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cardiopulm final > pulmonary disease exercise prescription > Flashcards

pulmonary disease exercise prescription Flashcards

1
Q

in mild lung disease the spirometry testing is < ____ of predictive values of FEV1 but < ___ for FEV1/FVC

A

80%
70%

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2
Q

if static lung volume is between 80% -120% this it is ___, if it < 80% then it is ___ if it is > 120% then it is ___

A

normal
restrictive
obstructive

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3
Q

for moderate lung disease ___ is < 80% if predicated value

A

FEV1

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4
Q

exercise tolerance limited due to:
 abnormal ventilatory responses
 patient becomes SOB with mild activity
 little ventilator reserve

in what lung disease

A

moderate

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5
Q

pateints with moderate lung disease will have mid to moderate ___ at rest

A

hypoxemia

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6
Q

which vital may not be the best to assess in patients with moderate lung disease bc meds can increase it

A

HR

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7
Q

in patients with severe lung disease the fev1 is < ___ of predicted values

A

50%

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8
Q

a patient with severe lung disease may have ___ ventricular dysfunction during exercise

A

right

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9
Q

poor ___ limits exercise capacity

A

oxygenation

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10
Q

what are some sings of poor oxygenation

A

SOB
decreases SaO2
retained secretions
cyanosis

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11
Q

what are clinical examples of poor oxygenation patients

A

Pneumonia, chronic bronchitis, cystic fibrosis

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12
Q

ventilatory pump dysfunction is due to ___ mm fatigue or weakness of ____

A

respiratory
diaphragm

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13
Q

ventilatory pump dysfunction is a precursor of pump failure and characterized by increased reliance on ___ mm and ____ retraction during exercise

A

accessory
costal

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14
Q

if O2 sat is < ___ stop exercise

A

88%

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15
Q

goal of supplemental O2 is to maintain O2 saturation at lease ___ - ____ without suppression of respiratory drive from CNS

A

88-92

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16
Q

ventilatory pump failure casues what nerve damage

A

phrenic

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17
Q

what type of breathing is present with ventilatory pump failure

A

paradoxical breathing pattern

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18
Q

the abdomen moves ___ and ribcage move ___ during inspiration for paradoxical breathing

A

inwards
outwards

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19
Q

what position may help a patient with paradoxical breathing pattern

A

leaning forward in a chair over abdominal binder bc helps add pressure to push dia[hragm up

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20
Q

what is defined as a mean pulmonary arterial pressure greater than 20 mmHg at rest and greater then 30 mmHg during exercise

A

pulmonary hypertension

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21
Q

how is pulmonary hypertension measured

A

swan gaze catheter

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22
Q

pulmonary hypertension is when MAP is ___ at rest and ____ during exercise

A

> 20
30

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23
Q

what is the hallmark sign of pulmonary hypertension

A

chronically elevated pulmonary artery [pressure

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24
Q

what are clinical examples of pulmonary hypertension

A

Advanced stage of COPD, Cor
Pulmonale, pulmonary fibrosis

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25
Q

is pulmonary hypertension (MAP) is between 40-50 what should you do as a PT

A

water symptoms and sit them down and change intensity

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26
Q

what is the cascade of events that can happen w someone with pulmonary hypertension if they experience sudden decrease in exercise capacity

A

increase hypoxia
increase pulmonary vascular resistance
decrease right SV
decreased Oxygenated blood volume to the left heart
decreased CO
Bp drops and patient becomes dizzy and lightheaded

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27
Q

what are some treatment options for poor oxygenation

A

Supplemental O2, bronchodilators,
effective airway clearance technique, mechanical
ventilators

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28
Q

what are some treatment options for ventilatory pump dysfunction

A

Supplemental O2 ,
facilitated breathing technique, exercise training

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29
Q

what are some treatment options for ventilatory pump failure

A

Forward leaning /abdominal
binder; facilitatory/ inhibitory breathing technique,
Ventilatory muscle training, purse-lip breathing

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30
Q

what are some treatment options for Pulmonary Arterial Hypertension

A

Supplemental O2, vasodilators
(Flolan, Ventavis, Viagra, Cialis, etc), Ca channel blockers, sitting
with arms supported and semi-fowler’s position

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31
Q

what are the acceptable parameters from initiation of PT for RR, HR , pulse ox , and supplemental O2

A

RR : < 40
HR : 60-120
PUlse ox: > 90%
supplemental: Spo2 > 90%

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32
Q

what are the reason to stop or modify pt intervention for RR , SpO2, HR and SBP

A

RR: unable to speak comfortably
SpO2 : < 85%
HR: decreased in 10 BPM
SBP: drop in > 10 mmhg

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33
Q

Obstructive lung disease: chronic bronchitis patients will have ___ of mucus , ___ endurance, ___ on light exertion , ___ of air way wall , ___ retention

A

hypersecretion
low
dyspnea
thickening
CO2

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34
Q

obstructive lung disease: emphysema patients will have ___ and destruction fo the terminal bronchiole and/or alveolar wall , ___ of the lung due to enchanced tissue ___

A

dilation
hyperinflation
compliance

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35
Q

both chronic bronchitis and emphysema patients will have reduced ___ and ____

A

FEV1
FEV1/ FVC

prob wont have a decreased in FVC

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36
Q

T/F: emphysema patients will have increased TLC

A

true

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37
Q

___ traingin shoudl be an integral part of the exercise program for COPD patients

A

resistance

38
Q

what may be needed for both the emphysema and chronic bronchitis patients

A

extra nutritional support

39
Q

for patients with COPD , increased dyspnea may be found with agressive ___ aerobic exercises

A

UE

40
Q

what scale is a reliable measure during exercise for COPD patient

A

dyspnea

41
Q

what level of SAO2 may require supplemental O2 during exercise for COPD patients

A

< 88%

42
Q

T/F: you cane exercise a patient during acute pulmonary exacerbation

A

false

43
Q

what grade on the dyspnea scale is stops for breath after walking 100 yards

A

4

44
Q

what is the main limitation at peak exercise in patients with severe COPD

A

ventilatory limitations

45
Q

As an alternative to using peak work rate or ሶ VO2peak to determine exercise
intensity, dyspnea ratings of between __ and __ on the Borg CR10 Scale may be used for COPD patients

A

3-6

46
Q

Maximizing pulmonary function using ____ before exercise training in those with airflow limitation can reduce dyspnea and improve exercise tolerance from COPD patients

A

bronchodilators

47
Q

Because individuals with COPD may experience greater dyspnea while performing ADL involving the upper extremities, include resistance exercises for the muscles of the ____

A

upper body

48
Q

Supplemental oxygen is indicated for patients with a PaO2 < __ mm Hg or an SaO2 < __% while breathing room air for COPD patients

A

55
88

49
Q

_____ muscle weakness is a contributor to exercise intolerance and dyspnea in those with COPD.

A

inspiratory

50
Q

what breath sound may you hear with an asthma patient

A

wheezing

51
Q

patients that have restrictive lung disease have a ___ in lung and cheat wall compliance

A

reduction

52
Q

in restrictive lung disease if the RR is to high that leads to ___ anatomical dead space

A

increased

53
Q

what is the positioning in bed for an obesity patient with restrictive lung diease

A

semifowlers or sidelying

54
Q

if you are preforming a cardiopulmonary exercise test and VE max is 70% or height then the predicted MVV that what does that mean

A

respiratory system is the limiting factor

55
Q

here are no clear guidelines for IMT although an intensity of the training load of > ___% of maximal inspiratory pressure has been recommended.

A

30

56
Q

IMT improves ____ muscle strength and endurance, functional capacity, dyspnea, and quality of life which may lead to improvements in exercise tolerance

A

inspiratory

57
Q

what are some symptoms with someone with asthma

A

wheezing
chest tightness
SOB
decreased FEV1 greater than the reduction of FVC

58
Q

asthma is inflammation of the ___ ____

A

airway walls

59
Q

asthma ____ mucus production

A

increased

60
Q

asthma is ___ of the airway walls and ___ mm contraction

A

thickening
smooth

61
Q

if your pateint has asthma and they are going to exercises ____ should be used before test and achieve at least a ___% improvement of FEV1

A

bronchodilators
12-15%

62
Q

for asthma patients the Use of heart rate to set exercise intensity may not be appropriate due to
ventilatory limitations to exercise (T/F)

A

true

63
Q

exercise induced asthma should be assessed with ____ ex tests:

A

vigorous

64
Q

with people with obstructive lung diease you should considers using ____ based walking program with progressive increases in ___

A

interval
duration

65
Q

in restrictive lung disease as the compliance ___ , TV ___ as well

A

decreased 2x

66
Q

in RLD , transoulmonary pressure is ___ which increased the work to achieve TV breathing

A

increased

67
Q

in RLD , as RR increased , TV decreased to maintain what

A

minute ventilation

68
Q

what are pulmonary causes of RLD

A

atelectasis
pneumonia
brhonchiogenic CA

69
Q

in RLD, what are the 3 things exercise / activity consideration are based on

A

ventilatory compromise
hemodynamic stability
immunologic responses

70
Q

if a patient has a C5 or higher SCI what will be weak and what kind of breathing pattern will they have

A

diaphragm will be weak

Paradoxical breathing pattern

71
Q

what training do we do for inspiratory mm weakness with RLD

A

Inspiratory mm training

72
Q

if your patient has ASL (RLD) you want to refrain from ___ physical exertion

A

excessive

73
Q

what do you want to teach your pateints with ALS (RLD)

A

breathing techniques

74
Q

what are the 3 exercises you should teach your pateint with kyphoscoliosis

A

breathing / chest wall expansion exercise (segmental breathing)
extension based strengthening
active breathing exercsies

75
Q

what are 4 thing you want to teach your pateint wiht anklyosing Spondylitis (RLD)

A

patient positioning in extension
trunk extensor and scapula retractor strengthening
activit breathing exercsies
thoracic mob techniques

76
Q

pateint with RA (RLD ) have may ___ and ___ complication

A

cardiovascular and pulmonary

77
Q

pateint RA (RLD) will have ___ VC , lung compliance and diffusion gradient

A

decreased

78
Q

patients with RA (RLD) have pleural ____ , effusion and interstitial ___

A

thickening
fibrosis

79
Q

patients with RA may have pulmonary ___ and pulmonary ___

A

HTN
vasculitis

80
Q

pateints with connective tissue disease for RLD may have steroid induced weakness of what mm

A

diaphragm

81
Q

what are some symptoms of Lupes (RLD)

A

SOB, hypoxemia, cyanosis, tachypnea, tachycardia

82
Q

Lupes (RDL) may lead to what

A

interstitial pulmonary fibrosis

83
Q

what is Antigen-antibody reactions that affect the skin, joints, kidneys, lung, heart and nervous
system

A

SLE

84
Q

50-90% of SLE involves the ___

A

lung

85
Q

Lupes , SLE , RA pateints typical have ____ weakness , elevated and ___ diaphragm , and weakness in other ___ MM

A

diaphragmatic
shortened
inspiratory

86
Q

what is a RLD that is Progressive fibrosis of lung, heart, skin, kidney, GI tract, vascular system

A

scleroderma

87
Q

what is the pateint RX for scleroderma

A

 IMT
 Active cycle breathing
 Segmental breathing
 Positioning education
 Thoracic mobilization
 ROM and strengthening of trunk extensors , UEs and LEs

88
Q

what metabolic disease Leads to hypoventilation syndrome and is also a RLD

A

obesity

89
Q

patients wiht obesity have RLD and the diaphragm is forced ___ due to ___ abdominal pressure

A

upwards
increased

90
Q

patients with obesity have RLD and have ___ compliance of the chest wall

A

decreased

91
Q

pateint with obesity have RLD and this promotes early airway ___ and ___ lung expansion

A

closure
decreased

92
Q

what is the PT RX for patients with obesity and RLD

A

 Positioning in bed:
 Semifowlers
 Sidelying
 Referral to dentist and physician for sleep appliance and / or CPAP machine

cardiopulm final (8 decks)

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