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Unit 7 > common pulmonary disorders > Flashcards

common pulmonary disorders Flashcards

1
Q

What are four acute pulmonary conditions?

A

atelectasis, pneumonia, pulmonary edema, acute respiratory distress syndrome

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2
Q

What are some causes of atelectasis?

A

Blockage of airway, compression (pneumothorax) post-anesthetic

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3
Q

What are three ways atelectasis may present?

A

poor gas exchange, low SpO2
diminished breath sounds over area of atelectasis
possible fever, opacity on chest film

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4
Q

What are the aims of PT in atelectasis treatment?

A

deep breathing
positioning
mobilization
airway clearance if needed

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5
Q

What is acute inflammation of the lung called?

A

pneumonia

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6
Q

How does pneumonia present?

A 
cough
pleuritic pain
rapid shallow breathing
fever
malaise
tachycardia
diminished breath sounds
transmitted vocalization
opacity on chest film
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7
Q

What PT goals in pneumonia treatment?

A

Improve gas exchange with breathing and positioning
Minimize effects of inactivity
Airway clearance if indicated

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8
Q

Symptoms of a small pulmonary embolism are often unrecognized, but can accumulate and include clogging of the pulmonary capillary bed which leads to pulmonary hypertension. True or False?

A

True

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9
Q

What are the symptoms of a medium-sized pulmonary embolism?

A

pleuritic pain with dyspnea, slight fever, tachycardia

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10
Q

What are symptoms of a massive pulmonary embolism?

A 
sudden hemodynamic collapse w/shock
pallor
chest pain
loss of consciousness
rapid and weak pulse
hypotension
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11
Q

What are two causes of pulmonary edema?

A

increased capillary hydrostatic pressure

increased capillary permeability

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12
Q

What is the major symptom of pulmonary edema?

A

Dyspnea, cough (dry of frothy)

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13
Q

What dyspnea when supine called?

A

orthopnea

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14
Q

What is the rapid onset of dyspnea at night called?

A

paroxysmal nocturnal dyspnea

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15
Q

What is the PT focus in treating pulmonary edema?

A

Combat the effects of inactivity

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16
Q

What can cause acute respiratory distress syndrome?

A

end result of a variety of insults (trauma, aspiration, sepsis, shock)
part of multiple organ failure

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17
Q

What are symptoms of acute respiratory distress syndrome?

A

Severe hemorraghic pulmonary edema
loss of surfactant decrease lung compliance
alveolar collapse

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18
Q

What are the PT implications for acute respiratory distress syndrome?

A

severe hypoxemia

high mortality

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19
Q

What are three types of obstructive disease?

A

Chronic Obstructive Pulmonary Disease (COPD)
Asthma
Cystic Fibrosis

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20
Q

What are causes of obstruction in the airway?

A

Excessive secretions
Thickened airway due to inflammation or hypertrophy
Loss of radial traction which leads to airway collapse

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21
Q

What impact does airway obstruction have on resistance to airflow and what does this mean for pressure in the lungs?

A

Obstruction increases resistance to airflow

So greater pressure gradient needed to drive airflow which increases the work of breathing.

22
Q

What is FEV1?

A

The amount of air that can be exhaled in 1 sec

23
Q

What is the FEV1/FVC ratio indicate?

A

The % of lung size that can be exhaled out in 1 sec

24
Q

What is the clinical presentation of COPD?

A 
Increasing SOB,
Weight loss
Chronic cough
poor exercise tolerance
Chest hyperinflation
decreased breath sounds
Exacerbations=acute change in dyspnea, cough, sputem, usually due to infection
25
Q

What are non-modifiable risk factors for COPD?

A

genetic
increasing age
male
history of infections

26
Q

What is the genetic deficiency that can cause emphysema?

A

alpha-1 antitrypsin deficiency

27
Q

What are modifiable risk factors for COPD?

A

tobacco smoke

exposure to occupational dusts, indoor and outdoor air pollution

28
Q

How is a pack year measured?

A

pack years=# of packs per day *years smoked

29
Q

In emphysema, what are the two causes of the enlargement of air spaces distal to the terminal bronchiole with destruction of their walls?

A

loss of elastin in lung parenchyma

damaged capillary bed

30
Q

What is the result of the enlargement of air spaces distal to the terminal bronchiole w destruction of their walls?

A

Air is trapped in the lungs

Hyperinflation

31
Q

What is chronic bronchitis?

A

Excessive mucus production in the bronchial tree sufficient to cause excessive expectoration of sputem

32
Q

What is the clinical presentation of chronic bronchitis?

A

persistent cough w excessive sputum
fluid retention= course crackles
severe hypoxemia

33
Q

What are the PT goals for treatment of COPD?

A

Breathing and position
Exercise training to maintain functional capacity
Energy conservation techniques
Airway clearance

34
Q

Increased responsiveness of airways leads to episodes of bronchoconstriction and inflammation is called?

A

Asthma

35
Q

What are three physiological processes that occur in cystic fibrosis?

A

diminished ciliary function
excessive secretions, mucus plugging
chronic infections=bronchiectasis/destruction of lung tissue

36
Q

What are three physical presentations of cystic fibrosis?

A

productive cough
decreased exercise tolerance
chronic hypoxemia (finger clubbing)

37
Q

What are the three aspects of PT focus for cystic fibrosis?

A

regular and vigorous airway clearancel
exercise training to improve strength and endurance
posture training to maximize ventilation

38
Q

Which do obstructive diseases affect more: expiration or inspiration?

A

expiration

39
Q

What are the three categories of restrictive disease?

A

diseases of the pleura
diseases of the chest wall
neuromuscular disorders

40
Q

What are two examples of diseases of the pleura?

A

pneumothorax

hemothorax

41
Q

What are three examples of diseases of the chest wall?

A

scoliosis
kyphosis
ankylosing spondylitis

42
Q

What are two causes of pulmonary hypertension?

A

increased left atrial pressure due to mitral stenosis or heart failure
increased pulmonary vascular resistance

43
Q

What is the clinical presentation of acute respiratory failure?

A

Increasing dyspnea, cyanosis, arrhythmia, light-headedness, loss of consciousness

44
Q

What is the clinical presentation of chronic respiratory failure?

A

poor arterial blood gasses
cyanosis
fatigue

45
Q

What is the PT focus for respiratory failure?

A

breathing
positioning
max ventilation

46
Q

What happens in the lungs during emphysema to cause hyperinflation?

A
  1. Decrease of elastic recoil
  2. End stage exhale requires an active contraction
  3. Destruction of airway support leads to airway collapse
  4. Air is trapped in lungs which causes hyperinflation
47
Q

What happens to the mechanical advantage due to hyperinflation and the flattening of the diaphragm?

A

decreases

increases work of breathing

48
Q

Is pulmonary fibrosis restrictive or obstruction?

A

restrictive

49
Q

What is pulmonary fibrosis?

A

Thickening of interstitium and alveolar wall

50
Q

What happens to lung compliance in pulmonary fibrosis?

A

decreases
increase muscular effort required for ventilation
increases work of breathing

51
Q

Why is gas exchange impaired in restrictive disease?

A

ventilation-perfusion mismatched

Unit 7 (12 decks)

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