Dyspnea, Cyanosis and Abnormal Respiratory Patterns

Question 1

subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity

Answer 1

Dyspnea

Question 2

Onbejective manifestation of dyspnea

Answer 2

Collaborating signs

Question 3

Neurl signa; sent to the sensory cortex at the same time that motor output is directed to the ventillatory muscles

Answer 3

Corollary discharge

Question 4

Different sensory afferents

Answer 4

Chemoreceptors

Mechanoreceptors

Question 5

Chemoreceptors

Answer 5

Carotid bodies and medulla

Question 6

Thing that activate the carotid bodies and medulla

Answer 6

hypoxemia, acute hypercapnia, and academia

Question 7

Mechanoreceptors

Answer 7

Chest wall receptors and afferents

Pulmonary Vagal receptors -> chest tightness

J receptors -> air hunger

Question 8

Receptor sensitive by bronchospam

Answer 8

Pulmonary Vagal Receptors

Question 9

receptors sensitive to interstitial edema

Answer 9

J receptors

Question 10

Receptor that is activated by acute changes in pulmonary artery pressure

Answer 10

Pulmonary Vascular Receptors

Question 11

Breathlessness occurs during?

Answer 11

Heightened ventilatory demand
Respiratory muscle abnormalities
Abnormal ventilatory response
Abnormal breathing patterns
Blood-gas abnormalities

Question 12

Different Receptor Pathways

Answer 12

Intrapulmonary parenchymal receptors
Airway irritant receptors
Carotid receptors
Central chemoreceptors
Peripheral vascular receptors

Question 13

Stretch receptors in interstitial edema and charge in pulmonary compliance

Answer 13

Intrapulmonary parenchymal receptors

Question 14

Receptors that detects hypoxic drive

Answer 14

Carotid body reeptors

Question 15

Receptor that detects hypercapnic drive

Answer 15

Central chemoreceptors

Question 16

Atrial mechanoreceptors, pulmonary artery baroreceptor

Answer 16

Peripheral Vascular Receptors

Question 17

ration of the pressure generated by the respiratory muscle to the maximum pressure generating capacity of the muscles

Answer 17

Sense of Respiratory Effort

Question 18

ASthma and CHF

Answer 18

Descriptor: Chest tightness or constriction

Pathophysiology: Bronchoconstriction, interstitial edema

Question 19

COPD, asthma, neuromuscular. chest wa;; restriction

Answer 19

Descriptor: Increased work or effort

Pathophysiology: Airway obstruction, neuromuscular disease

Question 20

COPD, pulmonary fibrosis, chest wall disease

Answer 20

Descriptor: Inability to get a deep breath, unsatisfying breath

Pathophysiology: Hyperinflation and restricted tidal volume

Question 21

Sedentary status in healthy individual or patient with cardiopulmonary disease

Answer 21

Descriptor: Heavy breathing, rapid breathing, breathimg more

Pathophysiology: Deconditioning

Question 22

Language of dyspnea

Answer 22

Controller stimulation - > air hunger
Acute bronchoconstriction - > Chest tightness
Ventilatory pump problem - > increased work of breathing
Deconditioning -> heavy breathing
Pulmonary edema -> suffocating

Question 23

Distinguishing cardiovascular from respiratory system dyspnea

Answer 23

Cardiopulmonary exercise test
* Increase in dead space or hypoxemia or bronchospansm -> RESPIRATORY

*O2 pulse falls or ischemic changes in ECG -> cardiovascular

Question 24

Verbal brathlessness Scale

Answer 24

Borg Dyspnea Scale

0 - nothing at all
1 - Very slight
2 - slight
3 - Moderate
4 - Somewhat severe
5 - Severe
6
7 - very severe
8 
9 - very, very severe
10 - Maximal

Question 25

American Thoracic Society Grade of Breathlessness Scale

Answer 25

Grade 0 - not troubled with breathlessness except with strenuous exercise 1 - troubled by shortness of breath when hurrying on level ground or walking up a slight hill 2 - walks slower than people of the same age 3 - Stops for breath after walking approx. 100 yeards 4 - Too breathless to leave the house or breathless when dressing and undressing

Question 26

Platypnea

Answer 26

Left atrial myxoma, hepatopulmonary syndrome

Question 27

Normal ranges in Respiration

Answer 27

RR : 12-16 cpm TV 400-500 ml MV:5L/min 5 secs to complete 1 cycle(1 sec in inspiration, 2 sec expiration)

Question 28

Restricted lung

Answer 28

Problem with lung compliance Rapid, shallow breathing Decreases effort against stiff lung, compensate by increasd freq.

Question 29

Obstructed lungs

Answer 29

Problems with airway resistance Slow, deep breathing Fewer breaths but more ambient air reaches the alveoli

Question 30

Occurs when duration of expiration is insufficient to allow lungs to deflate to relaxation volume prior to the next inspiration. Occurs in conditions wherin expiratory flow is impeded due to increased respiratory system resistance

Answer 30

Dynamic hyperinflation

Question 31

Pursed lipBreathing

Answer 31

COPD | SLows down the breathing rate, giving the patient enough time to completely exhale

Question 32

mainly deep but also rapid respiration, caused by severe metabolic acidemia states necessitating respiratory compensatory hyperventilation

Answer 32

Kussmaul Breathing

Question 33

Regularly irregular, with progressive increase in depth and sometimes frequency in cresendo decresecendo manner, ending in apnea (15-60 secs). Signifies that the respiratory centers are sluggish in their response to variations CO2.

Answer 33

Cheyne-stokes breathing -causes: aging, obesity, CHF, neurologic disorder

Question 34

There is succession of hyperapnea, hyperventilation, apnea, but not regular, no cresendo-decrescendo

Answer 34

Biot's Breathing Pattern -causes : meningitis, medullary compression

Question 35

Deep inspiration - breath holding 0 rapid exhalation

Answer 35

Apneustic Breathing Pattern -brainstem lesions usually at the level of pons

Question 36

Very rapid, very deep (faster than kussmaul which is mainly very deep)

Answer 36

Central hyperventilation Breathing Pattern -midbrain or upper pontine lesion

Question 37

Continuos irregular shift of hyperventilation, hypoventilation and apnea in no particular succession

Answer 37

Ataxic Breathing pattern - damage to medullary respiratory centers and is sort of fibrillation of respiratory centers, usually precedes death

Question 38

Tongue falls during sleep, obstructing the upper airway until the effort is string enough to wake the patient

Answer 38

Obstructive Sleep apnea

Question 39

A bluish color of skin and mucous membrane, in lips, nail beds and malar eminences

Answer 39

Cyanosis

Question 40

The ____ the hemoglobin concentration , the greater the tendency toward cyanosis

Answer 40

higher

Question 41

Causes of hypoxemia

Answer 41

``` Low GiO2 Hypoventilation True sjunt Diffusion Abnormality Ventilation/ perfusion Mismatching ```

Question 42

true cyanosis

Answer 42

``` impaired pulmonary function R to L shunting of blood Reduced arterial oxygen saturation Involves highly vascularied tissues through which bloof flow is brisk and the arteriovenous difference is minimal Normal cardiac output Patients have warm extremities ```

Question 43

Peripheral cyanosis

Answer 43

Increased oxygen consumption in peripheral tissue Normal systemic arterial oxygen saturation and increased oxygen extraction, resulting in a wide arteriovenous oxygen difference CAUSES: Vasoconstriction and Slowing of blood flow

Question 44

Methemoglobinemia

Answer 44

Hereditary Intake or exposure to some drugs or chemicals such as sulfa drugs, nitirite salts "enterogenic cyanosis"

Question 45

Sulfhemoglobinemia

Answer 45

>0.5g/dl sulfhemoglobin

Question 46

Cyanosis + dyspnea

Answer 46

respiratory or CVS

Question 47

Cyanosis with midl or no dyspnea

Answer 47

Methemoglobinemia, sulfaHgb

Question 48

cyanosis + clubbing

Answer 48

severe, long duration