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OS 213 Respiratory EXAM 1 > Dyspnea, Cyanosis and Abnormal Respiratory Patterns > Flashcards

Dyspnea, Cyanosis and Abnormal Respiratory Patterns Flashcards

1
Q

subjective experience of breathing discomfort that consists of qualitatively distinct sensations that vary in intensity

A

Dyspnea

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2
Q

Onbejective manifestation of dyspnea

A

Collaborating signs

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3
Q

Neurl signa; sent to the sensory cortex at the same time that motor output is directed to the ventillatory muscles

A

Corollary discharge

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4
Q

Different sensory afferents

A

Chemoreceptors

Mechanoreceptors

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5
Q

Chemoreceptors

A

Carotid bodies and medulla

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6
Q

Thing that activate the carotid bodies and medulla

A

hypoxemia, acute hypercapnia, and academia

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7
Q

Mechanoreceptors

A

Chest wall receptors and afferents

Pulmonary Vagal receptors -> chest tightness

J receptors -> air hunger

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8
Q

Receptor sensitive by bronchospam

A

Pulmonary Vagal Receptors

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9
Q

receptors sensitive to interstitial edema

A

J receptors

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10
Q

Receptor that is activated by acute changes in pulmonary artery pressure

A

Pulmonary Vascular Receptors

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11
Q

Breathlessness occurs during?

A 
Heightened ventilatory demand
Respiratory muscle abnormalities
Abnormal ventilatory response
Abnormal breathing patterns
Blood-gas abnormalities
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12
Q

Different Receptor Pathways

A 
Intrapulmonary parenchymal receptors
Airway irritant receptors
Carotid receptors
Central chemoreceptors
Peripheral vascular receptors
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13
Q

Stretch receptors in interstitial edema and charge in pulmonary compliance

A

Intrapulmonary parenchymal receptors

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14
Q

Receptors that detects hypoxic drive

A

Carotid body reeptors

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15
Q

Receptor that detects hypercapnic drive

A

Central chemoreceptors

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16
Q

Atrial mechanoreceptors, pulmonary artery baroreceptor

A

Peripheral Vascular Receptors

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17
Q

ration of the pressure generated by the respiratory muscle to the maximum pressure generating capacity of the muscles

A

Sense of Respiratory Effort

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18
Q

ASthma and CHF

A

Descriptor: Chest tightness or constriction

Pathophysiology: Bronchoconstriction, interstitial edema

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19
Q

COPD, asthma, neuromuscular. chest wa;; restriction

A

Descriptor: Increased work or effort

Pathophysiology: Airway obstruction, neuromuscular disease

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20
Q

COPD, pulmonary fibrosis, chest wall disease

A

Descriptor: Inability to get a deep breath, unsatisfying breath

Pathophysiology: Hyperinflation and restricted tidal volume

21
Q

Sedentary status in healthy individual or patient with cardiopulmonary disease

A

Descriptor: Heavy breathing, rapid breathing, breathimg more

Pathophysiology: Deconditioning

22
Q

Language of dyspnea

A

Controller stimulation - > air hunger
Acute bronchoconstriction - > Chest tightness
Ventilatory pump problem - > increased work of breathing
Deconditioning -> heavy breathing
Pulmonary edema -> suffocating

23
Q

Distinguishing cardiovascular from respiratory system dyspnea

A

Cardiopulmonary exercise test
* Increase in dead space or hypoxemia or bronchospansm -> RESPIRATORY

*O2 pulse falls or ischemic changes in ECG -> cardiovascular

24
Q

Verbal brathlessness Scale

A

Borg Dyspnea Scale

0 - nothing at all
1 - Very slight
2 - slight
3 - Moderate
4 - Somewhat severe
5 - Severe
6
7 - very severe
8 
9 - very, very severe
10 - Maximal
25
Q

American Thoracic Society Grade of Breathlessness Scale

A

Grade
0 - not troubled with breathlessness except with strenuous exercise
1 - troubled by shortness of breath when hurrying on level ground or walking up a slight hill
2 - walks slower than people of the same age
3 - Stops for breath after walking approx. 100 yeards
4 - Too breathless to leave the house or breathless when dressing and undressing

26
Q

Platypnea

A

Left atrial myxoma, hepatopulmonary syndrome

27
Q

Normal ranges in Respiration

A

RR : 12-16 cpm
TV 400-500 ml
MV:5L/min
5 secs to complete 1 cycle(1 sec in inspiration, 2 sec expiration)

28
Q

Restricted lung

A

Problem with lung compliance
Rapid, shallow breathing
Decreases effort against stiff lung, compensate by increasd freq.

29
Q

Obstructed lungs

A

Problems with airway resistance
Slow, deep breathing
Fewer breaths but more ambient air reaches the alveoli

30
Q

Occurs when duration of expiration is insufficient to allow lungs to deflate to relaxation volume prior to the next inspiration. Occurs in conditions wherin expiratory flow is impeded due to increased respiratory system resistance

A

Dynamic hyperinflation

31
Q

Pursed lipBreathing

A

COPD

SLows down the breathing rate, giving the patient enough time to completely exhale

32
Q

mainly deep but also rapid respiration, caused by severe metabolic acidemia states necessitating respiratory compensatory hyperventilation

A

Kussmaul Breathing

33
Q

Regularly irregular, with progressive increase in depth and sometimes frequency in cresendo decresecendo manner, ending in apnea (15-60 secs). Signifies that the respiratory centers are sluggish in their response to variations CO2.

A

Cheyne-stokes breathing

-causes: aging, obesity, CHF, neurologic disorder

34
Q

There is succession of hyperapnea, hyperventilation, apnea, but not regular, no cresendo-decrescendo

A

Biot’s Breathing Pattern

-causes : meningitis, medullary compression

35
Q

Deep inspiration - breath holding 0 rapid exhalation

A

Apneustic Breathing Pattern

-brainstem lesions usually at the level of pons

36
Q

Very rapid, very deep (faster than kussmaul which is mainly very deep)

A

Central hyperventilation Breathing Pattern

-midbrain or upper pontine lesion

37
Q

Continuos irregular shift of hyperventilation, hypoventilation and apnea in no particular succession

A

Ataxic Breathing pattern

  • damage to medullary respiratory centers and is sort of fibrillation of respiratory centers, usually precedes death
38
Q

Tongue falls during sleep, obstructing the upper airway until the effort is string enough to wake the patient

A

Obstructive Sleep apnea

39
Q

A bluish color of skin and mucous membrane, in lips, nail beds and malar eminences

A

Cyanosis

40
Q

The ____ the hemoglobin concentration , the greater the tendency toward cyanosis

A

higher

41
Q

Causes of hypoxemia

A 
Low GiO2
Hypoventilation
True sjunt
Diffusion Abnormality
Ventilation/ perfusion Mismatching
42
Q

true cyanosis

A 
impaired pulmonary function
R to L shunting of blood
Reduced arterial oxygen saturation
Involves highly vascularied tissues through which bloof flow is brisk and the arteriovenous difference is minimal
Normal cardiac output
Patients have warm extremities
43
Q

Peripheral cyanosis

A

Increased oxygen consumption in peripheral tissue
Normal systemic arterial oxygen saturation and increased oxygen extraction, resulting in a wide arteriovenous oxygen difference
CAUSES: Vasoconstriction and Slowing of blood flow

44
Q

Methemoglobinemia

A

Hereditary
Intake or exposure to some drugs or chemicals such as sulfa drugs, nitirite salts
“enterogenic cyanosis”

45
Q

Sulfhemoglobinemia

A

> 0.5g/dl sulfhemoglobin

46
Q

Cyanosis + dyspnea

A

respiratory or CVS

47
Q

Cyanosis with midl or no dyspnea

A

Methemoglobinemia, sulfaHgb

48
Q

cyanosis + clubbing

A

severe, long duration

OS 213 Respiratory EXAM 1 (19 decks)

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