Breathlessness Flashcards
How does central information processing in the brain result in breathlessness
Central information processing in the brain compares the afferent and efferent pathways. Dyspnoea occurs when mismatch occurs between 2
Define breathlessness
Need for ventilation (afferent signal) is not met by breathing (efferent signal)
Which receptors are involved in breathlessness experienced in type 1 resp failure
Peripheral chemoreceptors
Are most cases of type 2 respiratory failure related to breathlessness
No (hypoventilation)
How does metabolic acidosis lead to breathlessness
All causes of metabolikc acidosis cause breathlessness due to effect on peripheral chemoreceptor
How can hypotension lead to breathlessness
Leads to stagnant hypoxia resulting in decreased p02 in peripheral chemoreceptor
How does exercise lead to breathlessness
Inreased pC02 and via afferents from skeletal muscles stimulating resp centre
How does pregnancy lead to breathlessness
Due to direct effect on respiratory centre from progesterone
Also, increased CO2 production
How does anxiety and pain lead to breathlessness
Impulses passing from hypothalamus to the resp centre
How can pulmonary oedema lead to breathlessness
Stimulates J receptors in lung
Does anaemia cause breathlessness
Yes
What receptor are affected when breathign CO2
Central chemoreceptors
2 ways of classifying breathlessness
Surgical sieve
Systems based
What pneumonic can be used to classify breathlessness via surgical sieve
Very Early Man Did Not Talk I I I I I
What does the breathlessness pneumonic stand for
Vascular Endocrine Metabolic Degenerative Neoplastic Truamatic Infective Inflammatory Immunological Iatrogenic Idiopathic
Name some vascular causes of breathlessness
Pulmonary hypertension Pulmonary embolism Pleural effusion CAD Congestive heart failure Arrythmia Acquired vascular heart disease Congenital heart disease
Name some endocrine causes of breathlessness
DKA
Cushings syndrome
Phageo-chromocytoma
Name some metabolic causes of breathlessness
Pericardial effusion Cardiac drugs Uraemia Ascites CO poisoning Anaemia
Name some degenerative causes of breathlessness
COPD GORD Interstitial lung disease Aortic dissection Kyphoscoliosis
Name some neoplastic causes of breathlessness
Tumours
Pleural effusion
Phrenic nerve paralysis
Name some traumatic causes of breathlessness
Foreign body aspiration
Anxiety
Aortic dissection
Name some infective causes of breathlessness
Septic shock Epiglottis Laryngitis Diptheria Bronchitis Pneumothorax
Name some inflammatory causes of breathlessness
Cardiomyopathy
Myocarditis
Name some iatrogenic causes of breathlessness
phrenic nerve paralysis
What are the systems involved in the systems approach
Airway Breathing Cardiovasc Endocrine Haematological Neurological Allergic
What some MET stand of
Metabolic equivelent
What is sitting down in terms of METs
1
How many METS are used climbing a flight of stairs
4
How many METS are used walking at 2mph
2
7 things tested for in primary investigation for breathlessness
- FBC
- U&E
- pulse oximetry
- PEFK
- PFT
- ABG
- Cardiac enzymes
5 things tested for in secondary investigation for breathlessness
- ECG
- CXR
- Echo
- Shuttle walk
- VQ scan
