...
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) , ......
... 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 o...
... 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 aspi...
... 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 diseas...
... 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 shu...
...
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 a...
... Neuroimaging studies reveal a low-lying
conus (below L1-L2) and a short and thickened filum terminale.
Chapter 016. Back and Neck Pain
(Part 6)
Congenital Anomalies of the Lumbar Spine
Spondylolysis ...
This is a common cause of chronic or recurrent low back and leg pain
(Figs. 16-3 and 16-4). Disk disease is most likely to occur at the L4-L5 and L5-S1
levels, but...
...
improve safety, including improved lighting and the installation of grab bars and
nonslip surfaces.
Chapter 024. Gait and Balance Disorders
(Part 6)
Toppling Falls
Some patients maintain ... imbalance,
apprehension, and fear of falling. Deficits in joint position and vibration sense are
apparent on physical examination.
Interventions to Reduce the Risk of Falls and...
... improve immune function and reduce the inflammatory
response. Parenteral emulsions containing medium-chain triglycerides, olive oil,
and fish oil are available in Europe and Japan but not yet ... reasonable to actually measure energy expenditure and
to aim for energy balance with SNS.
Insulin resistance is associated with increased gluconeogenesis and reduced
glucose utilization...
... hypoalbuminemia, hypokalemia and caloric deficits
may be involved in the edema of starvation.
Other Causes of Edema
These include hypothyroidism, in which the edema (myxedema) is located
typically ... of Edema
The distribution of edema is an important guide to its cause. Thus, edema
limited to one leg or to one or both arms is usually the result of venous and/ or
lymph...