According to the medical literature, puerile breathing is one of the types of vesicular breathing in healthy children belonging to the age group from 1 year to 7 years. In certain situations, similar breathing can be observed in certain categories of patients. Further, we will discuss the systematization of noise arising during breathing, as well as what constitutes puerile breathing in children and how old it can be heard, what is the system of its formation, and what are the qualitative and quantitative characteristics of vesicular breathing, what you need to know diagnostic point of view.
Respiratory murmurs and their classification
In medicine, all breathing noises are divided as basic and secondary. The first group should include:
- vesicular or alveolar murmur;
- bronchial or laryngo-tracheal;
- mixed or, as it is also called, bronchovesicular.
The following should be mentioned as additional respiratory sounds:
- wet and dry rales;
- crepitus;
- noise arising from pleural friction;
- pleuropericardial murmur.
Specifications
Pueryl 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 characteristics of the respiratory organs, including the narrowness of the larynx, incomplete development of the chest muscles and rigidity of the skeleton due to cartilage.
Talking about vesicular puerile breathing is not entirely correct in terms of terminology. It differs in transitional characteristics between vesicular and bronchial.
If you try to highlight its features, it should be emphasized that puerile breathing is such a kind of respiratory noise, which is characteristic of:
- As in the case of vesicular, with puerile, a sound resembling the letter "f" is heard.
- This type of respiratory noise is characterized by a more distinct breath and a louder and longer expiration.
- It can be heard over both lobes of the chest.
Pueryl breathing - how old is it? At the age of 6 months to 5-7 years. In a healthy state, it cannot be observed in adults.
Formation system
The key noises that occur during inhalation and exhalation, which includes breathing, are formed in the larynx at the moment of passage of the inhaled air masses and taking into account the state of the respiratory system and the musculoskeletal base of the chest, the process of their transfer to the chest is carried out with varying degrees. Depending on the healthy or pathological condition, the types of respiratory sounds in babies are different.
Healthy and painful breathing noises
Noises formed during inspiration and expiration can be either physiological (or basic) or pathological (additional). That is, puerile breathing is a variant of physiological normal noise. And wet and dry rales or crepitus, which were previously allocated as an additional group of noise, are recognized by experts as pathological options.
The state of vesicular respiration, including puerile, will depend on factors such as:
- Gender, age, and type of human constitution. Pueryl breathing is heard before the age of 7 years.
- The condition of the respiratory muscles, as well as their ability to pass powerful air currents.
- The level of airway patency.
- The degree of elasticity of the lung tissue and the ability of the alveoli to stretch and fall as quickly as possible.
- The degree of intensity of ventilation.
- The development of the muscle layer and the thickness of the walls of the chest.
Taking into account these 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 breathing sounds, a long and persistent ear training is necessary, which should be supported by listening to the breath of healthy people with strict observance of the rules of auscultation.
If in the process of diagnosis a weakening of vesicular breathing is detected, then this can be triggered by the following reasons:
- The structure of the alveolar wall has changed, which can be caused by a beginning inflammatory or fibrosing process.
- The elastic properties of the alveoli are lost, which can be explained by progressive pulmonary emphysema.
- The mobility of the chest is reduced, which is explained by the obesity of the patient, adhesions in the pleural cavity, pain as a result of a chest injury, fracture of the ribs, intercostal neuralgia and dry pleurisy.
- The accumulation of fluid or gas in the pleural cavity, which leads to compression of the lung.
Strengthening of puerile vesicular respiration in the case of the development of a pathological condition of the lungs is quite rare in practice. This is possible only when it comes to compensatory enhancement of the respiratory process on a healthy organ lobe with localization of the pathology to another.
Pathological respiratory sounds
In the case of the development of pathological processes in the respiratory organs, the occurrence of side respiratory sounds is possible. The main ones will be described below.
Wheezing
The most commonly observed respiratory noise in medical practice is wheezing. They are formed in the bronchi or in the affected cavities, filled with pathological secretions 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. At the same time, wheezing can be both dry and wet.
The former can be heard both when inhaling and exhaling, usually in combination with hard breathing. As for wet side respiratory sounds, their formation is directly related to the accumulation of liquid secretions. You can listen to wet rales in both phases of breathing. At the same time, they differ in sound heterogeneity.
Crepitus
In a situation when a person is simultaneously uncoiling a significant part of the alveoli, crepitus is heard. It resembles short-term volleys, consisting of a series of short and uniform sounds that form at the peak of inspiration. The sound of this breathing noise is similar to the crack of cellophane or a rustling sound. As experience shows, you can listen to crepitation in patients with diagnosed croupous pneumonia.
Pleural friction
If we talk about the noise of friction of the pleura, then it is he who is perceived by experts as the only objective sign of dry pleurisy. At the same time, it can be observed in case of seeding of pleura with cancer metastases, as well as in case of renal failure and extreme dehydration of the body. Listen to the noise of pleural friction in the lower lateral parts of the chest. If a significant amount of exudate is accumulated 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 inconsistency, 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 health, 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, to start the treatment process in a timely manner and to avoid a number of negative consequences.