Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Medical & Surgical Nursing
Easy
Tongue fall is the main cause of:
Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Explanation
- Obstructive Sleep Apnea (OSA) is caused by a physical blockage of the upper airway during sleep.
- During sleep, the muscles of the pharynx, including the tongue, relax.
- In some individuals, particularly those who are older or obese, this relaxation causes the tongue to fall backward and completely or partially obstruct the airway.
- This obstruction prevents air from flowing into the lungs, despite the body's continued effort to breathe, defining an obstructive apneic event.
Why Other Options Were Wrong
- Option A: Central Sleep Apnea (CSA) is a neurological issue, not a mechanical one. It occurs when the brain's respiratory control centers fail to send signals to the muscles that control breathing. The airway itself is not blocked.
- Option C: This option is incorrect because tongue fall is a mechanism of physical obstruction, which is characteristic only of OSA, not CSA.
- Option D: This is incorrect as Obstructive Sleep Apnea is a well-established condition directly caused by mechanisms including tongue fall.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Pathophysiology of Sleep Apnea as background academic context rather than a clinical decision trigger.
- Nurses should assess patients for signs of OSA, such as reports of loud snoring, partner-observed apnea, and excessive daytime sleepiness, as it is a significant risk factor for cardiovascular diseases like hypertension.
- Patient education is crucial, including lifestyle modifications like weight loss and positional therapy (e.g., avoiding sleeping on the back) to prevent the tongue from obstructing the airway.
- What if? If a patient with known OSA requires sedation or opioids for pain management, the nurse must monitor their respiratory status with extreme vigilance. These medications can worsen muscle relaxation and suppress the respiratory drive, increasing the frequency and severity of apneic events.
How to Approach the Question
- First, identify the key term in the question: 'Tongue fall'.
- Define 'tongue fall' in a physiological context. It refers to the tongue relaxing and moving backward, potentially blocking the throat.
- Consider the definitions of the options. 'Obstructive' implies a blockage, while 'Central' implies an issue with the central nervous system (the brain).
- Connect the definition of tongue fall (a physical blockage) with the most fitting option. A falling tongue is a physical obstruction.
- Therefore, tongue fall is a direct cause of Obstructive Sleep Apnea.
Concept Tested & Keywords
- Concept Tested: Pathophysiology of Sleep Apnea
- Stem keywords: Tongue fall, main cause
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Negative lead-in flag: false
Question ID
Qb_Dqu-DQoixicunEXpmOd
Reference Book
E6 Physiology Guyton 4SAE Part 2A p. 137-139
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 6998-7000
Practise the full Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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