A palpable foreign body shock sensation under the thyroid cartilage

Introduction The thyroid cartilage is the square cartilage in front of the neck, one on each side, connected in front of the neck, and the lower part is connected with the ring cartilage. The male is particularly prominent, also called the larynx. Under the thyroid cartilage, it can touch the vibration of the foreign body. This is the symptom of the foreign body in the trachea. The foreign body has just inhaled. The symptoms are similar to those of the laryngeal foreign body. Later, the active foreign body moves with the airflow, which can cause paroxysmal cough and difficulty in breathing. At the end of exhalation, the foreign body can be heard at the trachea to impact the slap sound of the tracheal wall and the subglottic area.

Cause

(1) Children like to tease the small things in their mouths, the teeth have not yet been born, can not chew food, and the cough reflection is not perfect. Whenever you cry, laugh, or startle, you suddenly inhale, and you can inhale the respiratory tract with carelessness.

(B), the foreign body itself is smooth, small and light, such as melon seeds, peanuts, beans, small rubber caps, plastic caps, etc. are easy to inhale the respiratory tract.

(3) Bad habits at work, such as shoemakers pinning needles, studs, buttons, etc. between the teeth, occasionally inadvertently, or suddenly speaking, inhaling foreign objects. In addition, it can also be caused by vomiting, anesthesia, poisoning, or suffering from a nervous system disease, so that throat reflex is inhibited. In the upper airway operation, the instrument parts are detached or the tissue is removed, and the instrument is occasionally inhaled during the treatment of the upper root canal.

an examination

Related inspection

Chest perspective

When a foreign body enters the lower respiratory tract, there is a severe cough. It often has a long or short asymptomatic period, so it is easy to be misdiagnosed. Due to the nature of the foreign body, the location and shape of the foreign body, the symptoms are also different, which are described as follows:

(1), throat foreign body

When a foreign body enters the throat, cough, shortness of breath, and reflexive throat occur immediately, causing inspiratory difficulty and wheezing. If the foreign body stays in the mouth of the throat, there is hoarseness or difficulty in swallowing. If a slightly larger foreign body is blocked in the glottis, it can be immediately suffocated to death.

(B), tracheal foreign body

The foreign body has just been inhaled, and its symptoms are similar to those of the throat, and it is mainly cough. Later, the active foreign body moves with the airflow, which can cause paroxysmal cough and difficulty in breathing. At the end of exhalation, the foreign body can be heard at the trachea to impact the slap sound of the tracheal wall and the subglottic area. And under the thyroid cartilage, the foreign body can be touched and the shock is felt. Because the tracheal cavity is occupied by foreign bodies, or the edema under the glottis is narrow, it causes difficulty in breathing and can cause wheezing.

(three), bronchial foreign body

Early symptoms are similar to tracheal foreign bodies. Different symptoms can occur due to different types of foreign bodies. Botanical foreign bodies, such as peanuts and beans, contain free fatty acid and oleic acid, which are highly irritating to mucous membranes, and often have acute bronchitis symptoms such as high fever, cough, and purulent sputum. If it is a metal foreign body, it has less local irritation. If it does not block, it can remain in the bronchi for several months without symptoms. Later, due to the intrusion of foreign bodies into the bronchus, different degrees of obstruction occurred and different symptoms appeared.

Differential diagnosis

Since the foreign body in the respiratory tract is mostly a child, when the foreign body is inhaled, the family member may not see it, and the child cannot complain of it. Can not ask the history of foreign body inhalation, children often because of wheezing, but were misdiagnosed as "asthmatic bronchitis", or misdiagnosed as "pertussis" due to paroxysmal cough, or misdiagnosis due to long-term respiratory infection "Pneumonia", "bronchodilation" and so on.

There are local lesions in the lungs of children, long-term unhealed or good-time offenders, the so-called "three unlike" symptoms, that is, neither like tuberculosis nor typical bronchopneumonia, nor other lung diseases. In this case, the possibility of foreign bodies in the respiratory tract should be considered and should be taken seriously. Careful physical examination and X-ray examination are important means for diagnosing foreign bodies.

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