{"title":"气道的发育解剖","authors":"Thokozani M Zhande, Alasdair Howie","doi":"10.1016/j.mpaic.2024.07.005","DOIUrl":null,"url":null,"abstract":"<div><div>A thorough understanding of the airway anatomy, as well as the differences that exist between the paediatric and the adult airway is crucial for one to safely manage it. The human airway originates from the primitive foregut at 4 weeks' gestation and fully matures at 36 weeks’ gestation. At birth, the term neonate has a relatively large head, flat occiput, short neck, small mouth opening and a small mandible; features which make them prone to upper airway obstruction as well as a difficult laryngoscopy. Neonates are obligate nasal breathers; allowing them to breathe and suckle simultaneously. The Hagen–Poiseuille equation explains how nasal congestion causes obstruction in neonates which can lead to the development of significant respiratory distress.</div><div>The subglottic area of the airway is the most susceptible area to damage from intubation or instrumentation of the airway resulting in subglottic stenosis. Correct endotracheal tube sizing and meticulous attention to detail with respect to cuff pressure are essential to prevent damage to the airway.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Developmental anatomy of the airway\",\"authors\":\"Thokozani M Zhande, Alasdair Howie\",\"doi\":\"10.1016/j.mpaic.2024.07.005\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><div>A thorough understanding of the airway anatomy, as well as the differences that exist between the paediatric and the adult airway is crucial for one to safely manage it. The human airway originates from the primitive foregut at 4 weeks' gestation and fully matures at 36 weeks’ gestation. At birth, the term neonate has a relatively large head, flat occiput, short neck, small mouth opening and a small mandible; features which make them prone to upper airway obstruction as well as a difficult laryngoscopy. Neonates are obligate nasal breathers; allowing them to breathe and suckle simultaneously. The Hagen–Poiseuille equation explains how nasal congestion causes obstruction in neonates which can lead to the development of significant respiratory distress.</div><div>The subglottic area of the airway is the most susceptible area to damage from intubation or instrumentation of the airway resulting in subglottic stenosis. Correct endotracheal tube sizing and meticulous attention to detail with respect to cuff pressure are essential to prevent damage to the airway.</div></div>\",\"PeriodicalId\":45856,\"journal\":{\"name\":\"Anaesthesia and Intensive Care Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anaesthesia and Intensive Care Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1472029924001462\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"ANESTHESIOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anaesthesia and Intensive Care Medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1472029924001462","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
A thorough understanding of the airway anatomy, as well as the differences that exist between the paediatric and the adult airway is crucial for one to safely manage it. The human airway originates from the primitive foregut at 4 weeks' gestation and fully matures at 36 weeks’ gestation. At birth, the term neonate has a relatively large head, flat occiput, short neck, small mouth opening and a small mandible; features which make them prone to upper airway obstruction as well as a difficult laryngoscopy. Neonates are obligate nasal breathers; allowing them to breathe and suckle simultaneously. The Hagen–Poiseuille equation explains how nasal congestion causes obstruction in neonates which can lead to the development of significant respiratory distress.
The subglottic area of the airway is the most susceptible area to damage from intubation or instrumentation of the airway resulting in subglottic stenosis. Correct endotracheal tube sizing and meticulous attention to detail with respect to cuff pressure are essential to prevent damage to the airway.
期刊介绍:
Anaesthesia and Intensive Care Medicine, an invaluable source of up-to-date information, with the curriculum of both the Primary and Final FRCA examinations covered over a three-year cycle. Published monthly this ever-updating text book will be an invaluable source for both trainee and experienced anaesthetists. The enthusiastic editorial board, under the guidance of two eminent and experienced series editors, ensures Anaesthesia and Intensive Care Medicine covers all the key topics in a comprehensive and authoritative manner. Articles now include learning objectives and eash issue features MCQs, facilitating self-directed learning and enabling readers at all levels to test their knowledge. Each issue is divided between basic scientific and clinical sections. The basic science articles include anatomy, physiology, pharmacology, physics and clinical measurement, while the clinical sections cover anaesthetic agents and techniques, assessment and perioperative management. Further sections cover audit, trials, statistics, ethical and legal medicine, and the management of acute and chronic pain.