Chapter 033 Dyspnea and Pulmonary Edema (Part 3) ppsx
Chapter 033. Dyspnea and Pulmonary Edema (Part 3) ppsx
... Chapter 033. Dyspnea and Pulmonary Edema (Part 3) Differential Diagnosis Dyspnea is the consequence of deviations from normal function in the cardiopulmonary systems. ... contribute to dyspnea, both by increasing the work of breathing and by stimulating pulmonary receptors if there is associated atelectasis. Gas Exchanger Pneumonia, pulmonary edema, and aspiration ... all interfere with gas exchange. Pulmonary vascular and interstitial lung disease and pulmonary vascular congestion may produce dyspnea by direct stimulation of pulmonary receptors. In these...
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Chapter 033. Dyspnea and Pulmonary Edema (Part 4) ppsx
... indicates pulmonary venous hypertension, while enlarged central pulmonary arteries suggest pulmonary artery hypertension. An enlarged cardiac silhouette suggests a Chapter 033. Dyspnea and Pulmonary ... interstitial edema or fibrosis, diaphragmatic dysfunction, or impaired chest wall motion). The pulmonary parenchyma should be examined for evidence of interstitial disease and emphysema. Prominent pulmonary ... cardiac silhouette suggests a Chapter 033. Dyspnea and Pulmonary Edema (Part 4) Approach to the Patient: Dyspnea (Fig. 33 -3) In obtaining a history, the patient should be asked to describe...
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Chapter 033. Dyspnea and Pulmonary Edema (Part 1) pps
... of chest tightness. J-receptors, sensitive to interstitial edema, and pulmonary vascular receptors, activated by acute changes in pulmonary artery pressure, appear to contribute to air hunger. ... and feedback messages do not match, an error signal is generated and the intensity of dyspnea increases. (Adapted from Gillette and Schwartzstein.) Motor Efferents Disorders of the ventilatory ... of dyspnea. Afferent information from the receptors throughout the respiratory system projects directly to the sensory cortex to contribute to primary qualitative sensory experiences and...
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Chapter 033. Dyspnea and Pulmonary Edema (Part 2) potx
... Chapter 033. Dyspnea and Pulmonary Edema (Part 2) Integration: Efferent-Reafferent Mismatch A discrepancy or mismatch between the feed-forward message to the ventilatory muscles and ... unpleasant and interpreted as abnormal. We are still in the early stages of learning the best ways to assess the affective dimension of dyspnea. Some therapies for dyspnea, such as pulmonary ... chronic obstructive pulmonary disease. Source: From Schwartzstein and Feller-Kopman. Sensory Intensity A modified Borg scale or visual analogue scale can be utilized to measure dyspnea at rest,...
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Chapter 033. Dyspnea and Pulmonary Edema (Part 5) pps
... vascular markings in Chapter 033. Dyspnea and Pulmonary Edema (Part 5) Distinguishing Cardiovascular from Respiratory System Dyspnea If a patient has evidence of both pulmonary and cardiac disease, ... forces, and a propensity for the alveoli to collapse at low lung volumes. Physiologically, noncardiogenic pulmonary edema is characterized by intrapulmonary shunt with hypoxemia and decreased pulmonary ... damage to the pulmonary capillaries in the case of reexpansion pulmonary edema. Table 33-2 Common Causes of Noncardiogenic Pulmonary Edema Direct Injury to Lung Chest trauma, pulmonary contusion...
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Chapter 033. Dyspnea and Pulmonary Edema (Part 6) pps
... Chapter 033. Dyspnea and Pulmonary Edema (Part 6) Distinguishing Cardiogenic from Noncardiogenic Pulmonary Edema The history is essential for assessing ... pulmonary edema. The physical examination in cardiogenic pulmonary edema is notable for evidence of increased intracardiac pressures (S3 gallop, elevated jugular venous pulse, peripheral edema) , ... and rales and/ or wheezes on auscultation of the chest. In contrast, the physical examination in noncardiogenic pulmonary edema is dominated by the findings of the precipitating condition; pulmonary...
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Chapter 016. Back and Neck Pain (Part 3) ppsx
... nerves and nerve roots. Sitting stretches the sciatic nerve (L5 and S1 roots) because the nerve passes posterior to the hip. The femoral nerve (L2, L3, and L4 roots) passes anterior to the hip and ... spine disease. Hip pain can be reproduced by internal and external rotation at the hip with the knee and hip in flexion (Patrick sign) and by tapping the heel with the examiner's palm while ... elicited by standing the patient next to the examination table and passively extending each leg with the knee fully extended. This maneuver, which stretches the L2-L4 nerve roots and the femoral...
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Chapter 024. Gait and Balance Disorders (Part 3) pptx
... extent and topography of cerebellar atrophy. A short expansion Chapter 024. Gait and Balance Disorders (Part 3) Parkinsonism and Freezing Gait Parkinson's disease (Chap. 366) is common, ... tumor, and neurodegenerative disease, including multiple system atrophy (Chaps. 366 and 370) and various forms of hereditary cerebellar degeneration (Chap. 368). MRI demonstrates the extent and ... to walk tandem. Difficulty maintaining balance when turning is often an early feature. Patients are unable to walk tandem heel to toe, and display truncal sway in narrow-based or tandem stance....
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Chapter 045. Azotemia and Urinary Abnormalities (Part 3) potx
... series of neural and humoral responses that include activation of the sympathetic nervous and renin-angiotensin-aldosterone systems and ADH release. GFR is maintained by prostaglandin-mediated ... disease and providing symptomatic relief for edema, acidosis, anemia, and hyperphosphatemia, as discussed in Chap. 274. Acute renal failure (Chap. 2 73) can result from processes affecting renal ... plasma), and small kidneys on ultrasound, characterized by increased echogenicity and cortical thinning. Treatment should be directed toward slowing the progression of renal disease and providing...
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Chapter 072. Malnutrition and Nutritional Assessment (Part 3) pps
... infections such Chapter 072. Malnutrition and Nutritional Assessment (Part 3) Physiologic Characteristics of Hypometabolic and Hypermetabolic States The metabolic characteristics and nutritional ... kwashiorkor seen in developing countries. Metabolic Rate In starvation and semistarvation, the resting metabolic rate falls between 10% and 30% as an adaptive response to energy restriction, slowing ... gram-negative septicemia, and as much as 110% after major burns. If the metabolic rate (energy requirement) is not matched by energy intake, weight loss results—slowly in hypometabolism and quickly in...
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