Stages in Upper Respiratory Tract Obstruction

An obstruction of the upper respiratory tract can be staged based on clinical findings.

Clinical Findings	Severity	Stage
stridor on moderate exertion hoarseness or cough oral or nasal obstruction alone	mild	I
stridor on slight exertion indrawing of soft tissue of neck jaw and trachea tugged down on inspiration dyspnea rib retraction on inspiration accessory muscles of respiration in use alae nasi dilate on inspiration	moderate	II
stridor at rest exaggerated excursion of neck veins restlessness, sleeplessness pallor and sweating tachycardia increased blood pressure	severe	III
slowed respirations cyanosis hypotension impaired consciousness	very severe	IV

Voice Quality	Location of Obstruction	Examination
lack of resonance	nasal airway	occlude one nostril at a time; nasal speculum
defective articulation	oral cavity	examination of mouth and tongue
moist, guttural voice	pharynx	laryngoscope or endoscopy
hoarseness	larynx	laryngoscope or endoscopy
weak but clear voice	lesion below level of vocal cords	endoscopy

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