Chest physio

Question 1

How does the spirometrter works & what are the physiological effect?

Answer 1

1. How : Breath out completly → breath in in the device (slow, consistant inspiration) Try to keep the indication (ball or disc) in the targeted flow zone.
   1 part of the device indicates the flow at which the patient is breathing in (inspiration). The 2nd part of the device shows the volume achieved by the patient.
2. Physiological effect : *📉 Intrathoracic Pressure📈 collateral ventilation; alveoli recruitment; lung volume (📈 VT)

The SI create a laminar flow that reach the deep alveoli

Question 2

How do you perform the EDIC method & explain the physiological effect.

Answer 2

1. Slow inspiration manoeuver applied on the side lying patient, placing the affected lung on supralateral. We assist the inspiration (w/ pursed lips) with our hand on the lower rib cage & higher hips.
2. 📉 Intrathoracic Pressure
   📈 collateral ventilation; alveoli recruitment; lung volume (📈 VT)📈 gravitational forces*

<=> superolateral lung hy w/ 📈 transversal thorax diameter

Can use any type of SI method w/ it.
/!/ Affected lung up

Question 3

For wich condition can we use a Slow inspiration technique/manoeuver?

Answer 3

Atelectasis, Pneumonia, Insuff resp II (=hypoventilation), Pulmonary oedema

Question 4

What is the effect of pursed lips breathing?

Answer 4

Exhalation through drawn lips -> maintains pressure inside the airways, preventing then from collapsing.

Often inpatient w: severe airway disease, eg: COPD

Question 5

How do you perform ELTGOL method & what are the physiologiocal effects?

Answer 5

1. We start w/ assisted SI tehcnique. Then we performe an assisted slow and prolonged expirations with the glottis opened.
2. Airways clearance; 📉 hyperinflation;
   Displace EPP; 📈 FRC (=funcitonal residual capacity)

/!/ Affected lung dow & glottis open

This method use the good lung to lift the bad lung, spring theory

Question 6

How to mobilize the lung secretion?

Answer 6

📈 Expiratory flow to
1. maintain open the small airway
2. mobilize the HYDRATED airway secretion

Question 7

For an EDIC method, in case of desaturation, what should you do?

Answer 7

Turn the patient.

The “bad lung” was up & should go down.

Question 8

For an ELTGOL method, in case of desaturation what should you do?

Answer 8

Put the patient sitted or lying on gis back.

The”bad lung” was down