"Choanal Atresia" is a congenital abnormality which is an abnormal opening between?

PGIMER Chandigarh NO - 2015

Child Health Nursing (Pediatrics)

Easy

Appeared in: PGIMER Chandigarh NO - 2015

Explanation

Choanal atresia is the congenital blockage of the posterior nasal apertures (choanae).
These choanae are the passages that connect the nasal cavity to the nasopharynx, the upper part of the pharynx.
Therefore, the abnormality is located at the junction between the nasal cavity and the nasopharynx.
Although the question uses the misleading term 'abnormal opening', the anatomical location it refers to is the nasopharynx.

Option B: This refers to the area of the glottis and vocal cords. An abnormality here would be something like laryngeal web or laryngomalacia, not choanal atresia.
Option C: This refers to the connection between the throat and the food pipe. An abnormal opening here is a tracheoesophageal fistula, a different congenital defect.
Option D: This describes an anorectal malformation, such as an imperforate anus or a rectourethral fistula, which are congenital defects of the gastrointestinal and urogenital systems, completely unrelated to the respiratory tract.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Congenital abnormalities of the upper respiratory tract as background academic context rather than a clinical decision trigger.
Recognizing the signs of choanal atresia is a critical nursing skill in the neonatal unit, as bilateral atresia is a life-threatening emergency requiring immediate airway intervention.
The primary nursing responsibility is to maintain a patent airway. This may involve simple positioning or the use of an oral airway until definitive surgical treatment can be performed.
What if? If the infant has unilateral choanal atresia, they may present later in childhood with persistent unilateral nasal discharge and obstruction, often mistaken for chronic sinusitis. The nursing assessment should include checking nasal patency in such cases.

How to Approach the Question

First, identify the key term in the question: 'Choanal Atresia'.
Recall the definition and anatomical location of this condition. 'Choana' refers to the posterior nasal aperture, and 'atresia' means blockage.
Analyze the question's phrasing. Note that it incorrectly uses 'abnormal opening' instead of 'blockage'. Focus on the anatomical structures involved, which are the nasal cavity and the pharynx.
Evaluate the options based on the correct anatomical location. The choanae connect the nasal cavity to the nasopharynx.
Eliminate the other options which refer to different parts of the body (larynx, esophagus, anus/urethra).
Select 'Nasopharynx' as it is the correct anatomical region directly affected by the atresia.

Concept Tested & Keywords

Concept Tested: Congenital abnormalities of the upper respiratory tract
Stem keywords: Choanal Atresia, congenital abnormality
Lead-in keywords: abnormal opening between
Clinical cues: The image shows a blockage between the nasal cavity and nasopharynx, confirming the anatomical location of the defect.
Negative lead-in flag: false

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 330-332