Airway occlusion

Introduction Decreased pharyngeal muscle tone can cause trapping of the upper airway during inhalation.

Cause

Respiratory muscle contraction is highly coordinated during normal breathing. The upper airway muscle has a certain base tension to keep the airway open. The nerve discharge causes the upper airway muscle to contract before each diaphragm contraction. The contraction of the genioglossus moves the tongue to fix the pharyngeal wall forward, further maintaining the upper airway opening and resisting the trapping effect of the negative pressure in the pharyngeal cavity on the upper airway. Subsequently, the intercostal muscle contraction stabilizes the chest wall, and the diaphragm contraction produces a pleural negative pressure to complete the inhalation.

In the normal NREM sleep phase, the basal tension of the upper airway muscle is reduced, the upper airway diameter is reduced, and the airway resistance is increased, but the discharge phase of the upper airway muscle and the rhythmic contraction of the intercostal muscle remain intact. The base tension of the upper airway muscles, the intercostal muscles, and most of the skeletal muscles is further suppressed during REM sleep. Decreased pharyngeal muscle tone can cause trapping of the upper airway during inhalation. Decreased basal tension of the genioglossus can cause the base of the tongue to shift backwards and the airway to narrow. Decreased intercostal muscle tension can lead to instability of the chest wall during inhalation, resulting in contradictory movements of the chest and abdomen. In the REM sleep phase, the inspiratory phase discharge of the upper airway and intercostal muscle can also be inhibited. When the diaphragm negative pressure increases after the diaphragm contraction, the upper airway trapping tendency and chest wall instability are aggravated.

an examination

Related inspection

Electromyography chest CT examination

Electromyography: Electromyography is a means of assisting the examination of diseases through myoelectricity.

Ventilation and perfusion ratio (V/Q): The ratio of total lung alveolar ventilation to total pulmonary blood volume is called ventilation and blood flow ratio.

Electroencephalogram examination: EEG examination is a graph obtained by amplifying and recording the spontaneous biopotentials of the brain from the scalp through an instrument.

Electrocardiogram: In each cardiac cycle, the heart is excited by the pacemaker, the atria, and the ventricle. With the changes in bioelectricity, various forms of potential change patterns (ECG) are extracted from the body surface through the electrocardiograph. An electrocardiogram is an objective indicator of the process of cardiac excitability, transmission, and recovery. Electrocardiogram is the earliest, most commonly used and most basic diagnostic method for the diagnosis of coronary heart disease.

Pulmonary ventilation: The pulmonary ventilation function is a dynamic indicator of the process by which air enters the alveoli and the exhaust gas is expelled from the alveoli, containing the concept of time. Commonly used indicators include resting ventilation, alveolar ventilation, maximum ventilation, time vital capacity, and some flow rate indicators.

Polysomnography (PSG): Polysomnography (PSG) is the most important test for the diagnosis of sleep snoring (sleep apnea hypopnea syndrome, OSAHS). Through continuous monitoring of nighttime breathing, arterial oxygen saturation, electroencephalogram, electrocardiogram, heart rate and other indicators, you can know whether the snorer has apnea, the number of pauses, the time of suspension, the minimum arterial oxygen value at the time of suspension, and The extent of physical health effects is an internationally accepted gold standard for the diagnosis of sleep apnea hypopnea syndrome. The polysomnography is the most commonly used sleep monitoring method. It is the most important test for diagnosing snoring. It is the internationally recognized gold standard for diagnosing sleep apnea hypopnea syndrome.

Differential diagnosis

More common in sleep-disordered breathing, apnea, although there is no airflow in the upper airway, but there is still chest and abdomen breathing exercise, and the chest negative pressure fluctuations can be as high as 7.8kPa (80cmH2O). Due to upper airway trapping, there is little or no external environmental gas entering the alveoli for gas exchange, which can result in severe hypoxemia and C02 retention, progressive bradycardia, and transient tachycardia at the end of the apnea. Occasionally, sinus block, atrioventricular septum, nodular or ventricular escape, hypoxemia-induced acidosis and myocardial ischemia produce atrial and ventricular ectopic rhythm. Severe OSAS patients are accompanied by daytime sleepiness, hypercapnia in waking, and even pulmonary hypertension and right heart failure.

EMG:

Electromyography is a means of assisting the examination of diseases through myoelectricity.

Ventilation and perfusion ratio (V/Q):

The ratio of total lung alveolar ventilation to total pulmonary blood flow is called ventilation and blood flow ratio.

EEG examination:

Electroencephalography is a graph obtained by amplifying and recording the spontaneous biopotentials of the brain from the scalp by means of an instrument.

ECG:

During each cardiac cycle, the heart is excited by the pacemaker, the atria, and the ventricle. With the changes in bioelectricity, various forms of potential change patterns (ECG) are extracted from the body surface by electrocardiograph. An electrocardiogram is an objective indicator of the process of cardiac excitability, transmission, and recovery. Electrocardiogram is the earliest, most commonly used and most basic diagnostic method for the diagnosis of coronary heart disease.

Lung ventilation function:

Lung ventilation is a dynamic indicator of the process by which air enters the alveoli and exhausts from the alveoli, containing the concept of time. Commonly used indicators include resting ventilation, alveolar ventilation, maximum ventilation, time vital capacity, and some flow rate indicators.

Polysomnography (PSG):

Polysomnography (PSG) is the most important test for the diagnosis of sleep snoring (sleep apnea hypopnea syndrome, OSAHS). Through continuous monitoring of nighttime breathing, arterial oxygen saturation, electroencephalogram, electrocardiogram, heart rate and other indicators, you can know whether the snorer has apnea, the number of pauses, the time of suspension, the minimum arterial oxygen value at the time of suspension, and The extent of physical health effects is an internationally accepted gold standard for the diagnosis of sleep apnea hypopnea syndrome. The polysomnography is the most commonly used sleep monitoring method. It is the most important test for diagnosing snoring. It is the internationally recognized gold standard for diagnosing sleep apnea hypopnea syndrome.

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