Congenital obstruction of the posterior nares at the entrance to the naso-pharynx is called?

AIIMS Raipur - 2017 (shift-2)

Child Health Nursing (Pediatrics)

Easy

Appeared in: AIIMS Raipur - 2017 (shift-2)

Explanation

Choanal atresia is the congenital blockage of the posterior nasal passages (nares), which prevents air from flowing from the nose into the nasopharynx.
This condition is diagnosed when a catheter cannot be passed through the nares into the pharynx, a key diagnostic sign.
Newborns are obligate nose breathers, so this obstruction leads to characteristic cyclic cyanosis, where the baby turns blue while quiet or feeding and pinks up when crying (as they breathe through their mouth).

Option A: This is an abnormal connection between the trachea and esophagus, not a nasal obstruction. It affects the airway and digestive tract lower down.
Option B: This is a condition where the esophagus ends in a blind pouch and does not connect to the stomach. It does not involve the nasal passages.
Option D: This involves the protrusion of abdominal organs into the chest cavity through a defect in the diaphragm, causing respiratory distress due to lung compression, not a nasal blockage.

Visual 1: Diagram: Sagittal view of a newborn's head showing the location of choanal atresia, contrasting it with a normal patent airway.
Visual 2: Illustration: Comparison of four congenital anomalies: Choanal Atresia, Esophageal Atresia, Tracheoesophageal Fistula, and Diaphragmatic Hernia, highlighting the affected anatomical structures for each.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of congenital anomalies based on anatomical description as background academic context rather than a clinical decision trigger.
Recognizing the signs of choanal atresia, especially cyclic cyanosis, is a critical nursing skill for immediate airway management in a newborn.
Bilateral choanal atresia is a neonatal emergency requiring immediate intervention to establish an oral airway, as the infant cannot breathe at rest.
What if? If the cyanosis did not improve with crying but worsened, and bowel sounds were heard in the chest, the priority diagnosis would shift from choanal atresia to congenital diaphragmatic hernia, requiring different immediate interventions like intubation and gastric decompression.

How to Approach the Question

First, analyze the keywords in the question stem: 'congenital obstruction,' 'posterior nares,' and 'naso-pharynx.' This points to a blockage at the back of the nose.
Next, evaluate each option based on this anatomical location.
Option A (Tracheoesophageal fistula) involves the trachea and esophagus.
Option B (Esophageal atresia) involves the esophagus.
Option C (Choanal atresia) directly relates to the 'choanae' or posterior nares.
Option D (Diaphragmatic Hernia) involves the diaphragm and chest cavity.

Concept Tested & Keywords

Concept Tested: Identification of congenital anomalies based on anatomical description.
Stem keywords: Congenital obstruction, posterior nares, naso-pharynx
Lead-in keywords: is called

Q5MfMCstQVmYQd14BhTZOt