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2. Respiratory Medicine (Lectures) > Sleep Apnoea and Neuromuscular Failure > Flashcards

Sleep Apnoea and Neuromuscular Failure Flashcards

1
Q

What is sleep apnoea?

A

Recurrent episodes of upper airway obstruction leading to apnoea during sleep

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2
Q

What is sleep apnoea usually associated with?

A

Heavy snoring

Unrefreshing sleep

Daytime smnolence/sleepiness

Poor daytime concentration

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3
Q

What is A?

A

Tensor palatini

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4
Q

What is B?

A

Levator palatini

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5
Q

What is C?

A

Genioglossus

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6
Q

What is D?

A

Epiglottis

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7
Q

What is E?

A

Genu of mandible

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8
Q

What is F?

A

Geniohyoid

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9
Q

What is G?

A

Hyoid bone

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10
Q

What is H?

A

Thyrohyoid

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11
Q

What is I?

A

Thyroid cartilage

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12
Q

What is J?

A

Nasopharynx

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13
Q

What is K?

A

Velopharynx

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14
Q

What is L?

A

Oropharynx

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15
Q

What is M?

A

Hypopharnx

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16
Q

What does OSAS stand for?

A

Obstructive sleep apnoea

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17
Q

What does obstructive sleep apnoea lead to?

A

Impaired quality of life

Martial disharmony

Increased risk of road traffic accidents

Associated with hypertension, increased risk of stroke and probably increase risk of heart disease

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18
Q

What is the prevalence of sleep apnoea?

A

2% of adult men

1% of adult woman

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19
Q

What does the diagnosis of sleep apnoea involve?

A

Clinical history and examination

Epworth questionaire

Overnight sleep study

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20
Q

What are examples of overnight sleep studies?

A

Pulse oximetry

Limited sleep studies

Full polysomnography

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21
Q

What is the epworth questionaire?

A

Different things where you rate your chance of dozing between 0 and 3

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22
Q

What is this?

A

Overnight oximetry

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23
Q

What is polysomnography?

A

Sleep study used to diagnose sleep disorders, recording brain waves, oxygen level in your blood, heart rate and breathing

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24
Q

What does a polysomnography record?

A

Brain waves

Oxygen level in your blood

Heart rate

Breathing

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25
Q

What is a sleep stud that diagnoses sleep disorders by recording brain waves, oxygen levels, heart rate and breathing?

A

Polysomnography

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26
Q

What does PSG stand for?

A

Polysomnography

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27
Q

What does a polysomnography involve?

A

Oronasal airflow

Thoracoabdominal movement

Oximetry

Body position

Brain activity (EEG)

Audio-visual recording

Eye movements (EOG)

Skeletal muscle activation (EMG)

Electrocardiogram (ECG)

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28
Q

What is oximetry?

A

Measures a persons oxygen saturation

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29
Q

What measures a persons oxygen saturation?

A

Oximetry

30
Q

What does EEG measure?

A

Brain activity

31
Q

What does EOG measure?

A

Eye movements

32
Q

What does EMG measure?

A

Skeletal muscle activation

33
Q

What does ECG measure?

A

Heart rhythm and electrical activity

34
Q

What does the severity of obstructive sleep apnoea (OSA) depend on?

A

Amount of apnoea per hour

35
Q

What are the different classes of severity of obstructive sleep apnoea?

A

Normal (0-5)

Mild (5-15)

Moderate (15-30)

Severe (>30)

36
Q

What is considered normal severity?

A

0 - 5 apnoea

37
Q

What is considered mild severity?

A

5-15 apnoea

38
Q

What is considered moderate severity?

A

15-30 apnoea

39
Q

What is considered severe severity?

A

>30 apnoea

40
Q

What is an apnoea?

A

Temporary cessation (stopping) of breathing, especially during sleep

41
Q

What is the temporary cessation of breathing, especially during sleep called?

A

Apnoea

42
Q

What is AHI?

A

Number of apnoea’s recorded during the study per hour of sleep

43
Q

What does the treatment of sleep apnoea involve?

A

Identify exacerbating factors

Continous positive airways pressure

Mandibular repositioning splint

44
Q

What could be exacerbating factors for sleep apnoea?

A

Weight

Alcohol

Endocrine disorders

45
Q

What can be said about patients with sleep apnoea and driving?

A

They should not drive, you should inform the DVLA of their condition

46
Q

What is narcolepsy?

A

Sleep disorder characterised by excessive sleepiness, sleep paralysis, hallucinations and in some cases episodes of cataplexy

47
Q

What is a sleep disorder characterise by excessive sleepiness, sleep paralysis, hallucinations and in some cases episodes of cataplexy?

A

Narcolepsy

48
Q

What is cataplexy?

A

Total or partial loss of muscle control

49
Q

What is total or partial loss of muscle control called?

A

Cataplexy

50
Q

What is the prevalence of narcolepsy?

A

0.05%

51
Q

How do people develop narcolepsy?

A

It is genetic

52
Q

What genes is narcolepsy associated with?

A

HLA-DRB1*1501

HLA-DQB1*0602

53
Q

What are the clinical features of narcolepsy?

A

Cataplexy

Excessive daytime somnolence

Hypnagogic hallucinations

Sleep paralysis

54
Q

What is sleep paralysis?

A

Temporary inability to move or speak when you are falling asleep or waking up

55
Q

What is the temporary inability to move or speak when you are falling asleep or waking up called?

A

Sleep paralysis

56
Q

What is used for the treatment of narcolepsy?

A

Modafinil

Clomipramine

Sodium oxybate

57
Q

What is chronic ventilatory failure?

A

Elevated PCO2 (>6kPa)

PO2 < 8kPa

Normal blood pH

Elevated bicarbonate

58
Q

What is the aetiology of chronic ventilatory failure?

A

Airways disease

Chest wall abnormalities

Respiratory muscle weakness

Central hypoventilation

59
Q

What are examples of airway diseases that can lead to chronic ventilatory failure?

A

COPD

Bronchiectasis

OSA (obstructive sleep apnoea)

60
Q

What is an example of a chest wall abnormality that can lead to chronic ventilatory failure?

A

Kyphoscoliosis

61
Q

What are examples of respiratory muscle weakness that can lead to chronic ventilatory failure?

A

Motor neurone disease (ALS)

Muscular dystrophy

62
Q

What are examples of central hypoventilation problems that can lead to chronic ventilatory failure?

A

Obesity hypoventilation syndrome

Central hypoventilation syndrome (Ondine’s curse)

63
Q

What are typical symptoms of chronic ventilatory failure?

A

Breathlessness

Orthopnoea

Ankle swelling

Morning headache

Recurrent chest infections

Disturbed sleep

64
Q

What is orthopnoea?

A

Shortness of breath when lying flat

65
Q

What is shortness of breath when lying flat called?

A

Orthopnoea

66
Q

What are the examination findings of chronic ventilatory failure?

A

Reflects underlying diease

Particularly look for paradoxical abdominal wall motion in suspected neuromuscular disease

Ankle oedema

67
Q

What should you particularly look for in the examination for suspected neuromuscular disease?

A

Paradoxical abdominal wall motion

68
Q

What investigations are done for neuromuscular disease?

A

Lung function

Assessment of hypoventilation

Flouroscopic screening of diaphragms

69
Q

What is used for the assessement of lung function for neuromuscular disease?

A

Lying and standing vital capacity

Mouth pressures

70
Q

What is used for the assessment of hypoventilation in neuromuscular disease?

A

Early morning arterial blood gases

Overnight oximetry

Transcutaneous CO2 monitoring

2. Respiratory Medicine (Lectures) (50 decks)

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