الفهرس Only 14 pages are availabe for public view
 |  | from | 149 |  |  |
| | | from | 149 | | |
Abstract
Wheezing in Early Life
Wheezing in the infants menta special mention because it is common and presents substantial diagnostic and therapeutic problems.. It is a continuous sound with musical quality heard mainly during expiration. The word is derived from. an. old Norse word wearing ”to hiss”. By common usage it has come to be associated with the had breathing of asthma.. However, wheeze should not be used interchangeably with bronchospasm nor asthma, as there are many other possible causes which lead to airways obstruction and wheezes other than bronchospasm.(1’
A number of anatomic and physiologic peculiarities of early life predispose to obstnictive airway disease: (1) a decreased amount of smooth muscle in the peripheral airways compared with adults may result in less support.; (2) mucous gland hypeiplasia in the major bronchi compared with adults favors increased intraltuninal mucus production; (3) disproportionately narrow peripheral airways up to 5 yr of age result in decreased conductance relative to adults and render the infant and young child vulnerable to disease affecting the small airways; (4) decreased static elastic recoil of the young lung predisposes to early airway closure during tidal breathing and results in mismatching of ventilation and perfusion and hypoxemia; (5) highly compliant rib cage and mechanically disadvantageous angle of insertion of the diaphragm to rib cage (horizontal vs. oblique in the adult) increase the diaphragmatic work of breathing; (6) decreased number of fatigue-resistant skeletal muscle fibers in the diaphragm leave the