Flashcards in Paediatrics Deck (51)
What 4 main anatomical reasons result in children being more likely to suffer from respiratory issues
1. Narrower airway
2. Shorter airway
3. Tonsils disproportionately large
4. Epiglottis disproportionately large
Why do children have less surface area for gas exchange?
They have fewer alveoli than adults
Why does the larynx sit higher and further forward in children?
Because they have a ‘shorter neck’
Children are obligate ........... breathers?
What structure is primarily drives breathing in children?
Why are children’s chest walls easily collapsible?
Cartilaginous skeleton has not fully ossified
What can children’s immature neurological reflexes for blood gas lead to more easily?
Why do children consume more energy at rest?
Through the work of breathing
How many times more oxygen do children consume compared to adults?
What can be triggered by laryngeal stimulation in children?
The aponeic response
What four main things can activate the aponeic response?
1. Foreign bodies
2. Airway adjuncts
How are childrens ribs orientated differently?
They are more horizontal - restricting upward movement
What two cavities does the diaphragm separate?
The abdominal and thoracic cavities
Up to what age approximately are children diaphragmatic breathers?
Why does the paediatric diaphragm have a reduced range of movement?
It is anatomically flatter than an adults
What 2 other properties of the paediatric diaphragm lead to issues?
1. Lack of type 1 muscle fibres (resistance to fatigue and fast reaction)
2. Abdominal organs cause resistance on inspiration
Why do chest retractions occur in respiratory distress?
A reduction of pressure in the chest and a less self supporting rib cage
What two locations will paradoxical breathing primarily be seen?
2. Below the scapula
What happens to respiratory rate as age increases?
At birth how much of the heart is made up of myocardium?
What two properties result from there being less myocardium?
1. Less mass
2. Less compliance
Why do the myocardium cells have less compliance in children?
There are fewer mitochondria in paediatric myocardium compared to adults
Why do children have the capacity for less stroke volume?
Anatomically smaller hearts that are less pliable
Is cardiac output higher in children than in adults?
What is the equation for cardiac output?
HR x SV
Why is heart rate in children less sensitive to adrenaline and noradrenaline?
Due to the lack of receptors
Are heart murmurs common in children?
Yes (innocent murmurs)
Why are children at an increased risk of dehydration?
Due to their volume:surface area ratio their loose more fluid
List some signs and symptoms of dehydration in children
- Lack of wet nappies
- Sunken eyes
- Dry membranes
- Skin turgour (lack of)
- Low B.P.