Pediatric Flashcards
What are some differences in the larynx of infants versus adults? What do you need to do because of this?
The larynx is more cephalad in infants. It is at C4 as opposed to see six with adults. This makes the larynx appear more interior during laryngoscopy, it makes the sniffing position less helpful, and cricoid pressure is more important for glottic visualization.
What is the narrowest part of the airway in PD? At what age does this change?
The cricoid cartilage is the narrowest part of the airway until 7 to 10 years old, after which the vocal cords become the most narrow part; properly fitting uncuffed ETT’s maybe used until then.
Why would a straight blade possibly be better during laryngoscopy of a child?
Because the epiglottis is long? Steph? And extends posteriorly. Covering the glottis in justify the use of a straight blade.
Is laryngospasm more common in children? And are the upper airway muscles more or less sensitive to the depressant effects of an aesthetic’s?
The upper airway muscles are more sensitive to the depressant effects of anesthetics insulation. Laryngospasm is more common in children
Do you need to have a higher or lower consumption of O2? Tell me about the ribs, FRC, and minute ventilation of a neonate? Tell me about the diaphragms of kids? And tell me about the abdominal contents?
Neonates have a higher O2 consumption an adult 7-9 mL/kg/min vs 3 mL/kg/min in an adult. The ribs are compliant and cartilaginous which predisposes to chest wall collapse. tThey also have a horizontal angulation of the ribs which leads to inefficient inspiration. Neonates have a lower FRC as well as an increased VO2. Infants have a higher minute ventilation. They also have only 25% of the slow twitch fatigue resistant type one fibers versus 55% in the adult.
Does the newborn have the same drive to breathe as an adult?
No. The newborn hypoxic and hypercarbic drives to breed are immature so that hypoxia and hypercarbia depressed respiration during the first three weeks of life.
In a child greater than three years old, Is there total lung capacity, tidal volume, and FRC similar to those of an adult?
Yes-on a per kg basis
Do you neonate have higher closing volumes? What does this pre-disposed them to?
They have higher closing volumes, predisposing them to airway closure And alveolar collapse during tidal volume ventilation. Then later dead space tidal volume loss to compliant tubing and in accuracies with capnography are more significant in the neonate.
