A 4-year-old child aspirates a small plastic toy that becomes lodged in the intrathoracic portion of the trachea, creating a partial obstruction. During which phase of breathing will airway resistance be MOST pronounced?
Expiration
Both inspiration and expiration equally
Neither phase; resistance is unchanged
Inspiration
Intrathoracic airway lesions, including foreign bodies below the thoracic inlet, are compressed by positive pleural pressure during expiration. This dynamic narrowing, combined with the ball-valve effect often produced by a tracheal foreign body, permits relatively easier inspiratory flow but impedes exhalation. Airway resistance therefore peaks during expiration, leading to air trapping, hyperinflation, and possible barotrauma. Inspiratory obstruction is more typical of extrathoracic lesions above the vocal cords; fixed obstructions may cause biphasic resistance.
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