Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Cardiopulmonary PT > COPD and Restrictive lung disease > Flashcards

COPD and Restrictive lung disease Flashcards

1
Q

What are sections and sub sections of the respiratory system?

A

Trachea, Carina, R & L main stem, lobar bronchi, segmental bronchi, subsegmental bronchi, terminal bronchioles, respiratory bronchioles, alveolar ducts, alveolar sacs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the normal lung units?

A

Alveoli sacs for gas exchange: elastic in nature, exchange CO2 and O2 for ATP production, 300 million clusters in adult lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is COPD?

A

Disease that affects both mechanical function and gas exchange of respiratory system.
Trouble getting air out: long expiratory time (1:4+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is epidemiology-COPD risk factors and physical symptoms?

A

Smoking (>85%), air pollution, family history, occupational dusts

Dyspnea on exertion, fatigue, chronic cough, wheezing &/or rhonchi, expectoration of mucus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is COPD pathophysiology?

A

Loss of normal elastic recoil and bronchial tubes collapse (air trapping promotes hyperinflation)

Changes in PFT: decreased ERV, increased RV

Decreased bronchial lumen

Respiratory muscles must work harder

Changes in CXR and PFTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens when there is decreased bronchial lumen and respiratory muscles must work harder?

A

Lumen: increased mucus production, inflammation of mucosal lining (thickening), spasm (constriction) of bronchial smooth muscle

Muscles: enlarged thorax is already inflated, must overcome resistance to airflow obstruction, alveolar ventilation is decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are COPD signs and symptoms?

A

Hypoxemia: pulmonary artery hypertension
Polycythemia: increased RBC count, viscosity (increases resistance)
Cor pulmonale
Cor pulmonale AND respiratory failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is COPD treatment?

A

Remove the irritant
Inhaled medications: B agonists, anticholinergics, corticosteroids, antibiotics
Exercise training

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is pathophysiology of emphysema?

A

Alveolar/parenchymal disease: enlargement of air spaces distal to terminal bronchioles, loss of elastic fibers, and destruction of alveolar septal walls

Lung function altered: elastic recoil, collapse of airways with exhalation and chronic air flow obstruction

Abnormal PFTs and CXR: hyperinflation with flattened diaphragm on x ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 2 types of emphysema?

A

Centriacinar (centrilobular): affects respiratory bronchioles, worse in upper lobes
Panacinar (panlobular): lower lobes more affected, observed in people with alpha-1-antitrypsin deficiency (protein deficiency)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What parts of the respiratory system are affected in emphysema?

A

Respiratory bronchioles
Alveolar ducts
Alveolar sacs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the clinical features of empysema?

A 
Severe dyspnea
Dry nonproductive cough
"skin and bones"
All energy is used to breath
Absent (very decreased) breath sounds heard during auscultation of chest
Expiratory phase increased
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is pathophysiology of chronic bronchitis?

A

Chronic productive cough for 3 months or year for >2 consecutive years
Proliferation of submucosal glands and goblet cells
Insidious: smokers cough, morning cough, continual cough (recurrent “pneumonia”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do the lungs do in response to irritants?

A

Contraction of bronchial smooth muscle
Denuded cilia
Increased secretions
Swelling of mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are clinical features of CB?

A

Chronic, productive cough: generally clear mucous unless infection
Overweight
Blue-ish color to lips and nails: peripheral edema in LE’s d/t right side heart failure)
Rhonchi and wheezes heard during auscultation
Expiratory phase increased
Abnormal PFT and CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What parts of the respiratory system is involved with CB?

A

Lobar bronchi, segmental bronchi, subsegmental bronchi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is asthma?

A

Inflammatory disease causing SOA and DOE, wheezing, coughing
Bronchospasm and inflammation caused by hypersensitivity to extrinsic and intrinsic stimuli (pollen, grass, cold air, exercise, stress, etc)
Structural changes of airway with vast amount of thickening of airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What happens to lung function with asthma and how do you treat it?

A

Results in air trapping increasing RV, increasing CO2, and decreasing O2.
Reduction of FEV1 and peak flow

Treatment: trigger awareness, inhaled agents (bronchodilators, anti-inflammatories, prophylactic agents)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is EIB?

A

Caused by increased air flow and drying of airways.
Can experience without history of diagnosed asthma
Up to 30% of Olympic athletes have it.
Prevent with proper warm up and pharmacological therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is cor pulmonale?

A

Right ventricular hypertrophy secondary to abnormalities of lung structure and function-
Developing pulmonary disease results in increasing hypoxemia.
Vasoconstriction causes pulmonary hypertension (makes right heart work harder which leads to peripheral edema)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is CF?

A

Inherited chronic disease that affects lungs and digestive system.
Defective gene and its protein product cause body to produce unusually thick, sticky mucus that: clogs lungs and leads to infections, obstructs pancreas and stops natural enzymes from helping body break down and absorb food

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is life span of CF?

A

mid 40s

90% die from pulmonary complications: hypercarbia, hypoxia, cor pulmonale

23
Q

What are symptoms of CF?

A

Persistent coughing, frequent lung infections, wheezing or shortness of breath, very salty tasting skin, poor growth/weight gain, frequent greasy bulky stools or difficulty with bowel movements

24
Q

What is CF pathology?

A

Cystic fibrosis transmembrane conductance regulator (CFTR protein): dysregulation of this protein leads to failure of airways to clear mucus

Lung function progresses from obstruction to addition of a restrictive component

25
Q

What are treatments for CF?

A 
Inhaled meds: bronchodilators, mucolytics, antibiotics
Exercise
Nutrition
Lung transplant
Drug therapies
26
Q

What are the drug therapies for CF?

A

Kalydeco: oral pill taken twice a day for kids >6 with G551D mutation, helps improve lung function, lowers sweat chloride levels, helps patients gain weight, allows cell to produce protein that enables movement of chloride through cell membrane

Orkambi: delta 508 drug, used in kids >12, helps correct misfolded CFTR protein, treats root cause of CF instead of treating symtpoms

27
Q

What are signs and symptoms of COPDers?

A 
SOA, DOE for all
Hypoxia for emphysema
Hypercarbia for CB
Dry cough for emphysema
Productive cough for CB
Fatigue
Weight loss
Anorexia
Cough
Syncope
Peripheral edema
Depression
Anxiety
28
Q

What is our job as PTs to help with COPD?

A

Evaluate exercise endurance, muscle strength, flexibility, and body comp
Assess and reassese exercise prescription
Goals for increasing flex, strength, endurance
Educate energy conservation
Body mechanics to reduce O2 requirement
Breathing techniques such as pursed lip and diaphragmatic (decreases RR, VE)
Observe for dyspnea
Oxygen sat levels
Focus on ADLs

29
Q

In COPD who should get oxygen support?

A

Empysema patients can benefit from low flow oxygen

DO NOT give CB patients oxygen because their drive to breathe is gone completely

30
Q

What are differences between obstructive and restrictive lung diseases?

A

Obstructive: trouble getting air out, pursed lip helps prevent air trapping, decreased flow rates and hypercapnia, radiographically identified by hyperinflation

Restrictive: trouble getting air in, hypoxia, reduced lung volumes with normal flow rates, radiographically identified by diffuse bilateral persistent interstitial densities

31
Q

T/F: with restrictive lung diseases the patient course is typically chronic and diffuse firbrosis is the ultimate pathologic process in most conditions

A

True

32
Q

What is pulmonary fibrosis?

A

Devastating and progressive disease: lung tissue becomes thickened, stiff, and scarred.
Causes range from autoimmune diseases to occupation exposures, or idopathic
Seen in people over age 65
Men account for 70% of patients
Survival is 2-3 years after diagnosis

33
Q

What are the 5 types of pulmonary fibrosis?

A 
Sarcoidosis
lupus
Rheumatoid disease
Scleroderma
IPF
34
Q

What is sarcoidosis?

A

Systemic granulomatous disease of unknown etiology
Most common in blacks, 20-30, F>M
Chest Xray will show: fibrosis, alveolitis, scarring, honeycombing

35
Q

What are signs and symptoms of sarcoidosis? Treatment?

A 
Specific organ dysfunction (cough and dyspnea)
Generalized weakness
Fatigue
Weight loss
Malaise
Fever

Corticosteroids and immunosuppressive drugs

36
Q

What is lupus?

A

Systemic autoimmune disease with varied clinical manifestations.
Most common in women of child bearing age.
Chronic, with remission and exacerbations
70% of cases involve lungs and progress to pulm fib
Treatment: corticosteroids, prevention and treatment of pulmonary S&S

37
Q

What is a rheumatoid restrictive lung disease?

A

Systemic disease with pleuro-pulmonary manifestations.
Unknown cause
F>M, but men have more pulmonary involvement
Treat signs and symptoms

38
Q

What is scleroderma?

A

Primarily involves blood vessels and connective tissues resulting in fibrosis of organs.
F>M
Autoimmune problem so no satisfactory treatment
Progressive, with poor prognosis
Death due to pulmonary involvement

39
Q

What is IPF?

A 
Chronic lung disease of unknown cause
Chronic, slow, progressive dyspnea
Chronic inflammation and fibrosis
Middle age, M>F
Treatment: no known effective treatment, use corticosteroids and immunosuppressive drugs, supportive and treat signs and symptoms
50% live 5 more years at time of dx
40
Q

What are environmental lung disease?

A

pathologic condition of respiratory tract that result directly from inhalation of gas or particulate matter in the air

41
Q

What are the 4 categories of pulmonary pathogens?

A

Infectious agents
Organic dusts
Inorganic dusts: pneumoconiosis
Gases

42
Q

What are the different causes of pneumoconiosis?

A

Disease caused by inhalation of inorganic dust
Silicosis: from silica
Asbestosis: from silicates
CWP: carbon

Diagnosis based on exposure history, duration, intensity
No effective treatment
Treat signs and symptoms

43
Q

What are types of irritant gases and what are consequences if inhaled?

A

gases: ammonia, sulfur dioxide, chlorine, nitrogen dioxide, ozone, phosgene

May cause hyperemia, edema, epithelial injury, mucosal sloughing, coughing, dyspnea, cyanosis

Management is supportive and symptomatic

If significant exposure: pulmonary fibrosis by result

44
Q

What are disease of spine and chest wall?

A 
Kyphosis: posterior curve
Scoliosis: lateral curve
Kyphoscoliosis: post and lat
Lordosis: sway back
Pectus excavatum: funnel
Pectus carinatum: pigeon
45
Q

What are causes of spine and chest wall diseases? What are possible signs and symptoms?

A

Cause: congenital, traumatic, paralytic, infectious agents
F>M
children asymptomatic
adults 4/5th decade: CP embarrassment

Dyspnea, frequent pneumonia, respiratory insufficiency, hypoxia, hypercapnia, cardiac failure risks

46
Q

What are possible diseases of the NM system that cause restrictive lung diseases?

A

Myastenia gravis
ALS
guillan barre
quadraplegia

47
Q

What is MG?

A

Autoimmune disorder of neuromuscular junction
Descending muscular weakness and fatigue
May involve respiratory muscles
F>M
Tx= anticholinesterase drugs and steroids
Watch NIF and VC for changing condition

48
Q

What is GB syndrome?

A

Acute from of inflammatory polyneuritis of unknown cause.
Effects peripheral nerves, ascending paralysis for 1-3 weeks, recovery in 2-4 weeks
Tx= plasmapheresis, immunoglobulin therapy
Watch NIC and VC from changing condition

49
Q

How would quadriplegia affect the lungs?

A 
C3-C5= diaphragm
C5-C6= scalenes
T1-T11= intercostals
T8-T12= abdominals
50
Q

What is pathophys of pneumonia?

A

Acute inflammatory process that effects the gas exchange units of the lung.
In response to inflammation, fluid and RBC pour into alveoli.
PMN’s also move into infected area to engulf and kill bacteria.
Macrophages appear to remove cellular debris

51
Q

What is consolidation?

A

Alveoli become filled with fluid

52
Q

What is onset, presentation, and complications for pneumonia?

A

onset: gradual or abrupt
Manifestations: general malaise, chills, fever, cough, chest pain, dyspnea
Complications: adjacent pleural lining may get involved and lead to pleural effusion

53
Q

What is treatment and prognosis for pneumonia?

A

treatment: brought under control spontaneously or by antimicrobial therapy, resolution of inflammation and healing take place

Prognosis:

With no necrosis: resolution without sequelae is expected.

With destructive changes, fibrous scar tissue develops and there may be measurable loss of lung function

54
Q

What is our role as PT for restrictive lung disease patients?

A

Difficult to exercise.
Endurance may be limited by chronic disease.
Supplemental O2 may improve exercise tolerance: no more than 6 lpm nasal cannula

Cardiopulmonary PT (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions