This document discusses breathing patterns, including normal breathing and several abnormal patterns. It begins by covering the physiology of breathing and influencing factors. It then examines parameters for assessing breathing and various abnormal patterns such as apnea, tachypnea, bradypnea, hyperventilation, Kussmaul breathing, Cheyne-Stokes breathing, Biot's breathing, sighing breathing, and obstructed breathing. Each abnormal pattern is defined and examples of potential causes are provided.

1. Choithram Institute of Health
Sciences
PRESENTATION ON-BREATHING
PATTERNS
Guided By- Submitted By-
Dr. Kiran P. S. Aparna Bhagwat
B.P.T. 3rd year

2. CONTENTS :
 PHYSIOLOGY OF BREATHING
 INFLUENCING FACTORS
 PARAMETERS OF ASSESSMENT
 ABNORMAL BREATHING PATTERNS

3.  PHYSIOLOGY OF BREATHING:
• Breathing is a process by which Oxygen is
taken in and Carbon dioxide is given out of
the body.
• It is the process of gas exchange that occurs
in alveoli by passive diffusion of gases
between the alveoli and blood.
• The normal rate of breathing is 12-20/min.
(in adults) and 30-50/min. (in infants).
• The normal relaxed breathing is called as
EUPNEA.
• There are two phases of breathing-
1. Inspiration/Inhalation
2. Expiration/Exhalation

4. 1.INSPIRATION 2. EXPIRATION
PHASE PHASE

5.  INFLUENCING FACTORS:
1. AGE
• New born- 30-50 breath/min
• 3 years - 20-30 breath/min
• 10 years – 16-22 breath/min
• Adults - 12-20 breath/min
2. Body size and stature
3. Exercise
4. Body position

6.  PARAMETERS OF ASSESING:
• Rate
• Depth
• Rhythm
• Character

7.  ABNORMAL BREATHING
PATTERNS:
1. Apnea
2. Tachypnea
3. Bradypnea
4. Hyperventilation
5. Kussmaul breathing
6. Cheyne-Stokes breathing
7. Biot’s/Ataxic breathing
8. Sighing breathing
9. Obstructed breathing

8. APNEA :
 Suspension of breathing.
 No movement of muscles of resp.
and volume of lungs remains same.
 No airflow into or out from the
lungs.
 Gaseous exchange & cellular resp.
is not affected.
 Apnea can be achieved _
1. Voluntarily (breath holding)
2. Mechanically-strangulation/choking
3. From neurological trauma

9.  Prolonged apnea leads to severe
lack of oxygen in circulation, b’coz
under normal conditions body cannot
store much oxygen.
 A person cannot sustain voluntary
apnea for more than 1-2 min. (This
is much more decreased in smokers)
 This is to maintain constant values
of CO2 conc. & pH of blood.
 Here CO2 is not removed out of
lungs, it accumulates in blood,
leading to stimulation of resp.
centers in brain c stops apnea.

10.  Apneic oxygenation
 Apnea test in determining brain
death:
The 3 diagnostic criteria of brain
death are as follows-
1. Coma
2. Absence of pulse
3. Apnea

11. TACHYPNEA :
o Increased rate of breathing ,
i.e. >20 breaths/min.
o Characterized by rapid, shallow
breathing.

12.  It is seen in following conditions-
1. Fever
2. Pneumonia
3. Compensatory resp.alkalosis
4. Respiratory insufficiency
5. Lesions to resp. centers in brain
6. Salicylate poisoning
7. Elevated diaphragm
 Transient tachypnea of newborns

13. BRADYPNEA :
 Decreased rate of breathing ,
i.e. <12 breaths/min.
 Characterized by slow, shallow
breathing.

14.  The rate at c bradypnea is
diagnosed depends on the age –
• 0-1 years - <30 breaths/min.
• 1-3 years - <25 breaths/min.
• 3-12 years - <20 breaths/min.
• 12 & above - <12 breaths/min.
 It is see secondary to following
conditions-
• Diabetic coma
• Respiratory depression
• Increased intra-cranial pressure

15. HYPERVENTILATION :
 Characterized by rapid, deep
breathing.
 Caused by increased levels of CO2.

16.  Other causes include –
• Anxiety or pain
• Excessive use of aspirin
• Obstructive disorders- COPD,
asthma, & pulmonary embolism.
• Infections – pneumonia
• Congestive heart failure
• Diabetic ketoacidosis

17.  Hyperventilation leads to following
symptoms-
• Dizziness
• Light headedness
• Weakness
• Shortness of breath
• Muscle spasm in hands & feet.
 All these symptoms are the result
of increased CO2 in blood caused by
over-breathing.

18. KUSSMAUL BREATHING :
 Rapid, gasping & very deep type of
labored breathing.
 Commonly called as “air hunger”.
 It is been named for -
“Adolph Kussmaul”, a German doctor
who first noted it among patients
with advanced diabetes mellitus.
 It is associated with severe
metabolic acidosis, particularly
diabetic ketoacidosis.

19.  Mechanism of kussmaul breathing.
 Kussmaul’s sign – increase in JVP
during inspiration.

20. CHEYNE-STOKES BREATHING:
 Also called as “periodic breathing”.
 This condition was named after
“John Cheyne & William Stokes”,
the physicians who first described
it in 19th century.
 Characterized by alternate periods
of tachypnea and apnea.
 Occurs as a compensation for
changing serum pO2 & pCO2, and
classically seen in damage to pons
where resp. centers are located.

21.  Mechanism
 Conditions in c it is seen are-
• Stroke
• Traumatic brain injury
• Brain tumors
• Heart failure
• Toxic metabolic encephalopathy

22. BIOT’S BREATHING :
 Also called as “cluster breathing" or
“ataxic breathing”.
 It is named for a French Physician
“Camille Biot” who characterized it
in 1876.
 It is periodic in nature & is
characterized by unpredictable
irregularities in breathing that
alternates with periods of apnea.

23.  It is a group of quick, shallow
inspirations followed by regular or
irregular periods of apnea.
 Causes include-
• Lesion to brainstem (sp. Medulla)
• Cervical spine injury – leading to
resp.depression.

24.  In ataxic breathing, there is
complete irregularity of breathing,
with irregular pauses & increasing
periods of apnea.
 As the breathing pattern
deteriorates, it merges with the
Agonal breathing.

25. AGONAL BREATHING :
 shallow & very slow inspirations
(about 3-4 breaths/min.) followed
by irregular pauses of apnea.
 Characterized by gasping, labored
breathing, accompanied by strange
vocalizations.
 Causes include-
• Cerebral ischemia
• Severe hypoxia/anoxia
• Cardiac arrest

26. SIGHING RESPIRATION :
• Is is the breathing punctuated by
frequent sighs.
• Alerts you for possibility of
hyperventilation syndrome.
• Common cause of dyspnea &
dizziness.

27. OBSTRUCTED BREATHING :
 Also called as “air trapping”.
 It is seen in obstructive diseases
of lungs.

28.  Here, expiration is prolonged
because of increased airway
resistance.
 As the respiratory rate increases
patient lacks sufficient time for
full expiration.
Hence the chest over-expands
i.e. air trapping occurs and the
breathing becomes more shallow.

29. Revision of waveforms:

30. …Thank you..