Chapter 4

• ok

  A) Chest Cavity

  B) Epiglottis

  C) glottic

  D) infraglottic

  E) trachea, mainstem bronchi, and multiple bronchial gen.

  
• Upper respiratory tract includes the following:

  • Nose
  • Nasal Cavity
  • Sinuses
• Lower respiratory tract includes the following:

  • Voice box (larynx)
  • Windpipe (trachea)
  • Lungs
  • Airways (bronchi and bronchioles)
  • Air sacs (alveoli)
• Respiration

  A) 3

  B) 2

  
• Boyle's Law - the gas law that states that in a closed space, pressure and volume are inversely related.

  As volume decreases, pressure increases and vice versa.
• Inspiration Expiration

  A) Tidal Volume

  B) Functional Residual Capacity

  C) Atmospheric Pressure

  
• Respiration - act of breathing in and out.
• When you inhale, you take in oxygen. When you exhale, you give off caron dioxide.
• 3 elements of respiration process: external respiration, internal respiration, cellular respiration.
• External respiration - process of breathing, also called ventilation.
• Internal respiration - the diffusion of gases between bodily fluids and tissues.
• Cellular respiration - a metabolic pathway that uses glucose to produce adenosine triphosphate (ATP)
• Three processes of ATP production or cellular respiration: glycolysis, the tricarboxylic acid, and oxidative phosphorylation.
• Glucose and oxygen are converted to carbon dioxide, water, and the high energy molecule ATP.
• CO2

  A) interstitial fluid surrounding cells

  B) macromolecule synthesis

  C) blood plasma and red blood cells

  D) cilia and flagella movement

  E) cell division

  
• Nasopharyngitis

  A) 2 to 3 days

  B) Rhinovirus

  C) Respiratory synctial virus

  D) Adenovirus

  E) Parainfluenza and influenza virus

  
• Aspirin - inhibits functions of platelets which are essential for anti-clotting; can lead to massive bleeding.
• Reye's Syndrome

  -rare disorder

  -affects all body organs but most harmful to brain {swelling may occur [can cause seizure (no fever), convulsion (may fever)]} and liver (may swell, and fats may build up)

  -child's blood sugar drops while levels of ammonia and acidity in the blood rises.
• Tonsilitis - infection and inflammation of palatine tonsils.

  A) palatine tonsils

  B) adenoids

  C) tubal tonsil

  D) lingual tonsil

  
• CA of Tonsilitis:

  Group A beta-hemolytic streptococcus
• Management:

  A) antipyretics

  B) analgesic

  C) full 10-day course of antibiotic

  
• Tonsillectomy - surgical removal of the tonsils from the back of the throat.
• Most dangerous periods after:

  First 24 hours to 5-7 days
• Epistaxis

  -bleeding from tissues inside the nose caused by broken blood vessel

  -vasoconstriction (too much blood vessel constriction)

  -rare younger than 2 y/o
• Thrombocytopenia - decrease in platelets.
• Tx for Epistaxis:


  direct compression of nasal alae for 5-10 mins
• Other techniques for recurrent epistaxis:

  • vasoconstrictor nose spray
  • cautery with silver nitrate
  • topical sealants or glue
  • nasal packing
  • balloon catheters
• Common Neurological Conditions Affecting

  • Cerebral Palsy
  • Neural Tube Defects
  • Hydrochephalus
  • Meningitis

  
• WHO ARE AT RISK for Epistaxis?

  • Lives in a dry climate
  • Picks his or her nose
  • Has allergies
  • Has a cold
• Treatment for Epistaxis


  1. Calm and comfort your child

  2. Have your child sit up and lean forward slightly

  3. Tell your child to breathe out of his or her mouth

  4. Gently pinch the nostrils closed for 5 to 10 minutes

  5. Apply a cold compress to the bridge of the nose

  6. If bleeding does not stop, repeat the above steps again

  7. Once the bleeding stops, tell your child not to rub, pick, or blow his or her nose for 2 to 3 days
• Types of Sinusitis


  • Short-term (acute) - last less than 12 weeks
  • Long-term (chronic) - last longer than 12 weeks
  • Recurrent - 3 or more episodes of acute sinusitis in a year
• The 4 different sinuses

  • Ethmoid sinus - bridge of the nose (present at birth, and continues to grow)
  • Maxillary sinus - around the cheeks (present at birth, and continues to grow)
  • Frontal sinus - area of the forehead (around age of 7)
  • Sphenoid sinus - deep behind the nose (until teen years)
• Conditions that can lead to sinusitis


  • Abnormal shape of the nose
  • Infection from a tooth
  • Nose injury
  • Foreign object in the nose
  • Birth defect with abnormality of the roof of the mouth (cleft palate)
  • Problem with stomach acids (gastroesophageal reflux disease, or GERD)
  • Cystic fibrosis and immunodeficiency syndromes
• How is sinusitis diagnosed in a child?

  • Healthcare provider will ask about symptoms and health history
  • Physical exam
  • Sinus X-rays
  • CT scan of the sinuses
• How sinusitis develops

  1. Cold causes swelling that blocks sinus openings

  2. Bacteria start to grow in blocked sinuses

  3. This leads to sinus infection or sinusitis
• Most common bacteria that cause acute sinusitis

  • Streptococcus pneumonia
  • Haemophilus influenzae
  • Moraxella catarrhalis
• Symptoms of sinusitis in a child

  • Stuffy nose
  • Thick, colored drainage in the nose
  • Drainage down the back of the throat (postnasal drip)
  • Headache
  • Cough
  • Pain or soreness over sinuses
  • Fever
  • Loss of smell
• Acute sinusitis treatment

  1. Antibiotics if infected with bacteria

  2. Allergy medicines for allergy-caused sinusitis

  3. Avoid over-the-counter decongestant nasal sprays
• Chronic sinusitis treatment

  1. ENT specialist visit

  2. Longer-term antibiotics

  3. Inhaled corticosteroid medicine

  4. Other medicines like nasal sprays

  5. Allergy shots or immunotherapy

  6. Surgery (rarely in children)
• Home care for sinusitis

  • Fluids to thin mucus
  • Saline wash to keep sinuses and nose moist
  • Warm compresses to ease facial pain