气道的发育解剖

IF 0.2 Q4 ANESTHESIOLOGY Anaesthesia and Intensive Care Medicine Pub Date : 2024-10-01 DOI:10.1016/j.mpaic.2024.07.005
Thokozani M Zhande, Alasdair Howie
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引用次数: 0

摘要

全面了解气道解剖结构以及儿科气道与成人气道之间存在的差异,对于安全管理气道至关重要。人类气道在妊娠 4 周时起源于原始前肠,在妊娠 36 周时完全成熟。刚出生的新生儿头部相对较大,枕部扁平,颈部较短,口腔开口较小,下颌骨较小,这些特征使他们容易发生上呼吸道阻塞,喉镜检查也很困难。新生儿必须用鼻呼吸,因此可以同时进行呼吸和吸吮。Hagen-Poiseuille 等式解释了鼻塞如何导致新生儿呼吸道阻塞,进而引发严重的呼吸窘迫。气道的声门下区域是最容易因插管或气道器械操作而受损的区域,从而导致声门下狭窄。正确的气管导管尺寸和对充气罩囊压力的细致关注对于防止气道损伤至关重要。
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Developmental anatomy of the airway
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.
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来源期刊
CiteScore
0.50
自引率
0.00%
发文量
152
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.
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Editorial Board Contents Medical gases Spinal anaesthesia Premedication
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