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Physiotherapy > pulmonary > Flashcards

pulmonary Flashcards

1
Q

lobes

A

right- upper/superir, middle, lower/inferior (3 lobes)
left- upper and lower lobes (2 lobes)

equivalent to the right middle lobe on the left side is called the lingula.

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2
Q

pulmonary function tests

A
  • spirometry is a versatile test of pulmonary physiology
  • pulmonary function testing assesses: mechanical properties of the respiratory system (measures expiratory volumes and flow rates)
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3
Q

tidal volume

A

the volume of air inspired and expired during each respiratory cycle when at rest

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4
Q

inspiratory reserve volume

A

the max amount of air that can be inspired above tidal volume

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5
Q

expiratory reserve volume

A

the max amount of air that can be expired after normal tidal volume

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6
Q

residual volume

A

air that remains after max expiration which doesn’t participate in gas exchange

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7
Q

total lung capacity

A

the sum of residual volume, tidal volume, max expiratory reserve volume, max inspiratory reserve volume

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8
Q

restrictive disease

A

any respiratory problem where patient cannot fully expand lungs to take in a normal deep breath (due to chest cage, lung, or nervous system disease)

  • could even be a fractured rib
  • once patient has inhaled, they can exhale no problem.
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9
Q

Restrictive Breathing Pattern: central nervous system

A 
polio
obesity
guillain barre syndrome
flail chest (multiple broken ribs)
diaphragm paralysis
spinal cord disease
pleural effusion and pleural disease
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10
Q

Restrictive Breathing Pattern: lungs

A 
congestive heart failure
advanced lung cancer
pulmonary edema
lung fibrosis
sarcoidosis
pneumonia
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11
Q

Obstructive Disease

A

The characteristic of this group is difficulty getting all the air out. (This is the largest group of pulmonary diseases.)

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12
Q

examples of obstructive disease

A

Asthma, chronic bronchitis, and emphysema

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13
Q

The major distinction between restrictive and obstructive lung disease is…

A

….is between difficulty getting all the air in (restrictive) and getting all the air out (obstructive).

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14
Q

Chronic Obstructive Pulmonary Disease

A

Chronic Obstructive Pulmonary Disease, or COPD, is a term primarily used to describe two diseases that affect the lungs—chronic bronchitis and emphysema. COPD causes progressive damage to the lungs.

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15
Q

chronic bronchitis

A
  • inflammation of the bronchial tube lining (excess production of mucus)
  • irritation causes scarring and thickening of the lining of the bronchial tubes
  • smoking is the most common cause of irritation
  • airway flow may be obstructed
  • repeated exposure to irritants causes chronic bronchitis
  • inflammation is caused by smoke, infections, chemicals, pollution, or stomach acid
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16
Q

symptoms of chronic bronchitis

A
  • wheezing
  • coughing
  • extreme mucus production
  • SOB with exercise especially
  • chest tightness
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17
Q

characteristics of chronic bronchitis

A
  • persistent cough
  • hypoventilation
  • cyanosis
  • edema
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18
Q

characteristics of emphysema

A
  • chronic dyspnea (breathlessness)
  • hyperinflation with barrel chest
  • cyanosis and edema are rare
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19
Q

clubbing of fingers results from…

A

chronic hypoxia to nail beds

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20
Q

cyanosis

A

bluish coloration of the skin due to presence of deoxygenated hemoglobin in blood vessels near the skin surface
-can occur in fingers, under fingernails, and other extremities (peripheral cyanosis) or in the lips and face (central cyanosis)

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21
Q

treatment of COPD

A
  • slow down lung damage
  • manage symptoms (cough. SOB)
  • improve quality of life
  • improve general fitness
  • decrease flareups
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22
Q

pneumonia, what is it?

signs and symptoms?

A
  • infections of 1 or 2 lungs, caused by virus, bacteria, or fungi
  • before antibiotics, 1/3 people with pneumonia would die
  • older adults, chronic illness, or compromised immune system- extra caution
  • signs and symptoms: sharp chest pain on inspiration, coughing with sputum, fever
  • diagnosed by abnormal chest sounds, confirmed with x-ray
  • bacteria caused infection can be diagnosed with sputum test
23
Q

bronchiectasis

A
  • damaged cilia to airways
  • cannot do a proper job of sweeping out mucus, dirt, and germs
  • bronchioles widen and stretch out, creating pockets for things to get trapped
  • many infections occur
  • happens to adults after pneumonia or tuberculosis
24
Q

cystic fibrosis

A
  • common, fatal, genetic disease amongst young Canadians
  • overproduction of mucous in lungs causes chronic respiratory infections
  • overproduction of mucous in pancreas prevents digestive enzymes from reaching stomach and intestines
  • PT to clear secretions, exercise to prevent musculoskeletal dysfunction, and parents taught chest physiotherapy
25
Q

asthma

A
  • caused by constricted bronchial tubes and mucous
  • characterized by SOB and coughing and tight chest
  • chronic inflammatory disease
  • symptoms can vary from person, and vary from episode
26
Q

asthmatic attacks

A
  • asthma attacks are caused by cold air, exercise or exertion, emotional stress, environmental stimulant or allergen
  • asthma attacks in children are viral (common cold)
27
Q

bronchodilators

A
  • increase airflow and decrease resistance
  • most useful in COPD and asthma (obstructive lung diseases)
  • fast acting: acute, immediate needs
  • long acting: controls and prevents
28
Q

chest physiotherapy

A
  • removes sputum from lungs via physical means

- part of it is educating breathing techniques, assisting in cough, and trying to improve ventilation of lungs

29
Q

bronchial hygiene

A

-anything that maintains clear airflow of lungs and enhance function and gas exchange: chest physio (postural drainage, suctioning, percussion, vibration, assisted cough, breathing exercises)

30
Q

segments of the lung

A
  • 19 lobes of the lung
  • 11 different positions for chest physio
  • most collect in lower segments of the lungs
31
Q

adventitious breath sounds: decreased air entry

A

-decreased sound of airflow

32
Q

adventitious breath sounds: crackles and creps

A

-heard on inspiration, sign of excess secretions (pneumonia)

33
Q

adventitious breath sounds: wheezes or rhondi

A

-heard on expiration, sign of airway closing early, whistling sound (asthma and emphysema)

34
Q

assisted cough

A
  • manual assistance to cough in order to clear secretions

- mechanical pressure on epigastric region or thoracic cage with forced exhalation

35
Q

contraindications to assisted cough

A 
1- potential for aspiration
2-pregnancy, abdominal pathology, abd. aortic aneurysm, hiatus hernia
3-bleeding
4-osteoporosis
5-flail chest
6-untreated pneumothorax
36
Q

method for assisted cough

A
  • at the request of patient
  • client is in supine or in sitting
  • talk about hand placement
  • do a demo and talk about procedure
  • timing is crucial (have client nod when inspiration is complete)
  • apply physical pressure when exhaling/coughing
  • if client is on ventilator, apply pressure at the end of inspiratory cycle
37
Q

postural draining/percussions

A
  • used when there is an excess production of mucous
  • mucous could be blocked, bacteria could develop, and infection could occur (toxins could be released into body)
  • goal is to prevent accumulation of secretions and remove accumulation of secretions
38
Q

indications of postural drainage and percussion

A
  • excess sputum production
  • effectiveness in coughing
  • history of pulmonary problems treated successfully
  • decreased breathe sounds/rhonchi, crackles–> suggesting mucous in airways
  • change in vital signs
  • abnormal chest x-ray
  • mucous plugging or infiltrates
  • deterioration in arterial blood gas valves or oxygen saturation
39
Q

contraindications to postural drainage

A

hemorrhage
untreated acute conditions
recent neurosurgery
cardiovascular instability

40
Q

percussions: method

A

clapping over chest wall
10-15 minutes , 2-3 x a day
cupped hand, relaxed wrist, elbow, and shoulder
the more air under the hand, the greater the vibration

41
Q

percussions treatment

A 
cushion area with a towel
client wears loose clothing
sputum cup available
sufficient pillows
explain and demo
watch for dyspnea and pain
examine sputum for change in color and consistency
watch for changes in breathing pattern and rate
42
Q

sputum

A

PT will monitor changes in consistency, colour, and volume

43
Q

goals of breathing exercises (8)

A 
full expansion of lungs
mobility of thorax
clears secretions from lungs
promotes relaxation
retrain muscles of inspiration
improves ventilation
improves gas exchange and oxygenation
decreases the work of breathing
44
Q

pursed lip breathing (6)

A 
improves ventilation
releases trapped air in lungs
keeps airways open longer
prolongs exhalation
relieves SOB
causes general relaxation
45
Q

incentive inspirometer

A

various conditions
increases strength and endurance of muscles
used post-op to prevent pneumonia

46
Q

tracheostomy

A

incision on the anterior aspect of the neck-
direct airway thru an incision in the trachea
stoma is airway or site for a tracheostomy tube to be inserted (which can be attached to ventilator)

47
Q

indications for a tracheostomy

A

blockage (foreign bodies or tumours)
reduces length of airway and improves respiratory functions (bronchitis with emphysema)
respiratory nerve damage (temp/perm)- paralysis of chest muscles, head injury, poliomyelitis

48
Q

suctioning

A

secretions that are detrimental
accessible to catheter
cannot be cleared by other means

49
Q

oxygen therapy

A

short term- acute lung disorder-pneumonia

long term- chronic lung disorder- consistently low O2

50
Q

benefits of oxygen therapy

A

improves sleep and mood
improves mental alertness and stamina
prevents heart failure in severe lung disease

51
Q

SO2

A

oxygen saturation (percent of hemoglobin binding sites in bloodstream occupied by oxygen) 97%-99% is healthy

52
Q

SAO2

A

arterial O2 saturation
below 90% causes hypoxemia (can be caused by anemia)
*hypoxemia due to low SAO2 is indicated by cyanosis

53
Q

Nasal Cannula

A

used at home/hospital to deliver extra O2
1L-6L/min flow range
oxygen % is 24-35%

54
Q

Indications for medical ventilation

A 
acute lung injury
signs of respiratory distress
COPD
neurological disease (GB,, SC injury, ALS)
hypoxemia
congestive heart failure

Physiotherapy (3 decks)

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