General Medicine Dyspnea & Tachypnea

Front 1

What is the definition of dyspnea?

Back 1

Labored or difficult breathing

Front 2

What are the 3 underlying physiologic causes of dyspnea?

Back 2

Hypoxemia, hypercapnia, acidemia

Front 3

What receptors sense hypoxemia?

Back 3

Chemoreceptors in aortic and carotid bodies of aorta and subclavian arteries

Front 4

What receptors detect increased hydrogen ion concentrations or carbon dioxide?

Back 4

Both central chemoreceptors in respiratory center and peripheral chemoreceptors

Front 5

What are 7 general conditions that can cause dyspnea?

Back 5

1) Airway disease
2) Pulmonary parenchymal disease
3) Pleural wall disease
4) Peripheral neurophathy/myopathy
5) Thoracic wall disease
6) Pain
7) High environmental temepratures

Front 6

What are 2 airway diseases that can cause dyspnea?

Back 6

Nasopharyngeal polyps
Brachycephalic syndrome

Front 7

What are the 4 components of brachycephalic syndrome?

Back 7

1) Stenotic nares*
2) Everted laryngeal saccules*
3) Elongated soft palate
4) Tracheal hypoplasia

Front 8

What are 4 peripheral neuropathy/myopathies that can cause dyspnea?

Back 8

Myasthenia gravis
Botulism
Polyradiculoneuritis
Tick paralysis

Front 9

What are 5 examples of thoracic wall disease that can cause dyspnea?

Back 9

1) Neoplasia
2) Neuropathy
3) Flail chest
4) Penetrating chest wound
5) Rib fractures

Front 10

Why is it really important to treat dyspneic patients promptly and appropriately w/o aggrevation?

Back 10

patients are often unstable and susceptible to respiratory arrest

Front 11

Patients with respiratory distress may present with signs related to upper airway obstruction, bronchial, _______, intrathoracic/extrapleural, or _______ disease.

Back 11

Parenchymal
Cardiac disease

Front 12

How does breathing often change with upper airway obstruction?

Back 12

Increase rate & depth
-Inspiration is often more prominent w/ upper airway obstruction (e.g. laryngeal paralysis)

Front 13

Compare the breathing patterns of animals with upper airway obstruction compared to those with parenchymal and lower airway disease.

Back 13

Upper airway obstruction=increased depth & rate= inspiration more prominent
Lower airway/ parenchyma= expiration more prominent and difficult

Front 14

What is stertor? What causes it?

Back 14

Refers to noisy nasal breathing
-Increased noise at the pharynx and/or larynx

Front 15

In cats, decreased compliance of the cranial thorax is often associated with what?

Back 15

Masses in cranial mediastinum (lymphoma, thymoma)

Front 16

Do fixed airway obstructions cause inspiratory or expiratory dyspnea?

Back 16

May cause both
-e.g. laryngeal mass, tracheal mass

Front 17

What might be found upon auscultation of an animal with bronchial disease/

Back 17

Crackles (airways opening)-suggestive of fluid and/or debri in airways e.g. pneumonia
Wheezes (airways are narrowing) e.g. asthma, bronchitis

Front 18

What are rhonchi?

Back 18

Sounds due to fluid in larger airways

Front 19

What are the typical physical exam findings of an animal with an intrapleural lesion?

Back 19

Signs of a space-occupying nature such as decreased respiratory pattern and/or heart sounds (air, fluid, soft tissue interference)

Front 20

What kind of breathing pattern is typically observed w/ pleural lesions?

Back 20

A restrictive pattern, tachypnea and decreased depth often seen

Front 21

How can you distinguish b/w air, fluid or soft tissue in the chest?

Back 21

Fluid or soft tissue will result in a dull percussion, air produces resonance

Front 22

Disease of the thoracic wall may b seen as a _____ and these animals may have a history or evidence of thoracic trauma.

Back 22

Flail chest
-A flail chest is a life-threatening medical condition that occurs when a segment of the rib cage breaks under extreme stress and becomes detached from the rest of the chest wall.

Front 23

How may animals with a polyneuropathy or neuromuscular disease (myasthenia gravis) present?

Back 23

With signs of diffuse neuromuscular disease and pronounced abdominal effort

Front 24

What are some other signs of dyspnea that can be seen with any form of respiratory disease? (there's a ton)

Back 24

Flared nostrils, open mouth breathing, orthopnea (standing to breathe), head & neck extension, elbow abduction, a heave line, cyanosis (increased deoxygenated hemoglobin), collapse, increased salivation, increased or decreased respiratory rate

Front 25

Treatment of dyspnea should include treating the underlying disease leading to dyspnea, but often immediate treatment is necessary. What are 7 of these treatments that may be employed?

Back 25

1) Oxygen therapy
2) Sedation (airway obstruction)
3) Diuretics
-congestive heart failure
4) Glucocorticoids (feline asthma)
5) bronchodilators (feline asthma)
6) Thoracocentesis
-pneumothorax, pleural effusion
7) placement of a chest tube

Front 26

What should you do for a patient that undergoes respiratory arrest?

Back 26

Require intubation to provide a patent airway and oxygen supplementation
-mechanical ventilation may be necessary

Front 27

What is hyperpnea?

Back 27

Increased rate and depth of respiration
e.g. upper airway obstruction

Front 28

Panting is a method of ______.

Back 28

cooling

Front 29

When does physiologic tachypnea occur?

Back 29

when there is no underlying disease such as exercise, pain, heat, fever, anxiety

Front 30

What are some causes of pathologic tachypnea?

Back 30

Hypoxemia, hypercapnea, metabolic acidosis, elevated ambient temperature, damage to respiratory center, peripheral neuropathy, peripheral myopathy and pain of respiratory appratus

Front 31

What are 4 differentials for tachypnea?

Back 31

1) Pulmonary parenchymal disease
2) Pleural space disease
3) Throacic wall disease
4) Metabolic acidosis

Front 32

What are 8 differentials for metabolic acidosis?

Back 32

1) diabetic ketoacidosis
2) ethylene glycol intoxication
3) renal failure- uremic acidosis
4) lactic acidosis
5) salicylate intoxication
6) hypoadrenocorticism
7) diarrhea
8) ammonium chloride