Anne Connell Mater Children’s Hospital

2012 New Zealand

IMAGING THEPAEDIATRIC

AIRWAY

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

ADULT

CHILD

Anne Connell Mater Children’s Hospital

ADULT CHILD

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

BUTTON BATTERIES and COINS

Anne Connell Mater Children’s Hospital

Anne Connell

Anne Connell

21 Month old swallowed watch battery (10.30am)

Oesophageal mucosa burn12 noon

Anne Connell Mater Children’s Hospital

SORE THROAT ? TONSILITIS

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

SORE THROAT ? TONSILITIS

DROOLING, CHOKING ? FOREIGN BODY

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

Stylohyoid ligament calcification

Anne Connell Mater Children’s Hospital

SORE THROAT ? TONSILITIS

DROOLING, CHOKING ? FOREIGN BODY

NECK SWELLING ? RETROPHARYNGEAL ABCESS

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

SORE THROAT ? TONSILITIS

DROOLING, CHOKING ? FOREIGN BODY

NECK SWELLING ? RETROPHARYNGEAL ABCESS

BARKING COUGH, “HOOP” ? CROUP

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

SORE THROAT ? TONSILITIS

DROOLING, CHOKING ? FOREIGN BODY

NECK SWELLING ? RETROPHARYNGEAL ABCESS

BARKING COUGH, “HOOP” ? CROUP

STRIDOR ? EPIGLOTITIS

Anne Connell Mater Children’s Hospital

EPIGLOTITIS

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

? RETROPHARYNGEAL ABCESSSUPINENECK EXTENDED

Anne Connell Mater Children’s Hospital

Anne Connell Mater Children’s Hospital

Anne ConnellMater Children’s Hospital

PSEUDO SUBLUXATION

PSEUDO Dictionary definition

1. False not genuine

2. Resembling or Imitating

Appearance of subluxation

Created artificially

Pseudosubluxation

Anne ConnellMater Children’s Hospital

SWISCHUCK LINE

Posterior cervical line drawn

Posterior arch of C1 to

Posterior arch of C3

Should pass through or be less than 1mm anterior to posterior arch of C2

Spino-Laminar line

Anne ConnellMater Children’s Hospital

Pseudosubluxation True subluxation

Anne Connell

Anne Connell

Anne Connell

Article from Neurosurgery March 2002

MANAGEMENT OF THE PAEDIATRIC CERVICAL SPINE AND SPINE CORD INJURY

Conclusion

Thoracic elevation or occipital recess to prevent flexion of the head and neck when restrained supine on flat board allows better neutral alignment in children younger than 8 years.

Anne Connell

CORRECT NECK FLEXION SHOULD PRODUCE

NEUTRAL POSITION

Anne Connell

MATER RADIOLOGY QUEST

Produce the most effective “TED”

Thoracic elevation Device

Study by Nypaver & Treloar 1994

Evaluated 40 children younger than 8 years

Assessed their neutral position on backboard

All 40 required elevation of torso to eliminate

neck flexion

Mean amount of elevation required was 25mm

Anne Connell

Mater TED

Dimensions 30mm high

20cms wide

Placed under shoulders at level of acromioclavicular ligament

Anne Connell Mater Children’s Hospital

ELEVATION

EXTEND THE NECK

CONCLUSION

Anne Connell Mater Children’s Hospital

GRATEFUL THANKS

Dr Tony Lamont

Dr Gill Long

Adam Lack for photography

Gerard Duckworth for photography

Ivan Simic & my son Crawford for computer skills

Olivia & Madonna, Jordan & Sally for modeling

Kate Bilby for speech pathology assistance

Vic Summers for his image suggestion

Yourselves for listening

Anne Connell Mater Children’s Hospital

REFERENCES AND TEXTS

Pediatric Videofluoroscopy Studies Joan C. Arvendson

Maureen A. Lefton-Greif

Atlas of Human Body Professor Peter Abrahams

Eyewitness visual dictionary of human body Covent Garden Books

Internet article Bobby R. Alford Dept. of Otorhinolaryngology

Atlas of Human Anatomy Frank H. Netter