Paediatric

Question 1

Ribs

Answer 1

Have horizontal ribs

No bucket handle movement so limits increase in lung volume

Question 2

Diaphragm

Answer 2

Diaphragm fibres insert horizontally so reduced efficiency of contraction

Question 3

Diaphragm fibres

Answer 3

Only 10% are resistant to fatigue in premature

Only 30% in one year

Question 4

Alveoli

Answer 4

Are small and have a tendency to collapse

Question 5

Collateral ventilation

Answer 5

Poorly established at birth

Question 6

Cartilage

Answer 6

Less cartilaginous support in airways

Question 7

Cilia

Answer 7

Cilial immaturity

Question 8

Ribcage

Answer 8

Very soft and compliant so cannot counteract elastic recoil of lungs
Causing low FRC

Question 9

Metabolic rate

Answer 9

Higher resting metabolic rate so more demand for oxygen

Question 10

Heat

Answer 10

Lose heat quickly due to large surface area to volume ratio

Question 11

Prone to..

Answer 11

Atelectasis and secretion retention

Question 12

Sign of respiratory distress

Answer 12

Nasal flaring
Head bobbing
Grunting
Abnormal ABGs
Tachypnoea, tachycardia and bradycardia
Abnormal breath sounds

Question 13

Positioning for infants

Answer 13

Regular changing
Avoid supine
Avoid head down
Use head up to reduce diaphragm splitting
Prone best for V/Q in bilateral lung pathology
Position with affected side uppermost for secretion drainage
Position with affected side down for V/Q matching.