Ch. 21 - Pulmonary Disease Flashcards
What is the key difference between obstructive and restrictive pulmonary diseases?
- Obstructive: Airflow into and out of lungs impeded
- Restrictive: Expansion of lungs reduced due to problems in the chest cavity or lung tissue
What are some types of chronic obstructive pulmonary disease?
- Asthma
- Chronic bronchitis
- Emphysema
- Obstructive pulmonary disorder (genetic): cystic fibrosis
What is the range of symptoms for asthma?
Varies from wheezing and slight breathlessness to severe attacks resulting in suffocation
What are some potential causes of asthma?
- Allergic reactions
- Emotional stress
- Exercise
- Viral infections
- Or unidentifiable cause
What is exercise-induced bronchoconstriction?
A reactive airway disease that can occur in individuals with asthma as well as in the general population
What tends to cause bronchioles to constrict during exercise?
(bronchoconstriction)
- Evaporative water loss
- Temperature change
- Exposure to irritants
What is chronic bronchitis characterized by?
Inflammation of bronchi with sputum(phlegm)-producing cough
What is emphysema characterized by?
Destruction of alveolar walls and enlargement of air spaces, which reduces lung surface area for gas exchange
What is a common risk factor for both chronic bronchitis and emphysema?
Cigarette smoking
What are some other risk factors for both chronic bronchitis and emphysema?
- Secondhand smoke
- Air pollution
- Chemical fumes
- Workplace or environmental dust
- Genetics (rare)
1. What type of disorder is cystic fibrosis?
2. What is the underlying issue?
1. A recessively inherited genetic disorder
2. A genetic mutation that impacts a mucus-producing protein found in body organs
Mucus thick and sticky, which can block airways and make infections more likely
What are some causes of restrictive lung diseases?
- Pulmonary edema
- Pulmonary embolism
- Exposure to inorganic or organic dust
- Radiation therapy
What other types of diseases can be restrictive (for lung expansion)?
Neuromuscular diseases including:
* Muscular dystrophy
* Amyotrophic lateral sclerosis
* Polio
What is pulmonary rehabilitation?
A comprehensive intervention: exercise, education, psychological evaluation, nutrition, and behavior change
What are the benefits of a comprehensive intervention for pulmonary rehabilitation?
Does not directly improve lung function, but:
* Offers symptom relief
* Enhances exercise tolerance
* Provides health-related quality of life benefits
1. What might exercise testing include for individuals with pulmonary disease?
2. What are some field tests?
1. Standard GXT
2. 6-minute walk test, shuttle walk test
What typically limits exercise capacity more in individuals with pulmonary disease, the lungs or the cardiovascular system?
The lungs
What is the Dyspnea sprial?
Lung function impariment -> Dyspenia -> Sedentary lifestyle -> Deconditioning -> Increased Dyspenia -> Repeat
What scale is used for symptom evaluation?
(pulmonary dieases)
Dyspnea rating scale (ratio or visual analog)
What device is used to assess oxygen saturation during exercise for pulmonary patients?
Pulse oximeter
What are the general components of an exercise program for pulmonary diseases?
- Aerobic exercise: 3 to 5 days per week (use percentage of peak work rate or ratio scale)
- Resistance training: at least 2 nonconsecutive days per week
- Flexibility: daily, or at a minimum 2 or 3 days per week
What might be required during exercise for some pulmonary patients?
Supplemental oxygen
What are the recommended FITT prinicples for aerobic exercise in COPD?
- F: 1-2 sessions/day; 3-5 sessions/week
-
I: 40-60% of Wmax cycle ergometer; 80% of 6MWT speed on treadmill;
aquatic exercise may be used – 12-14 RPE (Borg) - T: 30-60 min/session; Shorter sessions if >1 bout per day; Shorter interval exercise if unable to complete continuous exercise
- T: Walking; upper body cycle ergometry
What are the recommended FITT prinicples for resistance exercise in COPD?
- F: 2-3 days/week; non-consecutive
- I: 30-40% of 1 RM (upper body); 50-60% 1RM (lower body)
- T: 8-15 comfortable reps; 1-3 sets; build muscular endurance
- T: Machine/free weights; Body weight exercises; 8-10 whole body exercises
