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APEX-across the lifespan > LIFESPAN-neonate > Flashcards

LIFESPAN-neonate Flashcards

1
Q

When is the neonatal period versus the infant period

A 
neonate = 0-28 days
infant = 20 days to 1 year
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2
Q 
Normal values for the following in the NEWBORN:
SBP=
DBP=
HR=
RR=
A 
SBP= 70
DBP= 40
HR= 140 
RR= 40-60
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3
Q 
Normal values for the following in the 1-y/o:
SBP=
DBP=
HR=
RR=
A 
SBP= 95
DBP= 60
HR= 120
RR= 40
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4
Q 
Normal values for the following in the 3-y/o:
SBP=
DBP=
HR=
RR=
A 
SBP= 100
DBP= 65
HR= 100
RR= 30
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5
Q 
Normal values for the following in the 12-y/o:
SBP=
DBP=
HR=
RR=
A 
SBP= 110
DBP= 70
HR= 80
RR= 20
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6
Q

Why is RR so high in the nenonate

A

B/c O2 consumption and CO2 production are double that in adults

Alveolar ventilation must increase to match the metabolic difference

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7
Q

What variable is the primary determinant of CO in the pediatric pt

A

HR

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8
Q

Why is SV difficult to adjust in the neonate

A

The myocardium lacks contractile elements to significantly adjust contractility or SV

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9
Q

At what threshold is HoTN in the following:
Newborn =
1-year =
>1-year =

A 
Newborn = <60 mmHg
1-year = <70 mmHg
>1-year = <[70+(age x 2)]
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10
Q

Which medication is preferred for bradycardia in the neonate

A

Epinephrine

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11
Q

Why is bradycardia a more common response to stress than tachycardia in the neonate

A

Because the PNS is more mature than the SNS

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12
Q

Describe the baroreceptor reflex development in the neonate

A

It is poorly developed and it fails to increase HR in the setting of hypovolemia

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13
Q

How does tongue anatomy differ between adults and infants and the anesthetic implication

A

difference = infant is relatively large

implications =

  • more likely to obstruct upper airway
  • more difficult to displace during DL
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14
Q

How does neck anatomy differ between adults and infants and the anesthetic implications

A

Infants have shorter necks

implication = more acute angle required to visualize glottis

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15
Q

How does epiglottis anatomy differ between adults and infants and the anesthetic implications

A 
Adult = leaf or C shape, floppy, short
Infant = U shape, stiff, long

Implications = stiff epiglottis is more difficult to displace

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16
Q

How does VC anatomy differ between adults and infants

A 
Adult = perpendicular to trachea
Infant = anterior slant
17
Q

2 Anesthetic implications of infant VC anatomy

A
  1. visualization and passage of ETT more difficult

2. ETT can get stuck in anterior commissure

18
Q

How does laryngeal anatomy differ between adults and infants

A

Adult = positioned at C5-C6
Infant = positioned at C3-C4
-more superior/cephalad/rostral NOT anterior

19
Q

Anesthetic implications of infant laryngeal position

A
  1. Miller may be preferential over Mac

2. The larynx descends to C4 ~1 yr

20
Q

When does the pediatric larynx achieve adult positioning

A

around age 5-6

21
Q

What is the narrowest portion of the airway in the adult vs infant

A 
Adult = glottis (VC)
Infant = Cricoid or glottis
22
Q

3 Anesthetic implications of narrowest point of infant airway

A
  1. resistance to ett beyond VC is likely the cricoid rings
  2. Cricoid tissue is prone to inflammation and edema (stridor/obstruction)
  3. Consider Poiseuille’s law, airway radius, and airflow resistance
23
Q

Compare the subglottic airway shape between adults and infants

A 
adult =  cylindrical 
infant = funnel
24
Q

Compare the bronchus positions between adults and infants

A 
adult = more vertical (25* off midline)
infant = less vertical (55* off midline)
25
Q

Compare intubation position between adults and infants

A 
Adults = sniffing position
Infant = head on bed with shoulder roll
26
Q

Why is intubating position different for adults and infants

A

Infants have large occiput

27
Q

What is the narrowest fixed region of the infant airway

A

Cricoid rings

28
Q

What are 4 situations that increase the risk of cricoid edema

A
  1. ETT too large
  2. multiple intubation attempts
  3. prolong intubation
  4. frequent head positioning while intubated
29
Q

What is the narrowest dynamic region of the infant airway

A

Vocal cord

APEX-across the lifespan (7 decks)

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