Pulmonary - Asthma Flashcards
What is the global intiative definition for asthma?
As a chronic airway inflammation
hx of respiratory sx like wheezes, SOB, chest tightness and cough that vary over time and in intensity
- toegher with variable expiratory airflow limitations
What are the sx of asthma?
wheezing
SOB
chest tighness
fatigue during exercise
poor athletic performance
avoiding activity
coughing - worse at night and early morning
Since asthma is an inflammatory response, the trigger leads to?
- narrow airways = bronchospasm
- increased secretions
- resistance to airflow and airtrapping on exhalation = hyperinflation
The medium-sized bronchi sustain the most what?
most pronounced physiological effects of the inflammation that’s associated with asthma
Over time, what does chronic inflammation lead to?
Remodeling of the airways
What are the risk factors of asthma?
- genetics
- sex
- environmental factors
- infections
- allergens
- obesity
Environmental - like smoke
allergens - house dust mites, mold
How does obesity increase the risk of asthma?
Due to the likely involvement of the inflammatory process in the lungs, adipose tissue and/or immune system
sx appear to be harder to control and responsiveness to standard pharm therapies are reduced
How is asthma diagnosed?
with spirometry
- because of the provocation with bronchoconstrictor agents and with bronchodilators for comparison
How is asthma diagnosis confirmed?
improvements in the sx with medical management with over time and repeated testing
results are reversible which helps guarantee asthma
What is the clinical presentation of asthma?
Decreased FEV1
Increased RV and FRC
What are the results of peak-flow meter indicate?
Green 80-100 = normal
Yellow 50-80 = airways are narrowing and treatment is warranted
Red < 50 = medical emergency
Asthma Severity
Intermittent
< 2x/wk - exacerbations are rare, nighttime sx
< 2x/month - does not interfere with normal activities
normal spirometry (>80%) when NOT having attack
Asthma Severity
Mild persistent
sx > 2x/wk
night time sx 3-4/months
attacks are more severe or interfere with activities
normal spirometry (>80%) when not having attack
Asthma Severity
Moderate persistent
Daily sx and use of daily meds
nighttime sx > 1x/wk but not daily
interferes with daily activities
abnormal spirometry > 60% but < 80%
Asthma Severity
Severe persistent
Continous sx day and night (night often every night)
activity is severely limited
exacerbations are frequent
abnormal spirometry 60% or less
What is the medical management of asthma?
prevention - avoiding triggers and reduce exposure
emphasis on long-term control
pharmacologic therapy
50% of children with asthma will have sx as an adult
Pharm - anti-inflammatory, bronchodilators or combo meds
What is the clinical presentation of asthma?
- observe altered breathing pattern
- lung auscultation
- report dyspnea on exertion
- bouts of coughing (especially at night and lingering viral infection)
- accessory muscle use - pursed lip breathing
- postural changes (forward leaning)
What are some components of patient hx/interview that needs to be addressed?
- any major sx
- possible flare ups
- improvements
- nighttime sx
- what happens when it gets cold
- how it impacts
What are the lifestyle modifications for asthma?
healthy diet
sleep patterns
reduce exposure to irritants
hydration
healthy weight
regular physical activity
annual flu shot
What are the educational and preventative strategies for asthma?
- Lifestyle modifications
- minimize exposure to environmental irritants
- household modifications
- exercise-induced asthma
What are some household modifications?
Molds
pets
wash bedding regularly
HEPA filters
sanitize regularly with stuffed toys
choose proper cleaning products
What are the exercise modifications for people with asthma?
- important to warm up before any intense aerobic activity
- adequate hydration
- masks or scarf covering nose/mouth with outdoor cold weather exposure
What are the COPD implications for PT treatment?
- begin once medication regimen is stable
- secretion clearance
- controlled breathing
- exercise and strength training
- thoracic stretching
- postural reeducation
- patient education and home program
What is the effects of aerobic exercise on asthma?
Helps with control and lung function but not airway inflammation
What is the physiological effects of aerobic exercise?
reduced BHR and serum proinflammatory cytokines and improved QoL and asthma exacerbation in patients with moderate or severe asthma
What type of exercise helps with asthma control?
Low volume HITT
