Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

GENERAL OTOLARYNGOLOGY > CHAPTER 15: Sleep Apnea and Sleep Disorders > Flashcards

CHAPTER 15: Sleep Apnea and Sleep Disorders Flashcards

1
Q

The idea of obesity is written by Charles Dickens in…

A

The Posthumous Papers of the Pickwick Club (1837)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Sound generated by the vibration of the pharyngeal soft tissues

A

Snoring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

TRUE or FALSE

Snoring is often louder during inspiration than expiration

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A cessation of airflow for at least 10sec

A

Apnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A reduction in airflow (>30%) at least 10sec with >4% oxyhemoglobin desaturation

A

Hypopnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A reduction in airflow (>50%) at least 10sec with >3% oxyhemoglobin desaturation or an electroencephalogram (EEG) arousal

A

Hypopnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Sequence of breaths for at least 10sec with increasing respiratory effort or flattening of the nasal pressure waveform, leading to an arousal from sleep when the sequence of breaths does not meet the criteria of an apnea or a hypopnea

A

Respiratory effort-related arousal (RERA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Continued thoracoabdominal effort in the setting of partial or complete airfloe cessation

A

Obstructive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The lack of thoracoabdominal effort in the setting of partial or complete cessation of airflow

A

Central

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A respiratory event with both obstructive and central features, with mixed events generally beginning as central events and ending with thoracoabdominal effort without airflow

A

Mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Used to described patients who do not meet the criteria for OSA syndrome but who experience excessive daytime somnolence and other debilitating somatic complaints

A

Upper Airway Resistance Syndrome (UARS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Characterized by respiratory effort-related arousals

A

Upper Airway Resistance Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Is detected by esophageal pressure manometry, which reveals a pattern of progressively increasing negative esophageal pressure followed by an arousal

A

Respiratory effort-related arousals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diagnostic criteria for OSA in adults requires a polysomnogram or home sleep apnes test (HSAT) that demostrates either…

A
  1. 5 or more predominately obstructive respiratory events (obstructive and/or mixed apneas, hypopneas, or RERAs)
  2. 15 or more predominately respiratory events per hour of sleep regardless of symptoms or comorbidities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Symptoms related to OSA

A
  1. Excessive daytime somnolence
  2. Waking with gasping
  3. Choking
  4. Breath holding
  5. Witnessed reports of apneas
  6. Loud snoring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Comorbidities include

A
  1. Hypertension
  2. Mood disorder
  3. Congnitive dysfunction
  4. Coronary artery disease
  5. Stroke
  6. Congestive heart failure
  7. Atrial fibrillation
  8. Type II DM
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Number of apneas per hour of total sleep time

A

Apnea index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Number of hypopneas per hour of total sleep time

A

Hypopnea index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Number of apneas and hypopneas per hour of total sleep time

A

Apnea-hypopnea index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Number of RERAs per hour of total sleep time

A

Respiratory effort-related arousal index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Number of apneas, hypopneas, and RERAs per hour of total sleep time

A

Respiratory disturbance index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Number of central apneas per hour of total sleep time

A

Central apnea index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Number of mixed apneas per hour of total sleep time

A

Mixed apnea index

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

TRUE or FALSE

Diagnosis of OSA may be made on in-lab PSG or by HSAT

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Symptoms of Sleep-Disordered Breathing

A
  1. Restless sleep
  2. Loud snoring
  3. Observed apnea, choking, or gasping episodes
  4. Excessive daytime sleepiness
  5. Morning fatigue or irritability
  6. Memory loss
  7. Decreased cognitive function
  8. Depression
  9. Personality or mood changes
  10. Decreased libido and impotence
  11. Morning and nocturnal headaches
  12. Nocturnal sweating
  13. Nocturnal enuresis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Mild OSA

A

5-15 events per hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Moderate OSA

A

15-30 events per hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Severe OSA

A

30 events or more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

4 key traits or phenotypes that contribute to OSA

A
  1. Impaired upper airway anatomy that is narrow or collapsible
  2. Low respirtory arousal threshold
  3. Inadequate responsiveness of upper airway dilator muscles during sleep
  4. Unstable or overly sensitive respiratory control, a concept referred to as high loop gain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

TRUE or FALSE
Obesity, soft tissue hypertrophy, and craniofacial characteristics such as retrognathia contribute to the upper airway anatomy by increasing the extraluminal tissue pressures surrounding the upper airway

A

TRUE

31
Q

TRUED or FALSE

Patients without anatomic abnormalities may also have OSA

A

TRUE

32
Q

3 major areas of obstruction

A
  1. Nose
  2. Palate
  3. Hypopharynx
33
Q

Classification of patterns of obstruction by anatomic location: Type I

A

Collapse in the retropalatal region only

34
Q

Classification of patterns of obstruction by anatomic location: Type II

A

Collapse in both retropalatal and retrolingual regions

35
Q

Classification of patterns of obstruction by anatomic location: Type III

A

Collapse in the retrolingual region only

36
Q

Major risk factor for OSA

A

Obesity

37
Q

TRUE or FALSE
The increase fat deposition around the neck and parapharyngeal spaces is postulated to narrow and compress the upper airway and may offset the effects if dilator muscles that maintain airway patency

A

TRUE

38
Q

TRUE or FALSE
Obesity contribute to OSA through its deleterious effects on metabolism, ventilation, and lung volume, resulting in a mismatch between alveolar ventilation and pulmoary perfusion

A

TRUE

39
Q

Changes in lung volume significantly reduce pharyngeal upper airway size through the mechanical effect of tracheal and thoracic traction

A

Tracheal tug

40
Q

Major cause of OSA in children

A

Adenotonsillar hypertrophy

41
Q

Craniofacial variations that have been associated with OSA

A
  1. Increased distance of the hyoid bone from the mandibular plane
  2. Decreased mandibular and maxillary projection
  3. Downward and posterior rotation of mandibular and maxillary growth
  4. Increased vertical facial length
  5. Increased vertical length of the posterior airway
  6. Increased cervical angulation
42
Q

TRUE or FALSE
To quantify the functional collapsibility of the upper airway, the passive criticla closing pressure (Pcrit) is measured using a mask attached to a device that can deliver both positive and negative airway pressure

A

TRUE

43
Q

Is the luminal pressure at which the upper airway collapses after a prolonged period of therapeutic positive pressure, such that there is minimal recruitment of the pharyngeal dilator muscles when airway pressures are suddenly reduced

A

Passive critical closing pressure (Pcrit)

44
Q

Pcrit of individuals with OSA

A

Pcrit above atmospheric pressure

45
Q

Pcrit of individuals without OSA

A

Pcrit below -5 cm H2O

46
Q

TRUE or FALSE

Neuromuscular tone contributes to the patency of the upper airway

A

TRUE

47
Q

Considered to be the most important muscle in maintaining airway patency in OSA

A

Genioglossus

48
Q

The sensitivity of the respiratory control system to perturbations in CO2 level

A

Concept of loop gain

49
Q

Indicates an unstable respiratory control system that is prone to overcompensation, resulting in excessive changes in ventilation

A

High loop gain

50
Q

Indicates a more stable respiratory control system where responses to perturbation are less prone to overcompensation, resulting in a more rapid return to homeostasis

A

Low loop gain

51
Q

TRUE or FALSE
High loop gain can contribute to OSA by causing rapid increases in respiratory drive in response to small increases in CO2, resulting in large negative luminal negative pressures and increasing the likelihood of airway collapse

A

TRUE

52
Q

Negative health effects attributed to untreated OSA

A
  1. Increased mortality
  2. Increase in cardiovascular disease
  3. Neurocognitive difficulties
53
Q

Independent risk factor for insulin resistance

A

Untreated OSA

54
Q

Most common symptoms of OSA

A
  1. Loud snoring
  2. Restles sleep
  3. Daytime hypersomnolence
55
Q

Most common finding in patient with OSA

A

Obesity

56
Q

Widely used tool that assesses daytime sleepiness

A

Epworth Sleepiness Scale

57
Q

TRUE or FALSE

OSA may be suspected in patients with an ESS score greater than 10

A

TRUE

58
Q

STOP-BANG

A 
S- snor
T-  tired
O- observed you stop breathing
P- high blood pressure
B- BMI
A- age (50)
N- neck circumference (>40 cm/female, >43 cm/male)
G- gender (male)
59
Q

Physical examination findings: Nasal obstruction

A
  1. Septal deviation
  2. Turbinate hypertrophy
  3. Nasal valve collapse
  4. Adenoid hypertrophy
  5. Nasal tumors or polyps
60
Q

Physical examination findings: Oropharyngeal obstruction

A
  1. Large soft palate
  2. Palatine tonsillar hypertrophy
  3. Posterior pharyngeal wall banding
  4. Macroglossia
  5. Large mandibular tori
  6. Narrow skeletal arch
61
Q

Physical examination findings: Hypopharyngeal obstruction

A
  1. Lateral pharyngeal wall collpase
  2. Omega-shaped epiglottis
  3. Hypopharyngeal tumor
  4. Lingual tonsillar hypertrophy
  5. Retrognathia and micrognathia
62
Q

Physical examination findings: Laryngeal obstruction

A
  1. True vocal cord paralysis

2. Laryngeal tumor

63
Q

Physical examination findings: General neck obstruction

A
  1. Increased neck circumference

2. Redundant cervical adipose tissue

64
Q

Physical examination findings: General body habitus

A
  1. Obesity
  2. Achondroplasia
  3. Chest wall deformity
  4. Marfan syndrome
65
Q

Physical examination findings: Cardiovascular signs

A
  1. Arterial hypertension, especially morning hypertension

2. Peripheral edema

66
Q

Is performed in an awake patient, who generates negative pressure buy inhaling against a closed glottis with the nose and mouth closed to trigger airway collapse

A

Muller maneuver

67
Q

Agent for sedation for DISE for adults

A

Midazolam and profopol

68
Q

Agents for seadtion of DISE in children

A

Dexmedetomidine

69
Q

A proposed method of standardizing DISE findings

A

V- velum
O- oropharynx
T- tongue base
E- epiglottis

70
Q

Radiologic technique used to aid in the identification of the site and severity of upper airway obstruction or collapse in OSA

A

Cephalometric radigraph

71
Q

TRUE or FALSE
The differences between OSA and non-OSA patients noted on cephalometry have not been significant enough to allow for the use of lateral cephalograms as a sole diagnostic tool

A

TRUE

72
Q

Provides good anatomic detail of the bone and soft tissue

A

Awake CT

73
Q

Primary advantage of CT

A

Highn anatomic resolution of dynamic airway movement during sleep without the presence of an endoscope that might potentially alter inflow

74
Q

Provided excellent soft tissue differentiation and does not require radiation exposure

A

MRI

GENERAL OTOLARYNGOLOGY (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions