L7 Pulmonary and Cardio Flashcards
Sleep deprivation for infants
impacts health, behavior, emotional functioning, neurocognitive functioning
pre-term infants need more sleep than full-term infants
Infancy sleep
parents need to safeguard sleep
quiet sleep best for brain plasticity, processing information
PT role in infancy sleep
minimize distractions during sleep, particularly in hospital settings such as NICU
back-to-sleep protocols for positioning with healthy infants
Early Childhood Sleep
change in patterns
role in cognition, psychosocial aspects of life like learning, memory, emotional regulation, brain structure development
PT Role Early Childhood sleep
ask about sleep
encourage healthy sleep pattern
Adolescence Sleep
Association between sleep and development at time of puberty
usually there is more prevalence of delayed sleep and shortened sleep
PT Role with Adolescence Sleep
ask about sleep
encourage healthy sleep pattern
Individual aspects that impact breathing
muscle force generation for inspiration
vessel diameter
ROM of thorax
airway responsiveness
Environmental impacts on breathing
gravity
air quality
temperature
humidity
oxygen content of air
Task impact on breathing
ventilation
circulation
respiration
Ventilation
flow of gases between lungs and external environment
Circulation
movement of blood throughout the body
Respiration
tissue level gas exchange
Formation of CV System
formed via merging of two epithelial tubes to create single cardiac tube
heart beat begins at 17 days gestation
Fetal heart sounds are detected by
8-10 weeks of gestation
Circulation of blood in fetus
12% will follow the pathway of adult circulation
fetal blood is oxygenated by the placenta and mother, not by lungs
Cardiac looping begins
3.5 weeks of embryonic life
single cardiac tube folds onto itself creating R/L sides of heart and endocardial cushions become valves
When does effective blood begin in fetus?
end of first month
Foramen ovale
located in atrial septum, allows for blood to go from RA –> LA –> LV –> Aorta
Ductus Arteriosus
use of vascular link outside heart between pulmonary artery and aorta
blood exits pulmonary artery to aorta, bypassing lungs and L heart
Foramen ovale will close…
within a few hours after birth, the pressure changes within cardiac chambers close it
Ductus arteriosus closes…
within a few weeks
Pulmonary System development
not functional until first postnatal breath b/c of fluid environment in utero
transient newborn tachypnea may occur after birth
Alveoli will ____ from birth to childhood
increase
Airway of child
higher larynx
smaller diameter of airways
increased resistance to airflow
increased work of breathing
less cartilage within the airway walls for support
Alveolar Capillary membrane of child
fewer alveoli
less developed ventilation channels
thicker alveolar walls
capillary bed farther from wall
Bony thorax of child
increased compliance of ribcage
horizontal alignment of ribcage
Muscles of ventilation of child
muscles act as stabilizers vs mobilizers
decreased length tension relationship
fatigue faster
Embryonic Phase (1)
lung bud formation
differentiation between trachea and bronchi
Pseudoglandular (2)
formation of airways
terminal bronchioles
Canalicular (3)
lung periphery formation
increased vascularizatoin
formation of air-blood interphase
Saccular (4)
alveolar saccules formation
surfactant detectable
Alveolar (5)
mature alveoli formation
proliferation and expansion of capillaries
nerve and gas exchange
Newborns and Breathing
Cartilaginous ribs are compliant, so less stability. more horizontal
more fatiguable diaphragm
decreased stability of upper chest and neck
more upright positions help to develop diaphragm
Pediatric Outcomes Data Collection Instrument
Parent reported outcome measure for daily activiities and QOL
for 2-10 years (proxy), 11-18(self or proxy)
tests global function, transfer and basic mobility, sports and physical function, pain/comfort, happiness
takes about 20 min
Participation and Environment Measure (PEM-CY)
participation patterns for children and youth in home, school, and community environments
for 5-17, self report or proxy
measures 25 activities and their relative ease or difficulty with task
about 25 to 40 min
