In a patient tongue and epiglottis are protrude inside the mouth then what finding area seen in the patient?

Appeared in: NORCET 2 - 2021 (shift-1)

Explanation

Stridor is a high-pitched, harsh sound produced by turbulent airflow through a narrowed upper airway.
The question describes an obstruction involving the epiglottis, which is part of the upper airway (supraglottic region).
Conditions causing swelling or displacement of the epiglottis, such as epiglottitis, are classic causes of inspiratory stridor.
This sound is a critical sign of significant respiratory distress and requires immediate medical attention.

Option A: Rhonchi are low-pitched, rattling sounds caused by secretions or obstruction in the larger, lower airways (bronchi), not the upper airway (larynx/epiglottis).
Option C: Wheezing is a high-pitched, musical sound caused by the narrowing of the small, lower airways (bronchioles). The obstruction in the question is in the upper airway.
Option D: A gurgling sound is caused by the presence of liquid (like saliva, blood, or vomit) in the upper airway, not by the structural narrowing from a protruding epiglottis.

Clinical Relevance

Nursing practice connection: Use the key finding related to Identification of adventitious breath sounds related to airway obstruction to guide bedside assessment, documentation, and the next nursing action.
Recognizing stridor is a critical nursing skill as it indicates a life-threatening airway emergency that requires immediate intervention.
A nurse hearing stridor must immediately assess the patient's respiratory effort, oxygen saturation, and level of consciousness, and prepare for emergency airway management.
What if? If the patient was unconscious and the sound was a low-pitched snoring sound instead of a high-pitched harsh sound, the cause would more likely be the tongue falling back and obstructing the oropharynx (stertor), which might be relieved by a simple head-tilt-chin-lift or jaw-thrust maneuver.

How to Approach the Question

First, analyze the clinical signs in the question stem: 'tongue and epiglottis are protrude'.
Identify the anatomical location of this problem. The epiglottis is in the upper airway.
Correlate the location of the problem (upper airway obstruction) with the types of breath sounds listed in the options.
Recall that stridor is the hallmark sound of upper airway obstruction.
Differentiate this from other sounds: wheezing (lower airway narrowing), rhonchi (secretions in large airways), and gurgling (fluid in the airway).
Select the option that directly matches the pathophysiology described.

Concept Tested & Keywords

Concept Tested: Identification of adventitious breath sounds related to airway obstruction.
Stem keywords: tongue, epiglottis, protrude, finding
Lead-in keywords: what finding
Clinical cues: Protrusion of tongue and epiglottis signifies a critical upper airway obstruction.

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E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 397-399

Practise the full NORCET 2 - 2021 (shift-1)

Attempt every question from this paper in a timed mock, then review the full solution for each one.