The Respiratory System
Anatomical Differences.
The following table indicates the anatomical differences between Adult and Paediatric respiratory system. (Weathers, 2010) (Zahraa, Paediatric respiratory system, 2010)
Adult System Paediatric System
Rib Cartilage Obliquely orientated and less
compliant. Horizontally orientated and
more compliant.
Intercostal
Muscles Fully developed and assist in
movement of chest wall. Not fully developed and do not
have leverage to lift ribs.
Diaphragm Situated Obliquely to ribs. Situated Horizontally to ribs.
Head and Neck Proportionate Occiput and
neck does not compromise airway. Large Occiput and when in
supine position neck is flexed and compromises airway.
Tongue Proportionate tongue size in
comparison to oropharyngeal space. Larger tongue size in
comparison to oropharyngeal. Space
Trachea Larger in adults approximately
10mm. Smaller and shorter. Smaller in paediatrics
approximately 4mm. Wider and longer.
Thyroid
Cartilage Surrounds Cylinder shaped
airway. Surrounds Funnel shaped
airway and cricoid ring is narrowest part.
Epiglottis Firm and flatter. More Floppy and meets the
larynx at acute angle.
Larynx Located at c5. Located at c3-c4.
Vocal Cords Vocal cords flat. Vocal cords more inclined.
Collateral
Ventilation
Well developed. Not well developed in early
years.
Physiological Differences
(Brasoveanu, 2006)States that Adults can increase lung volume by raising the ribs and contracting the diaphragm. Oxygen consumption in adults is approximately 3ml/kg/min. Having fully developed and functioning respiratory muscles, they are more resi...
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...ld be in more neutral position than in adult for airway. Suction for no more than a few seconds at a time. Chest and Abdomen are less developed and more elastic making distressed breathing obvious from a distance. Infants and Children use diaphragms for breathing more than adults. (Weston)
Paediatrics have smaller Lungs
• Increased risk of barotrauma from aggressive ventilation (pneumothorax). Respiratory
Arrest is more common than cardiac arrest
Respiratory Equipment Considerations
Equipment Sizing Differences (Adult/Child/Infant)
• Oxygen Masks
− NRB, Nasal Cannulas
• Endotracheal Tubes
− Cuffed and Uncuffed
Circulatory Considerations
Blood Volume in Paediatrics is lower than Adults
• Newborn – less than 350ml
• 8 year old – 2 liters
• Adolescent – 3-4 liters
• Adult – 4-6 lite
• Bleeding is more Serious in Paediatrics
(Weston)
The contraction of the inspiratory muscles increases the volume of the thoracic cavity causing the pressure within the alveoli to decrease and air to flow into the alveoli. During resting inspiration, the diaphragm, the external intercostals and the parasternal intercostals contract to stimulate inspiration. During forced inspiration the scalene and the sternocleidomastoid muscles contract to further expand the thoracic cavity. The pectoralis minor muscles also play a minor role in forced inspiration. During quiet breathing, relaxation of these muscles causes the volume of the thoracic cavity to decrease, resulting in expiration. During a forced expiration, the compression of the chest cavity is increased by contraction of the internal intercostal muscles and various abdominal
In this lab, we explored the theory of maximal oxygen consumption. “Maximal oxygen uptake (VO2max) is defined as the highest rate at which oxygen can be taken up and utilized by the body during severe exercise” (Bassett and Howley, 2000). VO2max is measured in millimeters of O2 consumed per kilogram of body weight per min (ml/kg/min). It is commonly known as a good way to determine a subject’s cardio-respiratory endurance and aerobic fitness level. Two people whom are given the same aerobic task (can both be considered “fit”) however, the more fit individual can consume more oxygen to produce enough energy to sustain higher, intense work loads during exercise. The purpose of this lab experiment was performed to determine the VO2max results of a trained vs. an untrained participant to see who was more fit.
However, the lower respiratory tract is consist of trachea, two mainstem bronchi, lobar, segmental and sub-segmental bronchi, bronchioles, alveolar, ducts, and alveoli (Ignatavicius & Workman, 2010).
Healthy lung tissue is predominately soft, elastic connective tissue, designed to slide easily over the thorax with each breath. The lungs are covered with visceral pleura which glide fluidly over the parietal pleura of the thoracic cavity thanks to the serous secretion of pleural fluid (Marieb, 2006, p. 430). During inhalation, the lungs expand with air, similar to filling a balloon. The pliable latex of the balloon allows it to expand, just as the pliability of lungs and their components allows for expansion. During exhalation, the volume of air decrease causing a deflation, similar to letting air out of the balloon. However, unlike a balloon, the paired lungs are not filled with empty spaces; the bronchi enter the lungs and subdivide progressively smaller into bronchioles, a network of conducting passageways leading to the alveoli (Marieb, 2006, p. 433). Alveoli are small air sacs in the respiratory zone. The respiratory zone also consists of bronchioles and alveolar ducts, and is responsible for the exchange of oxygen and carbon dioxide (Marieb, 2006, p. 433).
McKenzie, D. C. (2012). Respiratory physiology: Adaptations to high-level exercise. British Journal of Sports Medicine, 46(6), 381. doi:10.1136/bjsports-2011-090824
HENDERSON, Y (1998) A practical approach to breathing control in primary care. Nursing Standard (JULY) 22 (44) p41
Porhomayon, J., P. Papadakos, and ND Nader. "Alteration in Respiratory Physiology in Obesity for Anesthesia-critical Care Physician." HSR Proceedings in Intensive Care and Cardiovascular Anesthesia 3.2 (2011): 109-18. Web.
The next step is to open the airway. Place two or three fingers under each side of the jaw, at its angle. Lift the jaw upward and outward. If this alone does not open the airway, slightly tilt the child’s head. Check for signs of breathing by using the look, listen, and feel method. Also, check for anything that may be blocking the airway. If something is visible, remove it.
Haven't you ever wondered what would happen if you didn't have a digestive or circulatory system? Well, basically you wouldn't be able to be reading this or even be alive. While there are many important systems in the body, the circulatory and digestive are the two most important. There are many ways that they are similar, different, and how they work together.
•While exercising your lungs tries to increase the intake of oxygen as well as release the carbon dioxide.
Person, A. & Mintz, M., (2006), Anatomy and Physiology of the Respiratory Tract, Disorders of the Respiratory Tract, pp. 11-17, New Jersey: Human Press Inc.
Hess Dean R., M. N. (2012). Respiratory Care: Principles and Practice 12th Edition. Sudbury, MA: Jones and Bartlett Learning.
The breath is brought into the nose and exhaled through the mouth with slightly pursed lips which should help you to feel a deeper contraction of the abdominals. = == == ==
There are 2 types of breathing, costal and diaphragmatic breathing (Berman, 2015). Costal refers to the intercostal and accessory muscles while diaphragmatic refers to breathing using your diaphragm (Berman, 2015).It is important to understand the two different types of breathing because it is vital in the assessment of the patient. For example, if a patient is suing their accessory muscles to aid in breathing then we can safely assume that they are having breathing problems and use a focused assessment of their respiration. Assessing respiration is fairly straightforward. The patient’s respiration rate can be affected by anxiety so a useful to avoid this is to check pulse first and after you have finished that, while still holding their pulse point, check their respiration rate. Inconspicuous assessment avoids the patient changing their breathing because they know they are being assessed which patients can sometimes do subconsciously. Through textbooks and practical classes I have learned what to be aware of while assessing a patient’s respiratory rate. For example; their normal breathing pattern, if and how their health problems are affecting their breathing, any medications that could affect their respiratory rate and also the rate, depth, rhythm and quality of their breathing (Berman, 2015). The only problem I found while assessing respiration rate was I thought it seemed a bit invasive looking at the
While this is happening diaphragm muscles contract and push down towards the abdomen. The lungs are made to expand because the pleural surfaces of the lungs are attached to the pleural on the chest wall; this increases the volume. of the air spaces and drops the air pressure in the lungs so that air rushes in. Expiration is mainly an involuntary reaction to the external intercostals and diaphragm muscles relax. The elastic fibres in the stretched lung are recoiled which allows the ribs and diaphragm to return to their original position.