Compression
of the Trachea
The trachea is a membranous tube kept patent under normal conditions
by U-shaped bars of cartilage. In the neck, a unilateral or bilateral
enlargement of the thyroid gland can cause gross displacement or compression of
the trachea. A dilatation of the aortic arch (aneurysm) can compress the
trachea. With each cardiac systole, the pulsating aneurysm may tug at the
trachea and left bronchus, a clinical sign that can be felt by palpating the
trachea in the suprasternal notch
Tracheitis
or Bronchitis
The mucosa lining the trachea is innervated by the recurrent
laryngeal nerve and, in the region of its bifurcation, by the pulmonary plexus.
A tracheitis or bronchitis gives rise to a raw, burning sensation felt deep to
the sternum instead of actual pain. Many thoracic and abdominal viscera, when
diseased, give rise to discomfort that is felt in the midline .It seems that organs possessing a sensory
innervation that is not under normal conditions directly relayed to
consciousness display this phenomenon. The afferent fibers from these organs traveling
to the central nervous system accompany autonomic nerves
Inhaled Foreign Bodies
Inhalation of foreign bodies into the lower respiratory
tract is common, especially in children. Pins, screws, nuts, bolts, peanuts, and
parts of chicken bones and toys have all found their way into the bronchi.
Parts of teeth may be inhaled while a patient is under anesthesia during a
difficult dental extraction. Because the right bronchus is the wider and more
direct continuation of the trachea , foreign bodies tend to enter the right
instead of the left bronchus. From there, they usually pass into the middle or
lower lobe bronchi
Bronchoscopy
Bronchoscopy enables a physician to examine the interior of
the trachea; its bifurcation, called the carina; and the main bronchi.
With experience, it is possible to examine the interior of the lobar bronchi
and the beginning of the first segmental bronchi. By means of this procedure,
it is also possible to obtain biopsy specimens of mucous membrane and to remove
inhaled foreign bodies (even an open safety pin). Lodgment of a foreign body in
the larynx or edema of the mucous membrane of the larynx secondary to infection
or trauma may require immediate relief to prevent asphyxiation. A method
commonly used to relieve complete obstruction is tracheostomy.
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