Cardiorespiratory Physiotherapy Adults And Paediatrics 5th Edition – Eleanor Main (1)

Notably, the sensation of air hunger/ unsatis ed inspiration has been reported to be more unpleasant than the sensation of work/effort (Banzett et al 2015). Lansing et al (2009) proposed a staged model for the perceptual processes underpinning the sensation of breathlessness in which afferent input is initially evaluated for intensity and sensory quality.

Subse- quently, an assessment of the degree of unpleasantness is made which culminates in immediate and longer- term emotional responses (fear, frustration, anxiety) and behavioural consequences (immediate cessation of activity or life style changes) (Lansing et al 2009). In order to consciously appreciate and describe the sensation, complex integration is therefore required between afferent information arising from systems within the body and cortical areas associated with res- piratory motor drive, attention, memory, expectation and affective state (Parshall et al 2012).

Respiratory motor control is an automatic process involving the brainstem respiratory centre which, under normal cir- cumstances, does not require or result in conscious awareness of breathing by the individual (O’Donnell et al 2007). Respiratory motor control can also be vol- untarily altered as a result of input from cortical struc- tures (Parshall et al 2012). A respiratory gating model has been proposed in order to explain the connections between systems permitting a conscious appreciation of breathing (Davenport in O’Donnell et al 2007).

A simple schematic derived from O’Donnell et al (2007) and Parshall et al (2012) is presented in Figure 7-52. Unlike pain, there are no specialized receptors for dyspnoea. Parshall et al (2012) comprehensively sum- marize the variety of sources which may contribute afferent input from systems within the body (chem- oreceptors, stretch, irritant, airway, muscle, joint, vas- cular, skin receptors) and cortical structures (motor cortex, sensory cortex, association cortex and limbic system (see Fig.

7-52A). Many of the respiratory affer- ents within the body have projections to the respira- tory network in the brainstem and projections to higher cortical centres (O’Donnell et al 2007).

• Bank of 350 images Activate the complete learning experience that comes with each textbook purchase by registering at evolve.elsevier.com/Main/cardiorespiratory YOU’VE JUST PURCHASED MORE THAN A TEXTBOOK! REGISTER TODAY! Scan the QR code to access your free mobile content.* 2015v1.0 Cardiorespiratory Physiotherapy To Barbara, Jennifer and Ammani Cardiorespiratory Physiotherapy ADULTS AND PAEDIATRICS Fifth Edition EDITED BY ELEANOR MAIN BSc BA MSc PhD FCSP Professor of Physiotherapy and Director of UCL Postgraduate Physiotherapy Programme, UCL School of Life and Medical Sciences, University College London, London, UK LINDA DENEHY BAppSc(Phty) GradDipPhysio(Cardiothoracic Phty) PhD Professor and Head, Department of Physiotherapy, Melbourne School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia FOREWORD BY BARBARA A WEBBER FCSP DSc(Hons) Formerly Head of Physiotherapy, Royal Brompton Hospital, London, UK JENNIFER A PRYOR PhD MBA MSc FNZSP MCSP Formerly Senior Research Fellow in Physiotherapy, Royal Brompton & Hare eld NHS Trust; Honorary Lecturer, University College London and Imperial College London, London, UK S AMMANI PRASAD GradDipPhys FCSP Cystic Fibrosis Manager, Respiratory Unit, Great Ormond Street Hospital for Children NHS Trust, London, UK Edinburgh London New York Oxford Philadelphia St Louis Sydney Toronto 2016 © 2016 Elsevier Ltd.

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