Cardiopulmonary Conditions Worksheet Flashcards

1
Q

Pulmonary physical therapy focuses on excercise intervetnions and manual techniques that enhance _________ and __________ ____________ to meet necessary and functional demands.

A

ventialtion

airway clearance

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2
Q

what are some warnings that may indicate there is a problem with a persons respiratory system?

A
  • Chronic cough
  • Shortness of Breath
  • Chronic Mucus Production
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3
Q

A cough that you have had for a month or more.

This is an important early symptom.

A

Chronic cough

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4
Q

not being able to catch your breath even after exercise, or after little or no exertion. Labored or difficult breathing. The feeling that it is hard to breath in or out.

A

Shortness of Breath

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5
Q

Mucus, also called sputum or phlegm, is produced byt he airways. it is a defense response to infection or irriatants.

If mucus production has lasted a month. It can indicate lung disease.

A

Chronic Mucus Production

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6
Q

Noisy breathing is a sign that something unusual is blocking the lungs’ airways or making them too narrow.

what is the sound known as?

A

Wheezing

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7
Q

blood may be coming from lungs or upper resiratory tract.

A

coughing up blood

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8
Q

Unexplained chest pain that lasts for a month or more - especially if it gets worse when taking a breath in or coughing

A

Chronic chest pain

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9
Q
  • 6 no exertion at all
  • 7
  • 8 extremely light
  • 9 very light
  • 10
  • 11 light
  • 12
  • 13 Somewhat hard
  • 14
  • 15 Hard (heavy)
  • 16
  • 17 very hard
  • 18
  • 19 extremely hard
  • 20 Maximal exertion
A

borg scale

or

PRE scale

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10
Q

3 General goals for cardiovascular and pulmonary physical therapy

A
  1. Prevent airway obstruction
  2. improve airway clearance
  3. improve endurance
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11
Q

what type of sputum

Typical causes: Normally present

Observation of Sputum: Clear/watery

A

Saliva

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12
Q

what type of sputum

Typical causes: pulmonary edema

Observation of Sputum:bubbly either white or pink colored

A

Frothy

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13
Q

what type of sputum

Typical causes: pulmonary conditions with no infection, eg. Asthma, chronic bronchitis

Observation of Sputum: White and opaque

A

Mucoid

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14
Q

what type of sputum

Typical causes: cystic fibrosis, pneumonia, bronchiectasis

Observation of Sputum: May have a slight yellow tinege and is slightly thicker thatn mucoid: may have a slight odor; cystic fibrosis sputum is often foul smelling due to infection

A

Mucopurulent

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15
Q

what type of sputum

Typical causes: pulmonary infections, ex pseudomonas, pneumococcus bacteria

Observation of Sputum: thick, yellow or green; may be rust colored due to presence of old blood or red due to presence of fresh blood; often has a bad odor

A

Purulent

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16
Q

what type of sputum

Typical causes: infections such as tuberculosis or bronchiectasis, pulmonary infarction, trauma causing damage to the lung, diorders of coagulation

Observation of Sputum: Blood spots in sputum or a lot of blood; old blood appears brown and fresh blood red

A

hemoptysis

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17
Q

what type of sputum

Typical causes: inhalation of smoke from cigarettes, fires or heroin use; inhalation of coal dust

Observation of Sputum: spots of black in the sputum

A

black sputum

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18
Q

This term is used to describe gas exchange within the body and can be categorized as either external or internal

A

respiration

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19
Q

the exchange of gas at the alveolar-capillary membrane and the pulmonary capillaries

A

external respiration

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20
Q

describes the exchange of gas between the pulmonary capillaries and the cells of the surrounding tissues

A

internal respiration

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21
Q

the mass exchange of air to and from the body during inspiration and expiration

A

ventilation

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22
Q

what are the main muscles of inspiration?

A
  1. Diaphragm
  2. scalenes
  3. parasternal intercostals
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23
Q

you are trying to discourage the use of your pt’s accessory muscles for quiet inspiration.

What muscles would you inhibit?

these muscles become extremely active with greater inspiratory effort which frequently occurs with strenuous physical activity.

A
  1. SCM
  2. upper traps
  3. pectoralis major
  4. pectoralis minor
  5. subclavius
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24
Q

what are the main muscles of EXpiration?

A

abdominals

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25
Q

what are the accessory muscles of EXpiration?

A
  1. pectoralis major
  2. quadrates lumborum because of its attachment on 12th rib
  3. possibly internal intercostals
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26
Q

the inspiratory capacity plus the functional residual capacity; the volume of air contained in the lungs at the end of a maximal inspiration; also equals vital capacity plus residual volume.

Vital capacity + residual volume

A

total lung capacity (TLC)

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27
Q

the lung volume representing the normal volume of air displaced between normal inspiration and expiration when extra effort is not applied.

A

Tidal Volume

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28
Q

The maximum volume that can be inhaled above the tidal volume

A

Inspiratory Reserve capacity

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29
Q

the amount of air Remains in the lungs after a maximal expiratory effort; cannot be exhaled

A

Residual volume

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30
Q

The maximum volume that can be inhaled

A

Inspiratory capacity

31
Q

Volume left in the lungs at the end of a normal breath which is not normally part of the subdivisions

A

Functional residual capacity (FRV)

32
Q

The maximum volume that can be inhaled and exhaled

Vital capacity–VC

A

Vital capacity–VC

33
Q

the maximal amount of gas that can be exhaled from the resting end-expiratory level.

A

expiratory reserve volume

34
Q

General appearance of the patient

LEVEL OF AWARENESS(level of consciousness):

alert, responsive, or cooperative vs. lethargic, disoriented or inattentive

what would the implications be?

A

Respiratory acidosis, hypercarbia (increased Pco2 level) or hypoxia (decreasedPO2 level) can alter level of consciousness

35
Q

General appearance of the patient

BODY TYPE: normal, obese or cachectic

what would the implications be?

A

May reflect intolerance to exercise

36
Q

General appearance of the patient

COLOR: cyanosis (bluish appearance)

what would the implications be?

A

Peripheral cyanosis may indicate low cardiac output; central cyanosis may indicate inadequate as exchange in the lungs

37
Q

General appearance of the patient

FACIAL SIGNS OR EXPRESSIONS: focused or dilated pupils, nasalflaring, sweating or distressed appearance.

what would the implications be?

A

Signs of respiratory distress, fatigue or pulmonary or musculoskeletal pain.

38
Q

General appearance of the patient

JUGULAR VEIN ENGORGEMENT: visualization of the jugular venous pulse with the pt supine and the head and neck on pillow at a 45* angle

what would the implications be?

A

Bilateral distension associated with congestive heart failure/right-sided heart failure

39
Q

General appearance of the patient

HYPERTROPHY OF OR USE AT REST OF ACCESSORY MUSCLES OF VENTILATION: SCM, upper traps

what would the implications be?

A

Seen in pt with early chronic lung disease or weakness of the diaphragm

40
Q

General appearance of the patient

SUPRACLAVICULAR OR INTERCOSTALS RETRACTIONS occurring with inspriation.

what would the implications be?

A

Seen in pts with labored breathing

41
Q

General appearance of the patient

USE OF PURSED LIPS BREATHING (usually w/ EXpiration)

what would the implications be?

A

inidcates difficulty with exxpiration; often seen in pts with COPD

42
Q

General appearance of the patient

CLUBBING OF DIGITS: loss of angle between the nail bed and DIP joint

what would the implications be?

A

May be linked to perfusion

43
Q

General appearance of the patient

PERIPHERAL EDEMA

what would the implications be?

A

Signs of R ventricular failure or lymphatic disorder

44
Q

Circumference of upper chest appears larger than that of the lower chest.

common in pts with COPD

A

Barrel Chest

45
Q

The lower part of the sternum is depressed and the lower ribs flare out.

A

Pectus excavatum

46
Q

The sternum is prominent and protrudes anteriorly.

A

pectus carinatum

47
Q

what is the common posture or preferred positioning that a pt with respiratroy dysfunction assumes?

A

a pt who has difficulty breathing often leans forward on hands or forearms to stabilize and elevate the shoulder girdle to assist with inspriation.

48
Q

what is the NORMAL ratio of inspiration to expiration is

A

1:2

49
Q

Does the rate of inspriation and expiration change with activity? if so, what does the ration change to ?

A

Normal inspiration to expiration is 1:1 with activity

50
Q

COPD has difficulty Xhaling

what is their ration at rest?

Mrs T says to know this

A

1:4

51
Q

Distressed, labored breathing as the result of SOB

A

dyspnea

52
Q
  • Rapid, shallow breathing:
  • decreased tidal volume but increased rate:
  • associate with restrictive or obstructive lung disease
  • use of accessory muscle of inspiration
A

tachypnea

53
Q

slow rate with shallow or normal depth and regular rhythm: may be associated with drug overdose

A

bradypnea

54
Q

deep, rapid respiration: increased tidal volume and increased rate of respiration: regular rhythm

A

Hyperventilation

55
Q

difficulty breathing in the supine position

A

otrhopnea

56
Q

Cessation of breathing in the expiratroy phase

A

Apnea

57
Q

Cessation of breathing in the inspriatory phase

A

Apneusis

58
Q

Cycles of gradually increasing tidal volumes followed by a series of gradually decreasing tidal volumes and then a period of apnea. This is sometimes seen in the pt with a severe head injury

A

Cheyne-Stokes

59
Q

This sound during inspiration can be fine or coarse as a result of secretions moving in the airways or in closed airways that are rapidly reopening.

formally called rales

A

Crackles

60
Q

usually heard during Xhalation and occasionally during Inhalation. It is a continuous high or low pitched sound or sometimes musical tones.

A

Wheezing

61
Q

Normal breath sounds are classified in what 3 ways?

A
  1. vesicular
  2. bronchial
  3. bronchovesicular
62
Q

The absence of air and collapse of an area of lung tissues in known as what?

A

atelectasis

63
Q

Obstruction of airways can be caused by what things?

A
  • fluids
  • mucus
  • bronchospasm
  • compression from a tumor
64
Q

Precautions to teaching an effective cough

A
  • Never allow a pt to gasp in air
  • avoid uncontrolled coughing spasms
  • avoid forceful coughing pt-CVA or aneurysm
  • errect or side-lying position
65
Q

A cough may be productive or nonproductive in the presence of pathology. Secretions are checked for:

A
  1. Color (clear, yellow, green, blood-stained)
  2. Consistency (viscous, thin, frothy)
  3. Amount ( minimal to copious)
  4. Odor (no order or foul smelling)
66
Q

what are the goals of breathing exercises and vetilatory muscle training.

A
  • improve or redistribute ventilation
  • increasethe effectiveness
  • prevent post op complications
  • improve, strenght, endurance,and coordination of ventilation
  • Maintain and improve chest and thoracic spine mobility
  • correct inefficient or abnormal breathing patters and decrease the work of breathing
  • promote relax and releive stress
  • teach the pt how to deal with episodes of dyspnea
  • improve overall function
67
Q

What is a semi-Fowler’s position?

A

head and trunk elevated approx 45*

68
Q

What are the precautions when teaching breathing techniques?

A
  1. No forceful expiration(xhale without sound)
  2. no highly prolonged expiration
  3. accessory muscle should not be used
  4. only 3-4 inspiration/expirations to avoid hyperventilation
69
Q

What is the difference between diaphragmatic breathing and pursed lip breathing?

A
  1. Diaphragmatic is for relaxation
  2. pursed lips is used to control emergency breathing
70
Q

a strategy of breathing that involves lightly pursing the lips together during controlled exhalation.

what pt would most benefit from this breathing pattern?

A

Pursed lip breathing

COPD pts

71
Q

placing a hand or pillow over a painful area or a place of surgical repair during coughing.

the theapist can do it if the pt cannot reach

A

Splinting

72
Q

Manual techniques that may assist with postural drainage

A
  1. Vibration
  2. Percussion
  3. Shaking
73
Q

What are the 6 relative contras for percussion?

A
  1. over fx, spinal fuse, osteoporotic bone
  2. over tumor area
  3. had pulmonary embolism
  4. pt had hemorrhage condition->low platelet count or receiving anticoagulation therapy
  5. unstable angina
  6. chest wall pain-> thoracic surgery or trauma
74
Q

When applying any technique, preparation is key. Waht can you, as the PTA, do to prepare the pt prior to implementing postural drainage techniques?

A