14. Small Group Resp Symptoms Flashcards
why might someone who has had a laryngectomy have problems coughing?
no glottis, which is needed to generate force. pts who have no larynx cough through a stoma and sometimes require suction
why might someone with a lung transplant have problems coughing?
severed vagal nerve. they are able to cough but don’t get the impulse. they will be ok if they cough even without feeling the need
why might a patient with ALS have problems coughing?
generalized skel muscle weakness, which eventually involves the muscles of respiration.
why might a 16 year old with asthma experience chronic cough?
cough thought to be caused by airway inflammation resulting in stimulation of vagal irritant receptors. receptors can be triggered by constriction of bronchial smooth muscle
what are the mechanisms of chronic cough with acid reflux?
- acid refluxing up the level or the larynx, causing direct stimulation of airway receptors
- acid reflux in the esophagus stimulates the vagus and interpreted as a stimulus for cough. essentially the signal is misinterpreted.
why might a patient with ILD experience chronic cough?
inflammation in the lung stimulates vagal receptors, which is the presumed mech of cough in ILD/IPF
why might a patient with allergic rhinitis and post-nasal drip experience chronic cough?
- upper airway secretions may drip down and stim receptors on larynx
- may be inflammation in larynx/other airways which may stim cough receptors
is hypoxia typically a mechanism for breathlessness?
NO. there is only a very rough correlation between physiological measures and the severity of a patient’s breathlessness.
why might someone with COPD experience dyspnea with exertion?
mechanism is due to hyperinflation, which places the insp muscles at a mechanical disadvantage. eventually, tidal volume approaches total lung capacity. sense of constrained breathing. but sat probably remains normal/is not the cause of his dyspnea
why someone with an asthma attack experience dyspnea? her sat is 95%
airway inflammation may irritate vagal nerve receptors which increases the sense of breathlessness.
depending on the load placed on her muscles due to airway obstruction, her work of breathing may have increased.
why might someone with ALS experience dyspnea?
with inspiratory muscle weakness, sense of resp muscle effort is increased. this sense is proportional toe the pressure that needs to be generated, relative to the capacity of the muscles to achieve that pressure. Mismatch of expected output to actual output.
why might a man with advanced heart disease experience dyspnea?
not entirely sure: might be high L sided filling pressure sensed by the vagus nerve. might be low CO reducing blood flow to resp muscles, which might inc perceived work of breathing.
