Sleep apnea

Sleep apnea

1. Anatomy of upper respiratory tract

   • nose
     • bony framework
     • cartilegnous framework
     • nostrilues
       • Nares or anterior nasal apertures
       • . Bounded laterally by the alae of the nose.
     • nasal cavity
       • roof
         • is narrow and is highest in central regions where it is formed by the cribriform plate of the ethmoid bone
       • floor
         • is formed by the upper surface of the palate
     • paranasal sinuses
       • Frontal
       • Ethmoidal
       • Maxillary
   • pharynx
     • Isamusculofascialhalf-cylinderthatlinkstheoralandnasalcavitiesinthe head to the larynx and esophagus in the neck.
       • nasopharynx
         • Shows opening of auditory (Eustachian) tube lies in its lateral wall.
         • The auditory tube equalizes pressure in the middle ear with the atmospheric pressure
         • nasopharyngeal tonsil
           • adeniods
       • oropharynx
         • The part of the pharynx which lies behind the oral cavity (tongue).
         • tworidges (folds) on each side, the palatine tonsil lies between them.
       • laryngopharynx
         • The part of the pharynx which lies behind the larynx
         • THE PIRIFORM FOSSA
   • larynx
     • lies in the anterior midline of the neck in front of 3rd, 4th, 5th and 6th cervical vertebrae
       • cartilages
         • unpaired
           • criciod
           • epigloitis
           • thyriod
         • paired
           • Corniculate.
           • Cuneiform.
           • Aytenoids.
       • membrane
         • THYROHYOID MEMRANE
         • CRICOTHYROID MEMBRANE:
         • THE QUADRATE MEMBRANE:

2. sleep

   • snoring
     • Vibration of respiratory structures which results in a sound, due to obstructed air movement during breathing while sleeping
     • causes
   • sleep cycle
   • Sleep Paralysis
     • Sleep paralysis is a feeling of being conscious but unable to move.
     • factors
       • Lack of sleep
       • bipolar disorder
       • Sleeping on the back

3. types

   • central sleep apnea
   • complex sleep apnea
   • obstructive sleep apnea

4. sign and sympotms

   • Waking up with a very sore or dry throat.
   • Loud snoring
   • . Sleepiness or lack of energy during the day

5. treatment

   • mild cases
     • Lifestyle changes
       • Weight loss
       • Reduce alcohol use
       • Change sleep position
   • moderate cases
     • Auto-CPAP
     • Continuous positive airway pressure (CPAP)

6. investegations

   • Polysomnography
     • is a multi-parametric test used in the study of sleep and as a diagnostic tool in sleep medicine. The test result is called a polysomnogram, also abbreviated PSG.
     • Medical uses
       • Narcolepsy idiopathic hypersomnia periodic limb movement disorder (PLMD) REM behavior disorder Parasomnias
   • Medical history
   • Physical examination

7. Definition

   • breathing repeatedly stops and starts during sleep..

8. Risk factors

   • Smoking
   • Diabetes
   • Obesity
   • Male Gender
   • Hypertension

9. Normal Control of breathing

   • Medullary Rhythmicity area of medulla oblongata
     • Dorsal respiratory group
       • Quiet inhalation and exhalation
     • Ventral respiratory group
       • Promote expiration in forceful breathing
   • Pneumotaxic center of upper pons
     • Control respiratory rate and regulate inspiration
   • Apneustic center in lower pons
     • Fine tuning, prolong inspiration
   • Chemoreceptors
     • Central
       • detect low PH
     • Peripheral
       • Aortic and carotid bodies detect CO2 and PH changes

10. Diffusion capacity of lung

11. O2 TRANSPORT

12. Carbon dioxide transport

13. Pathophysiology

    • Anatomic factors
      • enlarged tonsils
        • decrease in the cross-sectional area of the upper airway and/or increase the pressure surrounding the airway
          • airway collapse
      • volume of the tongue, soft tissue, or lateral pharyngeal walls
      • length of the soft palate
    • Decreased neuromuscular activity during sleep
    • Reduced ventilatory motor output to upper airway muscles

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