Chronic Bronchitis Flashcards
Muscles of Inspiration to consider when treating
Diaphragm
external intercostals
scalenes (ant/post/middle)
Muscles of FORCED inspiration to consider:
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
how many breaths upon activity to adults take on average
50 breaths per minute
What muscles need to relax for expiration to occur properly
diaphragm
external intercostals and scalenes
what muscles are involved in FORCED expiration
internal intercostals (also innermost) rectus abdominis Internal and external obliques Quadratus lumborum
diaphragm origin insertion
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
SCM O/I nerve action
sternal head : anterior manubrium
clavicular head: medial 1/3 clavicle
Inserts:
mastoid process and lateral 1/3 superior nuchal line
CIs treating chronic bronchitis
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
what muscles will feel tender and or hypertonic
diaphragm scm scalenes intercostals pec minor pec major abdominals
what special tests wold you perform
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
The left lung is divided into ___ lobes while the right is divided into ____.
2
3
The fissure dividing the upper left and lower left lobes run from ____ anteriorly and ____ posteriorly
5th rib
T3
Fissure between the upper and middle lobe of the ___ lung runs from _____ anteriorly to _____ posteriorly
Right
third rib
T3
The fissure between the middle and lower lobes of the ___ lung run from ____ anteriorly and ____ posteriorly
right
6th rib
5th rib at the level of lateral border of scapula
With the diaphragm relaxed the left dome sits at the level of _____ while the right dome sits at about the level of ______
rib 5
intercostal space between ribs 4/5
trigger points in pec major refer to ______
chest
shoulder
medial arm
TP’s serratus anterior refer ___ and result in
to lateral ribs
breathlessness or reduced tidal volume due to restricted thoracic expansion
What are the various positions depending on lobe drainage
how long are these positions kept
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
what lobes are most commonly affected in bedridden clients
upper lobes
Self care for chronic bronchitis clients
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
