Chapter 033 Dyspnea and Pulmonary Edema (Part 4) ppsx
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 ... enlarged 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...
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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 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 4) docx
... knee Chapter 016. Back and Neck Pain (Part 4) The neurologic examination includes a search for focal weakness or muscle atrophy, focal reflex changes, diminished sensation in the legs, and ... strength during muscle testing. Breakaway weakness may be due to pain or a combination of pain and underlying true weakness. Breakaway weakness without pain is due to lack of effort. In uncertain ... not true weakness is present. Findings with specific nerve root lesions are shown in Table 16-2 and are discussed below. Table 16-2 Lumbosacral Radiculopathy—Neurologic Features adduction...
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Chapter 024. Gait and Balance Disorders (Part 4) pptx
... nystagmus, but balance is impaired on standing and walking, and the patient cannot navigate in the dark. Laboratory testing is available to explore vestibulo-oculomotor and vestibulo-spinal deficits. ... present with difficulty maintaining posture standing and walking and with a subjective sense of disequilibrium, a form of dizziness. The cerebellum and vestibular system organize antigravity responses ... disease and those with hepatic failure, in whom asterixis may impair postural support. Sedative drugs, especially neuroleptics and long-acting benzodiazepines, affect postural control and increase...
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Chapter 045. Azotemia and Urinary Abnormalities (Part 4) pps
... prognosis, and treatment. Hematuria without RBC casts can also be an indication of glomerular disease, and this evaluation is summarized in Fig. 45-2. Figure 45-2 Chapter 045. Azotemia and Urinary ... combinations of glomerular injury: proteinuria, hematuria, reduced GFR, and alterations of Na excretion leading to hypertension, edema, and circulatory congestion (acute nephritic syndrome). These findings ... proteinuria and hematuria, whereas renal vein thrombosis typically induces heavy proteinuria and hematuria. These vascular complications often require angiography for confirmation and are discussed...
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Chapter 072. Malnutrition and Nutritional Assessment (Part 4) pdf
... underlying illness does not necessarily indicate malnutrition. Chapter 072. Malnutrition and Nutritional Assessment (Part 4) Protein Catabolism The rate of endogenous protein breakdown ... some, such as acute cardiopulmonary failure, can be life-threatening. Nutritional Assessment Because interactions between illness and nutrition are complex, many physical and laboratory findings ... hypometabolic patient is adapted to starvation and conserves body mass by reducing the metabolic rate and using fat as the primary fuel (rather than glucose and its precursor amino acids). The hypermetabolic...
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