Breathing and Oxygen Flashcards
What are the primary functions of breathing?
Biomechanical (moving air, lymph, blood by changing intra-abdominal/thoracic pressure)
Biochemical (regulating blood gases and body chemistry).
3rd = Psychopysiological
What is the difference between functional and dysfunctional breathing?
- functional breathing is efficient and adaptive.
- dysfunctional breathing involves hyperventilation, mouth breathing, upper chest breathing, and breathing discomfort.
What are the characteristics of biochemical dysfunctional breathing?
Hyperventilation with low CO2, leading to the perception of insufficient breathing, causing further hyperventilation.
What are the characteristics of biomechanical dysfunctional breathing?
Thoracic/upper rib cage breathing, sighing, dyspnea, breath-holding, and paradoxical breathing, leading to muscle imbalances and poor spinal support.
How can psychophysiological factors affect breathing?
Mental and emotional states influence ventilatory drive and breathing patterns, requiring attention to improve overall breathing function.
What assessments are used to evaluate breathing dysfunction?
MSK Assessment
- AROM/PROM UE and Spinal
- Recommended SFMA Screening
Biochemical Assessment
- Observation, Testing
- Breath Holds
Biomechanical Assessment
- Hi-Lo Assessment
- MARM Assessment
Psychophysiological Assessment
- Nijmegen Questionnaire
- Self Evaluation Breathing Questionnaire
What breath-holding tests are used in breathing assessments?
Breath-hold time at Functional Residual Capacity (FRC) and Total Lung Capacity (TLC) are used to evaluate potential breathing dysfunction.
What are the key indications for supplemental oxygen use?
- PaO2 < 55 mmHg or SaO2 < 88% on room air
- PaO2 56-59 mmHg or SaO2 89%-90% with pulmonary hypertension, cor pulmonale
- hematocrit > 56%
What are the benefits of oxygen titration?
- improves minute ventilation
- decreases dynamic hyperinflation
- improves ventilatory muscle function
- increases cardiac output
- improves hemodynamics
What is the PT’s role in titrating supplemental oxygen?
Ensure safety with activity, provide appropriate exercise prescriptions, instruct patients in breathing exercises, and educate on oxygen titration during activities.
What are the common methods of oxygen delivery?
- nasal cannula
- oronasal masks
- tracheostomy masks
- aerosol masks
- high-flow nasal cannula
What are the flow rates for nasal cannula oxygen delivery?
- 1-6 L/min, with discomfort and nasal dryness occurring
- Rates > 4 L/min, requiring humidification for comfort
What is the function of a high-flow nasal cannula?
Delivers oxygen at rates > 6 L/min with humidification, washing out CO2 and reducing anatomical dead space to improve breathing.
- Simple Mask = ?
- Aerosol Mask = ?
- Venturi Mask = ?
- Reservoir Masks = ?
Simple Mask:
- Flow of gas into a face piece over nose and mouth
- Can have dilutor that allows room air to enter
Aerosol Mask:
- Originally for aerosolized medications
- Able to administer higher rates of O2 than simple mask
- Used with nebulizer to humidify the gas
Venturi Mask:
- Mixes oxygen with room air through ports
- Can provide greater flow of gas to the patient
- Easier to vary the rates by adjusting the size of the ports along with flow rate
Reservoir Masks:
- Attached to bag to allow of higher percentage of oxygen
- Partial rebreathing or nonrebreather masks
- Must be tightly sealed to work
What are the FiO2 (Fraction of Inspired Oxygen) levels for room air and supplemental oxygen?
Ambient air has FiO2 of 21%. Every 1 L/min of oxygen increases FiO2 by ~4%.
