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Jason's Respiratory Block > Resp Depression, Breathlessness > Flashcards

Flashcards in Resp Depression, Breathlessness Deck (50):
1

At Rest respiratory system clears how much O2 and CO2 per minute?

O2 = 250ml
CO2 = 200ml

2

How many horsepower can the aerobic&anaerobic metabolism sustain?

0.1 horse power

3

What PaO2, PaCO2 and pH are the chemoreceptors trying to maintain?

PaO2 = 100mmHg
PaCO2=40mmHg
pH =7.4

4

How many litres/minute can the alveolar capillary membrane exchange?

4L/min

5

Central chemoreceptors respond to what chemical? versus peripheral chemoreceptors?

Central: H+
Peripheral: CO2, O2, H+

6

Name 3 sensors for respiratory control?

Chemoreceptors
lung receptors
stretch/joint receptors

7

What's the major output nerve of the brainstem for respiration?

phrenic nerve

8

Can the cortex override the brainstem re: respiration?

Yes.

9

Where are the peripheral chemoreceptors?

carotid bodies and aortic arch

10

T/F? small increase in O2 = increase ventilation?

False. Small CO2 = rapid increase ventilation

11

At what point would you start hyperventilating re: PaO2 levels?

<60mmHg

12

During exercise, what happens to PaO2?

Stays same

13

During exercise, what happens to PaCO2?

decreases slightlty due to increased ventilation

14

During exercise, what happens to pH?

drops slightly due to lactic acid

15

Hypoventilation is what in terms of PaO2 and CO2?

decreased PaO2
increased PaCO2

16

Acute hypoventilation causes respiratory what?

acidosis

17

Chronic hypoventilation causes metabolic what?

alkalosis

18

5 causes of hypoventilation?

Central (drive, suppression)
Neuromusular
chest wall
obesity
sleep disorder

19

3 kinds of sleep apnea:

obstructive sleep apnoea
central
obesity hypoventilation syndrome

20

do all snorers have OSA?

Nope

21

Mechnism for snoring?

airway relaxes>throat narrowed>tongue falls backwards>turbulant flow = snoring

22

OSA cycle results in what kind of sleep?

fragmented sleep/deprivation

23

6 reasons to suspect OSA?

snoring
witnessed apnoeas
arousals
disturbed sleep
persistent HTN/unexplained resp failure

24

what is paradoxical movement on polysomnogram mean?

no airflow but still trying to breath

25

Management of OSA?

CPAP
surgery
mandibular splint
lie on side

26

what happens to the brain after chronic hypoventilation due to OSA?

brain accepts higher levels of CO2, you wake less but then it spills over into daytime and normally have lower O2 and higher CO2 in your body

27

Resetting of respiratory centre happens with what other conditions?

severe COPD, pulmnoary fibrosis, neuromuscular disease

28

If patients have chronic hypercapnoea, what do you do about supplemental oxygen?

You don't have large amounts (only until they reach their 'normal') or else they'll die as they are breathing re: O2 levels rather than CO2 levels

29

4 key words for breathlessness?

recognition
inappropriate
respiratory work
total body work

30

When is most of the respiratory work done?

inspiratory

31

Two other things make up respiratory work besides inspiration

stretching work - elastic
airflow work - resistive

32

Dyspnea is sensation of increased what? and what?

load and drive

33

Besides repiratory and cardiac causes, name 4 other causes of dyspnea?

muscle weakness
metabolic
anaemic
psychogenic

34

Does phrenic nerve palsy cause dyspnea?

yes

35

What is usually the cause of SOB, cough, sputum, wheeze/stridor? what tests to do?

affected airways, (upper or lower) bronchiectasis, most likely obstructive
test with spirometry

36

68 yr old with SOB, cough, sputum, tobacco, hyperinflation and wheezes, what imaging? what tests?

CT scan
spirometry
most likely COPD

37

SOB, cough and crepitations, where are problems most likely?

alveolar, could also be bronchiectasis

38

Someone with normal chest examination, haemoptysis, pleuritic pain, look out for?

PE, or pulmonary hypertension/vasculitis

39

What is the Wells Score?

To help dx a PE

40

If Wells score is >4 what to do?

rule in with pulmonary angiogram

41

If Wells Score is <4 then what?

D dimer to rule out

42

How many % of dyspnoea are diagnosed with symptoms, signs and special tests?

80%

43

what is MUD?

medically undiagnosed dyspnoea?

44

Types of MUD include?

psychogenic/anxiety?
other disease/new? MI, DM2
increased awareness of maximum effort

45

Breathlessness in young athletes in 12-15% of Australians are usually diagnosed with this?

atopic asthma

46

Breathlessness in young athletes, 30-40% have what? how treat?

exercise induced bronchoconstriction
treat with asthma treatments

47

What can be confused with Breathlessness in young athletes and responds to speech therapy and CBT?

vocal cord dysfunction/laryngeal dysfunction

48

If there are no ECG, BP of SaO2 abnormalities but have have steep heart rate, exceeive Ve max, early anaerobic threshold, what could it be?

De-conditioning

49

How to confirm deconditioning?

3 months of aerobic training then remeasure

50

What is a key marker for if dyspnoea is psychogenic?

If you have it at rest, but goes away during exercise