Chp 18 ARD Flashcards
Difference between child & adult
Nasal passages…
Smaller & easer to block
Difference between child & adult
Tongue ….
Larger - Airway obstruction
Difference between child & adult
Epiglottis….
Child: Floppy & U shape.
Obstruction risk
Difference between child & adult
Tonsil & adenoids…
Larger / Obstruction
Difference between child & adult
Laryx…
Child: Higher C3-4 aspiration
Adult lower C4-5
Difference between child & adult
Trachea & airway
Size…
Cartilage…
Resistance…
Size shorter & narrow
Cartilage softer & flexible/ risk of collapse
Resistance Higher Poiseulles Law - More resistance
Difference between child and adult
Lower resp structure
Alveoli…
Lung complance…
Diaphragm & intercostals….
Alveoli few 25 mil vs 300 mil adults
Lung compliance Less due to imature lungs
Diaphragm- dependent breathing, weak intercoastal muscles
Children vs Adult
Alveoli few 25 mil vs 300 mil adults
Lung compliance Less due to imature lungs
Diaphragm- dependent breathing, weak intercoastal muscles
Less alveolar surface area = This complication….
Rely on diaphragm for breathing ________ can impair breathing
Reduced oxygen exchange
Abdominal distention/ fatigue
Children vs adult
Basal metabolic rate…
Oxygen demand…
RR…
BMR Higher
Oxygen demand 6 - 8ml /kg /min vs 3-4
RR 30 - 60 neonates vs 12 - 20 adults
TACHYPNEA IS A EARLY SIGN OF DISTRESS
Avoid Hyperextension is children use tjis posistion..
Sniffing
Chest shape:
Barrell chest…
Asymmetrical…
Paradoxical breathing…
Barrel (Chronic lung disease/ cystic fibrosis)
Asymmetrical (Pneumothorax, diaphragmatic hernia)
Paradoxical ( Seesaw breathing = impending failure)
Assessment
Hyperresonance…
Dullness…
Flatness….
Hyperresonance Asthma, Pneumothorax
Dullness Pneumonia, Pleural Effusion
Flatness Atelectasis
Assessment
Tracheal deviation….
Tractile Fremitus (Vibration with 99)…
Symmetry of chest expansion…
Tracheal deviation; Pneumothorax/ Large pleural effusion
Tactile Fremitus
Increased: Consolidation (Pneumonia)
Decreased: Pneumothorax, pleural effusion
Asymmetry = ling collapse/ Obstruction
Assessment
Breath Sounds
Vesicular…
Bronchial…
Bronchovescular…
Vesicular Soft-low pitched nornal over Lungs
Bronchial Hollow, higjer pitched, normal over trachea
Bronchovescular Medium pitched over airways
Assessment
Breath Sounds (Name Associated Conditions)
Wheezing…
Stridor…
Crackels….
Diminished/absent….
Grunting…
Wheezing Asthma, bronchiolitis
Stridor Croup , foreign body obstruction
Crackels (Rales) Pneumonia, Pulmonary edema
Diminished/Absent: Pneumothorax, Atelectasis, Severe Astham
Grunting Severe distress (trying to keep alveoli open)
Retraction, nasal Flaring, Grunting, Cyanosis =…..
Emergency
Otis media is an ear infection common in children due to immature Eustachian tube (shorter, horizontal, prone to obstruction)
What is the difference between Acute Otis Media & Otitis media with effusion….
AOM infection of middle ear with rapid onset,inflammation, and fluid build up.
OME non infectious fluid build up in middle ear After an infection, hearing issues but no acute symptoms
