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NPTE Pulmonary PT > Physical Dysfunction/Impairments > Flashcards

Physical Dysfunction/Impairments Flashcards

1
Q

Acute disease - Bacterial pneumonia

A

an intra alveolar bacterial infection
Gram positive is usually acquired in the community
Gram negative is usually developed in a host with underlying chronic conditions

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2
Q

Acute disease - Bacterial pneumonia - most common gram positive is what

A

Pneumococcal pneumonia (strepococcal)

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3
Q

Acute disease - Bacterial pneumonia - gram negative infections usually result in

A

early tissue necrosis and abscess formation

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4
Q

Acute disease - Bacterial pneumonia - physical findings

A

fever, chest pain, cough can be productive of purulent blood streaked or rusty sputum
Dec bronchial breath sounds and/or crackles
Tachypnea, inc WBC
Hypoxemia, Hypocapnea initially

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5
Q

Acute disease - Viral pneumonia

A

an interstitial or intra-alveolar iflammatory process caused by viral agents (flu, adenovirus..)

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6
Q

Acute disease- viral pneumonia - physical findings

A

Recent URI
Fever, dry cough, HA, dec breath sounds and/or crackles
Hypoxemia and hypercapnea
Normal WBC count

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7
Q

Acute disease - aspiration pneumonia

A

aspirated material causes an acute inflammatory reaction within the lungs - usually in those with impaired swallowing, fixed neck extension, intoxication, impaired consciousness, neuromuscular disease, recent anesthesia

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8
Q

Acute disease - aspiration pneumonia - physical findings

A

cough can be dry at first and then produce putrid secretions
Dyspnea, Tachypnea, Cyanosis, Tachycardia, Wheezes and crackles with dec breath sounds
Hypoxemia, hypercapnea, chest pain, fever

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9
Q

Acute disease - TB

what is it, incubation, how long does primary dx last

A

spread by aerosolized droplets from an untreated infected host
incubation period 2-10 weejs
primary disease lasts 10 days to 2 weeks

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10
Q

Acute disease - TB medication taken fo rhow long

A

3 to 12 months

Gloves and special mask and pt in isolation during infectious stage

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11
Q

Acute disease - TB - physical findings of primary disease

A

go undiagnosed often because are mild

slight nonproductive cough, fever (low)

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12
Q

Acute disease - TB - physical findings of postprimary infection

A

Fever, weight loss, cough, hilar adenopathy, night sweats, crackles, blood streaked sputum, increased lymphocytes

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13
Q

Acute disease - Pneumocystis pneumonia

A

Pulmonary infection caused by a fungus in immunocompromised hosts
most often found after transplant, neonates, or those with HIV

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14
Q

Acute disease - Pneumocystis pneumonia - physical fingins

A

Insidious progressive SOB
nonproductive cough
crackles
weakness, fever

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15
Q

Acute disease - Severe acute respiratory syndrome (SARS)

A

an atypical respiratory illness caused by a coronovirus

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16
Q

Acute disease - Severe acute respiratory syndrome (SARS) - physical findings

A

High temp, dry cough, dec WBC, dec platelets, dec lymphocytes
increased liver function tests

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17
Q

Chronic obstructive diseases - COPD

A

characterized by airflow limitation that is not fully reversible
Airflow limitation is usually progressive and associated with an abnormal inflammatory response of lungs to noxious particles or gases

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18
Q

Chronic obstructive diseases - COPD stages - Stage 1

A

Mild
FEV1/FVC = less than 70%
FEV1 = over than 80% predicted
With or without chronic symptoms

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19
Q

Chronic obstructive diseases - COPD stages - Stage 2

A

Moderate
FEV1/FVC = less than 70%
FEV1 = greater than 50% but less than 80% predicted
Often with s/s of SOB with exertion

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20
Q

Chronic obstructive diseases - COPD stages - Stage 3

A

Severe
FEV1/FVC = less than 70%
FEV1 = greater than 30% but less than 50% predicted
Greater SOB, dec exercise capacity, exacerbation of disease

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21
Q

Chronic obstructive diseases - COPD stages - Stage 4

A 
Very Severe
FEV1/FVC = less than 70%
FEV1 = less than 30% predicted
FEV1 = less than 50% with chronic resp failure s/s
Impaired QOL
Exacerbations can be life threatening
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22
Q

Chronic obstructive diseases - COPD - physical findings

A 
Cough sputum production can see blood
Dyspnea with exertion
Breath sounds dec, maybe adventitious
Inc RR
Weight loss
Inc AP diameter of chest wall 
Cyanosis, clubbing, elevated shoulder girdle 
Hypoxemia, hypercapnea
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23
Q

Chronic obstructive diseases - asthma

A

Inc reactivity of the trachea and bronchi to various stimuli
Reversible in nature
Manifests by widespread narrowing of airways due to inflammation, smooth mm constriction, and inc secretions

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24
Q

Chronic obstructive diseases - asthma - physical findings

A

Wheezing, maybe crackles or dec sounds
Inc secretions
Dyspnea, inc acc mm use, anxiety, tachycardia, tachypnea, hypoxemia and hypercapnea
Cyanosis

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25
Q

Chronic obstructive diseases - Cystic fibrosis

A

A genetically inherited disease characterized by thickening of secretion of all exocrine glands leading to obstruction
Can present as an obstructive or restrictive or mixed diseases

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26
Q

Chronic obstructive diseases - CF - physical findings

A

Dyspnea, productive cough, hopoxemia, hypercapnea, cyanosis, clubbing, acc mm use, tachypnea
crackles, wheezes and.or dec sounds

27
Q

Chronic obstructive diseases - bronchiectasis

A

a chronic congenital or acquired disease characterized by abnormal dilation of the bronchi and excessive sputum production

28
Q

Chronic obstructive diseases - bronchiectasis - physical findings

A 
Cough and expectoration of large amounts of mucous 
Frequent secondary infections
Hemoptysis (blood streak sputum)
Crackles, dec breath sounds
Cyanosis, clubbbing, hypoexmia, dyspnea
29
Q

Chronic obstructive diseases - Resp Distress Syndrome (RDS)

A

Alveolar collapse n a premature infant resulting in lung immaturitym inadequate level of pulmonary surfactant

30
Q

Chronic obstructive diseases - RDS physical fidnings

A

Resp distress, crackles, tachypnea, hypoxemia, cyanosis, acc mm use, flaring nares

31
Q

Chronic obstructive diseases - RDS - PT considerations

A

Inc breathing effort caused by handling a premature infant must be weighed against possible benefit of PT

32
Q

Chronic obstructive diseases - Bronchopulmonary Dysplasia

A

An obstructive pulmonary disease often a sequela of premature infants with RDS - results from high pressures of mechanical ventilation, high fractions of inspired oxygen and/ore infection
Lungs will show areas of pulmonary immaturity

33
Q

Chronic obstructive diseases - Bronchopulmonary dysplasia Physical findings

A 
Hypoxemia, hypercapnea
Crackles, wheezes and/or dec sounds
Inc bronchial secretions
Hyperinflation
Frequent lower resp. infections
Delayed growth and development
Cor pulmonale
34
Q

Chronic restrictive diseases - Restrictive disease due to alterations in lung parenchyma and pleura

A

Fibrotic changes within the pulmonary aprenchyma or pleura due to idiopathic pulmonary fibrosis, absetosis, radiation pneumonitis, oxygen toxicity

35
Q

Chronic restrictive diseases - Restrictive disease due to alterations in lung parenchyma and pleura - physical fidnings

A

Dyspnea
Hypoxemia, hypocapnea intiailly
Crackles, clubbing, cyanosis

36
Q

Chronic restrictive diseases - Restrictive disease due to alterations in chest wall

A

Restricted motion of bony thorax with diseases such as ankylosing sponylitis, arthritis, scoliosis, pectus excavatum, arthrogryposis, or integumentary changes of thoracic wall (scleroderma)

37
Q

Chronic restrictive diseases - Restrictive disease due to alterations in chest wall - physical findings

A

Shallow, rapid breathing
Dyspnea
Hypoxemia, hypocapnea early on
Cyanosis, clubbing, reduced cough effectiveness

38
Q

Chronic restrictive diseases - Restrictive disease due to alteratiosn in the neuromuscular apparatus

A

Dec mm strength results in inability to expand rib cage seen in dx like MS, MD, parkinsons, SCI, CVA

39
Q

Chronic restrictive diseases - Restrictive disease due to alteratiosn in the neuromuscular apparatus - physical findings

A 
Dyspnea
Hypoxemia, Hypocapnea initially
Dec breath sounds, crackles
Clubbing, cyanosis
Reduced cough effectiveness
40
Q

Bronchogenic Carcinoma - what is it

A

a tumor that arises from the bronchial mucosa

41
Q

Bronchogenic Carcinoma - Characteristics - Cause

A

usually smoking and occupational exposures

42
Q

Bronchogenic Carcinoma - characteristics - secondary changes due to tumor

A

obstruction or compression of an airway, blood vessel, or nerve

43
Q

Bronchogenic Carcinoma - characteristics - metastasis

A

Local - to pleura, chest wall, mediastinal structures

Common distant metastasis to lymph nodes, liver, bone, brain, adrenals

44
Q

Bronchogenic Carcinoma - physical findings

A 
unexplained weight loss
hemoptysis
dyspnea, weakness, fatigue, wheezing
pneumonia with productive cough
hoarseness with compression of laryngeal nerve 
can get atelectasis
45
Q

Bronchogenic Carcinoma - Management

A

Chemotherapy
Radiation therapy
Surgical resection if possible

46
Q

Bronchogenic Carcinoma - PT considerations

A

Pneumonias that develop behind a completely obstructed bronchus cannot be cleared with PT techniques
Hold tx until palliative therapy reduced tumor size and relieves bronchial obstruction
Be aware of inc fx risk from metastasis, ecchynosis, and fatigue

47
Q

Trauma - rib fracture/flail chest

A

fracture of the ribs usually to blunt trauma

flail chest is two or more fractures in two or more adjacent ribs

48
Q

Trauma - rib fracture/flail chest - physical findings

A

shallow breathing
splinting from pain
crepitation might be felt
Paradoxical movements of a flail section (inspiration flail pulled inward)

49
Q

Trauma - Pleural injury - pneumothorax

A

Air in the pleural space usually through lacerated visceral pleura from a rib fracture of ruptured bullae

50
Q

Trauma - Pleural injury - pneumothorax - physical findings

A

Chest pain, dyspnea, trachea and mediastinal shift AWAY from injured side
absent or dec breath sounds
Inc tympany with percussion
Cyanosis, resp distress

51
Q

Trauma - Pleural injury - hemothorax

A

blood in the pleural space usually from a laceration of the parietal pleura

52
Q

Trauma - Pleural injury - hemothorax - physical findings

A

Chest pain, dyspnea, tracheal and mediastinal shift AWAY from the side of injury
Absent or dec breath sounds, cyanosis, resp distres

53
Q

Trauma - Pleural injury - lung contusion

A

Blood and edema within the alveoli and intersitial space due to blunt chest trauma with or without rib fractures

54
Q

Trauma - Pleural injury - lung contusion - physical findings

A

Cough with hemoptysis
Dyspnea, dec breath sounds or crackles
Cyanosis

55
Q

Pulmonary edema

A

excessive seepage of fluid from the pulmonary vascular system into the interstitial space
May eventually cause alveolar edema

56
Q

Pulmonary edema - Cardiogenic

A

Resutls from inc pressure in pulmonary capillaries associated with LV failure, aortic valvular disease, or mitral valve disease

57
Q

Pulmonary edema - Noncardiogenic

A

Results from increased permeability of the alveolar capillary membranes due to inhalation of toxic fumes, jypervolemia, narcotic overdose, or ARDS

58
Q

Pulmonary edema - physical findings

A 
Crackles
Tachypnea, Dyspnea
Hypoxemia
Peripheral edema fro cardiogenic 
Cough with pink frothy sputum
59
Q

Pulmonary emboli

A

A thrombus from the peripheral venous circulation becomes embolic and lodges in the pulmonary circulation

60
Q

PE - physical findings

A

Hx consitent with PE
Sudden onset of dyspnea
Tachycardia, hypoxemia, cyanosis
V/Q - V is normal, but Q is not

61
Q

Pleural effusion

A

Excessive fluid between the visceral and parietal pleura - caused mainly by an increased permeability to proteins from inflammatory diseases, neoplastic disease, inc hydrostatic pressure, dec osmotic pressure, peritoneal fluid in plerual space, tumor

62
Q

Pleural effusion - physical findings

A

Dec breath sounds over effusion site
Mediastinal shift AWAY from large effusion
Breathlessness with large

63
Q

Atelectasis

A

Collapsed or airless alveolar unit caused bby hypoventilation secondary to pain during the ventilatory cycle, internal bronchial obstructions, external bronchial compression, low tidal volumes, or neurologic insult

64
Q

Atelectasis - physical findings

A

Dec breath sounds
Dyspnea
Tachycardia
Inc temp

NPTE Pulmonary PT (5 decks)

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