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Patho 2 > Peds Airway Supp > Flashcards

Peds Airway Supp Flashcards

1
Q

What is unique about the structure of neonatal lungs?

A

They have immature duct like structures rather than true alveoli which results in less gas exchange

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2
Q

At what point during a neonates life does the alveoli enlarge and triple in size?

A

By 3 months

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3
Q

At maturity in the neonates life, what happens to the alveoli diameter and amount of alveoli present in the lungs?

A

The diameter is qintupled and the amount in increased 15 fold

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4
Q

By 6 months the weight of the lungs is _______ and _______ in a year and is ___ times greater at maturity

A
  • doubled
  • tripled
  • 10 times
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5
Q

With age, lung volume ________ and the rate of respirations ________

A

Increase ; decrease

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6
Q

What is the consequence of children having a decrease in functional residual capacity?

A

The consequence is them de-saturating more rapidly due to children having an increase O2 demand but a decreased O2 reserve which results in hypoxemia

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7
Q

Why is nasal congestion a serious threat to infants?

A

Because neonates are obligatory nasal breathers until a few months of age?

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8
Q

Neonates mainly use their diaphragm until about what month of age? What muscle group do they switch to after that?

A

7 months ; costal muscle

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9
Q

What is the most common cause of airway obstruction for neonates?

A

The loss of muscle tone which causes their tongue to slide back which is larger in proportion to their mouth

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10
Q

What are causes of loss in tongue tone which can cause an airway obstruction?

A
  • sleep
  • CNS dysfunction
  • sedation
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11
Q

The epiglottis is ____ and ______ in neonates

A

Larger and floppier

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12
Q

How does the larynx in neonates differ from those in adults?

A

It is more anterior and superior than adults

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13
Q

Where is the narrowest point of the paediatric airway?

A

At the cricoid cartilage

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14
Q

How does neonate airways differ in shape than the adults cylinder shape?

A

They are cone/funnel shaped

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15
Q

Is the chest wall compliance in infants and peds high or low?

A

High

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16
Q

Why is chest wall compliance so high in infants and peds?

A

The cartilaginous structures of the thoracic cage are not well ossified

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17
Q

What is the shape of the diaphragm in infants?

A

A horizontal less pronounced dome shape

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18
Q

What angle do the ribs come off the spine in children compared to adults. What does this angle prevent the ribs from doing?

A

Children ribs come off the spine at a 90 degree angle where as adults are 45 degrees. The angle prevents the ribs from lifting the chest wall to increase tidal volume during breathing

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19
Q

How do children compensate for their inability to lift the chest wall effectively?

A

They must increase their resp rate to compensate for the reduced ability of their ribs to life their chest wall which is supposed to increase tidal volume

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20
Q

What is the main support for the chest in children?

A

The main support comes from the chest muscles rather than the ribs

21
Q

Most causes of cardiac arrest in children are the result of what?

A

Respiratory failure and hypoxia

22
Q

What are the consequences of using chest muscles for breathing in children?

A

Use of chest muscles for breathing increases metabolic and O2 consumption which leads to quicker fatigue of these muscles

23
Q

Why do children have a more rapid fluid loss due to fever, environmental heat, or in association with tachypnea?

A

They have a high proportion of ECF

24
Q

What are you assessing for during the “appearance” portion of the PAT?

A

T = Tone
I = Interactiveness
C = Consolability
L = Look/Gaze
S = Speech/Cry

25
Q

What are you assessing for when at the “Work of Breathing” portion of the PAT

A
  • signs of distress
  • head-bobbing, nasal flaring, accessory muscle use, rate/volume of breathing, abdominal involvement, and body positioning
  • auditory clues : snoring, grunting, strider, wheezing, muffled or hoarse speech or silently focusing on breathing
26
Q

What are you assessing for at the “Circulation” portion of the PAT

A
  • pallor
  • mottling
  • cyanosis
27
Q

What does snoring/stertor in the airway signify? give examples.

A
  • a nasopharyngeal/proximal airway obstruction
    Examples include: tongue falling back, swelling, FBAO, or fluids/secretions in the airway
28
Q

What is strider and how does it sound? What is it caused by?

A

Strider is a harsh, vibrating noise varying in pitch but is usually high
It is caused by turbulent flow through a partially obstructed airway

29
Q

What are the common causes of strider?

A

Upper airway issues such as
- croup
- FBAO
- epiglottitis

30
Q

What characterizes inspiratory strider and where is it usually located/affecting?

A

Inspiratory strider is usually extrathoracic, affecting areas like the supragolttic region, larynx, and upper trachea

31
Q

What does expiratory strider indicate about the location of the obstruction?

A

Monophasic expiratory strider suggested and obstruction in the intra thoracic region such as the lower trachea and below

32
Q

What does biphasic strider indicate about the location of the obstruction?

A

This typically involves the glottis itself

33
Q

What is wheezing usually indicative of? When is it typically heard?

A
  • lower airway obstructions such as asthma or bronchiolitis
  • initially heard on expiration and and biphasic with increase in obstruction
34
Q

Crackles aka rales are heard with what conditions?

A

Parenchymal lung problems such as pneumonia or bronchiolitis

35
Q

What is grunting?

A

An expiratory noise when the child exhales against a partially closed glottis at the end of expiration

36
Q

What is the purpose of grunting in children experiencing respiratory issues?

A

A mechanism to create a positive end expiratory pressure (PEEP) to help keep alveoli open for gas exchange

37
Q

When is grunting often seen in children?

A

Seen in children w/ moderate to severe hypoxia

38
Q

What problem does a weak,horse voice suggest?

A

Problems at the larynx

39
Q

Why does lying down make breathing more difficult?

A

Because it causes an increase in intrathoracic pressure

40
Q

Why are Acute URTI?

A
  • Croup
  • Epiglottitis
41
Q

What is a LRTI

A

Bronchiolitis

42
Q

Bacterial croup is seen in what age group? When are peak incidence?

A
  • 6 months to 5 years
  • peak incidence 1 -2 years
43
Q

Viral croup is most often seen in what age range?

A

3months to 3 years

44
Q

What are clinical varieties of croup?

A
  • laryngitis
  • LTB (laryngotracheobronchitis)
  • acute spasmodic croup
45
Q

Why is acute spasmodic croup often a febrile?

A

Because the reaction could be allergic rather than infectious

46
Q

Acute spasmodic croup is common in the age range of…

A

1-3 yoa

47
Q

Acute epiglotititis is more common in children with what age range?

A

3-7 yoa

48
Q

What should you never do with a child who might have epiglottitis and why?

A

Never attempt to visualize the pharynx because it may trigger laryngospasm which can cause to a sudden completer airway obstruction

Patho 2 (30 decks)

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