Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
107 Cards in this Set
- Front
- Back
When assessing the lungs of babies, where is the most likely location of retractions from respiratory distress?
|
Along the posterior axillary line
|
|
What technique allows a HCP to differentiate congestion in the upper respiratory tract as opposed to the lower lungs?
|
Listen in both the CHEEK and the lungs
|
|
When auscultating the posterior thorax, which lobes are you hearing most?
|
the Lower LOBES
|
|
What is right middle lobe syndrome>
|
wheezes that are only heard in that location. must auscultate midaxillary
|
|
Children have a (larger/smaller) tongue than adults
|
Larger!!
|
|
Tonsils reach their maximum size by age __
|
7
|
|
COmpared to adults, the larynx of children is located __ and more __ in the neck
|
higher; anterior
|
|
Describe the epiglottis in peds.
|
-Floppy and omega shaped
-secretions increased |
|
CHildren have a (increased/decreased) angle between their epiglottis and laryngeal opening.
|
increased
|
|
Children have redundant ____ fold in the supraglottic region.
|
aryepiglottic
|
|
The airway of children is (broader/narrower) than adults
|
narrower
|
|
What causes croup?
|
swelling of mucosa airway lined with hair cells, lysosymes, mucus and IgA
|
|
What sign upon Xray indicates croup?
|
Steeple sign
|
|
What are the 2 most common infections leading to croup?
|
1. parainfluenza
2. RSV |
|
ToF: children have a greater amount of soft tissue surrounding their airway.
|
True
|
|
ToF: alveoli continues to develop during the first 5 years of life?
|
true
|
|
The sternum and ribs of children are predominatly ___
|
cartilaginous
|
|
Why are retractions easily seen in young children with respiratory distress?
|
-Poorly developed intercostal and accessory muscles
-Thin chest wall |
|
According to the WHO, children younger than 2 months are said to be tachypneic if they have ___ breaths a minute
|
60
|
|
If a child is breathing > 50breaths a minute and said to be tachypnic, how old are they
|
2 months to 12 months
|
|
for a child 1-5 years old, they must breath __ times a minute to be tachypnic.
|
>40
|
|
Any child > 5years old that is breathing > __ breaths a minute is tachypnic
|
20
|
|
What is the most sensitive indicator of respiratory distress?
|
Respiratory rate!
|
|
Describe what will be inspected with a high obstruction to the airway?
|
suprasternal and severe
|
|
Where are retractions seen with a low obstruction?
|
infrasternal but less intense
|
|
What is an important symmetry finding to assess for in the thorax? What can cause it?>
|
-precordial bulge: may indicate cardiac defect, pneumothorax or chlronic localized ches disease
|
|
Pectus ___ can shift the heart (PMI) to the left of midclavicular line
|
excavatum
|
|
What is a description of pectus carinatum?
|
pigeon chest
|
|
When does the tingling of tactile fremitus decrease?
|
-airway obstruction
-pleural effusion |
|
when percussing a child's lung fields, what position must the child be in and why?
|
Their head must be midline.
if the head is turned, there will be dullness on the other side |
|
YOu can hear a flat percussion over the ___
|
thigh
|
|
Dullness upon percussion is heard over the __
|
liver
|
|
The lung field should have a ___ percussion
|
resonant
|
|
Where is tympanny heard?
|
over the abdomen
|
|
ToF: palpation of tactile fremitus increases over areas of lung consolidation.
|
TRue
|
|
Decreased or absent vibration from tactile fremitus is heard when the bronchus is ___ or occupied by ___
|
obstructed; fluid
|
|
inspiratory sounds should be ___ time as long as expiratory sounds if they are vescicular.
|
three
|
|
Breath sounds in a child can be almost all ___ or ___
|
bronchovesicular or bronchial
|
|
If the inspiratory phase is twice as long as expiration, what kind of breath sound is it?
|
bronchovescicular
|
|
What type of breath sounds have equal length of inspiration and expiration
|
tracheal
|
|
Describe the timing of bronchial sounds
|
expiration is very slightly long
|
|
When listening over the neck and trachea, what are the quality of these sounds
|
tracheal: very loud expiratory sound and relatively high pitched expiratory sound
|
|
If listening over the manubrium, what is the pitch of a normal breath sound
|
bronchial: very loud, high pitched and sound heard close to the stethescope.
-intermediate expiratory sound |
|
Where are bronchovesicular breath sounds heard best?
|
in the 1st and 2nd ICS (anterior chest) and between the scapulaue (posterior chest). over the mainstem bronchi
|
|
If bronchovesicular sounds are heard anywhere other than over the mainstem bronchi, they are signs of ___
|
consolidation
|
|
Which sounds are heard over most of the lung: axillary and lung bases?
|
vesicular
|
|
Describe fine rales and crackles.
|
soft, high pitched and very brief
|
|
what are course rales and crackles like?
|
somewhat louder, lower in pitch and longer in duration
|
|
Rales are heard at lower parts of the chest in __ ___
|
heart failure
|
|
rales heard in __ __ in indicative of interstitial lung disease
|
late inspiration
|
|
ToF: all rales have significance.
|
False: rales heard after coughing have no significance
|
|
___ are lower pitched and have a snoring quality.
|
rhonchi
|
|
Describe wheezes, how are they heard best?
|
High pitched
-push in on child's chest to hear them at the end |
|
ToF: a child with asthma that has a quiet chest is a good sign?
|
FALSE: a quiet chest may be very bad!
|
|
What type of cough is common with asthma?
|
tight cough
|
|
A person with a staccato cough likely has ___
|
pneumonia
|
|
What 4 things should be noted when assessing for respiratory distress
|
-LOC
-Respiratory rate -work of breathing -color |
|
What are examples of work of breathing.
|
-expiratory grunt: keeps the airway open
-nasal flaring -retractions |
|
If the child says 99 and a louder clearer voice is heard on auscultation, what is this?
|
bronchophony
|
|
What is egophony?
|
when the child is asked to say EEE and it sounds like AY
|
|
Describe whisper pectoriloquy.
|
Have the child whisper 1,2,3 it will be clear if there is a consolidation pneumonia/fluid
|
|
the site of origin of wheezes are the ___ ___
|
intrathoracic airways
|
|
The adventitious sound that can come from either or both intra and extrathoracic airways are ___
|
rattles
|
|
Stridor originates from the __ airway
|
extrathoracic
|
|
A snore originates from the ___
|
oro-naso pharyngeal airway
|
|
What is the site of origin of a grunt
|
alveloi/lung parenchyma
|
|
sounds from the nasal passages/naso-pharynx are often __
|
snuffles or snorts
|
|
chronic rattles are found in patients with __ __
|
neuromuscular disorders
|
|
An Acute rattle is often an acute ___ ___
|
viral bronchitis
|
|
acute pharyngitis and tonsillitis often causes what adventitious sound?
|
a snore
|
|
chronic snuffles are from ...
|
allergic rhinitis
|
|
An acute wheeze is often caused by...
|
intermittent asthma
-viral induced wheeze |
|
A patient with chronically enlarged adenoids will often have a chronic ___
|
snore
|
|
what is the cause of a homophonic sound?
|
something trapped in large airway
|
|
What are the example of large airway obstructions causing wheezing.
|
-Monophonic or homophonic sound
-inhaled foreign body -endotracheal tuberculosis -bronchial adenoma -enlarged mediastinal nodes -achalasia -malignant mediastinal tumors |
|
in patients with monophonic localized wheezing, ___ __ needs to be considered.
|
mass lesion
|
|
what are the types of wheezing that result from a small airway obstruction?
|
polyphonic or heterophonus wheezing
|
|
give characteristics of small airway obstructions causing wheezing.
|
-expiratory predominant
-asthma, bronchiolitis -TEW: transient early wheezing -usually disappears in early childhood. |
|
___ get misdiagnosed in young children as a wheeze
|
rattles
|
|
ToF: kids with psych problems can induce a wheeze
|
true
|
|
What aspect of respiration is a stridor heard?
|
predominantly inspiratory
|
|
What is stridor a sign of ?
|
upper airway obstruction
|
|
What are the supraglottis causes of stridor?
|
-epiglottitis
-aryepiglottic flods -false vocal chords (prone to collapse resulting in obstruction) |
|
What are the glottic causes of stridor?
|
True vocal cords:
-laryngeal warts, larngeal web: papillomatosis |
|
What is papillomatosis? what does it cause?
|
Have laryngeal warts that can obstruct the airway and cause stridor. must be burned off periodically to allow for breathing
|
|
Where does the stridor of croup originate?
|
in the subglottic area.
|
|
What is the name of the disorder that has stridor with croup symptoms?
|
acute laryngotrachobronchitis
|
|
What is the diagnostic sign of epiglotitis?
|
the thumb sign on xray
|
|
How will a child with epiglotitis be acting?>
|
They will refuse to lay down, will have an acute high fever and will look sick
|
|
What causes a snore?
|
increase in resistance to airflow through the upper airways in the region of nasopharynx and oropharynx: big adenoids
|
|
ToF: infants should not have noisy breathing>
|
FALSE: it is a common finding to have noisy breathing
|
|
ToF: a rattle can be a symptom of asthma
|
false
|
|
ToF: it is common to mistake a wheeze for stridor.
|
true and a major error
|
|
ToF: current technology to support the use of acoustic analysis has been found to be effective.
|
FALSE!!!!!
|
|
What are the 3 phases of a cough?
|
-inspiratory
-compressive -expiratory |
|
A __ can be suppressed or initiated voluntary unless it is part of laryngeal expiratory reflex
|
cough
|
|
What are the 2 types of cough?
|
laryngeal and tracheobronchial
|
|
The suggested underlying processes of a barking or brassy cough are ...
|
-Croup
-tracheomalacia -habit cough |
|
What type of cough is a psychogenic cough?
|
honking
|
|
What is the cause of a paroxysmal cough
|
Pertussis and Parapertussis
(+/- inspiratory whoop) |
|
An infant with a staccato cough is thought to have __
|
chlamydia
|
|
Plastic bronchitis or asthma is thought to produce what type of cough
|
one productive of casts
|
|
What type of cough accompanies suppurative lung disease?
|
chronic wet cough in am only
|
|
If a toddler presents with stridor and will only take in fluids and not solid food, what is a likely cuase?>
|
Foreign body aspiration!
|
|
where are retropharyngeal abscesses found most common?
|
Bordered posteriorly by prevertebral fascia and anteriorly by the esophagus
|
|
What are the most common causes of retropharyngeal abscesses?
|
-Staphylococcus aureus
-anaerobic bacteria -beta hemolytic streptococci |
|
How does a retropharyngeal abscess appear?
|
Use a lateral neck film: there is an increase in the width of the prevertebral space and anterior displacement of the airway
|