Test #2 OSA PPt- Josh Flashcards
OSA: definition
OSA is the cessation of airflow for more than ____ seconds dispite continuing ventilation effort, ____ or more times per ____ of sleep, and is usually associated w/ a decrease in arterial O2 saturation SAO2 or more than ___%
- 10 sec
- 5 or more
- per hour
- 4%
OSA:
what % of general sx pts have OSA:
25%
(just thought that is alot)
OSA:
what are conditions that cause OSA
- Obesity
- Race/genetics
- Age
- Male
- Alcohol/sedatives/analgesics/anesthestics
- Smoking
- Nasal/pharyngeal/laryngeal obstruction
- Cranio-facial abnormality
- endocrine/metabolic d/o
- Connective tissue d/o
- Storage diseases
- Chronic renal failure
OSA:
what are the 3 main muscles of the upper airway that are considered dilator muscles? (they are the ones that keep the airway open)
from top to bottom airway
tensor palatine
Genio glossus
Hyoid Muscles
OSA:
what is the circular cycle of OSA
10 steps
- Sleep
- decreased airway tone
- Obstruction
- Apnea
- decreased PO2 increased PCO2
- Sympathetic Surge
- Arousal
- Increased airway tone
- Breathing resumes
- back to sleep and cycle restarts
OSA: Patho
with OSA the obstructed breathing can cause decreased O2 and Increased CO2 wchich can leax to what complications
- Arrhythmias- MI
- Pulmonary HTN- RVH
- Systemic HTN- LVH
- Daytime sleepiness-personality/behavior changes- accident prone
OSA: classification
what are the 3 classifications?
- Mild
- moderate
- Severe
OSA: classification
what is the AHI (apnea/hypopnea index) for mild OSA
- 5-15 episodes/ hr
OSA: classification
what are clinical findings with mild OSA
- Mild sleepiness/insomnia
- Mild O2 desat
- Benign cadiac arrhythmia
*
OSA: classification
what is the AHI for moderate OSA
- 15-30 episodes/hr
OSA: classification
S/S of moderate OSA
- Moderate daytime sleepiness, fatigue that interferes w/ ADLs
- Moderte O2 desat
- Mild arrhythmias
- At risk for injuries/accidents
- At risk for HTN/MI/Stroke/Cor pulmonale
OSA: classification
what is severe OSA AHI
- > 30 episodes/hr
- and/or
- Hypoxia < 90% for >20% of total sleep time
OSA: classification
S/S of severe OSA
- daytime sleepiness interferes w/ normal activities
- Severe O2 desat
- Moderate to severe cardiac arrhythmia
- At increased risk for injuries/accidents
- At risk for HTN, MI, Stroke, and cor pulmonale
Screening for OSA:
what is the gold standard for screening?
- Polysomnography
Screening for OSA:
what is the con of the polysomnography
- Not practical for each surgical pt