Chapter 033 Dyspnea and Pulmonary Edema (Part 2) potx
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 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 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 ... present at rest and for oxygen saturation. A "picture" of the patient while symptomatic may be worth thousands of dollars in laboratory tests. Following the history and physical examination,...
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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 2) doc
... Progressive focal neurologic deficit Chapter 016. Back and Neck Pain (Part 2) The posterior portion of the spine consists of the vertebral arches and seven processes. Each arch consists ... of muscles and ligaments. The contraction of muscles attached to the spinous and transverse processes produces a system of pulleys and levers that results in flexion, extension, and lateral ... apposition of a superior and inferior facet constitutes a facet joint. The functions of the posterior spine are to protect the spinal cord and nerves within the spinal canal and to stabilize the...
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Chapter 024. Gait and Balance Disorders (Part 2) pptx
... in the legs, an imbalance of muscle tone, and a tendency to circumduct and scuff the feet. The disorder reflects compromise of corticospinal command and overactivity of spinal reflexes. The patient ... tone in the adductors. Upper motor neuron signs are present on physical Chapter 024. Gait and Balance Disorders (Part 2) Disorders of Gait The heterogeneity of gait disorders observed in ... there is exaggerated lordosis of the lumbar spine and overactivation of antagonist muscles, which restricts trunk and lower limb movement and results in a wooden or fixed posture. Cases...
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Chapter 045. Azotemia and Urinary Abnormalities (Part 2) pot
... Chapter 045. Azotemia and Urinary Abnormalities (Part 2) Assessment of Glomerular Filtration Rate Monitoring the GFR is important in both the hospital and outpatient settings, and ... a measured GFR is not available, and the serum creatinine level is used to estimate the GFR in order to supply appropriate doses of renally excreted drugs and to follow short-term changes in ... GFR. Serum creatinine is the most widely used marker for GFR, and the GFR is related directly to the urine creatinine excretion and inversely to the serum creatinine (UCr/PCr). The creatinine...
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Chapter 072. Malnutrition and Nutritional Assessment (Part 2) ppt
... illnesses such as trauma and sepsis, and chronic illnesses that involve acute-phase inflammatory responses. The physiologic stress produced by these illnesses increases protein and energy requirements ... is blocked by the stressed state and by carbohydrate infusion. In its early stages, the physical findings of kwashiorkor are few and subtle. Fat reserves and muscle mass are initially unaffected, ... hair pluckability, edema, skin breakdown, and poor wound healing. The major sine qua non is severe reduction of levels of serum proteins such as albumin (<2.8 g/dL) and transferrin (<150...
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