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NPTE > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

What are the upper airways?

A

nose, mouth, pharynx, larynx

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2
Q

What are the lower airways?

A

trachea, terminal bronchioles (conducting airwyas, transport air, nil gas exchange)

respiratoy unit - resp bronchiles, alveolar ducts, alveolar sacs, alveoli (diffusion of gas)

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3
Q

What are primary and accessory muscles to inspiration?

A

Primary - diaphragm, external intercostals

accessory - scalenes, SCM, levator costarum, serratus, traps, pecs

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4
Q

What are expiratory muscles of ventilation?

A

used in exs or disease states

QL, internal intercostals, abs, triangularis sterni

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5
Q

What is normal HR?

A

60-100bpm

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6
Q

What is normal BP?

A

120-80

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7
Q

What is normal RR?

A

12-20

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8
Q

What is normal PaO2

A

80-100mmHg

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9
Q

What is normal PaCO2?

A

35-45 mmHg

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10
Q

What is normal pH?

A

73.5-7.45

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11
Q

What are crackles indicative of?

A

usually on inspiration

atelectasis, fibrosis, PE

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12
Q

What are wheezes indicative of?

A

during expiration

airway obstruction (asthma, COPD, foreign body aspiration)

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13
Q

What are normal hemoglobin levels?

A

12-16 g/dL

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14
Q

What is respiratory alkolosis and acidosis?

A

alkolosis - increased pH, decreased PaCO2, WNL HCO3; alveolar hyperventilation; dizziness, syncope, tingling, numbness

acidosis - decreased pH, increased PaCO2, NWL HCO3; alveolar hypoventilation; anxiety, restlessness, dyspnea, HA, confusion, coma

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15
Q

What is metabolic alkolosis and acidosis?

A

alkalosis - increased pH, increased HCO3, WNL PaCO2; bicarb ingestion, vomiting, duretics, steroids, adrenal disease; vauge symptoms of weakness, mental dullness

acidosis - decreased pH, decreased HCO3, WNL PaCO2; diabetic, lactic, prolonged diarrhea; secondary ventilation, nausea, lethary, coma

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16
Q

What is normal WBC count

A

4,000-11,000

17
Q

What is normal hematocrit levels?

A

35-48%

18
Q

What is the classification sclae GOLD for obstructive lung disease?

A

1 mild - 80% predicted, with/without chronic symptoms; unaware of lung function

2 moderate - 50-80%, SOB on exertion

3 severe - 30-50%, decreased exs capacity, exacerbations, heaps of SOB

4 very severe -

19
Q

What are the Graded Exs Test termination criteria?

A 
maximal SOB
cardiac ischemia
symptoms of fatigue
incrase of diastolic pressure of 20, systolic hypertension >250, decrease in blood pressure with increasing workloads
leg pain
total fatigue
signs of insufficient CO
reaching ventilatory max
20
Q

What are the types of pneumonia?

A

bacterial - intra-alveolar bacterial infection. gram positive (community) and gram negative

viral - interstitial or intra-alveolar inflammatory process caused by viral agents

aspiration pneumonia

21
Q

What are physical findings of COPD?

A 
cough sputum
dyspnea on exertion
decreased breath sounds
increased RR
wt loss/ anorexia
increased AP diameter of chest wall
cyanosis
clubbing
postures to elevate shoulder girdle
CXR showing hyperinflamtion, flattened diaphragm, hyperlucency
hypoxemia, hypercapnea
increased FRC and RV
decreased FEV1, FVC
22
Q

What is asthma?

A

obstructive disease
reversible in nature
reactivity of trachea and bronch to various stimuli (allergens, exs, cold)
widespread narrowing of ariways due to inflammation
smooth muscle constriction, increased secretions

23
Q

What are physical findings of asthma?

A 
wheezing, crackels, decreased breath dounds
increased secretion
dyspnea
increased accessory muscle use
anxiety
tachycardia
hypoxemia
hypocapnea, then hypercapnea
cyanosis
impaired flow rates
CXR hyperlucency and flattened diaphragm
24
Q

What is cystic fibrosis?

A

geneticlaly inherited disease characterised by thickening of secretions of all exocrine glands

25
Q

What is bronchiectasis?

A

chronic congenital or acquired disease characterised by abnormal dilation of bronchi and excessive sputum production

26
Q

What is resp distress syndrome/ RDS?

A

alveolar collapse in premature infant

*PT consideration: increased breathing effort casued by handling premature infant must be carefully weighed against possible benefits of PT

27
Q

What is bronchopulmonary dysplasia?

A

obstructive pulmonary disease, often a sequela of premature infants with resp distress syndrome

Results from high pressures of mechanical vent, high fractions of inspired O2 and/or infection

28
Q

What types of restrictive pulmonary diseases are there?

A

due to alterations in lung parenchyma and pleura - fibrotic changes

due to alterations in chest wall - restricted bony throax; ankylosing spond, scoliosis, arthritis, pectus excavatum, arthrogryposis, skin changes due to burns or scleroderma

due to neuromuscular apparatus - decreased muscle strength results in inability to expand ribs; MS, MD, PD, SCI, CVA

29
Q

What postural drainage position do you use for upper lobes (apical segment)?

A

Pt sitting, leaning back 30degrees

PT clpas of apices

30
Q

What postural drainage position do you use for upper lobes posterior seg?

A

leans forward over pillo 30 degrees

PT claps over upper back

31
Q

What postural drainage position do you use for upper lobes anterior?

A

supine pillow under knees, PT claps between clavicle and nipple

32
Q

What postural drainage position do you use for right middle lobe?

A

foot of table elevated 16in
patient head down on left side rotates 1/4 bakcward, knees flexed
PT claps over right nipple area

33
Q

What postural drainage position do you use for left upper lobe lingular seg?

A

foot of table elevated 16 in
patients head down on right side and rotates 1/4 turn bakcward
PT claps over left nipple area

34
Q

What postural drainage position do you use for lower lobe ant basal seg?

A

foot of table elevated 20 in
lie on side, head down, pillow under knees
PT claps over lower ribs

35
Q

What postural drainage position do you use for lower lobes lateral basal seg?

A

foot of table elevated 20 in
lie on abdo, head down, then rotate 1/4 turn upward
PT claps over uppermost portion of lower ribs

36
Q

What postural drainage position do you use for for lower lobes posterior basal seg?

A

foot of table elevated 20 in
prone, head down, pillow under hips
PT clasp over lower ribs close to spine on each side

37
Q

What postural drainage position do you use for lower lobes superior seg?

A

table flat
prone, two pillows under hips
PT claps over middle back at tip of scap on either side of spine

NPTE (13 decks)

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