Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardio Pulm Eval > Final - Peds > Flashcards

Final - Peds Flashcards

1
Q

Signs of respiratory problems

A
  • Lack of breath support
  • Breathy, broken speech
  • Weak cough
  • Audible breathing
  • Bluish tinge to skin around mouth, nail beds
  • Poor endurance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

signs of respiratory problem specific to children

A
  • Frequent rests with motor tasks
  • Poor sleeping
  • Decreased appetite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

normal chest development in an infant

A
  • 1/3 of trunk cavity
  • Triangular in shape
  • short neck
  • Narrow upper chest
  • Flared lower ribs
  • Narrow intercostal spacing
  • Belly Breather
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

normal chest development of adult

A
  • > ½ trunk cavity
  • Rectangular shape
  • Wide upper chest
  • Lower ribs integrated with abdominals
  • Wide intercostal spacing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

see comparison of infant to adult chest

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how does gravity influence normal chest development?

A

skeletal development
muscle activation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

pectus excavatum

A

*“Funnel Chest”/Concave
*Depresses lower sternum
*Causes breathing restrictions when severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

pectus carinatum

A
  • “Pigeon” chest
    *Chest wall is rigid
    *Can also impact respiration when severe
    *May result in fatigue and SOB
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

flattened chest wall due to:

A
  • Weakness
  • Paralysis of intercostal muscles
  • Prolonged supine positioning
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

flared ribs due to:

A

oblique muscle weakness or paralysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is asymmetry caused by:

A

muscle weakness on one side of the trunk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

kyphosis due to:

A

●Low tone in the trunk
●Paraspinal and abdominal muscle weakness
●Hamstring tightness
● Abnormally shaped spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

respiratory development in utero

A

● 4th week- start
● 16th week- bronchioles form
● 20th week- surfactant released
● 28th week- matured and child may be able to breath on own

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

why does infant breathing require more work

A
  • Narrow airway –easily obstructed
  • Nose breather-
  • Larynx is higher –so baby can breathe and swallow at same time
  • Diaphragm is main muscle of respiration
  • Diaphragm fatigability
  • Increased respiratory rate
  • Increased O2 consumption
  • Less efficient chest wall mechanics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

development of breathing - child to adult

A
  • Ribs stay more horizontal than adults until approximately 7 years of age
  • Number of alveoli increases until approximately 8 years of age, then rate slows
  • Lymphatic tissue (i.e. adenoids) grow rapidly –many children need removed
  • Type I fibers
  • Develops use of intercostal muscles, abdominal muscles, and accessory muscles of respiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

trunk muscles have dual function

A
  • breathing and postural support
  • breathing always wins
  • need to optimize posture for motor function to be efficient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Weakness of respiratory and postural
muscles may cause:

A
  • Thoracic stiffness (immobile chest)
  • Rib Flaring
  • Hypoventilation
  • Increased work of breathing
  • Inefficient cough
  • Risk of aspiration
  • Poor breath support for vocalization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Ribcage Development in Children with Cerebral Palsy

A

*Chest high (elevated)
*Chest flattened anteriorly
*Rib flaring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Down Syndrome

A
  • Trunk weakness/Hypotonia
  • Rib flaring
  • scar tissue – from cardiac surgeries
  • Decreased size of nasal passageways
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Myelomingocele –dependent on level of innervation

A
  • Arnold Chiari II, inspiratory stridor, apnea, respiratory distress
  • Trunk Weakness – insufficient diaphragm support/dependent on level of innervation
  • Hypotonia – insufficient diaphragm support/dependent on level of innervation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

sequence of normal breathing

A

*First: with easy onset, subtle rise of abdomen
*Second: lateral costal expansion
*Third: gentle rise of the upper chest primarily in the superior and anterior planes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Normal Respiratory Patterns

A

*Abdominal breathing
*Abdominal thoracic breathing
*Asynchronous breathing (normal for crying baby)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Abdominal Breathing

A
  • Normal for infants
  • See expansion in abdominal wall rather than in thorax
  • Respiration shallow and rapid
  • May be retained in some children with disabilities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

abdominal thoracic breathing

A
  • Begins at 6-8 months when a child can:
  • sit up against gravity
  • actively rotate trunk
  • actively extend trunk
  • See thoracic expansion during breathing
  • Begin utilization of intercostal mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Asynchronous Breathing

A
  • See when infant or young child cries or with a lot of effort of breathing
  • Upon inspiration, see abdominal expansion with thoracic depression
  • Can result in retraction of the sternum
26
Q

when can diagnosis of congenital heart defects occur?

A

prenatally, perinatally, after discharge home, or into adolescence

27
Q

congenital heart defects signs and symptoms

A

abnormal respiratory signs, increased RR, labored breathing, diaphoretic, tachycardia, edema around eyes, decreased urine output (dry diaper), eating problems, growth and developmental delays

28
Q

acyanotic

A

VSD and ASD
L –> R
Pink
Mixing of oxygenated blood

29
Q

cyanotic

A

Tetralogy of Fallot, left hypoplastic heart syndrome
R –> L
Blood not getting O2
Blue

30
Q

Heart defects associated with Down Syndrome

A

ASD
VSD
– observed

31
Q

which heart defect typically needs surgery

A

AVSD

32
Q

What are the potential effects of a congenital heart defect on development and PT intervention?

A
  • poor postural control
  • delayed motor skill development
  • decreased endurance
  • scars
  • family coach on what child is able to do
33
Q

pulmonary complications commonly seen in NICU

A
  • Respiratory Distress Syndrome (RDS) – restrictive lung disease
  • Bronchopulmonary Dysplasia (BPD)
    – restrictive lung disease
  • Chronic Respiratory Failure (CRF)
34
Q

Respiratory Distress Syndrome

A
  • AKA Hyaline Membrane Disease (HMD)
  • commonest cause of preterm neonatal mortality
  • RDS occurs primarily in premature infants; its incidence is inversely related to gestational age and birth weight
35
Q

RDS - Mortality

A

30% infant deaths, 50-70% preterm infant deaths

36
Q

RDS Causes

A

○Pulmonary immaturity
○Deficiency of surfactant

37
Q

Respiratory Distress Syndrome Symptoms

A
  • Periodic breathing – 5-10 second pauses in breathing
  • Apnea – absence of breathing for more
    than 20 seconds OR more than 10 seconds with cyanosis, pallor, or bradycardia
    *Bradycardia
38
Q

RDS - Bradycardia

A

*HR < 100 bpm – life threatening if untreated

39
Q

Normal HR

A
  • newborn: 120-160 bpm
  • premature infant: 120-180 bpm
40
Q

what is the most common chronic lung disease in infants

A

bronchopulmonary dysplasia

41
Q

what is bronchopulmonary dysplasia

A

*Unresolved or prolonged RDS
*Scarring of lung tissue & thickening of pulmonary arterial walls
*Dependence on supplemental oxygen
*Severe BPD increases incidence of Developmental Delay

42
Q

significance for working with kids with bronchopulmonary dysplasia

A

*Increased airway resistance
*Large increase in the work of breathing
*Frequent respiratory infections

43
Q

what is chronic respiratory failure defined as?

A

treatment with mechanical ventilation for more than 28 days

44
Q

what is chronic respiratory failure caused by?

A

*BPD
*Inadequate force generation of respiratory muscles caused by muscle disease (DMD)
*SCI
*Chest wall defects
*Muscle fatigue
*CHF
*Airway abnormalities

45
Q

what is respiratory syncytial virus?

A

-Most common cause of respiratory illness in
infants and young children
-Can be severe in babies younger than 6 months
old, babies that are born prematurely, and babies
with congenital heart or lung disease
-also severe in older adults, adults with
compromised immune systems, or those with
asthma
***obstructive lung disease

46
Q

what is highly correlated with later diagnosis of asthma

A

RSV in infancy

47
Q

what is cystic fibrosis

A
  • Obstructive lung disease
  • Most commonly inherited life-shortening illness in the Caucasian population- no longer true due to advances in medicine
  • early detection with newborn screening
  • Autosomal recessive, CFTR gene-discovered
48
Q

diagnosis of cystic fibrosis

A

Sweat test – elevated sodium chloride
Pulmonary function test
Genetics
CF usually dx in infancy

49
Q

asthma

A
  • most common childhood illness
  • > 3 million children in US dx/yr
  • more common in boys, but then more common in women
  • 3 X more common in black children
50
Q

diagnosis of asthma

A
  • History
  • Physical exam including auscultation
  • Pulmonary Function Test
  • Response to methacholine challenge
51
Q

symptoms of asthma

A

*SOB
*Chest tightness
*Coughing
* Seasonal challenges

52
Q

What are the Potential Effects of
Pulmonary conditions on development

A

*Decreased activity level
*Secondary musculoskeletal
changes

53
Q

RDS Management

A
  • Oxygen supplementation and assisted
    ventilation
  • Prophylactic surfactant administration
  • Maternal steroids –> Administered prior to delivery to facilitate production of surfactant
54
Q

RDS Management: ECMO

A
  • Technique of cardiopulmonary bypass used to
    support heart and lung function
  • Used for newborns with respiratory failure
  • Lungs allowed to recover without
    mechanical ventilation
  • Risk of systemic and intracranial
    hemorrhage –> Due to systemic heparin administration
55
Q

BPD Medical Management

A
  • Respiratory support - mechanical vent.
  • Nutrition and fluid management
  • Diuretic drugs
  • Bronchodilator drugs
  • Steroid therapy
56
Q

PT Role in BPD

A

● Infection control
● Chest PT
● Musculoskeletal considerations
● Strengthening muscles of respiration
● Positioning
● Anticipate and assist to meet developmental
milestones

57
Q

management of CF

A
  • Limit effects of airway obstruction
  • Nutrition and enzyme supplementation
  • Pulmonary function tests and x-rays
  • PEP mask
  • Lung transplant
58
Q

PT role in CF

A
  • Chest PT-postural drainage & percussion
  • MSK considerations
  • Developmental activities
  • Nutrition counseling
59
Q

Asthma Management - Pharmacologic

A
  • Short term relief
  • Long term
    management
  • Possible side
    effects of asthma
    medications
60
Q

PT role in asthma

A
  • Consultation and promotion of safe
    participation in fitness activities and
    recreational sports
  • Short term physical therapy to improve
    activity tolerance
  • Physical therapy to address secondary
    musculoskeletal impairments
61
Q

review child postural drainage positions

A

Cardio Pulm Eval (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions