RT Book, Section A1 Do and Mary Ellen Thurman, Huy A2 Ellinas, Herodotos A2 Matthes, Kai A2 Alrayashi, Walid A2 Bilge, Aykut SR Print(0) ID 1176456705 T1 Anatomic Considerations T2 Clinical Pediatric Anesthesiology YR 2021 FD 2021 PB McGraw Hill PP New York, NY SN 9781259585746 LK accessanesthesiology.mhmedical.com/content.aspx?aid=1176456705 RD 2024/10/15 AB FOCUS POINTSBrain growth and development occurs most rapidly in the first 5 years of life. Notable changes of the face and skull are seen in this young period. During adolescence these features approach adulthood.Neonate and young infants are considered preferential nasal breathers. Any obstruction to the nares (eg, secretions) often leads to increased work in breathing.A proportionately larger tongue, young epiglottic shape (long, narrow, and omega), and a cephalad larynx can affect airway management (eg, intubation). Similar to adults, the vocal cord region is the narrowest point of the airway in children.The airway dimensions (short trachea, less acutely angled right main bronchi) of neonate and young children predispose them to mainstem intubation. Meticulous placement of the endotracheal tube is needed because of limited size.Young pediatric patients have immature skeletal muscle and cartilaginous thorax (ie, compliant chest). These features can promote respiratory fatigue during increased demands in breathing (eg, illness).The caudal level of the dura and spinal cord encompasses about two to three interspaces lowered in a neonate compared to an adult. By the first year of life, they are in the adult position.