Obstructive Lung diseases

Question 1

what is the problem with obstructive lung diseases?

Answer 1

can’t get air out!

Question 2

ppl with obstructive lung diseases have increased what?

Answer 2

ERV and RV

Question 3

COPD

Answer 3

bronchitis or emphysema, asthma, CF

Question 4

symps of COPDs

Answer 4

dyspnea
fatigue
cough
wheeze
inc. in expectory mucus
decreased lumen
inc. spasms
dec. alveolar ventillation
dec. elastic recoil

Question 5

secondary complications of COPD

hypoxemia

Answer 5

hypoxemia= pulmonary artery hypertension

Question 6

secondary complications of COPD

polycythemia

Answer 6

inc in RBC = inc. in blood viscosity beyond healthy level

Question 7

secondary complications of COPD

cor pulmonale

Answer 7

R sided heart failure, back up of lungs causes R sided heart to become distended or hypertrophied

Question 8

treatment techniques to help with COPD

Answer 8

pursed lip breathing, postural drainage

Question 9

meds to treat COPD

Answer 9

bronchodilators, B2 agonists, glucocorticoids, prednisone, anticholinergics

Question 10

ppl with chronic bronchitis are called what? what do they present with?

Answer 10

blue bloaters and barrel chested, hyperinflated lungs (black on Xray)

Question 11

diagnosing chronic bronchitis? What is it exactly?

Answer 11

cough up 1 tsp. of mucus most days x 3 months/year x 2 years!
Chronic bronchitis is a hypersecretion of mucus and hypertrophy of submucosal glands in large and small bronchi and trachea. (8:10 gland to wall ratio when norm is 3:10) it denudes the ciliated epithelial cells and leads to contraction of bronchial smooth mm due to swelling of mucosa.

Question 12

what lung sounds do ppl with chronic bronchitis have?

Answer 12

ronchi and wheezing, prolonged exhale

Question 13

what does the FEV1 of a person with chronic bronchitis look like?

Answer 13

< 70-75%

Question 14

what does the FEV1/FVC ratio look like for a person with COPD vs. with restrictive lung disease

Answer 14

COPD= FEV1/FVC (small # on top, big # on bottom) = ratio looks ok even though total volume is diminished

Question 15

ppl with emphysema are called what?

Answer 15

pink puffers, destruction of pulmonary capillaries

Question 16

what is the problem with empysema?

Answer 16

air is trapped in the alveoli (or anywhere after the terminal bronchial duct). this causes altered lung function, collapse of airways with exhalation and chronic airflow obstruction may lead to fibrosis in lungs.

Question 17

environmental causes of chronic bronchitis

Answer 17

pollutants
smoke
coal/gold/asbestus
all these things cause irritation and increased mucus production until u can’t turn it off and its just chronic.

Question 18

how long is a normal expiratory phase?

Answer 18

4 seconds

Question 19

what values are increased with emphysema?

Answer 19

inc. TLC, FRC, RV

dec. ventilation and perfusion

Question 20

asthma

Answer 20

inflammatory disease triggered by hypersensitivity to intrinsic and extrinsic stimuli such as allergens, genetics, obesity, etc. Causes thickening of the airways resulting in SOB, wheezing, coughing.

Question 21

what are the values for asthma?

Answer 21

inc. RV, inc. CO2, dec. O2
dec. FEV1 and peak flow
inc. FRC (ERV+RV)

Question 22

what is exercise induced bronchospasm (EIB)?

Answer 22

increased airflow during exercise causes drying and cooling of airway and causes chest tightness and airway obstruction due to bronchospasm…

Question 23

how do u avoid EIB?

Answer 23

good warm up and humidity in the air if u can

Question 24

spirometry values?

Answer 24

at least 2 efforts within 150 mL of each other
exhalation > 6 seconds
volume plateus

Question 25

grades of spirometry values

Answer 25

must be greater than 70% of predicted norm
60-69= mild
40-59= moderate
>40= severe

Question 26

Exercise induced Asthma test protocol:

Answer 26

goal is to have pt reach 80-90% of their age predicted MHR [or VE= 40-60% MVV (35x FEV1) ] within 2-4 mins and stay there for an additional 4-6 min. Then you take spirometry at 2 mins, 5 min, 10 min, 15 mins, and 30 mins or if FEV1 falls by > 10% in 10 mins u can stop.

Question 27

Cystic Fibrosis affects what chromosome?

Answer 27

7

Question 28

what is the abnormal protein of CF?

Answer 28

CFTR

Question 29

what causes the problems with CF?

Answer 29

because of the CFTR protein malfunction, more Na and water is absorbed instead of being left to thin out the mucus, therefore the airway is dry with thick, sticky secretions that compress the cilia and allows collection of bacteria in the airways leading to recurrent lung infections. The mucus is very hard to clear.

Question 30

what lung sounds does a person with COPD have?

Answer 30

coarse rales, rhonchi, wheezing

Question 31

what organs does CF affect?

Answer 31

any organ with epithelial surfaces:
pancreas
GI tract

Question 32

secondary complications from CF

Answer 32

diabetes (if pancreas involved)
malabsorption and fecal infections (GI involved)
cor pulmonale
frequent lung infections that are hard to treat
digital clubbing

Question 33

sweat test for CF

Answer 33

norm= 60

Question 34

what is the FEV1 for end stage CF

Answer 34

< 30%

Question 35

values for CF

Answer 35

inc. CO2, dec. O2, inc. RV, decreased FEV1

Question 36

PT for CF

Answer 36

postural drainage!
exercise and strength training
endurance training and techniques
breathing techniques- forced expiration and pos. exp. pressure!