com
A Tracheoesophageal fistula (TEF) is an abnormal connection (fistula) between the Oesophagus and the trachea. TEF is a common congenital abnormality.
Oesophageal atresia is failure of oesophagus to form a continuous passage from the pharynx to the stomach
TEF is an abnormal connection between the trachea and the oesophagus
Acute epiglottitis is an acute inflammatory condition of the epiglottis and nearby structures like the arytenoids, aryepiglottic folds, and vallecula.It is a life-threatening infection that causes profound swelling of the upper airways which can lead to asphyxia and respiratory arrest.Bacterial etiology is the most common cause of epiglottitis. Soft tissue lateral xray of neck shows thumb sign. Airway management is the main concern of epiglottitis.
Acute epiglottitis is an acute inflammatory condition of the epiglottis and nearby structures like the arytenoids, aryepiglottic folds, and vallecula.It is a life-threatening infection that causes profound swelling of the upper airways which can lead to asphyxia and respiratory arrest.Bacterial etiology is the most common cause of epiglottitis. Soft tissue lateral xray of neck shows thumb sign. Airway management is the main concern of epiglottitis.
Approach to non-infectious Upper Airway Obstruction “Stridor” in children.pptxJwan AlSofi
This lecture will discus the approach to stridor / upper airway obstruction in children and paediatric age group.
Topics to be discussed:-
Upper Airway Obstruction (UAO):- eitiology, clinical features, invetigations, treatment
Foreign Body Aspiration
Choanal Stenosis (Atresia)
Laryngomalacia (Floppy Larynx)
Subglottic Stenosis
Adenoidal and Tonsillar Hypertrophy
Others causes of UAO
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
2. INTRODUCTION
• Neonatal airway obstruction leading to respiratory distress is a
fairly common problem in the pediatric ICU setting.
• The word “choana” comes from the Greek word meaning “funnel”.
The choana is essentially the posterior nasal aperture by which air
flows from the nasal cavity into the nasopharynx. The anatomic
borders of the choana are as: -
• Superior border: inferior surface of the sphenoid body –
• Lateral border: lamina of the medial pterygoid plate (inferior
projection of sphenoid bone)
• - Medial border: the nasal vomer
• - Inferior border: horizontal portion of the palatal bone
• The following anatomic abnormalities contribute to forming the
atretic choana: a narrowed nasal cavity, lateral impingement of the
medial pterygoid plate, an abnormally thickened vomer, and a
membrane most of mucosa and/or bone extending across the
choana.
3.
4. • Between 4-6 weeks of gestation, there is a
formation of primitive nasal structures .At
about the same time, nasal pits form and
burrow into the mesenchyme to create the
primitive nasal cavities. These nasal pits sit
atop the frontal portion of the stomodeum (i.e
primitive oral cavity), and the pits are separated
from the stomodeum by the nasobuccal
membrane. Once the nasobuccal membrane
ruptures, the primitive nasal cavity and
primitive choana are formed. The primitive
choana matures and transforms into the
definitive (i.e. secondary) choana
5.
6. HISTORY AND EPIDEMIOLOGY
• Choanal atresia was first described by a physician
named Roederer in 1755.
• However, the first recorded surgical repair was
done in 1854 .
• The condition is the most common nasal
abnormality in newborn infants ,affecting about 1
in 7,000 live births. Females get this condition
about twice as often as males. More than half of
affected infants also have other congenital
problems.
• In general, unilateral choanal atresia is more
common than bilateral (65-75% of patients with
unilateral)
7. Choanal atresia
• Choanal atresia is a rare condition that affects
babies & is caused by a blockage of choana, which is
a passage way that connects each side of nose to
the throat. These passageways are essential for
breathing through the nose. It is a congenital
condition, meaning it is present at birth. the
condition may be present as an isolated birth defect
in a baby that is otherwise healthy or it could be a
part of genetic disorder called charge syndrome
that affect various organs.
8. Two types of Choanal atresia are
UNILATERAL CHOANAL ATRESIA:
this more common of the two & is
also a less threatening, atresia effects
just one side of the nasal
passageways.
BILATERAL CHOANAL ATRESIA:
this can be a life threatening as
blockage affects both passageways,
causing extreme respiratory difficulty
9. Causes
• The cause of choanal atresia is unknown. It is
thought to occur when the thin tissue
separating the nose and mouth area during
fetal development remains after birth. Allergy
and sinus disease with associated secretions
and tissue swelling may contribute as well,
especially in children with cystic fibrosis. In
addition, nasal masses such as hemangiomas
and encephalocoeles must be ruled out in any
child with nasal obstruction.
10. Signs/Symptoms
Bilateral Atresia
• Presents as a newborn
• Cyanosis
• Increased respiratory
effort
• Chest retractions
• Classically
cyanosis/saturations
improve with crying
• Inability to nurse and
breathe at same time.
Uni lateral Atresia
• Present later in life (non-
emergent)
• Chronic nasal discharge
• Nasal obstruction
• Thick nasal secretions on
examination
11. Diagnosis
• A physical exam may show an obstruction of
the nose.
• • Inability to pass catheter or NG tube – 6 Fr –
32 mm as proposed distance
• • Absence of fogging of mirror under nose
13. CHARGE Syndrome
• Coloboma ( Essentially a hole
in one of the structures of the
eye.)
• Heart disease (TOF, PDA,
DORV, VSD, ASD, Right Aortic
Arch)
• Atresia choanae
• Retarded growth (CNS
anomalies)
• Genital anomalies
(hypogonadism)
• Ear anomalies
14. Treatment
Resuscitate the baby if necessary.
An airway may need to be placed so that the
infant can breathe. In some cases, intubation
or tracheostomy may be needed.
Surgery to remove the obstruction cures the
problem. Surgery may be delayed if the infant
can tolerate mouth breathing. The surgery
may be done through the nose (transnasal) or
through the mouth (transpalatal). Most
bilateral can be done within the first few days
of life to aid in growth and development
15. Timing of Surgical Repair
• Most bilateral can be done within the first few
days of life to aid in growth and development
• CHARGE syndrome may require a delay
– Tracheostomy typically needed
• Unilateral atresia
– Before school age
16.
17. • Outlook (Prognosis)
• Full recovery is expected.
Possible Complications
Aspiration while feeding and attempting to
breathe through the mouth
Respiratory arrest
Re narrowing of the area after surgery
18. NURSING MANAGEMENT
Consider CA in newborn/child with symptoms of nasal
obstruction
There is high association of choanal atresia with other
congenital defects, nurse must look for other defects also
Oxygen therapy is given for respiratory distress by use of
special nipple called a McGovern nipple which has a
large hole in its center for air passage or a plastic oral
airway piece.
Input output should be maintained before and after
surgery
Keep the client warm.
An intravenous drip is used to hydrate the patient.
Monitor patients vital signs
Provide oxygen in case of dyspnea and cyanosis
19. NURSING MANAGEMENT
• All drugs to be administered keeping in mind five
steps of drug administration
• Suction the nasal stents so that they don’t get
blocked up
• Teach parents also how to suction to keep stent
patent for period of three months after surgery
till stent will be removed
• Nurse must teach how to keep nose clean & how
to give your baby nose drops
• Make sure clients nasal passage is patent before
starting feed.
Choanal atresia is a congenital narrowing at the posterior choanae (the area from the nare to the nasopharynx). This is purely bony in 30% of cases and mixed bony and membranous in 70% of cases.