Peds Assessment: Respiratory

Front 1

When assessing the lungs of babies, where is the most likely location of retractions from respiratory distress?

Back 1

Along the posterior axillary line

Front 2

What technique allows a HCP to differentiate congestion in the upper respiratory tract as opposed to the lower lungs?

Back 2

Listen in both the CHEEK and the lungs

Front 3

When auscultating the posterior thorax, which lobes are you hearing most?

Back 3

the Lower LOBES

Front 4

What is right middle lobe syndrome>

Back 4

wheezes that are only heard in that location. must auscultate midaxillary

Front 5

Children have a (larger/smaller) tongue than adults

Back 5

Larger!!

Front 6

Tonsils reach their maximum size by age __

Back 6

7

Front 7

COmpared to adults, the larynx of children is located __ and more __ in the neck

Back 7

higher; anterior

Front 8

Describe the epiglottis in peds.

Back 8

-Floppy and omega shaped
-secretions increased

Front 9

CHildren have a (increased/decreased) angle between their epiglottis and laryngeal opening.

Back 9

increased

Front 10

Children have redundant ____ fold in the supraglottic region.

Back 10

aryepiglottic

Front 11

The airway of children is (broader/narrower) than adults

Back 11

narrower

Front 12

What causes croup?

Back 12

swelling of mucosa airway lined with hair cells, lysosymes, mucus and IgA

Front 13

What sign upon Xray indicates croup?

Back 13

Steeple sign

Front 14

What are the 2 most common infections leading to croup?

Back 14

1. parainfluenza
2. RSV

Front 15

ToF: children have a greater amount of soft tissue surrounding their airway.

Back 15

True

Front 16

ToF: alveoli continues to develop during the first 5 years of life?

Back 16

true

Front 17

The sternum and ribs of children are predominatly ___

Back 17

cartilaginous

Front 18

Why are retractions easily seen in young children with respiratory distress?

Back 18

-Poorly developed intercostal and accessory muscles
-Thin chest wall

Front 19

According to the WHO, children younger than 2 months are said to be tachypneic if they have ___ breaths a minute

Back 19

60

Front 20

If a child is breathing > 50breaths a minute and said to be tachypnic, how old are they

Back 20

2 months to 12 months

Front 21

for a child 1-5 years old, they must breath __ times a minute to be tachypnic.

Back 21

>40

Front 22

Any child > 5years old that is breathing > __ breaths a minute is tachypnic

Back 22

20

Front 23

What is the most sensitive indicator of respiratory distress?

Back 23

Respiratory rate!

Front 24

Describe what will be inspected with a high obstruction to the airway?

Back 24

suprasternal and severe

Front 25

Where are retractions seen with a low obstruction?

Back 25

infrasternal but less intense

Front 26

What is an important symmetry finding to assess for in the thorax? What can cause it?>

Back 26

-precordial bulge: may indicate cardiac defect, pneumothorax or chlronic localized ches disease

Front 27

Pectus ___ can shift the heart (PMI) to the left of midclavicular line

Back 27

excavatum

Front 28

What is a description of pectus carinatum?

Back 28

pigeon chest

Front 29

When does the tingling of tactile fremitus decrease?

Back 29

-airway obstruction
-pleural effusion

Front 30

when percussing a child's lung fields, what position must the child be in and why?

Back 30

Their head must be midline.
if the head is turned, there will be dullness on the other side

Front 31

YOu can hear a flat percussion over the ___

Back 31

thigh

Front 32

Dullness upon percussion is heard over the __

Back 32

liver

Front 33

The lung field should have a ___ percussion

Back 33

resonant

Front 34

Where is tympanny heard?

Back 34

over the abdomen

Front 35

ToF: palpation of tactile fremitus increases over areas of lung consolidation.

Back 35

TRue

Front 36

Decreased or absent vibration from tactile fremitus is heard when the bronchus is ___ or occupied by ___

Back 36

obstructed; fluid

Front 37

inspiratory sounds should be ___ time as long as expiratory sounds if they are vescicular.

Back 37

three

Front 38

Breath sounds in a child can be almost all ___ or ___

Back 38

bronchovesicular or bronchial

Front 39

If the inspiratory phase is twice as long as expiration, what kind of breath sound is it?

Back 39

bronchovescicular

Front 40

What type of breath sounds have equal length of inspiration and expiration

Back 40

tracheal

Front 41

Describe the timing of bronchial sounds

Back 41

expiration is very slightly long

Front 42

When listening over the neck and trachea, what are the quality of these sounds

Back 42

tracheal: very loud expiratory sound and relatively high pitched expiratory sound

Front 43

If listening over the manubrium, what is the pitch of a normal breath sound

Back 43

bronchial: very loud, high pitched and sound heard close to the stethescope.
-intermediate expiratory sound

Front 44

Where are bronchovesicular breath sounds heard best?

Back 44

in the 1st and 2nd ICS (anterior chest) and between the scapulaue (posterior chest). over the mainstem bronchi

Front 45

If bronchovesicular sounds are heard anywhere other than over the mainstem bronchi, they are signs of ___

Back 45

consolidation

Front 46

Which sounds are heard over most of the lung: axillary and lung bases?

Back 46

vesicular

Front 47

Describe fine rales and crackles.

Back 47

soft, high pitched and very brief

Front 48

what are course rales and crackles like?

Back 48

somewhat louder, lower in pitch and longer in duration

Front 49

Rales are heard at lower parts of the chest in __ ___

Back 49

heart failure

Front 50

rales heard in __ __ in indicative of interstitial lung disease

Back 50

late inspiration

Front 51

ToF: all rales have significance.

Back 51

False: rales heard after coughing have no significance

Front 52

___ are lower pitched and have a snoring quality.

Back 52

rhonchi

Front 53

Describe wheezes, how are they heard best?

Back 53

High pitched

-push in on child's chest to hear them at the end

Front 54

ToF: a child with asthma that has a quiet chest is a good sign?

Back 54

FALSE: a quiet chest may be very bad!

Front 55

What type of cough is common with asthma?

Back 55

tight cough

Front 56

A person with a staccato cough likely has ___

Back 56

pneumonia

Front 57

What 4 things should be noted when assessing for respiratory distress

Back 57

-LOC
-Respiratory rate
-work of breathing
-color

Front 58

What are examples of work of breathing.

Back 58

-expiratory grunt: keeps the airway open
-nasal flaring
-retractions

Front 59

If the child says 99 and a louder clearer voice is heard on auscultation, what is this?

Back 59

bronchophony

Front 60

What is egophony?

Back 60

when the child is asked to say EEE and it sounds like AY

Front 61

Describe whisper pectoriloquy.

Back 61

Have the child whisper 1,2,3 it will be clear if there is a consolidation pneumonia/fluid

Front 62

the site of origin of wheezes are the ___ ___

Back 62

intrathoracic airways

Front 63

The adventitious sound that can come from either or both intra and extrathoracic airways are ___

Back 63

rattles

Front 64

Stridor originates from the __ airway

Back 64

extrathoracic

Front 65

A snore originates from the ___

Back 65

oro-naso pharyngeal airway

Front 66

What is the site of origin of a grunt

Back 66

alveloi/lung parenchyma

Front 67

sounds from the nasal passages/naso-pharynx are often __

Back 67

snuffles or snorts

Front 68

chronic rattles are found in patients with __ __

Back 68

neuromuscular disorders

Front 69

An Acute rattle is often an acute ___ ___

Back 69

viral bronchitis

Front 70

acute pharyngitis and tonsillitis often causes what adventitious sound?

Back 70

a snore

Front 71

chronic snuffles are from ...

Back 71

allergic rhinitis

Front 72

An acute wheeze is often caused by...

Back 72

intermittent asthma

-viral induced wheeze

Front 73

A patient with chronically enlarged adenoids will often have a chronic ___

Back 73

snore

Front 74

what is the cause of a homophonic sound?

Back 74

something trapped in large airway

Front 75

What are the example of large airway obstructions causing wheezing.

Back 75

-Monophonic or homophonic sound
-inhaled foreign body
-endotracheal tuberculosis
-bronchial adenoma
-enlarged mediastinal nodes
-achalasia
-malignant mediastinal tumors

Front 76

in patients with monophonic localized wheezing, ___ __ needs to be considered.

Back 76

mass lesion

Front 77

what are the types of wheezing that result from a small airway obstruction?

Back 77

polyphonic or heterophonus wheezing

Front 78

give characteristics of small airway obstructions causing wheezing.

Back 78

-expiratory predominant
-asthma, bronchiolitis
-TEW: transient early wheezing
-usually disappears in early childhood.

Front 79

___ get misdiagnosed in young children as a wheeze

Back 79

rattles

Front 80

ToF: kids with psych problems can induce a wheeze

Back 80

true

Front 81

What aspect of respiration is a stridor heard?

Back 81

predominantly inspiratory

Front 82

What is stridor a sign of ?

Back 82

upper airway obstruction

Front 83

What are the supraglottis causes of stridor?

Back 83

-epiglottitis
-aryepiglottic flods
-false vocal chords (prone to collapse resulting in obstruction)

Front 84

What are the glottic causes of stridor?

Back 84

True vocal cords:
-laryngeal warts, larngeal web: papillomatosis

Front 85

What is papillomatosis? what does it cause?

Back 85

Have laryngeal warts that can obstruct the airway and cause stridor. must be burned off periodically to allow for breathing

Front 86

Where does the stridor of croup originate?

Back 86

in the subglottic area.

Front 87

What is the name of the disorder that has stridor with croup symptoms?

Back 87

acute laryngotrachobronchitis

Front 88

What is the diagnostic sign of epiglotitis?

Back 88

the thumb sign on xray

Front 89

How will a child with epiglotitis be acting?>

Back 89

They will refuse to lay down, will have an acute high fever and will look sick

Front 90

What causes a snore?

Back 90

increase in resistance to airflow through the upper airways in the region of nasopharynx and oropharynx: big adenoids

Front 91

ToF: infants should not have noisy breathing>

Back 91

FALSE: it is a common finding to have noisy breathing

Front 92

ToF: a rattle can be a symptom of asthma

Back 92

false

Front 93

ToF: it is common to mistake a wheeze for stridor.

Back 93

true and a major error

Front 94

ToF: current technology to support the use of acoustic analysis has been found to be effective.

Back 94

FALSE!!!!!

Front 95

What are the 3 phases of a cough?

Back 95

-inspiratory
-compressive
-expiratory

Front 96

A __ can be suppressed or initiated voluntary unless it is part of laryngeal expiratory reflex

Back 96

cough

Front 97

What are the 2 types of cough?

Back 97

laryngeal and tracheobronchial

Front 98

The suggested underlying processes of a barking or brassy cough are ...

Back 98

-Croup
-tracheomalacia
-habit cough

Front 99

What type of cough is a psychogenic cough?

Back 99

honking

Front 100

What is the cause of a paroxysmal cough

Back 100

Pertussis and Parapertussis

(+/- inspiratory whoop)

Front 101

An infant with a staccato cough is thought to have __

Back 101

chlamydia

Front 102

Plastic bronchitis or asthma is thought to produce what type of cough

Back 102

one productive of casts

Front 103

What type of cough accompanies suppurative lung disease?

Back 103

chronic wet cough in am only

Front 104

If a toddler presents with stridor and will only take in fluids and not solid food, what is a likely cuase?>

Back 104

Foreign body aspiration!

Front 105

where are retropharyngeal abscesses found most common?

Back 105

Bordered posteriorly by prevertebral fascia and anteriorly by the esophagus

Front 106

What are the most common causes of retropharyngeal abscesses?

Back 106

-Staphylococcus aureus
-anaerobic bacteria
-beta hemolytic streptococci

Front 107

How does a retropharyngeal abscess appear?

Back 107

Use a lateral neck film: there is an increase in the width of the prevertebral space and anterior displacement of the airway