Master of Science in Nursing (MSN) Student Scholarship

Date Written

Summer 2015

Document Type

Project

Course Number

NURS 5330

Course Name

Advanced Pathophysiology

Professor’s Name

John D. Chovan, James R. Cacchillo

Keywords

Vocal Cord Dysfunction, Dyspnea

Subject Categories

Medical Pathology | Medicine and Health Sciences | Nursing | Respiratory Tract Diseases

Abstract

Paradoxical vocal fold motion (PVFM), otherwise known as vocal cord dysfunction (VCD) is an abnormal degree the vocal folds adduct upon inspiration causing airflow narrowing. This restriction can cause severe dyspnea and can be misdiagnosed as asthma. The cause of the abnormality related to PVFM has not been directly recognized, but multiple factors or triggers are associated. It is this lack of clarity and association with asthma, exercise, extubation, stress, and gastric reflux that I take interest in this pathology. I have a personal connection with exercise induced asthma. In addition, my sister in-law was recently diagnosed with VCD who had previously been diagnosed solely with exercise induced asthma. The new diagnosis was reached after inhalers were proving ineffective. My lack of knowledge on the treatment of paradoxical vocal fold motion is another source of curiosity and cause for choosing this topic. The normal physiology of the vocal folds are to abduct (opening the airway) upon inspiration and slightly adduct (close the airway) upon expiration (Cohen, 2010). The normal abduction during inspiration to decrease airway resistance and slightly adducted with expiration to prevent alveolar collapse (Cline and Davis, 2006). With vocal cord dysfunction the vocal folds paradoxically adduct upon inspiration and or expiration (with expiration adduction is a higher degree than normal) (Mansur, 2013).

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