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PHTH 524 > IMT > Flashcards

IMT Flashcards

1
Q

What are the 3 muscles groups involved in breathing and what do they control

A
  • Muscles of pharynx and larynx control the upper airway
  • Diaphragm, spine, ribcage, and neck muscles contribute to inspiration
  • Muscles of abdominal wall, ribcage and spine contribute to expiration
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2
Q

Diaphragm contributes to __% of inspiration

A

40%

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3
Q

Diaphragm spends __% of the day contracting

A

45%

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4
Q

What are the two regions of the diaphragm

A
  • costal - arising from lower 6 ribs and xiphoid process

- crural arises from upper 3 lumbar vertebrae

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5
Q

What is the most important accessory muscle of inspiration

A

sternocleidomastoid

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6
Q

What are the 4 accessory muscles of inspiratinon

A
  1. SCM
  2. Scalenes
  3. Pec minor
  4. Intercostals
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7
Q

Which intercostal is the primary muscle of inspiration

A

parasternal

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8
Q

What intercostal are accessory for inspiration

A

external intercostals

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9
Q

what intercostals are accessory in expiration

A

internal intercostals

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10
Q

Expiration is ___ at rest

A

passive

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11
Q

during active breathing which muscle group is involved in expiration

A

abdominals increase abdominal pressure

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12
Q

Which abdominals have the greatest contribution to expiration

A

transversus abdominis

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13
Q

What is the results of weak abdominals

A

No firm base for diaphragm contraction -> diaphragm is resting lower, decreased ROM, generation of pressure is not as efficient - leads to outward motion of abdomen rather than inflation of rib cage

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14
Q

What is the result of the denervation of intercostals

A

loss of outward movement of upper chest wall. During diaphragm contraction upper chest is sucked inward, abdomen is pushed outward, less of a volume increase for diaphragm contraction

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15
Q

In what populations is IMT effective

A
  • some athletes
  • COPD
  • Congestive heart failure
  • Spinal cord injury
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16
Q

In people with COPD, CHF, SCI IMT can…

A
  • improve inspiratory muscle strength
  • decrease dyspnea
  • improve exercise tolerance
17
Q

What are the 4 steps to IMT treatment

A
  1. patient selection
  2. chose IMT device
  3. Measure IMT strength and/or endurance
  4. Prescription parameters
18
Q

What are the prescription parameters of IMT

A
  1. frequency
  2. intensity
  3. duration
  4. outcome measures
19
Q

What are the main considerations for patient selection for IMT in people with COPD and CHF

A
  • Stable condition and properly managed; not during or immediately after an exacerbation
  • Weakness of inspiratory muscles
  • Dyspnea that is more than usual
20
Q

What are the main considerations for patient selection for IMT in people with SCI

A
  • Those with higher level of injury but still partially intact diaphragm
21
Q

What are the main considerations for patient selection for IMT in athletes

A

depends on sport and individual

22
Q

What are two contraindication for IMT

A
  • acute respiratory failure

- cognitive impairment

23
Q

What is the most common appropriate device for IMT

A

Threshold type trainers (NOT trainers without target nonono)

24
Q

How do you measure IMT strength/endurance

A
  1. measure maximal inspiratory pressure with electronic force meter
  2. measure inspiratory muscle endurance with threshold device
25
Q

What is the frequency prescription for IMT

A

4-5 times per week

26
Q

What is the intensity prescription for IMT and progression

A

start very low (9 cmH2O) progress intensity slowly not more than 5% per week

27
Q

What is the duration prescription for IMT and progression

A

begin at 5-15 mins per day
add 1-3 minutes every 3rd day
continue until you can sustain two 15 min period or one 30 min period

28
Q

How do you monitor fatigue in a patient

A
  • chest wall movement
  • excessive dyspnea
  • long lasting fatigue after treatment
  • HR
  • SpO2
  • RR
29
Q

IMT should always be combined with…

A

aerobic and resistance training of the extremities

30
Q

What are outcome measures of IMT

A
  • Inspiratory muscle testing
  • Dyspnea (Borg scale)
  • Exercise capacity
  • Quality of life
  • Vitals
  • RPE

PHTH 524 (15 decks)

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