19 CHEST CONDITIONS

Question 1

OBSTRUCTIVE LUNG DISEASE

Answer 1

Characterized by:
Increased retention of pulmonary secretions.
Narrowing and obstruction of airways: inflammation and edema; increased mucous; m. spasm and bronchospasm.
Structural deterioration of alveoli.

Question 2

EXAMPLES OF OBSTRUCTIVE LUNG DISEASE

Answer 2

Chronic bronchitis
Emphysema
Asthma
Other: cystic fibrosis and bronchiectasis

Question 3

CLINICAL PRESENTATION OF OBSTRUCTIVE LUNG DISEASE

Answer 3

Persistent resistance in airflow
Prolonged and forced expiration
Decreased exercise tolerance
Dyspnea on exertion
Productive coughing
Barrel chest possibly

Question 4

CLINICAL PROBLEMS OF OBSTRUCTIVE LUNG DISEASE

Answer 4

Frequent episodes of SOB
Prolonged and labored expiration
Chronic accumulation of pulmonary secretions
Decreased endurance and exercise capacity
Associated postural defects

Question 5

TREATMENT MODALITIES TO OBSTRUCTIVE LUNG DISEASE

Answer 5

Postural drainage
Breathing exercises
Ambulation
Percussions, vibrations and other physical procedures
Education
Timing of treatment
Range of motion and stretching activities/postural correction
Endurance and aerobic exercise (modified)
Shortness of breath training

Question 6

RESTRICTIVE LUNG DISEASE

Answer 6

Characterized by:
Inability of the lungs to fully expand
Extrapulmonary or pulmonary restriction

Question 7

EXTRAPULMONARY RESTRICTION

Answer 7

Pleural disease
Chest wall injury or stiffness
Respiratory muscle weakness
Inability of diaphragm to adequately move
Pain

Question 8

PULMONARY RESTRICTION

Answer 8

Tumor
Pneumonia
Atelectasis
Heart disease
Pain

Question 9

CLINICAL PRESENTATION OF RESTRICTIVE LUNG DISEASE

Answer 9

Tidal volume, inspiratory and vital capacity are all diminished
Rate of respiration is usually increased
Limited mobility (chest and other)
May have cough (productive or non-productive)

Question 10

CLINICAL PROBLEMS OF RESTRICTIVE LUNG DISEASE

Answer 10

Inability to take a deep breath
Tachypnea
Ineffective cough
Decreased thoracic mobility
Postural deviations
General weakness and fatigue
Increased mucous (secondary to other problems)

Question 11

TREATMENT MODALITIES

Answer 11

Breathing exercises aimed at improving chest expansion
Range of motion and strengthening activities
Postural correction
Education
General mobility activities
Relaxation
Use of equipment/Splinting
Treatment timing

Question 12

ADJUNCTS TO PHYSIOTHERAPY TREATMENTS

Answer 12

Other activities can be used to assist with physiotherapy and breathing
May be done by other health care team members
Timing of PT may depend on the timing of the other activities