Peds - 9 - Test 2 Respiration - Core And More

Front 1

Assessing Respiratory Control in Infants and Children

Musculo-Skeletal Assessment :
•Ribs-
Rib flare (medial? lateral?)
Chest wall ___

•Spine-
Scoliosis
Kyphosis
Axial rotation

Back 1

excursion

Front 2

Musculoskeletal (cont.)

•Sternum
Pectus excavatum
Other deformities of interest

•Pelvis-tilt
Anterior
Posterior
Unilateral elevation

Back 2

ok

Front 3

Anatomy of Respiratory Musculature and Related Structures:

Skeleton of the Thorax:
•Ribs-12 individual pieces; numbers 11 and 12 do not insert on sternum
•Sternum-___
•Spine-stability

Potential for mobility of the rib cage increases as you move ___

Back 3

mobility

inferiorly and anteriorly.

Front 4

Muscles of Ventilation:

Diaphragm:
•concentric contraction-___

•___ contraction-controlled exhalation and speech

Back 4

inhalation

eccentric

Front 5

Muscles of Ventilation:

Intercostals:

•external-___

•internal-expiratory

Back 5

inspiratory

Front 6

Muscles of Ventilation:

Abdominals:
•___ lower rib cage
•provide ___ support for diaphragm

Back 6

stabilize

positive pressure

Front 7

Accessory Muscles:

Erector Spinae
Pectoralis muscles
___ muscles
Scalenes
Sternocleidomastoid
Trapezius

Back 7

Serratus

Front 8

Accessory muscles: Locations and functions

Physical exertion and pulmonary disease usually increase the work of breathing, taxing the diaphragm and external intercostal muscles. when this happens, accessory muscles provide the extra effort needed to maintain respirations.

the upper accessory muscles assist with ___, whereas the upper chest, sternum, internal intercostal, and abdominal muscles assist with expiration.

Back 8

inspiration

Front 9

Accessory muscles: Locations and functions

With ___, the scalene muscles elevate, fix, and expand the upper chest. the sternocleidomastoid muscles raise the sternum, expanding the chest's anteroposterior and longitudinal dimensions. the pectoralis major elevates the chest, increasing its anteroposterior size, and the trapezius raises the thoracic cage.

Back 9

inspiration

Front 10

Accessory muscles: Locations and functions

With expiration, the internal intercostals depress the ribs, decreasing the chest size. the ___ muscles pull the lower chest down, depress the lower ribs, and compress the abdominal contents, which exerts pressure on the chest.

Back 10

abdominal

Front 11

Normal Chest Development:

Newborn:
•Rib cage is ___
•Rib alignment is horizontal
•Intercostal spaces are narrow
•Rib cage makes up 1/3 of trunk

Back 11

triangular

Front 12

Normal Chest Development:

Three to Six Months:
•Rib cage is ___
•Rib cage moves as a block during rolling

Back 12

rectangular

Front 13

Normal Chest Development:

Six to Twelve Months:
•Rib cage is more rectangular
•Rib cage is elongating and rotating
•Rib cage now makes up ___ of trunk

Back 13

1/2

Front 14

Normal Chest Development:

Over Twelve Months:
•Lower ribs become ___ with abdomen
•Rib cage now makes up greater than 1/2 of trunk

Back 14

integrated

Front 15

Assessing Talking/Breathing
1. How many syllables per breath?
2. How long can patient hold a vowel sound?
3. Does voice change as posture changes?
4. Is patient's voice volume greater in supine?

Back 15

ok

Front 16

Assessing Talking/Breathing-continued-
5. Is patient's voice volume less in supine?
6. Is patient's voice volume less when sitting?
7. Is breathing coordinated with movement?
8. Is there breath holding with activity?
9. How stable are vital signs (e.g. blood pressure, heart rate, respiratory rate)?

Back 16

ok

Front 17

Use of Positioning Strategies to Influence Breathing Patterns:

Pelvis/Mid Trunk:

Anterior tilt-facilitates ___ breathing

Posterior tilt-facilitates ___ breathing

Back 17

upper chest breathing (anterior tilt)

diaphragmatic breathing (posterior tilt)

Front 18

Use of Positioning Strategies to Influence Breathing Patterns:

Shoulders/Upper Extremities:

Shoulder flexion, abduction and external rotation-facilitates ___ muscles

Shoulder extension, adduction, internal rotation-facilitates ___ and lower chest muscles

Back 18

upper accessory

diaphragm

Front 19

Use of Positioning Strategies to Influence Breathing Patterns:

Head Alignment:

Forward head may open airway.

___ is best position for vocal cords

Back 19

Neutral chin-tuck

Front 20

Effect of Vision and Movement on Breathing Patterns:

Eyes up-inhalation
Eyes down-exhalation

Rolling with extension-inhalation
Rolling with flexion-exhalation

Reaching up-inhalation
Reaching down-exhalation

Back 20

this will be on the competency

Front 21

Assessment of Breathing
In Supine, Sidelying, and Standing:

Observe sequence of breathing
Observe primary breathing pattern
Observe respiratory rate
Palpate upper, middle and lower rib cage
Palpate intercostal spaces (sidelying)

Back 21

ok

Front 22

Assessment of Talking
In Sitting, Supine, Stance:

Assess Volume
Assess number of syllables per breath
Assess ability to maintain a vowel sound
Assess breath holding
Assess ability to talk while moving

Back 22

ok

Front 23

Treatment

Positioning
Stretching/Mobilization
Strengthening
Facilitation of desired patterns
Integrate neuromuscular, respiratory, musculoskeletal and visual systems.

Back 23

ok

Front 24

Equipment to Assist Rx:
Abdominal binder
Towel roll
Bench
Thera-band
Bolster
Ball
Hands!

Back 24

ok