Chest Wall and Respiratory Muscle disorders Flashcards
in newborns, FRC is maintained by
increase RR
decreased duration of inspiratory contraction
decreased time for lung deflation
glottal closure
ventilator induced diaphragm dysfunction can occur as quickly as how many hrs
18 hrs on vent
chest wall dysfuntion
reduced: lung volume
absolute flow rates
strength of respi muscles
RV and FEV1/FVC ratio normal
*RV can be augmented
hypercapnia is present during wakefulness with respi muscle strength less than how many %
less than 25% predicted
decrease in VC greater than expected if muscle strength is
less than 50% predicted
(atelectasis -decreased compliance)
joint ankylosis
can be the 1st symptom of chronic respi pump impairment
General fatigue and dyspnea on exertion
clinical signs of impending respi failure
to meet muscle work requirement
increase respi drive and phrenic nerve output
increase recruitment of FAST twitch muscle fiber
recruitment of Accessory respi muscles of chest and neck
change in respi pattern (reduce itime)
Upper motor neuron d/o causing chest wall dysfunction
CP
hemi and quadrilegia
Critical periods at risk of vent failure
neonatal
respi infection
GA
last tri preg
Frequent cause of diaphragmatic paralysis in newborn
stretching of c3 to c5 root during breech delivery (Erbs palsy)
most common side affected in diaphragmatic paralysis
right side
(more than 2 rib spaces higher than the left)
bilateral diaphragmatic paralysis, TLC is often less than how many percent
50%
confirmatory test for diaphragmatic paralysis
EMG with percutaneous stimulation of phrenic nerve
Ultrasound in spont breathing patient witg diaphragmatic paralysis
paradoxical INspiratory UPward motion of the PARaLYZED diaphragm
onset or age of 3 SMA types
0-6 months (type 1)
after 6 months (type 2)
after 10 months (type 3)
SMA type which has poor prognosis
and usually die by 18 months from respi failure
intact sensory
lack of motor
SMA type 1
Closing parasol
good quality of life
SMa type II