Asthma Flashcards
Pathphys of cough
cough is a protective action –> initiated both voluntary and by cough receptors in respiratory tract
*receptors send signals to cough center (medulla) –> signal to vagus, phrenic, and spinal motor nerves –> cough
Assessing kids in respiratory distress
Speaking in full sentences?
SOB when speaking?
Causes of cough in kids
Infection Inflammation Irritation Anatomic Psychogenic
Acute Cough
more likely infectious or clear precipitating event
Chronic cough
more likely to mean it is not a life-threatening because symptoms have been tolerated for so long
Descriptors of a cough
Dry - irritant or asthma Wet/productive - lower respiratory infection Barky - croup Paroxysmal - pertussis, foreign body Worse at night - sinusitis or asthma Gagging - GERD
Wheeze
high-pitched whistling sound made when airway is narrowed by inflammation
Shortness of breath
difficulty breathing or sensing you are short of breath
ROS in kid with cough
Fever? - infection Change in voice? - chronic rhinitis or GERD Choking event? - foreign body or GERD Chest pain? - GERD or asthma Head ache? - sinusitis Sore throat? - post-nasal drip or URI
Pulmonary TB in kids
systemic symptoms are uncommon –> most symptoms are from bronchial compression (wheeze, cough)
CXR - hilar adenopathy with some mild hyperinflation
DDx for cough in kid
Asthma - common, cough worse at night (shiners)
Allergies - also common, post-nasal drip
Sinusitis
Bronchitis - clinical diagnosis from chronic cough and congestion from URI
GERD - worse at night
Atypical PNA - viral causes or atypical (influenza, adenovirus, mycoplasma)
Sign and Symptoms of Bacterial Sinusitis
TONS of similarity between viral URI and sinusitis
- Sinusitis = persistence of symptoms
- purulent nasal discharge with fever
Bacterial Sinusitis
Same bugs as AOM
Factors - allergies, URI, CF, thick mucus, trauma, polyps
Diagnosis - persistent symptoms, worsening cough, severe onset
Tx - amoxicillin
Tracheal deviation
suggest a mass or PTX
Retractions
seen in obstructive airway disease, asthma, foreign body,
Accessory muscle use
sign of significant respiratory distress
Hyperinflated thorax
increased AP chest diameter –> air-trapping from obstructive lung disease
Increased I:E
increased expiration time –> obstructive disease
Percussion
Hyperresonance - air-trapping (mucus plug, obstructive)
Dullnes - consolidation (PNA)
Egophony
EE and AA –> consolidation
Wheezing
sound of airflow through narrowed airways –> sign of asthma or reactive airway disease
- musical sounds (usually during expiration)
Rhonchi
continuous low-pitched sounds during inspiration/expiration
- due to mucus/secretions in airway
Crackles
heard on inspiration due to fluid in alveoli –> PNA
Stridor
high-pitched inspiratory noise from airway obstruction of extrathoracic airway (trachea or larynx)
