Question

An anxious patient as having rapid and shallow breathing. After a few moments, he complains of a tingling sensation. What could be the causes of this tingling sensation? What are the various patterns of respiration and their significance? Ethnicity and culture influence risk factors for heart disease. Do you agree? Why or why not? Would you anticipate hearing hyper residents on a patient with a history of tobacco use?s why or why not? What are the mechanics of breathing with reference to long boarders and the anatomical structure up the lungs and diaphragm?

Answer 1

Causes of tingling sensation in the given patient:

In the given case, the patient had rapid and shallow breathing (hyperventilation), which reduce the carbon dioxide levels in the blood and cause a feeling of breathless, and also the tingling sensation.

The two types of breathing pattern:

Normal breathing pattern (present in healthy people):

• About 12 breaths per minute
• Tidal volume – 500 mL
• Minute ventilation rates – 6 L/min
• Arterial and alveolar carbon dioxide partial pressure – 40 mmHg

Ineffective breathing pattern:

• About 18-20 breaths/minute
• Tidal volume - 700-800 mL
• Minute ventilation rates - 15 mL/min
• Arterial and alveolar carbon dioxide partial pressure – less than 35 mmHg

Abnormal breathing patterns:

Apnoea is the temporary obstruction in breathing, which typically occurs during the sleep. It is commonly observed in premature babies. CPAP (continuous positive airway pressure) is employed as a treatment option for sleep apnoea. Orthopnea is a condition of “shortness of breath or dyspnea.” It usually occur when lying flat.

The term “tachypnea” refers to an abnormal rapid shallow breathing, it is different from hyperventilation (rapid deep breathing). It occurs to meet the metabolic demands or during the conditions of respiratory diseases such as asthma. “Bradypnea” is abnormally slow breathing.

The abnormal breathing pattern resulting from an inward movement of breastbone or skin of the chest wall during inspiration is known as “retraction.” Sternal retractions and intercostal retractions are two types of retractions.

Hyperventilation causes decreased concentration of carbon dioxide in the blood, means decreased PaCO2 levels. The decreased CO2 levels increases the blood pH by decreasing the H+ ion concentration, causing respiratory alkalosis (raising the blood pH above 7.5). Respiratory alkalosis includes symptoms such as tingling around the lips and fingers, seizures, headache, fainting, dizziness and lethargy. Hyperventilation is triggered by reduced oxygen levels, stress and during the conditions of metabolic or respiratory acidosis.

Hypoventilation causes increased concentration of carbon dioxide levels, means increased PaCO2. The increased CO2 levels decrease the blood pH by producing more bicarbonate ions and H+ ions, causing respiratory acidosis (normal blood pH is 7.4), this is known as respiratory acidosis.

Kussmaul respirations that are characterized by laboured breathing, which occurs during respiratory acidosis. This is a mechanism to regulate pH because the forced breathing causes exhalation of carbon dioxide, which results in reduced pH.

Yes, ethnicity increase the risk of cardiovascular diseases in some people. For example, African-Americans, native Hawaiians, Mexican-Americans, American Indians, and Asian-American are at high of cardiovascular diseases, which might be because of their other risk factors such as obesity.

Mechanism of respiration:

The process of respiration includes the inspiration and expiration. The principal muscles of inspiration are, external intercostals, and diaphragm. The accessory muscles of inspiration include, sternocleidomastoid, and scalenes.

During normal quiet inspiration (i.e. during rest), the diaphragm contracts and thus, causing the chest cavity enlargement (increase in volume) from above downwards. The lungs expand in this stage, the pressure in the lungs is less than atmospheric pressure, so air enters into the lungs.