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Special Clientele > Chest Physical Therapy > Flashcards

Chest Physical Therapy Flashcards

0
Q

Typical goals of chest PT

A 
Prevent airway obstruction and ateclasis
Improve airway clearance and ventilation thru drainage
Improve endurance
Reduce energy costs during respiration
Prevent or improve postural deformities
Improve cough
Promote relaxation
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1
Q

What is ateclasis

A

Collapse of lung

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2
Q

Obstructive disorders

A 
COPD
Chronic bronchitis
Emphysema 
Asthma
Bronchiectasis
Cystic fibrosis
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3
Q

COPD

A

Term used to describe chronic lung diseases that are characterized by progressive obstruction of airflow into or out of lungs and SOB

Usually combo including chronic bronchitis and emphysema

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4
Q

Chronic bronchitis

A

Airway narrowing, excessive mucus secretion, productive cough for 3+ months at a time over 2 consecutive yrs.

Blue bloaters
Hypoxemia
Inadequate gas exchange?
Edema
Mortality rate 2x as high as pink puffers

Thought to be related to long term irritation of tracheobronchial tree; most commonly smoking

Pt is stocky, breathes w accessory mm, may wheeze, & have neck vein distention

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5
Q

Emphysema

A

Disease of alveoli which become hyperinflated
Tend to become pink puffers who maintain near normal blood gases at the expense of breathlessness & weight loss

Pt is dyspneic (difficulty breathing), thin, used accessory mm, pursed lips in expiration, commonly with chronic bronchitis

Rare among non smokers
Males are more likely to get it

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6
Q

Asthma

A

Increased reactivity of tracheobronchial tree in presence of various stimuli manifested in episodic attacks of wheezing and dyspnea

Extrinsic stimuli- pollen, animals, feathers, molds, dust, food

Intrinsic stimuli- weather (high humidity, cold air), Resp. Infections, drugs, emotions, exercise.

1st attack is usually after age 35 & has evidence of chronic airway obstruction w/episodes of acute bronchospasm (abnormal contraction of smooth mm, causing obstruction if airway)

Lumen is narrowed or occluded b inflammation

Tachypnea, use accessory mm, audible wheezing, frequent unproductive cough, c/o chest tightness

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7
Q

Bronchiectasis

A

Chronically dilated airways as a result of damage manifested in obstructed airflow, excess mucus, frequent infections that destroy cilia

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8
Q

Cystic fibrosis

A

Inherited disorder of excess exocrine gland activity affecting many organ systems.

Viscous secretions obstruct airways and pancreatic ducts

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9
Q

Restrictive disorders

A

Differing etiologies result in difficulty expanding the lungs and reduction in lung volume

Anything that affects elasticity or compliance of lung

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10
Q

Acute restrictive disorders

A

Atelectasis
ARDS
Pulmonary edema
Pneumonia

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11
Q

Atelectasis

A

Aka pneumothorax
Collapse of segments of lobes or lungs
Can be caused by compression of lung tissue or obstructed airway with absorption of trapped air which collapses lung tissue distal to obstruction.

Common after thoracic or abdominal surgery

S/s: decreased chest movement, absent breath sounds over involved area, mediastinal shift to involved side, rapid breathing, cyanosis.m

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12
Q

ARDS - Acute or adult respiratory distress

A

Increased permeability of alveolar capillary membrane and sever hypoxemia

May show: Resp. Distress, severe hypoxia that doesnt respond to high O2 concentration, decreased lung compliance

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13
Q

Pulmonary edema

A

Accumulation of fluid in the extra vascular space, which can initially occur in the interstitium and then go to alveolar spaces

Chest PT not indicated

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14
Q

Pneumonia

A

Acute inflammation of lung parenchyma (abnormal tissue growth of a structure) which fills alveoli with exudates and leads to conSOLIDation

Chest PT possibly for obtaining sputum samples
Deep breathing and positioning to improve gas exchange
Supported caught to remove secretions

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15
Q

Pleural effusion

A

Restrictive disorder where fluid accumulates in pleural cavity and compresses lungs

Mobilization helps prevent undue atelectasis
Deep breathing for gas exchange

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16
Q

Interstitial lung disease

A

Restrictive disorder group if about 130 disorders associated with immune disturbances

Chest PT rarely indicated except for maintaining fx activities

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17
Q

Neuromuscular & skeletal disorders

A

Restrictive disorder with kyphoscoliosis, ankylosing spondylitis, rib fx, & other trauma

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18
Q

Obesity

A

Restrictive disorder limits diaphragm movement

Can include ascites which is abnormal accumulation of fluid in abdomen

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19
Q

S/P abdominal or thoracic surgery

A

Restrictive disorder where pain limits respiratory movement and coughing

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20
Q

CNS depression

A

Restrictive disorder where respiration is depressed

21
Q

Abscess

A

Focal collection of pis caused by infection; deep breathing & positioning to improve gas exchange.

22
Q

Pulmonary TB

A

Potentially serious infectious disease that affects mostly ur lungs.
Spread thru tiny droplets

23
Q

External respiration

A

Exchange of gas at alveolar capillary membrane between atmospheric air and pulmonary capillaries

24
Q

Internal respiration

A

Exchange of gas at tissue level between RBC and tissue cells

25
Q

Inspiration muscles

A

Diaphragm- moves down as it contracts

External intercostals- prevent intercostal space being sucked in by negative pressure and it lifts ribs

26
Q

Accessory inspiration muscles

A 
Sternocleidomastoid
Upper traps
Scalenes
Serratus ant
Pec major 
Pec minor 
Erector spinae
27
Q

Expiratory muscles

A

Abdominal s

Internal intercostals

28
Q

Right lung

A

Has upper, middle, and lower lobe

29
Q

Left lung

A

Upper and lower lobes and lingula coming off upper lobe

30
Q

Total lung capacity

A

Volume of air in lungs at full inspiration

31
Q

Tidal volume

A

Amount of air inspired and expired during normal resting ventilation- about 500 mL/breath for young healthy male.
350 take part in gas exchange and 150 remain in conducting airways

32
Q

Inspiratory reserve volume

A

Volume of air that can be inspired in excess of tidal inhalation

33
Q

Expiratory reserve volume

A

Volume of air that can be expired in excess of tidal exhalation

34
Q

Residual volume

A

Volume of air remaining after ERV has been exhaled

35
Q

Inspiratory capacity

A

Tidal volume + inspiratory reserve volume- volume of air that can be inspired

36
Q

Functional residual capacity

A

Residual volume + expiratory reserve volume- volume of air remaining at end of tidal exhalation.

37
Q

Vital capacity

A

Tidal volume + inspiratory reserve volume + expiratory reserve volume - total volume of air within lungs that is under volitional control

38
Q

FEV1

A

Forced expiratory volume in 1 second

Thought to reflect status of larger airways of lungs

39
Q

FEF 25-75%

A

Flow rate in middle of forced expiratory flow volume curve

Thought to reflect status of smaller more fragile airways

40
Q

Vital signs to be aware of

A 
Awareness
Color
Facial signs
Mouth breathing
Jugular vein engorgememt
Hypertrophy of accessory mm
Edema
41
Q

Barrel chest

A

Upper chest circumference larger than lower chest. Sternum is prominent

42
Q

Pectus excavatum

A

Breastbone sunken into chest. Lower part of sternum is depressed and lower ribs flare out. Cm,on in diaphragmatic breathers

43
Q

Pectis carinatum

A

Pigeon breast

Deformity where sternum is prominent and protrudes anteriorly

44
Q

Normal ratio of inspiration to expiration at rest, with activity, and with chronic lung disease

A

Rest 1:2
Activity 1:1
Disease 1:4

45
Q

Bradypnea

A

Slow rate with shallow or normal depth.

May be associated with drug overdose

46
Q

Orthopnea

A

Abnormal condition in which a person must sit or stand to breathe deeply or comfortably

47
Q

Apnea

A

Cessation of breathing in respiratory phase

48
Q

Apneusis

A

Cessation of breathing in inspiratory phase

49
Q

Cheyne- Stokes

A

Cycles of gradually increasing tidal volumes, followed by a series of gradually decreasing tidal volumes, and then a period of apnea; somewhat associated with severe brain injury

50
Q

Good and bad coughing

A

Effective: sharp and deep
Ineffective: may be soft, throaty, shallow, dry

51
Q

Sputum color

A

Clear is normal
Yellow/green is infection
Blood streaked is described as hemoptysis

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