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
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Adapted from Mosby’s Guide to Physical Examination, 6th Ed.
*With growth, the lateral diameter will eventually exceed the A-P diameter (adult)
Neurological damage (birth trauma)?
Poorly controlled diabetes
Breast development in a newborn -d/t hormonal influences
Cause for concern if …
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 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.
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