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clinical med > Peds Thorax > Flashcards

Peds Thorax Flashcards

1
Q

How does the AP diameter in peds compare to those of adults?

A

decreases through the first 3 years of life

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2
Q

How does the diaphragm attach in peds compared to adults?

A

Angle of insertion is horizontal in infants, leading to lower contraction efficiency

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3
Q

When does alveolar multiplication stop?

A

until thoracic growth is complete–around two years of age

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4
Q

Who has more alveoli after two yo: boys or girls?

A

Boys

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5
Q

When are the capillaries grown to the adult form?

A

2-3 yo

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6
Q

Why are children more susceptible to respiratory distress?

A

not enough growth

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7
Q

What is the first step of child’s peds exam?

A

ABCs (airways, breathing, circulation)

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8
Q

What is the RR at birth and less than 28 days old?**

A

40-60**

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9
Q

How do infants breathe?

A

Obligate nasal breather

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10
Q

What is the normal breathing pattern in infants?

A

Periodic breathing

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11
Q

What is apnea considered for children?

A

greater than 20 seconds

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12
Q

What is the only way to count the number of breaths for infants?

A

counts over a minute

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13
Q

What are the six pertinent symptoms that can change breathing?

A
  1. High Fever
  2. Not Eating
  3. Color change (red is okay, blue is bad)
  4. Nasal congestion
  5. Cough
  6. Sudden onset (FB?)
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14
Q

Coughing to the point of vomiting for children is indicative of what preventable disease?

A

Pertussis

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15
Q

What are the signs of respiratory distress in infants?

A
  1. Rate and effort
  2. Retractions
  3. Nasal flaring
  4. Head bobbing
  5. Grunting
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16
Q

Where are retractions seen in children? (3)

A
  1. Suprasternal
  2. Subcostal
  3. Intercostal
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17
Q

What are the five aspects of the cardiac exam for peds?

A
  1. Heart
  2. Lungs
  3. Liver
  4. Skin
  5. Pulses
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18
Q

What is acrocyanosis?

A

Normal cyanosis in the fingers/extremities

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19
Q

When is cyanosis worrisome in children?

A

Central cyanosis

20
Q

What is the hyperoxitest? Result interpretation?

A

Check ABG, provide 100% PaO2.

Rise or pO2 > 100mmHg the cause is probably pulmonary. If no rise, cardiac

21
Q

Where is the heart listened to in peds?

A

midclavicular line, 4th or 5th intercostal space (same as adult)

22
Q

What are three conditions that can cause a heart shift?

A
  1. Pneumothorax
  2. Dextrocardia
  3. Diaphragmatic hernia
23
Q

What is the normal newborn HR?

A

120-160 BPM

24
Q

A fixed HR above 220 in children can be indicative of what?

A

Supraventricular tachycardia

25
Q

Which sound is higher in pitch; S1 or S2?

A

S2

26
Q

True or false: splitting of the heart sounds in common in infants

A

True

27
Q

True or false: murmurs are common in the newborn in the first 1-3 days

A

True

28
Q

What causes most murmurs in newborns?

A

Changes in vascular pressures during early transition after birth

29
Q

What is a machinery murmur indicative of?

A

PDA

30
Q

A bounding pulse in infants can indicative of what?

A

PDA

31
Q

Diminished femoral pulses may be due to what?

A

Aortic coarctation

32
Q

What is the order of the femoral artery, nerve, and vein, going medially to laterally?

A

VAN

33
Q

What is a hypertensive BP in infants?

A

> 80/50

34
Q

True or false: sinus arrhythmia is less common in peds than in adults?

A

False–more common

35
Q

What are innocent murmurs? (3)

A
  1. Midsystolic
  2. 2-3/6 intensity
  3. Maximally heard at the mid left sternal border
36
Q

When are murmurs common?

A

3-7 years of age

37
Q

After what age as murmurs concerning?

A

After 7 yo

38
Q

What happens when children lie supine (as far as murmurs go)?

A

Heard better

39
Q

What happens when children sit/stand up or hold their breath (as far as murmurs go)?

A

Heard less

40
Q

What happens to murmurs in instances of increased metabolic rate?

A

More pronounced

41
Q

Which murmurs are always concerning? (4)

A

Diastolic
Loud
Central cyanosis
Abnorm pulses

42
Q

What is a normal cap refill for children?

A

Under 2 seconds

43
Q

Where should the extremity be when cap refill is assessed?

A

Above the heart

44
Q

How does the diaphragm attach in peds compared to adults, and what is the consequence of this?

A

Diaphragm is more horizontal in infants, leading to decreased contraction efficiency

45
Q

True or false: an enlarged liver may be an early sign of heart failure in peds

A

True

clinical med (30 decks)

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