Chest and Lungs. Adapted from Mosby’s Guide to Physical Examination, 6 th Ed. Ch. 13. Newborns. Obligate Nose Breathers Only open their mouth to breathe if in respiratory distress Rely primarily on the diaphragm for respiratory effort Commonly use abdominal muscles
Chest and Lungs
Adapted from Mosby’s Guide to Physical Examination, 6th Ed.
*With growth, the lateral diameter will eventually exceed the A-P diameter (adult)
A newborn whose respirations are inadequate but who is otherwise normal…
Neurological damage (birth trauma)?
Intrauterine growth retardation
Poorly controlled diabetes
Breast development in a newborn -d/t hormonal influences
Cause for concern if …
If chest expansion is asymmetric
suspect inability to fill one of the lungs
Wait for quiet!
…may contribute to adventitious sounds making evaluation difficult
*Cannot be dismissed as inconsequential
If accompanied by cough, hoarseness or retraction you must consider a serious problem in trachea or larynx…
If persistent, cause for concern.
*Should be considered significant.
If you sense some loss of resonance, give it as much importance as you would give frank dullness in the adult.
Because the chest wall is thinner…
Bronchovesicular sounds may be heard throughout the chest.
Airway resistance increases and respiratory flow is impeded.
Episodes are characterized by:
A wheezing patient withgeneralized pulmonary findingsmay haveasthma or a viral infection, but rarely, if ever, a bacterial infection.
Lung is airless…
Viral; respiratory syncytial virus (RSV)
Most common: <6 months
Initial stimulus = irritation
(Internal or external)
As dysfunction progresses…
Who gets it?
Signs & symptoms:
the very young are at higher risk
Signs & symptoms:
*Generally benign and self-limiting with age