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24 Cards in this Set
- Front
- Back
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What pharynx muscle is obstructive while sleeping in OSA (obstructive sleep apnea)
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-Velopharynx
-Oropharynx -Hypopharynx -Occur when pharyngeal dilator muscle can't keep airwway open when sleeping |
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What type of Polysomnograph is used to DX OSA?
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-EEG (ElectroENCEphalography)
-EOG (Electro-OCUlography) -Nasal & Roal Thermistors -ElectroMYOgraphy (EMG) |
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What is the purpose of Pulse Oximetry?
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-Measure Hg saturation w/ O2 dinstinguish changes in blood O2 sutation during an apneic or hypopneic event
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What is the differences Apnea and Hypopnea?
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-Apnea: Complete Obstruction for > 10s
-Hypopnea: Partial obstruction for > 10s fulfilling other criteria |
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Describe the severity of Obstructive Sleep Disordered Breathing
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AHI = # Apneas + # hypopneas/ hours of sleep
-Normal (<5) -Mild (5-15) -Moderate (15-30) -Severe (>30) |
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What is OSAS (Syndrome)
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-Clinical symptoms of EX daytime sleepiness, hypersomnolence or cogntive impariment
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Describe OSA vs. Hypopnea vs. UARS
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-OSA & Hypopnea: Decrease Airflow, O2 Desaturation, Increase Respiratory Effort, EEG Arousal, AHI
-UARS: Increase Respiratory Effort, EEG Arousal. No change in Air flow, O2 Desaturation, AHI |
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Why UARS difficult to DX?
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-No changes in Air flow, O2 Desaturation, AHI
-Require Effort (PES) to DX |
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Natural course of OSA
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-Incrase with age, weight, alcohol, sedatives, physical exhausation in the evening and at bedtime, smoking.
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Describe UARS
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Young Adult females, normal or below wieght, profile w/ anxiety/distress, XS day time sleepiness/snoring, normal pharygenal mucosal mechanosensitivity,
-Co-morbid w/ functional somatic disorders, partically fibromyalgia |
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OSA can decrease the average life span of the general population by 20 years (T/F)
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True
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Significane of a __ mm Hg drop in mean artial blood pressure: means what
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-10 mm Hg
-37% reduction in risk of coronary heart disease -56% reduction in risk of stroke |
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What is the GOLD standard TX:
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Positive Airwya PRessure (CPAP, BiPAP)
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What are the types of PAP?
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-Manual CPAP Mode
-Bilevel Mode -Auto CPAP Mode |
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Indications for TOngue Retaining Devices?
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-No teeth or insufficient tooth support
-Patients w/ TMJ dysfunction/pain or who can't tolerate jaw advancement or who can't protrude the jaw |
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Indications for Tongue Restraining Devices (FBS)?
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1. Patients with TMJ dysfunction/pain or who can't tolerate jaw advancement or who can't protrude the jaw
2. To minimize risk of long-term changes in the bite or tooth position 3. Failure of, or in place of therapy with MAS |
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Indications for Combination of Oral Appliance & PAP?
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-Typically reserved for most severe cases of OSA. Enables reduction of PAP pressure
-Oral vs. nasal delivery of PAP (OPAP) -Reduce PAP "claustrophobia (eliminate head and chin straps) |
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Mechanism of Action of Mandibular Advancement Splints?
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-Pull the tongue and its base forward increasing the ML dimension of oropharynx
-Place tension across the soft palate via palatoglossus muslces, moving it forward, making it broader & more stable in position; increasing the AP and ML dimension of velopharynx -Increase activity and reflex response of pharyngeal dilator muslces -Reduce collapsibility of airway -Maintain jaw in more close position = less posterior movement |
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The Efficiency of MAS therapy may equal or exceed that of PAP therapy due to much better patient compliance w/ MAS therapy (T/F)
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-True
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What is Complex Sleep apnea?
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-Obstructive and Central Apnea
-Untreated pt often exhibit OSA but upon TX of OSA, CSA emerges |
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3 methods to Monitor Tooth Movement During the Course of Treatment?
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-Measurements from digital images of teeth
-Cephalographic evaluation (Orthodontists Standard) -Intraoral Photograph |
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3 Screening Tools in Dental Clinic?
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-STOP (Snore, Tired, Observed stop breathing, Pressure BP)
-Adjusted Neck Size -STOP-Bang |
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Muscle tone Inversely related to Upper Airway Obstruction (T/F)
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True
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Problem: Airway Obstruction at Base of Tongue
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Body's Solution: Brux to activate the tongue to bring forward
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