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PHS3300 RESPIRATORY DISORDERS
Questions and Answers (Expert Solutions)
Q: Dyspnea - what is it and what are some signs a patient is experiencing it?
ANS 🗹🗹: sensation of difficult or uncomfortable breathing; sensation of shortness
of breath, laboured breathing (working harder), preoccupied with breathing
SIGNS: flaring of nostrils, use of accessory muscles of respiration & retraction;
variety of possible reasons; initially on exertion, then at rest... Use of accessory
muscles to breathe: this includes rib cage moving to make more space for air to
come in. could be only during activity, not at rest, but could be at rest if serious.
Q: orthopnea - what is it? what types of conditions might cause orthopnea?
ANS 🗹🗹: difficulty breathing (shortness of breath) when lying down - usually
result of increased fluid in lung that is helped by being upright - e.g. left ventricular
heart failure, pulmonary edema for any other reason
dyspnea in response to change in body position: lying down. Post surgery, often we
lift bed upwards to help breathing and deter orthopnea. Someone who has left
ventricular failure or accumulation of fluid in lungs will do better if they are
upright
Q: apnea - what is it? provide an example.
ANS 🗹🗹: •temporary cessation of breathing (e.g. sleep apnea)
Q: Bradypnea vs Tachypnea - provide potential causes for each...
ANS 🗹🗹: •Bradypnea: rate of breathing < 12 breaths/min; e.g overuse of narcotics,
brain disorders (we have to stimulate process of breathing neuroly),
hypothyroidism (slowed down rate of breathing)
•
•Tachypnea: rate of breathing > 20 breaths/min (shallow breaths) - causes include
lung disease, anxiety, obesity, pulmonary embolism. We are not getting good gas
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exchange. CO2 is accumulating. Could happen with obesity since no room for
diaprgam to descend, or also a pulmonary embolism
Q: eupnea - what is it? what is the tidal volume and number of breaths.
sigh breaths - what is it? what could this provide?
short expiratory pause?
ANS 🗹🗹: normal rate and depth of breathing. Avg is 12. tidal volume is 500
ml/breath but can range from 400-800 ml/breath. .eupnea is rhythmic (8-16
breaths/min; tidal volume = 400-800 ml);
Also, sometimes we do sigh breaths: we taken a deeper breath... could give a boost
to surfactant production.
short expiratory pause - just a abnormal breathing pattern... pause after expriation
Q: Kussmaul respirations: what are they? they are indicative of what disease?
ANS 🗹🗹: deep breaths - initially rapid but then becoming slower as diabetic
ketoacidosis progresses
someone entering into DKA. Initially rapid deep breaths but as blood ph becomes
more acidic and interferes with neural functioning, it may slow done. We are trying
to move out more CO2 to counter acidic blood
Q: Cheyne-Stokes respirations
ANS 🗹🗹: (any condition that slows blood flow to brain stem; heart failure or
brainstem disease)... slows down blood flow going to brain stem where we initiate
respirations.
Q: what are some examples of abnormal breath sounds?
ANS 🗹🗹: wheezing (asthma), crackles (pneumonia, pulmonary fibrosis), stridor
(airway obstruction)
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Q: reffering to the carbonic acid equation, hypoventilation, in which we are not taking
enough breathes, will result in ________________ (PCO2>44 mm Hg) and lower blood
pH making in more acidic.
ANS 🗹🗹: Hypoventilation: results in hypercapnia (PCO2>44 mm Hg
Imporntant link between CO2 and blood PH. Rate and depth of breathing (rate at
which we onload CO2) can influence blood ph. Hypoventillation (shallow breathing)
causes us to retain CO2. leads to hypercapnia (increased CO2). This pushes reaction
to right leading to accumulation of H+ ions, making blood acidic,
Q: effering to the carbonic acid equation, hyperventilation results in ______________
(PCO2<36 mm Hg), which raises blood pH to make it more basic.
ANS 🗹🗹: Hyperventilation (not to be confused with hyperpnea (normal during
exercise) or with tachypnea): results in hypocapnia (PCO2<36 mm Hg) & increases
blood pH
We are getting rid of CO2 at a greater rate. Therefore, hypocapnia (low PCO2),
which pushes blood ph in alkaline direction.
Q: wha is the function of a cough? when does it become abnormal?
ANS 🗹🗹: 5.protective; clears lower airways; triggered by irritation of mucosa;
occasional coughing normal; persistent cough indicative of a disorder or disease
persistent is indicative of something more serious lower in respiratory system
Q: cyanosis
ANS 🗹🗹: bluish discoloration of skin & mucous membranes due to excess of
REDUCED hemoglobin...
.
Oxygen traveling in systemic arterial blood is not fully filled up with oxygen (too
much reduced oxygen). This gives bluish color instead of pinkish color.
Q: Can there be inadequate oxygenation of tissues without apparent cyanosis?
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ANS 🗹🗹: Carbon monoxide poisoning occupies same binding site on hemoglobin
molecule as oxygen, so we don't get good oxygen delivery to tissues but no cyanosis
since hemoglobin molecules ARE NOT REDUCED
Q: what could potentially lead to pain upon breathing?
ANS 🗹🗹: inflammation/infection of pleurae or major airways or muscle/rib pain
associated with chest wall..
inflammatory reactions with pelural membranes or cracked ribs could lead to pain
upon breathing.
Q: When suzanne puts her nail beds together, there is no space between them like her
friend Alex has when he does this. what can we infer about suzanne's past medical
history?
ANS 🗹🗹: Clubbing: ends of fingers become thicker. A bit of swelling. Increased
growth of capillaries. Is a sign of history of respiratory diseases.
8.selective bulbous enlargement of distal segment of a digit; usually painless
• diseases that interfere with oxygenation (lung cancer, cystic fibrosis, pulmonary
fibrosis, lung abscess, congenital heart disease)... NOTE THESE ARE ALL LONG TERM
CONDITIONS )
Q: Respiratory Distress Syndrome of the Newborn (RDS): WHAT IS THE PROBLEM?
what is the result?
ANS 🗹🗹: surfactant production by type 2 cells occurs late in gestation; not enough
in alveoli until 28-38 weeks gestation (varies infant-to-infant)
premature infants have small, immature alveoli with little surfactant
Q: surfactant - what is it? what occurs in babies who don't have enough surfactent?
PHS3300 RESPIRATORY DISORDERS
Questions and Answers (Expert Solutions)
Q: Dyspnea - what is it and what are some signs a patient is experiencing it?
ANS 🗹🗹: sensation of difficult or uncomfortable breathing; sensation of shortness
of breath, laboured breathing (working harder), preoccupied with breathing
SIGNS: flaring of nostrils, use of accessory muscles of respiration & retraction;
variety of possible reasons; initially on exertion, then at rest... Use of accessory
muscles to breathe: this includes rib cage moving to make more space for air to
come in. could be only during activity, not at rest, but could be at rest if serious.
Q: orthopnea - what is it? what types of conditions might cause orthopnea?
ANS 🗹🗹: difficulty breathing (shortness of breath) when lying down - usually
result of increased fluid in lung that is helped by being upright - e.g. left ventricular
heart failure, pulmonary edema for any other reason
dyspnea in response to change in body position: lying down. Post surgery, often we
lift bed upwards to help breathing and deter orthopnea. Someone who has left
ventricular failure or accumulation of fluid in lungs will do better if they are
upright
Q: apnea - what is it? provide an example.
ANS 🗹🗹: •temporary cessation of breathing (e.g. sleep apnea)
Q: Bradypnea vs Tachypnea - provide potential causes for each...
ANS 🗹🗹: •Bradypnea: rate of breathing < 12 breaths/min; e.g overuse of narcotics,
brain disorders (we have to stimulate process of breathing neuroly),
hypothyroidism (slowed down rate of breathing)
•
•Tachypnea: rate of breathing > 20 breaths/min (shallow breaths) - causes include
lung disease, anxiety, obesity, pulmonary embolism. We are not getting good gas
, Page | 2
exchange. CO2 is accumulating. Could happen with obesity since no room for
diaprgam to descend, or also a pulmonary embolism
Q: eupnea - what is it? what is the tidal volume and number of breaths.
sigh breaths - what is it? what could this provide?
short expiratory pause?
ANS 🗹🗹: normal rate and depth of breathing. Avg is 12. tidal volume is 500
ml/breath but can range from 400-800 ml/breath. .eupnea is rhythmic (8-16
breaths/min; tidal volume = 400-800 ml);
Also, sometimes we do sigh breaths: we taken a deeper breath... could give a boost
to surfactant production.
short expiratory pause - just a abnormal breathing pattern... pause after expriation
Q: Kussmaul respirations: what are they? they are indicative of what disease?
ANS 🗹🗹: deep breaths - initially rapid but then becoming slower as diabetic
ketoacidosis progresses
someone entering into DKA. Initially rapid deep breaths but as blood ph becomes
more acidic and interferes with neural functioning, it may slow done. We are trying
to move out more CO2 to counter acidic blood
Q: Cheyne-Stokes respirations
ANS 🗹🗹: (any condition that slows blood flow to brain stem; heart failure or
brainstem disease)... slows down blood flow going to brain stem where we initiate
respirations.
Q: what are some examples of abnormal breath sounds?
ANS 🗹🗹: wheezing (asthma), crackles (pneumonia, pulmonary fibrosis), stridor
(airway obstruction)
, Page | 3
Q: reffering to the carbonic acid equation, hypoventilation, in which we are not taking
enough breathes, will result in ________________ (PCO2>44 mm Hg) and lower blood
pH making in more acidic.
ANS 🗹🗹: Hypoventilation: results in hypercapnia (PCO2>44 mm Hg
Imporntant link between CO2 and blood PH. Rate and depth of breathing (rate at
which we onload CO2) can influence blood ph. Hypoventillation (shallow breathing)
causes us to retain CO2. leads to hypercapnia (increased CO2). This pushes reaction
to right leading to accumulation of H+ ions, making blood acidic,
Q: effering to the carbonic acid equation, hyperventilation results in ______________
(PCO2<36 mm Hg), which raises blood pH to make it more basic.
ANS 🗹🗹: Hyperventilation (not to be confused with hyperpnea (normal during
exercise) or with tachypnea): results in hypocapnia (PCO2<36 mm Hg) & increases
blood pH
We are getting rid of CO2 at a greater rate. Therefore, hypocapnia (low PCO2),
which pushes blood ph in alkaline direction.
Q: wha is the function of a cough? when does it become abnormal?
ANS 🗹🗹: 5.protective; clears lower airways; triggered by irritation of mucosa;
occasional coughing normal; persistent cough indicative of a disorder or disease
persistent is indicative of something more serious lower in respiratory system
Q: cyanosis
ANS 🗹🗹: bluish discoloration of skin & mucous membranes due to excess of
REDUCED hemoglobin...
.
Oxygen traveling in systemic arterial blood is not fully filled up with oxygen (too
much reduced oxygen). This gives bluish color instead of pinkish color.
Q: Can there be inadequate oxygenation of tissues without apparent cyanosis?
, Page | 4
ANS 🗹🗹: Carbon monoxide poisoning occupies same binding site on hemoglobin
molecule as oxygen, so we don't get good oxygen delivery to tissues but no cyanosis
since hemoglobin molecules ARE NOT REDUCED
Q: what could potentially lead to pain upon breathing?
ANS 🗹🗹: inflammation/infection of pleurae or major airways or muscle/rib pain
associated with chest wall..
inflammatory reactions with pelural membranes or cracked ribs could lead to pain
upon breathing.
Q: When suzanne puts her nail beds together, there is no space between them like her
friend Alex has when he does this. what can we infer about suzanne's past medical
history?
ANS 🗹🗹: Clubbing: ends of fingers become thicker. A bit of swelling. Increased
growth of capillaries. Is a sign of history of respiratory diseases.
8.selective bulbous enlargement of distal segment of a digit; usually painless
• diseases that interfere with oxygenation (lung cancer, cystic fibrosis, pulmonary
fibrosis, lung abscess, congenital heart disease)... NOTE THESE ARE ALL LONG TERM
CONDITIONS )
Q: Respiratory Distress Syndrome of the Newborn (RDS): WHAT IS THE PROBLEM?
what is the result?
ANS 🗹🗹: surfactant production by type 2 cells occurs late in gestation; not enough
in alveoli until 28-38 weeks gestation (varies infant-to-infant)
premature infants have small, immature alveoli with little surfactant
Q: surfactant - what is it? what occurs in babies who don't have enough surfactent?
