Certified Registered Nurse Anesthetist (CRNA) Practice Exam

What type of airway obstruction is characterized by the "steeple sign"?

1. Asthma

2. Croup or Laryngotracheobronchitis

3. Foreign body aspiration

4. Bronchiolitis

The correct answer is: Croup or Laryngotracheobronchitis

The "steeple sign" is specifically associated with croup, or laryngotracheobronchitis, which is a common viral infection seen primarily in young children. This sign is discernible on a radiograph of the neck, showing a narrowing of the airway at the level of the subglottis, resembling a steeple or church spire. In croup, the inflammation of the larynx and upper trachea leads to this characteristic narrowing, which manifests as stridor and a barking cough in affected children. Croup typically presents with symptoms of respiratory distress, including a distinct cough, and the steeple sign helps differentiate it from other conditions that might present with similar symptoms, such as foreign body aspiration or asthma. The key aspect of the steeple sign is that it reflects the inflammation and resulting narrowing of the airway due to viral infection rather than a physical obstruction or bronchospasm, which are more relevant in conditions like asthma and bronchiolitis.