HW/Worksheets/Lab

Question 1

Right upper lobe drainage

Answer 1

Sitting up, reclined slightly

Question 2

Right middle lobe drainage

Answer 2

elevate foot 30cm/12in
laying on left side

Question 3

Right lower lobe drainage

Answer 3

elevate foot 50cm/20in
laying on left side

Question 4

Left upper lobe, superior drainage

Answer 4

sitting with shoulders rounded, bent slightly over

Question 5

Left upper lobe, inferior drainage

Answer 5

elevate foot 30cm/12 in
laying on right side

Question 6

Left lobe drainage

Answer 6

elevate foot 50 cm/20in
lay on right side

Question 7

Physical Exam of Pulmonary Pt

Answer 7

1. Pt history
2. Physical exam
3. Inspection (especially around fingers, lips, respiratory pattern)

Question 8

Tracheal, Bronchial Sounds

Answer 8

loud, tubular sounds
between scapulae or on trachea

Question 9

Vesicular Sounds

Answer 9

soft, rustling sounds that are heard over more distal airways and lung parenchyma

Question 10

CTA

Answer 10

clear to auscultation

Question 11

Abnormal Breath sounds

Answer 11

heard outside their usual location or if they are quantitatively different from normal breath sounds or absent

Question 12

Bronchial abnormal

Answer 12

fluid or secretion consolidation

Question 13

Decreased or diminshed sounds

Answer 13

hypoventilation, severe congestion, emphysema, obesity

Question 14

Absent sounds

Answer 14

pneumothorax

Question 15

Adventitious sounds

Answer 15

wheeze
rhonchi
stridor

Question 16

Crackles

Answer 16

bubbling or popping sounds that represent the presence of fluid or secretions, or sudden opening of a closed airway

discontinuous sounds

Question 17

Wheeze

Answer 17

airway obstruction from bronchoconstriction or retained secretions
heard on expiration

Question 18

Rhonchi

Answer 18

low pitched or snoring sounds that are continuous
large airway obstruction

Question 19

Stridor

Answer 19

extremely high pitched wheeze that occurs with significant upper airway obstruction, present during both inspiration and expiration
medical emergency!

Question 20

Extrapulmonary

Answer 20

dysfunction outside of the lung tissue
pleural friction rub
loud grating sound
both inspiration and expiration

Question 21

Transmitted voice sounds

Answer 21

Whispered pectoriloquy (1, 2, 3)
bronchophony (99)
egophony (e to a)

Question 22

Sounds from mediate percussion

Answer 22

Resonant = normal
hyerresonant, tympanic, dull, flat

Question 23

Pulmonary Function Tests assess

Answer 23

1. how much air volume can be moved in and out of lungs
2. how fast the air in the lungs can be moved in and out
3. how stiff are the lungs and chest wall
4. diffusion characteristics of the membrane through which gas moves
5. how the lungs respond to chest physical therapy

Question 24

PFTs are used for

Answer 24

Screening for presence of obstructive or restrictive disease
evaluating pt prior to surgery
eval the pts condition for weaning from ventilator
progression of disease
effectiveness of intervention

Question 25

FVC

Answer 25

Forced Vital capacity
volume of air which can be forcibly exhaled out of lungs

Question 26

FEV1

Answer 26

forced expiratory volume in one second
volume of air which can be forcibly exhaled from lungs in one second

Question 27

FEV1/FVC

Answer 27

FEV1 percent, ratio of FEV1 to FVC
only relevant if FEV1 and FVC are abnormal

Question 28

PEFR

Answer 28

peak expiratory flow rate
max flow rate achieved during the forced vital capacity maneuver beginning after full inspiration and starting/ending with max expiration

shows if treatment is improving obstructive diseases

Question 29

FEF

Answer 29

Forced expiratory flow
measure of how much air can be expired from the lungs
flow rate measurement

Question 30

What does pursed lip breathing do?

Answer 30

releases air trapped in lungs
allows new air to enter lungs
slows breathing rate
relieves shortness of breath
causes relaxation

Question 31

Diaphragmatic Breathing

Answer 31

helps you use diaphragm correctly
strengthen the diaphragm
decrease the work of breathing by slowing breathing rate
decrease O2 demand
use less effort and energy to breathe

Question 32

Sleeping and PaO2

Answer 32

70 to 85 mmHg

Assuming the individual is laying on their side, blood flow will follow the path of gravity. Side-lying causes the blood to flow mainly to the lung on the side the individual is lying on. There will be little blood flow to the opposite lung. In this position, one lung is doing most of the perfusion and ventilation, because of the increased blood flow. PaO2 levels drop because you are using essentially one lung in contrast to two when you are sitting upright.

Question 33

During normal breathing, which position allows the diaphragm to have the greatest excursion?

Answer 33

Having an individual in supine allows for the diaphragm to expand as much as possible.

Question 34

During normal breathing, which position allows the largest change in lung volume to occur?

Answer 34

When an individual is sitting, the largest change in lung volume occurs.

Question 35

What are the four main categories of the physical therapy examination of the patient with an
acute exacerbation of COPD

Answer 35

Observing breathing patterns
Strength and endurance testing of respiratory muscles
Auscultation of the lungs
Walk test while observing pulse oximetry levels

Question 36

How does noninvasive positive pressure ventilation (NIPPV) such as BiPAP during exercise
training improve exercise duration and dyspnea?

Answer 36

NIPPV helps to push air into the lungs, or helps with the ventilation portion of breathing. This decreases the amount of work the respiratory muscles have to complete. Because the muscles aren’t working as hard, this decreases oxygen demand for the respiratory muscles, and helps them in turn to work more efficiently.