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Clinical Research on Dyspnea
Author Bios
What is Dyspnea?
What Provokes Dyspnea?
The Nature of Dyspnea
Language of Dyspnea
Clinical Application
Research Application
Variability in Sensations
Challenges in Study
Mechanical Loads and Sense of Effort
Chemoreceptors
Currently selected section: Mechanoreceptors
Neuro-Mechanical Dissociation
Phase of Respiration and Dyspnea
Physiology of Dyspnea
Respiratory System
Cardiovascular System
Measuring Dyspnea
Scaling Issues
Qualitative Aspects
Reliability and Validity Overview
Reliability and Validity
Sensitivity and Specificity
Scales
Sensation vs. Perception vs. Symptom
Treating Dyspnea
Why Measure?
Cluster Analysis
Statistical vs. Clinical Significance
Standard Error of Measurement
Measuring Fatigue
Measuring Depression
Measuring Anxiety and Hyperventilation
Measuring Quality of Life
Conclusion

 

Chapter 23: Dyspnea: Physiology of Dyspnea: Mechanoreceptors
        

The respiratory system is replete with a variety of mechanoreceptors that monitor changes in flow in the airways as well as changes in the volume of the lungs and chest wall. Although information from these receptors appears to be used in large part to assess the mechanical consequences of efferent neurological activity to the ventilatory muscles, stretch and irritant receptors along with c-fibers in the lungs may provide primary sensory information to the brain via the vagus nerve. This information appears to be processed in a manner that leads to a perception of respiratory discomfort. For example, a number of reports describe improvement in dyspnea among patients in whom the vagus nerve was blocked (Guz et al., 1971; Davies et al., 1987).

As discussed previously, acute bronchoconstriction produces several sensations including chest tightness, an increased effort or work of breathing, and a sense of air hunger (Moy, et al., 2000). Although the sensation of increased effort or work of breathing is also found when individuals with normal lung function breathe through an external resistive load, the sensation of chest tightness appears to be quite distinct.

Question 11.1

How might one design an experiment to determine if an element of the breathlessness associated with asthma arises from the lung?

Selection AStudy patients with bilateral lung transplants
Selection B Attempt to block pulmonary receptor activity during bronchoconstriction
Selection CStudy patients with bronchoconstriction during mechanical ventilation
Selection DAll of the above

 

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