ENPC Respiratory questions and answers 100% correct

ENPC Respiratory questions and answers 100% correct Anatomical and physiological features of the pediatric airway? large tongue relative to size of oropharynx obligate nose breathers smaller airway diameter cricoid cartilage narrowest area larynx more anterior and cephalad cartilaginous larynx short neck and short trachea What is normal respiratory rate for the 5 pediatric age groups? infant (1-12 months) - 30-60 toddler (1-3 years) - 24-40 preschooler (3-5 years) - 22-34 school age (5-11 years) - 18-30 adolescent (11-18 years) - 12-16 What is the narrowest area of the pediatric airway? the crichoid cartilage - provides anatomical seal for uncuffed or cuffless ETT in children younger than 8 years old Anatomical and physiological features of pediatric breathing? compensatory mechanisms less effective higher metabolic rate respiratory rate varies with age thin chest wall cartilaginous sternum and ribs poorly developed intercostal muscles diaphragm positioned flat ribs horizontally oriented fewer smaller alveoli What age is the respiratory system considered fully developed? 8 years old Most common chronic childhood illness? asthma, affects 9.3% of children Do pediatrics have a higher or lower metabolic rate? higher - results in more rapid respiratory rate and less efficient use of oxygen and glucose. In addition, other symptoms, such as fever or anxiety, may further increase metabolic rate A pulse ox reading of less than ____ at sea level is indicative of respiratory compromise? 92%, exceptions include children with uncorrected congenital heart defects How to estimate ETT size for pediatrics age 1-10? uncuffed - (age/4)+4, cuffed - (age/4)+3.5 CO2 monitors may not be effective if the child is less than ____? 2kg The esophageal detector may be considered for confirmation of tracheal tube placement in children weighing ___? more than 20kg. It is unreliable in children younger than 1 year The appropriate depth of insertion of an ETT can be estimated by the following formula? internal tube diameter x3. Studies show that the use of the length based resuscitation tape to determine depth of the ETT is the most accurate method An excess of either of these 2 substances causes a direct excitatory effect on the respiratory center, resulting in increased rate of ventilation? increased PaCO2 or increased H+ Most common cause of respiratory distress and failure in the pediatric patient? upper or lower airway obstructive disorders Causes of upper airway respiratory distress and failure in pediatric patients (several)? anaphylaxis bacterial tracheitis croup epiglotitis foreign body aspiration retropharyngeal abscess sleep apnea smoke inhalation subglottic stenosis tracheomalacia trauma Tracheomalacia? (from trachea and the Greek μαλακία, softening) is an upper airway condition characterized by flaccidity of the tracheal support cartilage which leads to tracheal collapse especially when increased airflow is demanded. Subglottic stenosis? (SGS) is a narrowing of the upper airway below the vocal cords (subglottis) and above the trachea. Subglottic stenosis will involve narrowing of the cricoid, the only complete cartilage ring in the airway. Retropharyngeal abscess? (RPA) is an abscess located in the upper airway tissues in the back of the throat behind the posterior pharyngeal wall (theretropharyngeal space). Because RPAs typically occur in deep tissue, they are difficult to diagnose by physical examination alone. ARDS? Lower airway condition in which fluid collects in the lungs' air sacs, depriving organs of oxygen. Causes of lower airway respiratory distress and failure in pediatric patients? ARDS aspiration asthma atelectasis bronchiolitis bronchomalacia foreign bodies pertussis pleural effusions hemo/pneumothorax pneumonia pulmonary contusion pulmonary edema smoke inhalation trauma What is Pertussis? also known as whooping cough, is a highly contagious lower respiratory disease. It is caused by the bacterium Bordetella pertussis. Incubation period of pertussis including 3 stages? 7-10 days characterized by 3 stages: catarrhal stage - insidious onset of nasal secretions, low grade fever, mild cough. cough becomes more severe over 1-2 weeks. paroxysmal stage - numerous rapid coughs secondary to thick mucus in trachobronchial tree, long inspiratory effort with high pitched whoop, cyanosis, vomiting and fatigue after each episode this lasts for 1-6 weeks. convalescent stage - gradual recovery over 2-3 weeks. How is the epiglottis different on pediatrics vs adults? the epiglottis is more U shaped, higher, and more anterior in the airway making it more prone to infection and trauma How is the larynx different on a pediatric pt vs an adult larynx is more positioned more anteriorly and cephalad (toward the head) Difference in tidal volume of a pedi vs an adult? pediatric tidal volume is approx 10ml/kg adult tidal volume is approx 50ml/kg result is low residual capacity for pediatrics Metabolic rate of pediatrics vs adults? metabolic rate is twice as high in the pediatric patient. This results in twice the O2 consumption. Hypoxia occurs more rapidly when the child is in respiratory distress. What is croup? Insidious inflammation that results in partial upper airway obstruction as the result of tracheal narrowing Viral illness caused by parainfluenza A or RSV Occurs most commonly in children 6-36 months, more in boys than girls