Which of the following is an abnormal breathing pattern characterised by deep, gasping inspiration with a pause at full inspiration followed by a brief, insufficient release?

1. A

   Apneustic respiration

2. B

   Paradoxical respiration

3. C

   Kussmaul’s respiration

4. D

   Cheyne stokes respiration

Appeared in: DSSSB 14 August 2024

Explanation

• Apneustic respiration is characterized by a prolonged inspiratory gasp with a distinct pause before a short, inefficient exhalation.
• This pattern directly matches the description in the question stem: 'deep, gasping inspiration with a pause at full inspiration followed by a brief, insufficient release'.
• It results from damage to the apneustic center in the pons, a part of the brainstem that regulates the transition between inspiration and expiration.

Why Other Options Were Wrong

• Option B: Paradoxical respiration describes an abnormal movement of the chest wall, not a specific rhythm of breathing. The chest wall sinks in during inspiration instead of expanding.
• Option C: Kussmaul's respiration is deep and rapid (labored) breathing without the characteristic inspiratory pause. It is a compensatory mechanism to expel carbon dioxide.
• Option D: Cheyne-Stokes respiration is a cyclical pattern where breathing gradually becomes deeper and faster, then shallower, followed by a period of apnea (no breathing). It does not involve a prolonged inspiratory gasp.

Related Visual

Clinical Relevance

• Nursing practice connection: Knowing Identification of abnormal breathing patterns helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• Recognizing abnormal breathing patterns is a critical nursing assessment skill, as they often signal life-threatening neurological or metabolic emergencies.
• The presence of apneustic breathing is an ominous sign of severe brainstem (pontine) damage and requires immediate neurological assessment and escalation to the medical team.
• What if? If the patient's breathing was deep and rapid without any pauses, and their blood glucose was 500 mg/dL, the most likely pattern would be Kussmaul's respiration, indicating diabetic ketoacidosis.

How to Approach the Question

• This is a recall-based question that tests your knowledge of specific medical terminology.
• First, carefully analyze the description in the question stem, identifying the key features: 1) deep, gasping inspiration, 2) a pause at full inspiration, and 3) a brief, insufficient release.
• Next, systematically review each option and compare its definition to the features identified in the stem.
• Recall that Apneustic respiration is defined by a prolonged inspiratory phase with a pause, which directly matches the description.
• Differentiate this from Kussmaul's (deep and fast, no pause), Cheyne-Stokes (cyclical with apnea), and Paradoxical (abnormal chest wall movement).
• Select the term that is a perfect match for the described breathing pattern.

Concept Tested & Keywords

• Concept Tested: Identification of abnormal breathing patterns
• Stem keywords: abnormal breathing pattern, deep, gasping inspiration, pause at full inspiration, brief, insufficient release
• Lead-in keywords: Which of the following

Question ID

QzBeH9y4CTkJ2dU3E71Y6t

Copy ID

Reference Book

E6 Physiology Guyton 4SAE Part 2A pp. 115-117, 114-116