... Wheezing is classically due to bronchial asthma, but there is a danger in jumping to that conclusion because it occurs in a few other conditions as well. The wheezing of bronchial asthma is heard primarily on expiration, whereas the wheezing of tracheal or laryngeal... DIAGNOSTIC WORKUP
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Is there excessive snoring? Excessive snoring would indicate obstructive sleep apnea from large tonsils, deviated nasal septum, cleft palate, other abnormalities, and obesity.
Is there obesity? More than 60% of patients with sleep ... DIAGNOSTIC WORKUP
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Paroxysmal nocturnal dyspnea is defined as severe difficulty breathing or air hunger that awakens the patient from sleep (usually 1–3 hours after lying down) and forces them to a sitting or standing position. The patient may gasp and proceed to an open window for... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Stridor is characterized by a high-pitched grating sound on inhalation or exhalation, but it is caused by narrowing or obstruction of the upper airway. Wheezing is a high-pitched musical sound on inhalation or exhalation that is due to oscillations of narrowed lower... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Apnea is defined as the cessation of breathing; how long a pause is physiologically significant depends on age. History will often be more helpful than physical exam. Central apnea refers to a lack of respiratory effort accompanied by a lack of air... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Breath sounds are made by air flow through airways. Normally they are fairly quiet and somewhat louder during inspiration as air flows toward the stethoscope. Wheezing is defined as continuous breath sounds that are more prominent during expiration and often... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... Nurses frequently become distressed and summon the intern during the night about these signs. Cheyne–Stokes respirations are a frequent source of bewilderment because they may occur at times with no direct evidence of damage to the nervous system. It
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... The differential diagnosis of sleep apnea may be arrived at by utilizing both physiology and anatomy. Normal sleep requires an unobstructed pathway from the nasopharynx to the lung and an intact central nervous system that responds to
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... Apnea, the cessation of spontaneous respiration, is occasionally temporary and self-limiting, as occurs during Cheyne-Stokes and Biot’s respirations. More commonly, however, it’s a life-threatening emergency that requires immediate... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Typically dramatic and terrifying to the patient, this sign refers to an attack of dyspnea that abruptly awakens the patient. Common findings include diaphoresis, coughing, wheezing, and chest discomfort. The attack abates after the patient sits up or stands for several minutes,... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Characterized by a harsh, rattling, or snoring sound, stertorous respirations usually result from the vibration of relaxed oropharyngeal structures during sleep or coma, causing partial airway obstruction. Less commonly, these respirations result from... Emergency interventions ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Wheezes are adventitious breath sounds with a high-pitched, musical, squealing, creaking, or groaning quality. They are caused by air flowing at a high velocity through a narrowed airway. When they originate in the large airways, they can be heard by placing... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... Asthma
Extrinsic
Intrinsic
Exercise- or cold-induced
Drug-induced
Aspirin
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... Apnea, the cessation of spontaneous respiration, is occasionally temporary and self-limiting, as in Cheyne-Stokes and Biot’s respirations. In most cases, though, it’s a life-threatening emergency that requires immediate intervention to prevent death. ... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Typically dramatic and terrifying to the patient, this sign refers to an attack of dyspnea that abruptly awakens the patient. Common findings include diaphoresis, coughing, wheezing, and chest discomfort. The attack abates after the patient sits up or stands for several minutes, but... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Characterized by a harsh, rattling, or snoring sound, stertorous respirations usually result from the vibration of relaxed oropharyngeal structures during sleep or coma, causing partial airway obstruction. Less often, these respirations result from... Emergency interventions ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Wheezes are adventitious breath sounds with a high-pitched, musical, squealing, creaking, or groaning quality. They’re caused by air flowing at a high velocity through a narrowed airway. When they originate in the large airways, they can be heard by... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Thomas C. Bent
Wheezing is one of the most common respiratory complaints to present to primary care physicians. Although most often caused by asthma or chronic obstructive pulmonary disease, there are multiple causes.... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Differential Overview
Wheezing
❑ Asthma
❑ Reactive airways disease
❑ Pulmonary edema
❑ Pulmonary embolism ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Apnea is the cessation of spontaneous respiration and is usually a life-threatening emergency that requires immediate intervention to prevent death. It may occur as a temporary and self-limiting event, such as Cheyne-Stokes and Biot’s respirations. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Characterized by a harsh, rattling, or snoring sound, stertorous respirations usually result from the vibration of relaxed oropharyngeal structures during sleep or coma, causing partial airway obstruction. Less commonly, these respirations result from... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Wheezes are adventitious breath sounds with a high-pitched, musical, squealing, creaking, or groaning quality. They’re caused by air flowing at a high velocity through a narrowed airway. When they originate in the large airways, they can be heard by... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... Characterized by a harsh, rattling, or snoring sound, stertorous respirations usually result from the vibration of relaxed oropharyngeal structures during sleep or coma, causing partial airway obstruction. Less commonly, these respirations result from retained mucus in... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Wheezes are adventitious breath sounds with a high-pitched, musical, squealing, creaking, or groaning quality. Also known as sibilant rhonchi, they’re caused by air flowing at a high velocity through a narrowed airway. When they originate in the large airways, they can be heard... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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...Wheezing is a high-pitched musical soundthat is usually produced by narrowing of the segmental bronchi andbronchioles. May be heard during inspiration, expiration, or both. Principal Causes of Wheezing Asthma Bronchiolitis Pneumonia ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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...Signs of respiratory distress include tachypnea,dyspnea, nasal flaring, grunting, retractions, and cyanosis. Apneais an extreme form of respiratory distress. Respiratory distress(neonatal and postneonatal) is discussed in the first part of thechapter and apnea... Principal Causes of Respiratory Distress (Neonatal) ... Clinical Features and Diagnosis: Respiratory Distress (Neonatal) ... Principal Causes of Respiratory Distress (Postneonatal) ... Clinical Features and Diagnosis: Respiratory Distress (Postneonatal) ... Diagnostic Approach: Respiratory Distress ... Principal Causes of Apnea ... Clinical Features and Diagnosis: Apnea ... Diagnostic Approach: Apnea ... References
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... Apnea, the cessation of spontaneous respiration, is occasionally temporary and self-limiting, as occurs during Cheyne-Stokes and Biot's respirations. More commonly, it's a life-threatening emergency that requires immediate intervention to prevent death.
... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Typically dramatic and terrifying to the patient, this sign refers to an attack of dyspnea that abruptly awakens the patient. Common findings include diaphoresis, coughing, wheezing, and chest discomfort. The attack abates after the patient sits up or stands for... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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... Characterized by a harsh, rattling, or snoring sound, stertorous respirations usually result from the vibration of relaxed oropharyngeal structures during sleep or coma, causing partial airway obstruction. Less commonly, these respirations result from... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Wheezes are adventitious breath sounds with a high-pitched, musical, squealing, creaking, or groaning quality. They're caused by air flowing at a high velocity through a narrowed airway. When they originate in the large airways, they can be heard by... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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...
Nurses frequently become distressed and summon the intern during the
night about these signs. Cheyne–Stokes respirations are a frequent source
of bewilderment because they may occur at times with no direct evidence of
damage... Pictures
... READ EXCERPTS »
...
The differential diagnosis of sleep apnea may be arrived at by
utilizing both physiology and anatomy. Normal sleep
requires an unobstructed pathway from the nasopharynx to the lung and an
intact central nervous system that responds to anoxia and... Pictures
... READ EXCERPTS »
... Author: Sarika Joshi, MD
What to Do - Interpret the Data
OSAS is an underrecognized but clinically important respiratory disorder in
children. OSAS is characterized by intermittent, complete, or partial upper
airway obstruction during sleep, sometimes with... Suggested Readings
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... Akinyemi O. Ajayi, MD Sleep Apnea—Obstructive Sleep Apnea Syndrome - BASICS Sleep Apnea—Obstructive Sleep Apnea Syndrome - description Sleep-disordered breathing encompasses a range of ... Sleep Apnea—Obstructive Sleep Apnea Syndrome - DIAGNOSIS ... Sleep Apnea—Obstructive Sleep Apnea Syndrome - TREATMENT ... Sleep Apnea—Obstructive Sleep Apnea Syndrome - FOLLOW UP ... Sleep Apnea—Obstructive Sleep Apnea Syndrome - bibliography ... Sleep Apnea—Obstructive Sleep Apnea Syndrome - CODES ... Sleep Apnea—Obstructive Sleep Apnea Syndrome - FAQ
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