15 neurovascular aspects of respiratory medicine

Question 1

Which would show more acute/chronic neuromuscular issues, central or peripheral structures?

Answer 1

central - acute

peripheral - chronic

Question 2

What are the 2 forms of pulmonary vascular disease?

Answer 2

pulmonary embolism

pulmonary hypertension

Question 3

How can brain injuries affect respiratory function?

Answer 3

If they damage the breathing centres in the brainstem, chemoreceptors in the medulla oblongata

Question 4

How would a lesion be spotted on an MRI?

Answer 4

sort of a greyish mass on the affeccted area

Question 5

How would a haemorrhage show up on an MRI?

Answer 5

big white mass

Question 6

How would ischaemia show up on an MRI?

Answer 6

darkness

Question 7

What effect do sedatives have on respiration?

Answer 7

decreases respiratory drive and ventilation

Question 8

Name 2 neuromuscular diseases that affect ventilation

Answer 8

MND

Duchennes’ muscular Dystrophy

Question 9

What causes motoneurone disease, what kind of symptoms would we therefore see?

Answer 9

egeneration of the ventral horn in spinal chord where UMN meet LMN, see e would see a mixture of UMN and LMN pathology

Question 10

How would you manage respiratory failure in MND

Answer 10

non-invaice ventilation

reduced CO2

Question 11

What happens to muscle tone and ysmpathetic activity in REM sleep?

Answer 11

muscle tone - decreases

sympathetic activity - increases

Question 12

What is obstructive apnoea?

Answer 12

when asleep,the tongue can block the airways, so work to breath increases, yet O2 continues to fall

Question 13

What is obstructive apnoea associated with?

Answer 13

obesity

craniofacial abnormalities

Question 14

What is micrognathia and what is it associated with?

Answer 14

very small jaw

treacher - collins syndrome

Question 15

name 3 symptoms of pulmonary embolism

Answer 15

pleuric chest pain
dyspnoea
haemoptysis

Question 16

What might you see on a CXR with pulmonary embolism?

Answer 16

basal atelectais (collapse of lung tissue)
hamptons’ lump, a pleural wedge shape
Westermark’s sign, decreased volume of blood circulating

Question 17

What might you see on an MRI of the heart in pulmonary embolism?

Answer 17

thrombus in major vessels

Question 18

What might you see in a V/Q scan of someone with pulmonary embolism?

Answer 18

V / Q mismatch, greater than 0.8

Question 19

How would you manage pulmonary embolism?

Answer 19

anticoagulation (LMWH, then NOAC or Warfarin)

Question 20

What is LMWH?

Answer 20

Low Molecular Weight Heparin

Question 21

What is an NOAC?

Answer 21

Novel Oral Anticoagulant

Question 22

What is the minimum pressure required for pulmonary hypertension?

Answer 22

25 mmHg (pulmonary artery)

Question 23

What is the most accurate way to measure pulmonary artery pressure?

Answer 23

Right heart catheter

Question 24

In the case of right heart failure in pulmonary hypertension, what other symptoms might be present?

Answer 24

peripheral oedema (peripheral fluid accumulation)
ascites (abdominal fluid accumulation)