RESP 207 OSA Flashcards

1
Q

What is the definition of obstructive sleep apnoea?

A

Intermittent and repeated upper airway collapse during sleep resulting in irregular breathing at night and excessive sleepiness during the day

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2
Q

How do you define complete apnoea?

A

10 seconds + of paused breathing

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3
Q

How do you define hypopnoea?

A

10 seconds where ventilation decreased by 50%

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4
Q

Name some risk factors for OSA?

A
Obesity
Middle aged
Male
Smoking
Sedatives / Alcohol
Jaw morphology
Hypothyroidism
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5
Q

What are the clinical features of OSA?

A
Excessive daytime sleepiness
Decreased concentration
Snoring
unrefreshing sleep
Withness apnoea
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6
Q

What is the pathophysiology behind OSA?

A

Oropharynx colla[ses due to decreased pharyngeal muscle tone so the tongue/posterior palate drop back onto the posterior pharyngeal wall occluding the airway

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7
Q

What stimulates arousal during sleep in OSA?

A

The rising PaCO2

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8
Q

What is the main treatment for OSA?

A

CPAP

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9
Q

Where are the respiratory centres in the central control of ventilation?

A

medulla oblongata

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10
Q

What are the 2 groups of UMN’s that control respiration? What is their function?

A

Dorsal respiratory group - Initiates respiration

Ventral respiratory group - mostly expiration

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11
Q

What do the UMN groups that control respiration respond to?

A

Input from the pons and the cortex

afferents from chemoreceptors peripherally and centrally that detect changes in blood and CSF pCO2 and pO2

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12
Q

Which of pCO2 or pO2 will make the most difference to ventilation rate?

A

pCO2 but after ~100mmHg pO2 becomes a driving factor

A change in either will make the ventilatory rate more sensitive to the other

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13
Q

What does the pontine respiratory group do?

A

Fine tune the respiratory rhythm

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14
Q

What is the pathway for voluntary control of breathing?

A

Cerebral cortex –> pyramidal tracts –> corticospinal tracts

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15
Q

What are the 3 different airway reflexes for modifying the respiratory rhythm?

A

Irritant receptors
Pulmonary stretch receptors
J-receptors

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16
Q

What do irritant receptors in the airway respond to and what do they result in?

A

Noxious gases detected in airway –> vagus nerve = bronchoconstriction
Irritants detected in nose and upper airway –> vagus = cough/sneeze

17
Q

What is the Hering-Bruer reflex?

A

A reflex to prevent over-inflation of the lungs by detecting excessive inhalation by pulmonary stretch receptors and sending signals via the vagus nerve to stimulate expiration

18
Q

What are J receptors?

A

Receptors that detect increased fluid in the lung - engorged capilliaries which triggers receptors – vagus to cause dyspnoea (in heart failure)

19
Q

Describe Type 1 respiratory failure?

A

Acute hypoxaemic respiratory failure
Low PaO2 and N/Low PaCO2 due to V/Q mismatch

Occurs due to under-ventilated alveoli (pulmonary oedema, pneumonia or acute asthma) or R-L shunt

20
Q

What are the common causes of type 1 respiratory failure?

A

Cardiogenic pulmonary oedema
Pneumonia
Acute lung injury
Lung fibrosis

21
Q

Describe type 2 respiratory failure?

A

Occurs when alveolar ventilation is insufficient to excrete the volume of carbon dioxide being produced by tissue metabolism
Due to: Reduced ventilatory effort/ inability to overcome a resistance to ventilation and failure to compensate for increased dead space or CO2 production

Low PaO2 and Normal/High PaCO2?

22
Q

What the common causes of type 2 respiratory failure?

A

COPD
Chest wall deformities
Respiratory muscle weakness (GBS)
Depression of respiratory centre (overdose)

23
Q

What is the likely blood gas in type 1 respiratory failure?

A

decreased pO2
Normal/low pCO2
normal/high pH (alkalosis)
normal/low bicarb

= respiratory alkalosis

24
Q

What is the likely blood gas in type 2 respiratory failure?

A

decreased pO2
increased pCO2
low/normal pH
high/normal bicarb

respiratory acidosis