Term
| Is chest wall compliance in pediatrics similar to adults? Explalin |
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Definition
| No. They lack the same amount of cartilagenous tissue which solidifies and reinforces their chest compartment. As a result their chest compliance is high. Which means they will readily move or collapse with very little force. |
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Term
| what is the FRC (Forced Residual capacity) in children and why is this important |
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Definition
| FRC acts as a respiratory reserve for the body. FRC Children's FRC is decreased due to several reasons: 1. increase chest wall compliance 2. increase proportion of abdominal contents obstructed chest from expanding 3. |
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Term
| ______is the volume of air present in the lungs at the end of passive expiration. |
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Definition
| functional residual capacity |
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Term
| At ___ Capacity, the elastic recoil forces of the lungs and chest wall are equal but opposite and there is no exertion by the diaphragm or other respiratory muscles. |
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Definition
| At FRC, the elastic recoil forces of the lungs and chest wall are equal but opposite and there is no exertion by the diaphragm or other respiratory muscles. |
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Term
| FRC can be increased or decreased by supine positioning |
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Definition
| decreased by up to 30% compared to sitting patient due abdominal contents pushing up on the diaphragm. |
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Term
| what capacity is thought of as a respiratory reserve volume |
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Definition
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Term
| what factors in a pediatric patients amplify to decrease in their FRC |
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Definition
1. increase chest wall compliance
2. small thoracic cage
3. large abdominal contents |
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Term
| If someone has a decrease FRC is this good or bad during induction then intubation? |
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Definition
| BAD!! Decrease FRC means decrease respiratory reserve volume. Which means preoxygenating a patient prior to intubation will only fill so much reserve volume and then you'll have less time to get the tube in before they start to become hypoxic. |
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Term
| what is chest wall compliance |
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Definition
Chest wall compliance is the opposite of elasticity, and elasticity is strongest when you refer to the lungs themselves and their natural want to recoil.
Compliance is essentially the ability of the any type of tissue to “absorb” the applied force whether that be blood pushing on vessel walls (if vessel compliant like veins it will expand accordingly, or air pushing on alveolar walls, or even thorax from pressure pushing it open),
For Pedi if your chest wall is very compliant then it will expand easily to a large diameter wihtout as much force as an adult since a child has less muscle and cartilage.
BUT if there is increase compliance of the CHEST THORAX then the chest not only easily opens to little presssure but it also immediately collapses when that pressure stops. Therefore the lungs with all their elasticity will retract the lungs EVEN FASTER and the thorax will plop right over them and decrease their residual volumes.
Less residual volume = less FRC = less reserve for kids. So their thorax anatomy is not good for anesthesia when intubating and needing extra time to tube them. |
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Term
| Children younger than 6 years of age have a closing capacity greater or less than FRC in the supine position |
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Definition
| Children younger than 6 years of age have a closing capacity greater than FRC in the supine position (V/Q mismatch) |
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Term
| pediatric larynx is cervical ? |
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Definition
pediatric c3-c4
adult is c4-c5
FOR THE LARYNX |
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Term
| basal metabolic rate of a child compared to an adult is? |
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Definition
child: 6 mL/kg/min
Adult: 3 mL/kg/min |
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Term
| how long does a pediatric patient have a blunted response to hypoxia |
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Definition
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Term
| Transient or intermittent stridor can result from |
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Definition
| Transient or intermittent stridor can result from aspiration with acute laryngospasm or from vocal cord dysfunction. |
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Term
| The most common causes of acute stridor in children include |
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Definition
The most common causes of acute stridor in children include
Croup
Foreign body aspiration |
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Term
| Epiglottitis has historically been a common cause of stridor in children, but its incidence has decreased since the introduction of |
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Definition
| Epiglottitis has historically been a common cause of stridor in children, but its incidence has decreased since the introduction of the Haemophilus influenzae type B (HiB) vaccine |
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Term
| Abrupt onset of high fever, sore throat, drooling, and often respiratory distress and marked anxiety is usually ___ |
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Definition
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Term
| Racemic epinephrine should not be used in what respiratory emergency |
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Definition
| Racemic epinephrine should not be used in cases of epiglottitis |
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Term
| nebulized Racemic epinephrine works by |
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Definition
| Racemic epinephrine works by stimulation of the α-adrenergic receptors in the airway with resultant tightening of the mucosa (mucosal vasoconstriction) and decreased fluid in the airway (subglottic edema) and by stimulation of the β-adrenergic receptors causing relaxation of the bronchial smooth muscle |
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Term
| a weak or hoarse voice or weak/hoarse cry suggests what kind of airway problem |
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Definition
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Term
| a cough is indicator of what kind of issue |
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Definition
| irritative perhaps from a aspirated body |
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Term
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Definition
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Term
| croup is the most common cause of |
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Definition
| infectious acute upper airway obstructions |
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Term
| Is bacterial croup or viral croup most common |
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Definition
|
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Term
| name some viral etiologies of croup |
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Definition
1. parainfluenza virus type 1
2. influenze
3. RSV Respiratory syncytial virus
4. rhinoviruses
5. measles |
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Term
| mean age of infected kids most commonly affected by croup is |
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Definition
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Term
| when is croup most prevelant during the year |
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Definition
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Term
| is drooling common in croup |
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Definition
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Term
| if a pediatric with likley resp trouble is lethargic and agitated this likely means? |
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Definition
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Term
| what resp abnormalities (signs) are associated with croup |
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Definition
| expiratory wheezes and inspiratory stridor |
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Term
| most common etiology for epiglottis is |
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Definition
| infection by haemophilus influenzae type B which is a bacterial infection |
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Term
| most common age for epiglottis |
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Definition
|
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Term
| what is the difference in voice or cry between croup and epiglotits |
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Definition
croup: voice/cry is hoarse
Epiglotitis: voic/cry is muffled (no air) |
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Term
| most common age for freign body aspiration |
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Definition
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Term
| sx of patient with foreign body aspiration |
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Definition
1. inspiratory stridor
2. expiratory wheezes
3. prolongation of expiratory phase
4. medium to coarse rhonchi |
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Term
| most common cause of childhood OSA is |
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Definition
| adenotonsillar hypertrophy |
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Term
| neonatal respiratory distress syndrome develops from |
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Definition
| insufficeinccy of surfactant production and structural immaturity of the lungs |
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Term
| increase risk for neonatal respiratory distress syndrome is directly related to? |
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Definition
| gestation. the more early you are born more at risk for this |
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Term
| does neonatal respiratory distress syndrome begin a couple weeks after birth, after birth or at infnancy |
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Definition
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Term
| what type of genetic disease is cystic fibrosis |
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Definition
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Term
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Definition
1. clogging of airways due to mucus build up
2. decrease muscocilliary clearance
3. inflammation |
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Term
| what is the physiology behind the sounds in croup |
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Definition
| When a cough forces air through this narrowed passage, the swollen vocal cords produce a noise similar to a seal barking. Likewise, taking a breath often produces a high-pitched whistling sound (stridor). |
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Term
| ___ resp illness in children is worse at night, and is further aggravated by crying and coughing, as well as anxiety and agitation, setting up a cycle of worsening symptoms |
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Definition
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Term
| the Hib vaccine is for? Given how many times and at what age |
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Definition
| Hib is for preventing haemophilus influenzae type B which is the most common cause of epiglotitis. Given in four doses at age 2 monhts, 4 months, 6 months 12 months. |
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Term
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Definition
| The closing capacity (CC) is the volume in the lungs at which its smallest airways, the respiratory bronchioles, collapse. The alveoli lack supporting cartilage and so depend on other factors to keep them open. The closing capacity is greater than the residual volume (RV), the amount of gas that normally remains in the lungs during respiration, and specifically, after forced expiration. This is because closing capacity is equal to closing volume plus residual volume. This means that there is normally enough air within the lungs to keep these airways open throughout both inhalation and exhalation. As the lungs age, there is a gradual increase in the closing capacity (i.e. The small airways begin to collapse at a higher volume/before exspiration is complete). This also occurs with certain disease processes, such as asthma, chronic obstructive pulmonary disease, andpulmonary edema. Any process that increases the CC by lowering the functional residual capacity (FRC) can increase an individual's risk of hypoxemia, as the small airways may collapse during exhalation, leading to air trapping and atelectasis. |
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Term
| chest compliance is high in pediatrics due to what physiological properties that are normal |
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Definition
1. cartilangenous ribs versus muscular
2. limited thoracic muscle mass. |
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