Respiratory system and infections Flashcards
stridor
upper airway
wheeze
lower airway
rhonchi
low note, fluid in big airways
crackles/rales
fluid or atelectasis in small airways (fine sounds)
foundation of lung studies
CXR
what would a barium swallow show us
TEF, GER, vascular rings
Good if you wanted to see if a structure was compressing the trachea
what will a lung CT show us
parenchymal changes , lung interstitium, Masses
what will laryngoscopy/bronchoscopy show us
obstructions and malacia, foreign bodies, intubation
bugs for croup
Parainfluenza (RSV, influenza, adenovirus, roseola,mycoplasm pneumoniae)
when/who gets croup
Fall and early winter, younger children(6mo-3yr)
Acute inflammatory disease of the larynx - common
Acute Inspiratory Stridor
croup
xray with croup
with subglottic narrowing and normal epiglottis
testing for croup
Viral swab for respiratory viruses
treatment for croup
if mild cases – supportive. (+/- mist)
how do you know when a kid with croup can go home?
If symptoms resolve within 3 hrs and there is no stridor at rest – can go home. If recurrent nebs (Q 20 min > 1-2 hrs) needed, hospitalize
bacterial croup
bacterial tracheitisInvasion of bacteria into mucosa of pt with viral croup
cause of bacterial tracheitis
Staph Aureus ( H flu, S. pyogenes, Morax cat)
Inflammatory edema, purulent secretions,
High fever, toxic, severe obstruction
Severe life threatening from of laryngotracheobronchitis
bacterial tracheitis
treatment for bacterial tracheitis
Hospitalization and monitoring, suctioning, hydration. IV ABX for Staph Aureus. More likely to need intubation.
bugs for epiglottitis
Hflu type B ( deceased incidince since HiB immunization) – now GAS , and Staph A
Kid comes in with inspiratory stridor
Resp distress
Drooling
Sudden onset
epiglottitis
Kid comes in, you think it is epiglottitis. What do you do first?
Emergency – anticipate intubation
Epiglottitis x ray
Lateral neck xrays. “Thumb sign” means thickened epiglottis
most common cause of stridor in infants
laryngomalacia-Underdeveloped cartilaginous structures
kid comes in w stridor-Worse supine, with activity, with infection, during feedings
laryngomalacia
Congenital or trauma/injury
Hoarseness, aspiration and high pitched stridor
vocal cord paralysis
Congenital or from intubation
Mild to severe with serious obstruction of airway
Stridor after extubation
Suspect in Pt with recurrent croup
subglottic stenosis
stridor or wheeze Airway compression (PDA, abberant inominant artery)
vascular ring or sling
tracheomalacia and vascular ring: upper or lower airway disorder?
Could be EITHER!
acute lower airway obstruction
asthma, bronchiolitis , foreign body
progressive lower airway disorders
CF or bronchiolitis obliterans
pt with chronic wheeze, pneumonias, asymmetric chest sounds presents with sudden cough, wheeze of respiratory distress
Foreign body- lower resp tract
treatment foreign body upper resp tract
Heimlich (over 1)Child < 1 turn over onto their chest and 5 measured back blows between the shoulder blades, followed by 5 chest compressions if needed – repeat