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Current time:0:00Total duration:7:02

Video transcript

epiglottitis is a potentially life-threatening condition that occurs when the epiglottis gets swollen now to really understand epiglottitis i have to understand what the epiglottis is so right over here what I'm circling this is the epiglottis it's really just a little small lid that is protective of the airway and I've got a couple different views right here so you can really see you know I'm not the best artist so hopefully this rendition you can kind of understand what's going on here but this is just a cross-section down in the middle of the patient to really expose what the airway looks on the inside so this would be the the throat right this is the trachea down here this would be the larynx also known as the glottis also you may be more familiar with the vocal cords that term so these would be the vocal cords and over the vocal cords is the epiglottis and like I said that just protects the airway so when you eat food or swallow a substance so for example let's let's just do like let's do a glass of water let's say water's going in into the mouth and so right here I didn't highlight this before but this is the tongue over here is the roof of the mouth and here's your uvula so that's just the little dangly thing in the back of the throat you see hanging down so when water's coming through right you don't want water to get into the airway otherwise you'll start coughing and you know you could potentially have an infection and Mitch to the lung tissue if bacteria goes in with that water so to be able to protect the airway the epiglottis whenever you swallow this little flap goes down so it'll it'll kind of cover it up like that kind of flip over and so that protects the airway protects the lungs from water or food or anything from getting into it so you swallow and water will go down the right hole down the esophagus so that's really the concept of what the epiglottis does it protects the airway and so there's also this other sketch over here from a different angle that I want to show you here again is the epiglottis here are the vocal cords right here and you've got the so here's the epiglottis let's go and circle that you've also got something called the re epiglottis folds and so these re epiglottis folds are these little flaps on the side that connect the epiglottis down to this area over here and the reason it's named the re epiglottis is because it goes down to where the written oyk cartilage is and so these what I'm circling right here is the original cartilage I point this out because the written word cartilage actually controls the vocal cords so they actually control the closure of the vocal cords themselves to add extra protection for the airway and here I have a another sketch that I drew showing an overhead view so this view right here is looking down at the vocal cords from this angle and so you see up here is the epiglottis right corresponds to over here and down the side right here is the re epiglottal and you can see I kind of drew them a little bit in my picture too just going down so I'm repeating all of this just so you can get a clearer understanding of what the normal view of the epiglottis and the airway looks like because the issue with epiglottitis is this epiglottis can swell so much that it expands to block the airway so whereas before it was just this tiny little flap now it's swollen to enormous size and it's actually closing off the ability for air to pass through into the trachea or into the windpipe now you can imagine because this this is very severe in fact George Washington most likely actually died from complications of epiglottitis back in 1799 a really interesting kind of a little side note of course they didn't really have any cures for epiglottitis back then antibiotics weren't invented until the 20th century but interestingly enough one physician suggested that they could establish an airway by cutting into the skin through the cartilage between the thyroid cartilage and the cricoid cartilage to cut a hole into their way to allow breathing and of course this is actually accepted now as a treatment known as a cricothyrotomy right cricoid cartilage and thyroid cartilage but this physician was actually scoffed at and they didn't perform this life-saving procedure on the first President of the United States so epiglottitis obviously can be very serious it's especially serious in children because they have a smaller airway the diameter of their airway is already fairly narrow so any additional swelling can cause this closure to be more prominent and more serious so swelling of the epiglottis can actually give some very distinct symptoms obviously the patient will be experiencing a sore throat they might also have a fever a patient might also have a muffled voice because you know they have difficulty speaking because it's so sore this epiglottis is so sore so they might have what's called a hot potato voice where they're leaning their throat forward and trying to talk without causing too much vibration to this area that's called a hot potato voice where they it sounds very muffled patients do this to avoid causing pain to their throat now as before I said patients may have a difficulty swallowing so that can actually lead to drooling so you see a pediatric patients will be drooling because you know they don't want to swallow so all the saliva just builds up another interesting symptom that can be seen is called Strider and what Strider is described as it's kind of a musical sound on inspiration so when a patient breathes in oxygen which I'll do this light blue color it is trying to get into the airway and because the airway is narrowed air kind of has this musical tune as it goes through this is similar to trying to whistle when you purse your lips you narrow that airway and allow the wind to create a sound so it actually sounds like on inspiration a patient has inspiratory stridor it kind of sounds like a hmm kind of they're trying to breathe Oh hmm and it's because this airway is narrowed and they they can't get air into the lungs now of course this is an emergency and patients with epiglottitis should be brought to the emergency department right away it should there should be really no delay because the swelling can get worse some worse and eventually close up the airway leading to pulmonary arrest so difficulty swallowing along with drooling maybe the Strider you might start thinking of epiglottitis and all of this can develop within a couple hours of a fever starting so it can be very serious and it should not be taken lightly