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U N I T 6
Respiratory Function
R E V I EW E X E R C I S E S
1.
It is flu season, and although you had a flu shot
last year, you have not had one this year. Imagine
yourself experiencing an abrupt onset of fever,
chills, malaise, muscle aching, and nasal stuffiness.
A.
Which of these symptoms would lead you to
believe you are coming down with the flu?
B.
Because you hate to miss classes, you decide
to go to the student health center to get
an antibiotic. After being seen by a health
professional, you are told that antibiotics are
ineffective against the flu virus, and you are
instructed not to attend classes but instead to
go home, take acetaminophen for your fever,
go to bed and stay warm, and drink a lot of
fluids. Explain the rationale for each of these
recommendations.
C.
Explain why last year’s flu shot did not protect
you during this year’s flu season.
D.
There is concern about the possibility of
an influenza pandemic such as the one that
occurred during the 1917–1918 season. What is
the rationale for this concern?
2.
Bacterial (e.g.,
S. pneumoniae
) pneumonia is
commonly manifested by a cough productive
of sputum, whereas with atypical (e.g.,
M.
pneumoniae
) pneumonia, the cough is usually
nonproductive or absent.
A.
Explain.
3.
A 4-month-old infant is admitted to the pediatric
intensive care unit with a diagnosis of bronchiolitis.
The infant is tachypneic, with wheezing, nasal
flaring, and retractions of the lower sternum and
intercostal spaces during inspiration.
A.
What is the usual pathogen in bronchiolitis?
Would this infection be treated with an
antibiotic?
B.
Explain the physiologic mechanism involved
in the retraction of the lower sternum and
intercostal spaces during inspiration.
C.
What would be the signs of impending
respiratory failure in this infant?
R E F E R E N C E S
1. American Lung Association. 2013.
Pneumonia fact sheet
.
[Online]. Available at:
/
influenza/in–depth–resources/pneumonia–fact–sheet.html.
Accessed October 11, 2013.
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Abbas AK, Fausto N, et al., eds.
Robbins and Cotran Pathologic
Basis of Disease
. 8th ed. Philadelphia, PA: Elsevier Saunders;
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3. Covington TR, Henkin R, Miller S, et al. Treating the common
cold.
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in children and adults.
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7. Aring AM, Chan MM. Acute rhinosinusitis in adults.
Am Fam
Physician
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8. Meltzer EO, Hamilos DL. Rhinosinusitis diagnosis and
management for the clinician: a synopsis of recent consensus
guidelines.
Mayo Clin Proc
. 2011;865:427–443.
9. Brook I. Acute and chronic bacterial sinusitis.
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North Am
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chronic sinusitis.
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12. Slavin RG, Spector SL, Bernstein IL, et al, chief editors; American
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Foundations of Medicine
. 6th ed. Philadelphia, PA: Wolters
Kluwer Health/Lippincott Williams & Wilkins; 2012:537–604.
14. Husain AN. The lung. In Kumar V, Abbas AK, Fausto N, et al.,
eds. 2010.
Robbins and Cotran Pathologic Basis of Disease
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15. Labella AM, Merel SE. Influenza.
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621–645.
16. Chestnut MS, Prendergast J, Tavan ET. Pulmonary disorders. In:
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2013:270–292.
■■
Children with restrictive lung disorders, such
as pulmonary edema or respiratory distress
syndrome, breathe at faster rates, and their
respiratory excursions are shallow. Grunting is
an audible noise emitted during expiration. An
expiratory grunt is common as the child tries to
raise the end-expiratory pressure to maintain
airway patency and prolong the period of
oxygen and carbon dioxide exchange across the
alveolar–capillary membrane.
■■
Because of the small size of the airway of infants
and children, respiratory tract infections in these
groups often are more serious. Infections that
may cause only a sore throat and hoarseness
in the adult may produce serious obstruction in
the child. Among the respiratory tract infections
that affect small children are croup, bronchiolitis,
and epiglottitis, a life-threatening supraglottic
infection that may cause airway obstruction and
asphyxia.
SUMMARY CONCEPTS
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