Test 3: Respiratory Flashcards
What is the difference between adult and pediatric lungs?
Pediatrics - focus on airways
Adults - focus on cardio
Children have ____ and ___ airways from trachea to bronchioles.
shorter (4 mm)
narrower
Which bronchus angle is more acute in children?
right bronchus
Lymph tissue grows until age ___.
12
T/F: Children have very small tongues.
false, children have LARGE tongues
T/F: The epiglottis is long and floppy in children.
True
Are the larynx and glottis higher or lower in the neck in children? What does this put them at risk of?
Higher
Risk of aspiration
What can happen to the cartilage in the neck due to its immaturity in children?
can collapse
Are there many functional muscles in the airway?
No
What leads to risk of edema and airway obstruction?
Large amounts of soft tissues and loosely anchored mucus
In children, the chest muscles are immature and the ribs are cartilaginous. This allows the chest wall to be ___.
flexible
Name the retraction:
Located BETWEEN ribs.
Indicates MILD distress.
intercostal
Name the retraction:
Located below the STERNUM.
Worsening distress.
substernal
Name the retraction:
Located below the RIBS.
Worsening distress.
subcostal
Name the retraction:
Located above the CLAVICLES.
Severe distress.
supraclavicular
Name the retraction:
Located above the STERNUM.
Severe distress.
suprasternal
What level of resp. distress is indicated by the involvement of the accessory muscles (SCM and traps)?
Severe
Another name for laryngotracheobronchitis is…
croup
What ages are most often affected by croup?
1 - 3 years
What is the most common form of croup?
LTB (laryngotracheobronchitis)
What is the classic sign of LTB?
inspiratory stridor
How does LTB begin?
simple URI for 1-2 days then infection
LTB early symptoms?
stridor
barking cough
LTB later symptoms?
- inflammation of trachea and bronchi
- hoarseness
- mild fever
- restlessness
- nasal flaring
- retractions
- hypoxia
- respiratory fatigue
How is MILD croup treated?
at home (if no stridor at rest)…
- oral fluids
- cool mist humidifier (steam or cool air)
- acetaminophen for fever
How is SEVERE croup treated?
at hospital (if stridor constant)…
- O2 / pulse ox
- nebulized racemic epinephrine or nebulized corticosteroids
What med is alpha-adrenergic and causes vasodilation of the mucosa?
racemic
What condition is potentially life-threatening and occurs when the epiglottis swells blocking airflow into your lungs?
epiglottis
Epiglottis is a medical ____! It is severe, sudden, and rapidly progressing.
emergency
What is the hallmark sign of epiglottis?
drooling
What ages are often affected by epiglottis?
3-7 years
What are other signs of epiglottis?
- very sore throat
- refusal to swallow/cry/speak
- tripod position
- muffled voice
- retractions
- anxiety
- fever
How does the epiglottis appear when inflamed?
swollen and cherry red
What is the “thumb sign” seen in a LATERAL x-ray?
when the epiglottis is swollen it appears like a thumb
What antibiotic is often prescribed for epiglottitis?
methylprednisolone
What meds often help with the inflammation of epiglottitis?
IV steroids
What vaccine prevents epiglottitis?
Hib
What age is most at risk for foreign body aspiration?
1-3 years old
What may be the first sign that a foreign body is aspirated?
infection
What determines the severity of foreign body aspiration?
- size of object
- where it’s located in lungs
- respiratory distress
What is done in a partial obstruction?
Go to ED if air is still moving
What is ordered for a partial obstruction?
laryngoscopy, bronchoscopy
antibiotics
x-ray
Signs of a foreign body in the nose…
- UNIlateral nasal discharge, foul smelling
- sneezing, discomfort
- infection
What are signs of infection with a foreign body in nose?
- foul breath
- discharge from nose (can be bloody)
