According to the medical literature, puerile breathing is one of the types of vesicular breathing in he althy children belonging to the age group from 1 to 7 years. In certain situations, similar breathing can be observed in certain categories of patients. Next, we will talk about the systematization of noises that occur during breathing, as well as what constitutes puerile breathing in children and up to what age it is possible to listen to it, what is the system of its formation, and what are the qualitative and quantitative characteristics of vesicular breathing, what you need to know with diagnostic point of view.
Breathing noises and their classification
In medicine, all breath sounds are divided into basic and secondary. The first group should include:
- vesicular or alveolar murmurs;
- bronchial or laryngo-tracheal;
- mixed or, as it is also called, bronchovesicular.
As additional breath sounds should be called:
- wet and drywheezing;
- crepitus;
- noise caused by pleural friction;
- pleuropericardial murmur.
Features
Puerile breathing is one of the modifications of normal breathing, which, for the most part, is emphasized by scientists of the Russian medical school in patients of early childhood and preschool age. This type of breathing is distinguished in young patients due to the anatomical and physiological features of the respiratory organs, including the narrowness of the larynx, the incomplete development of the muscles of the chest, and the rigidity of the skeleton due to cartilage tissues.
Talking about vesicular puerile respiration is not entirely correct in terms of terminology. It is characterized by transitional characteristics between vesicular and bronchial.
If you try to highlight its features, it should be emphasized that puerile breathing is a kind of breath noise, which is characterized by:
- As with the vesicular, the puerile sounds like the letter "f".
- This type of breath noise is characterized by a more distinct inhalation and a louder and longer exhalation.
- It can be heard over both lobes of the chest.
Puerile breath - up to what age is it heard? At the age of 6 months to 5-7 years. In a he althy state, it cannot be observed in adults.
Shaping system
Key noises that occurduring inhalation and exhalation, which includes breathing, are formed in the laryngeal part at the time of the passage of inhaled air masses and, taking into account the state of the respiratory system and the musculoskeletal basis of the chest, the process of their transmission to the chest is carried out to varying degrees. Depending on the he althy or pathological condition, the types of breath sounds differ in babies.
He althy and painful breath sounds
Noises generated during inhalation and exhalation can be both physiological (or basic) and pathological (additional). That is, puerile breathing is a variant of physiological normal noise. And wet and dry rales or crepitus, which were previously identified as an additional group of noises, are recognized by specialists as pathology options.
The state of vesicular respiration, including puerile, will depend on factors such as:
- Gender, age and type of human constitution. Puerile breathing is heard at the age of 7 years.
- The state of the respiratory muscles, as well as their ability to pass powerful air currents.
- Airway patency.
- The degree of elasticity of lung tissue and the ability of the alveoli to stretch and collapse as quickly as possible.
- Degrees of ventilation intensity.
- Development of the muscle layer and thickness of the chest walls.
Taking into account the above factors, we can say that vesicular breathing can be:
- normal;
- reinforced;
- weakened;
- puerile;
- saccaded.
In order to give an adequate quantitative and qualitative characteristic of breath sounds, a long and persistent ear training is necessary, which should be supported by listening to the breathing of he althy people with strict observance of the rules of auscultation.
If a weakening of vesicular respiration is detected during the diagnostic process, then this can be triggered by the following reasons:
- The structure of the alveolar wall has changed, which may be caused by an incipient inflammatory or fibrosing process.
- The elastic properties of the alveoli are lost, which can be explained by progressive emphysema of the lungs.
- Reduced mobility of the chest, which is explained by the patient's obesity, adhesions in the pleural cavity, pain as a result of a chest injury, fracture of the ribs, intercostal neuralgia and dry pleurisy.
- Accumulation of fluid or gas in the pleural cavity, causing compression of the lung.
Intensification of puerile vesicular breathing in the case of the development of a pathological condition of the lungs in practice is quite rare. This is possible only when it comes to a compensatory strengthening of the respiratory process on a he althy lobe of the organ with the localization of the pathology on the other.
Pathological breath sounds
In the case of the development of pathological processes in the respiratory organs, side effects may occurbreath sounds. The main ones will be described below.
Wheezing
Wheezing is the most commonly observed breath noise in medical practice. They are formed in the bronchi or affected cavities filled with a pathological secret in the form of exudate, pus or blood. The nature of these noises is determined by a number of factors, including the viscosity of the secretion, its volume, localization, etc. In this case, wheezing can be both dry and wet.
The first ones can be heard both during inhalation and exhalation, as a rule, in combination with hard breathing. As for moist side respiratory noises, their formation is directly related to the accumulation of liquid secretions. Moist rales can be heard in both phases of breathing. At the same time, they differ in heterogeneity in sound.
Crepitation
In a situation where a significant part of the alveoli simultaneously breaks apart in a person, crepitus is heard. It resembles short-term volleys, consisting of a series of short and uniform sounds that are formed at the peak of inspiration. In terms of sound, this breathing noise is similar to the crackling of cellophane or a rustling sound. Experience shows that it is possible to listen to crepitus in patients diagnosed with lobar pneumonia.
Friction of the pleura
If we talk about the noise of pleural friction, then it is he who is perceived by experts as the only objective sign of dry pleurisy. However, it can be observed in the case of seeding of the pleura with cancerous metastases, as well as in renalinsufficiency and extreme dehydration. You can listen to the pleural friction rub in the lower lateral parts of the chest. If a significant amount of exudate accumulates in the pleural cavity, then this side respiratory noise disappears.
Conclusion
Listening to puerile breathing in children is of great importance in pulmonology. Its violation and discrepancy, as well as the manifestation of additional noise, may indicate pathological processes in the organs of the respiratory system. Therefore, from the point of view of diagnosing their he alth, it is important for specialists to know and understand the specifics of such breathing. Only with this knowledge will it be possible to identify a huge number of diseases at an early stage, start the treatment process in a timely manner and avoid a number of negative consequences.
