Chronic Bronchitis Flashcards

1
Q

Muscles of Inspiration to consider when treating

A

Diaphragm
external intercostals
scalenes (ant/post/middle)

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2
Q

Muscles of FORCED inspiration to consider:

A

SCM(only when head/nk straight)
Subclavius (if clavicle fixed lifts 1st rib)
Levator costorum
Serratus Posterior superior
Lats(raise ribs 10-12)
Pec major raise the sternun and 2nd-6th rib)
Pec minor raise 3rd-5th rib

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3
Q

how many breaths upon activity to adults take on average

A

50 breaths per minute

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4
Q

What muscles need to relax for expiration to occur properly

A

diaphragm

external intercostals and scalenes

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5
Q

what muscles are involved in FORCED expiration

A
internal intercostals (also innermost)
rectus abdominis
Internal and external obliques
Quadratus lumborum
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6
Q

diaphragm origin insertion

A
ORIGINATES: 
xiphoid process 
ribs 6-12 and their costal cartilage 
inner surface of L1-3
INSERTS:
central tendon at the level of the xiphisternal joint 

increases the volume of thoracic cavity primary muscle of inspiration

Phrenic nerve C3-5

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7
Q

SCM O/I nerve action

A

sternal head : anterior manubrium
clavicular head: medial 1/3 clavicle

Inserts:
mastoid process and lateral 1/3 superior nuchal line

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8
Q

CIs treating chronic bronchitis

A

using postural drainage directly after theyve eaten

exhausting client with overtreatment or prolonged application of painful treatment

tapotement over bony prominences

thyme essential oil with pregnant clients or those with hypertension

prolonged tapotment with unstable angina, chest wall pain, hemoptysis, pulmonary embolism, prolonged steroid therapy (inhalers),

INCREASED water intake in clients with cardiac or renal disorders

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9
Q

what muscles will feel tender and or hypertonic

A
diaphragm 
scm
scalenes
intercostals 
pec minor
pec major
abdominals
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10
Q

what special tests wold you perform

A

vocal fremitus 1085
mediate percussion 1085

measurement of full inhalation and exhalation at axilla and xiphoid process (3-.75 cm different normal) exhalation subtracted from inhalation

rib motion/palpation tests

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11
Q

The left lung is divided into ___ lobes while the right is divided into ____.

A

2

3

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12
Q

The fissure dividing the upper left and lower left lobes run from ____ anteriorly and ____ posteriorly

A

5th rib

T3

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13
Q

Fissure between the upper and middle lobe of the ___ lung runs from _____ anteriorly to _____ posteriorly

A

Right
third rib
T3

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14
Q

The fissure between the middle and lower lobes of the ___ lung run from ____ anteriorly and ____ posteriorly

A

right
6th rib
5th rib at the level of lateral border of scapula

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15
Q

With the diaphragm relaxed the left dome sits at the level of _____ while the right dome sits at about the level of ______

A

rib 5

intercostal space between ribs 4/5

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16
Q

trigger points in pec major refer to ______

A

chest
shoulder
medial arm

17
Q

TP’s serratus anterior refer ___ and result in

A

to lateral ribs

breathlessness or reduced tidal volume due to restricted thoracic expansion

18
Q

What are the various positions depending on lobe drainage

how long are these positions kept

A

upper lobes: seated with
middle right lobe: lies one quarter supine with pillow under right hip/back
Lower lobes: prone hips elevated above head angle of 30-45 degrees for thorax

3-5 min or longer

19
Q

what lobes are most commonly affected in bedridden clients

A

upper lobes

20
Q

Self care for chronic bronchitis clients

A

pursed lip breathing:
hands stay on abdomninals to monitor how relaxed they stay inhalation is slow then client purses lips and exhales, must be relaxed no abdominal contraction during exhalation

productive cough:
seated lying forward on arms
diaphragmatic breathing 1st 
both hands on abdomen makes 2-3 coughs
deep breath in contract glottis and rapidly contract abdominals 
release and expel air 
repeat cycle 3-5 times