Common Pulmonary Dysfunction

Question 1

Indicators of pulmonary dysfunction

Answer 1

• history of cigarette smoking
• musculoskeletal pain that increases with respiratory movement
• shortness of breath with rest or exertion
• cough
• oxygen saturation below 90%
• can not elicit palpation tenderness
• pain does not change with positional change or increases in supine
• ROM does not reproduce symptoms

Question 2

Define empyema

Answer 2

• pus between the two spaces

Question 3

Describe disorders of pleura

Answer 3

• inflammation of pleura can be dry, pleural effusion, empyema
• pain: sensory fibers of parietal pleura; acute = sharp & malignant tumor = dull
• friction rub on auscultation

Question 4

Risk factors of a pleura disorder

Answer 4

• pneumonia
• TB
• long abscess
• Flu
• Lupus
• RA
• pulmonary infarction

Question 5

Define pneumonia

Answer 5

• inflammation of parenchyma
  of the lungs; lobar or bronchial

Question 6

Risk factors for pneumonia

Answer 6

• bacterial, viral, or mycoplasmal (parasite) infection
• inhalation of chemicals
• aspiration (water going into the lungs)

Question 7

Describe chronic obstructive pulmonary disease (COPD)

Answer 7

• disorders that effect movement of air in and out of the lungs: chronic bronchitis, emphysema, asthma

Question 8

Describe the BODE index

Answer 8

Body mass (BMI)
Obstruction of airflow (FEV1 score)
Dyspnea (difficulty breathing)
Exercise capacity (6 minute walk test distance)
- the lower the score the higher the 4 year survival rate

Question 9

Treatment for COPD

Answer 9

• medication
• oxygen
• pacing & energy conservation
• exercise with focus on ADLs
• postural correction
• pursed lip breathing (inhale 4 sec exhale 6 sec)

Question 10

Describe chronic obstructive bronchitis

Answer 10

• inflammation of the bronchial lining which obstructs airflow & creates mucus
• productive cough lasting greater than 3 months for 2 consecutive years
• shortness of breath
• prolonged expiration
• recurrent infection

Question 11

Describe emphysema

Answer 11

• pathologic accumulation of air in tissues
• centrilobular: inflammation of bronchioles
• panlobular: inflammation of entire alveoli; mainly lower lung
• increased ventilatory dead space due to partial airway collapse
• increased work of breathing & dyspnea

Question 12

Describe asthma

Answer 12

• extrinsic = allergic
• intrinsic = non allergic
• attacks precipitated by: exercise, psychological stress, chemical irritants, air pollution, bronchial infection, aspirin

Question 13

Pathogenesis of asthma

Answer 13

• inflammation of airways
• bronchial smooth muscle spasm
• vascular congestion
• thick muscus

Question 14

Describe pneumothorax

Answer 14

• free air in pleural cavity (collapsed lung)
• risk factors: surgery or invasive procedure of chest
• symptoms: dyspnea, lung collapse, pain upper, lateral chest wall & ipsilateral shoulder, decreased BP, rapid pulse

Question 15

Describe restrictive lung disease

Answer 15

• any condition that limits lung expansion
• rapid, shallow breathing pattern
• Progression: pulmonary hypertension = long term high blood pressure in the arteries of the lung & right ventricle of the heart can lead to Cor Pulmonale, decreased oxygenation, or ventilatory failure

Question 16

Describe pulmonary fibrosis/Interstitial lung disease

Answer 16

• chronic inflammation leads to scarring resulting in shortness of breath & dry cough
• survival is <4 years

Question 17

Describe lung cancer

Answer 17

• malignancy of the epithelial lining of the respiratory tract
• constitutional symptoms
• pain with inspiration
• cough
• dyspnea
• early metastasis results in low survival rate
• 5 year survival rate is 14%

Question 18

Describe pancoast tumor

Answer 18

• malignancy in the epithelium of respiratory tract
• risk factors: smoking, occupational exposure, age, & family history
• symptoms include: Horner’s syndrome (tumor growth on the 8th cervical nerve of brachial plexus), cough, dyspnea, chest pain, & constitutional symptoms

Question 19

Describe pulmonary embolism

Answer 19

• partial or complete obstruction of the pulmonary arterial blood flow
• risk factors: blood stasis, local trauma, & hyper coagulable states (CA)
• symptoms include: shortness of breath, chest pain with infarct, edema, wells prediction rule for DVT, revised Geneva score for PE