Upper respiratory tract

  • Created by: Emmatjies
  • Created on: 08-01-20 11:02

Disorders of the upper respiratory tract

  • Sinusitis- Inflammation of the sinuses
  • Tonsillitis- Inflammation of the palatine tonsils, and palatine arch.
  • Pharyngitis- Infection of pharynx, nose, and sinuses.
  • Laryngitis- Infection of larynx, epiglottis.
  • Diptheria- Bacterial infection of pharynx, can extend to nasopharynx and trachea.
  • Tuberculosis- Mycobacterial infection. Spread through droplets and sputum.
  • Tumours

Benign- Haemangiomata (overgrowth of nasal septum blood vessels)

Malignant - Carcinoma of nose, sinuses, nasopharynx and larynx.     

Pancoat's Tumour - In the apices of the lungs, Destructive and invasive neoplasm that causes  neuritic pain in arms and hands.

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Indications for imaging the Pharynx and larynx

  • Prescence of soft tissue swelling.
  • To locate foreign bodies.
  • Assesment of laryngeal trauma.
  • CT and MRI for the full evaluation of disease.
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Techniques in imaging the upper respiratory tract

Valsalva manoevre:

Forcibly exhaling with mouth and nose closed. This outlines the upper respiratory tract with air. Allowing for better evaluation.

Expiration on CXR:

Obstructed Lung will show an increased radiographic density on CXR - Emphysema.

On expiration the affected lung will have a raised diaphragm as air cannot leave the lungs.

The heart will also by pushed away from the affected lung, due to the lung expanding as air cannot leave but can enter.

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Anteroposterior pharynx and larynx

Similar to C-spine technique.

  • Pt is supine.
  • Median saggital plane is perpendicular to the image receptor.
  • Orbital meatal line should be 20 degrees from vertical.
  • the centring point is C4, this is with a 10 degree cranial angle.
  • Exposure should be taken with Valsalva manoevre.
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Lateral Pharynx and larynx

  • Pt can be supine but ideally erect.
  • Jaw raised slightly
  • Centre at C4 2.5 cm below and behind the angle of mandible.
  • Depress shoulders.
  • Valsalva manoevre done on exposure.
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Anteroposterior trachea and thoracic inlet

  • Pt is supine.
  • Median sagittal plane is perpendicular to the image receptor.
  • Centre at sternal notch.
  • Valsalva monoevre to be used.
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Lateral trachea, and thoracic inlet

  • Often called the "flying angel".
  • 200 cm SID
  • Centre at the level of sternal notch.
  • High kV technique.
  • Valsalva monoevre.
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Foreign bodies in the upper respiratory tract

  • Inhaled / aspirated.
  • 3 year olds are most at risk.
  • CXR is often normal.
  • An inhaled FB can lead to a pneumothorax or Emphysema.
  • The ratio of getting emphysema compared to Pneumothorax is 5:1


  • Inspiration pushes the the FB down the bronchus blocking it.
  • Air cannot enter the lung.
  • Expiration loosens the FB enough to allow air to escape. 


  • Inspiration causes bronchus to expand, allowing air into the lungs.
  • Expiration, bronchus goes back to normal size, not allowing air to escape.
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