Pulm Intro And Obstructive Flashcards
Describe each structure: parenchyma, pleura, hilum, alveoli,
Parenchyma: spongy, cone-shaped and holds alveoli for gas exchange
Pleura: 2 serous membranes (visceral covers outside of lung, parietal covers inner chest wall)
Hilum: entrance for n/vessels/bronchi
Alveoli: spongy, where gas exchange occurs
What are pneumocytes? Describe each type of
Epithelial cell
Type I: most abundant
Type II: cover minimal area and secretes surfactant to decrease surface tension and prevent collapse during exp
What does the conducting zone consist of? Respiratory zone?
Conducting: nose and bronchioles
Respiratory: alveoli
Describe the R and L main bronchus
R: shorter and downward, R upper and middle lobe bronchus
L: greater angle, upper and lower bronchus
Clinical presentation of COPD (6)
-dyspnea w/ activity
-chronic cough
-barrel chest
-wheezing
-decreased or absent breath sounds
-retain CO2
Grade 1 GOLD staging classification
-Grade 1: greater than or equal to 80% predicted FEV1
-MILD: symps mild and pt has SOB
Grade 2 GOLD staging classification
-Grade 2: 79-50% predicted FEV1
- MOD: may seek help for SOB
Grade 3 GOLD staging classification
-Grade 3: 30-49% predicted FEV1
-SEVERE: flare ups frequent
Grade 4 GOLD staging classification
-Grade 4: <30% predicted FEV1
-VERY SEVERE: lung fxn decreasing
General COPD medical management (6)
-quit smoking
-meds
-tx sleep disorders
-vaccines
-pulm rehab and exercises
-surgery
Emphysema - what is it, cause, clinical signs (5)
“pink puffer”
destruction of alveolar walls, increases airspace
cause: smoking and environment
signs: accessory mus breathing, pursed lip breathing, minimal/no cough, lean fwd breathing, dyspnea on exertion
Chronic bronchitis - what is it, cause, clinical signs (6)
“blue bloater”
cause: secretions block bronchioles, hypertrophy of submucosal glands
signs: gurgly/crackly breath sounds, excess body fluids, cyanosis, chronic cough, SOB on exertion, increased sputum
Asthma what is it, risk factors
chronic airway inflam
risk factors: environment, genetics, sex, infections, allergens, obesity**
Asthma clinical present
-alt breathing pattern
-wheezing w/ relaxed breathing or forced exhal
-decrease breath sounds during exacerbation
-dyspnea on exertion
-pursed lip breathing
-leaning fwd posture
Asthma symptoms (5)
-SOB
-tight chest
-wheezing
-fatigue during exercise
-cough (worse at night and early morn)
How to dx asthma?
spirometry - decreased FEV1 and increased RV and FRC
Asthma severity descriptions (4)
-intermittent: norm spirometry when NOT having attack, exacerbations <2x/wk and month, no activity interference
-mild persistent: symps >2x/wk and 3-4/m, norm spirometry NOT having attacks, attacks interfere w/ act
-mod persistent: daily symps and meds, frequeny night symps, interferes act, >60% but <80% spirometry
-severe: continuous symps daily, act very limited, abnorm spirometry <60%
Asthma medical management - PT exam, education, prevention
-exam: episodes of coughing, tight chest, wheezing, night symps, ADLS affected, flare up pattern
-edu: lifestyle mods, decrease environmental irritants, household mods, exercise induced asthma (warm up, nose/mouth covering outside, hydrate)
COPD implications for PT (7)
-secretion clearance
-controlled breathing
-rolling walker amb
-endurance ex
-strength
-thoracic stx
-postural re-ed
Asthma implications for PT (6)
-begin when med regimen stable
-secretion clearance
-controlled breathing
-ex and strength (aerobic improves asthma control but not inflam)
-thoracic stx
-postural re-ed
Cystic fibrosis - what is it, symp (8)
genetic condition where protein affects mucus and sweat production - affects multiple systems
-persistent cough (green sputum)
-recurrent lung infections
-malabsorption of nutrients in GI
-decreased fat-soluble vitamins
-pancreatic insufficiency
-muscle pain
-decreased bone density -> osteop.
-diabetes
Medical management (goal from NIHCE, prognosis, prevention, PT goals)
-goal: control lung infection, mucus clear, increase nutritional status, pancreatic status
-prognosis: increase in age of survival
-prevent: genetic counseling, screening for carrier
-PT goals: prevent secondary complications, increase QOL, maintain lung rxn
Cystic fibrosis clinical presentation (8)
-GI and pancreas dysfxn
-chronic cough
-frequent pulmonary infections
-crackles and wheezes
-cyanosis
-digital clubbing
-pursed-lip breathing
-accessory mus hypertrophy
PT tx for cystic fibrosis (7)
-secretion clearance
-controlled breathing
-ex and strength
-Inspiratory mus training
-thoracic stxing
-postural re-ed
-pt edu and home mgmt
Obstructive disease: anatomy affected, breathing phase difficulty, pathophysio, useful measurements
-airways
-expiration
-increased airway resistance
-flow rates
Restrictive disease: anatomy affected, breathing phase difficulty, pathophysio, useful measurements
-lung parenchyma, thoracic pump
-inspiration
-decreased lung or thoracic compliance
-volumes or capacities
