Pulmonary Diseases and Rehabilitation Flashcards
Inflammation of cartilage in the sternum and 1st rib
Costochondritis
Pulmonary Pain Pattern: (+) pain in the neck and anterior chest
Tracheobronchial Pain
Normal AP-TV Ratio
1:2
Costochondritis pain radiation
Ipsilateral towards back (neck > costal margin > scapula)
Chest Deformity: (+) AP-TV 1:1 ratio
Barrel Chest
Pulmonary Pain Pattern: (+) pain in the costal margin referred to the lumbar region
Peripheral Diaphragmatic Pain
When does costochondritis pain aggravates?
Increase during Inspiration
Chest Deformity: (+) Protruded sternum
Pectus Carinatum
Pulmonary Pain Pattern: (+) pain in the ipsilateral shoulder and upper trapezius
Central Diaphragmatic Pain
Chest Deformity: (+) Depressed sternum
Pectus Excavatum
Chest Symmetry landmark to assess upper lobe expansion
Angle of Louis
Changes that indicates a (R) CHF or Cor Pulmonale
Jugular Vein Distention and Peripheral Edema
Bluish discoloration of skins and nails
Cyanosis
Bulb-like phalanx due to increasing connective tissue under nails
Digital Clubbing
Chest Symmetry landmark to assess lower lobe expansion
10th Rib
Changes that indicates chronic DOB
SCM Prominence
The normal degree of Schamrot’s Sign
160 degree
Mediastinal Shift: Atelectasis
Ipsilateral
Chest Symmetry landmark to assess middle lobe expansion
Xiphoid Process
Mediastinal Shift: Pneumothorax
Contralateral
Cyanosis that seen in lips due to decreased oxygen level
Centra Cyanosis
Mediastinal Shift: Lobectomy
Ipsilateral
Difficulty in Breathing in Supine
Orthopnea
Mediastinal Shift: Pneumonectomy
Ipsilateral
Mediastinal Shift: Edema
Contralateral
Difficulty in Breathing in Side-Lying
Trepopnea
Relief position for patients with Orthopnea and Platypnea
Semi-Fowler
Mediastinal Shift: Hydrothorax
Contralateral
Difficulty in Breathing in Upright
Platypnea
Mediastinal Shift: Pleural Effusion
Contralateral
Sudden SOB after 1-2 hrs of supine
Paroxysmal Nocturnal Dyspnea
Labored Breathing present in Metabolic Acidosis`
Kussmaul’s Breathing
Mediastinal Shift: Abdominal Hernia
Contralateral
Breathing Pattern: (+) Irregular Rhythm
Biot
Type of sputum associated with dry cough
Non-productive
Sputum with prune juice odor
Rusty
Breathing Pattern: (+) Normal rate and depth
Eupnea
Sputum with a foul-smelling odor
Fetid
Sputum with white and clear odor
Mucoid
Breathing Pattern: (+) Slow rate
Bradypnea, Cheyne Stoke, Biot
Sputum that indicates infection
Fetid, Purulent
Breathing Pattern: (+) shallow and apnea
Biot
Sputum that indicates pulmonary edema
Frothy
Breathing Pattern: (+) waning and waxing with apnea
Cheyne-Stokes
Sputum with thicky and sticky odor
Tenacious
Breathing Pattern: (+) fast and shallow depth
Tachypnea
Sputum indicates pneumonia
Rusty
Sputum with white/pink hues and foamy texture
Frothy
Breathing Pattern: (+) slow rate with normal or shallow depth
Bradypnea
Sputum indicates chronic cough without infection
Mucoid
Sputum with blood
Hemoptysis
Breathing Pattern: (+) fast rate and normal depth
Hyperpnea
Sputum with yellow or green hues
Purulent
Breathing Pattern: (+) fast rate and deep depth
Hyperventilation
Bacteria present in sputum of a patient in late-stage infection
Pseudomonas Aeurugnosa
Sputum with purple hues
Cancer
Landmark level for Auscultation
T2, T6, T10
Normal Breath Sounds: Inspi = Expi
Tracheal, Bronchovesicular
Continuous abnormal breath sounds that sound like a snore
Rhonchi
Normal breath sounds heard in lung fields
Vesicular
Normal Breath Sounds: Inspi < Expi
Bronchial
Normal Breath Sounds: Loud
Tracheal, Bronchial
Continuous abnormal breath sounds that sound like a whistle
Wheezes
Normal breath sounds heard in primary bronchi
Bronchovesicular
Continuous abnormal breath sounds that are a medical emergency
Stridor
Structures that involves in stridor breath sound
Larynx and Trachea
Normal Breath Sounds: Inspi > Expi
Vesicular
Normal Breath Sounds: Faintest
Vesicular
During when do you hear wheezes?
Expiration
Voice sound that assesses the abnormal transmission of lung sounds
Bronchophony
The positive finding of whispered pectriloquy
Increasing loudness
A non-continuous abnormal breath sounds
Crackes/Rales
The positive finding of bronchophony
Clear or increasing intensity of sound
Voice sound that assesses the abnormal change in the quality of sound
Egophony
Abnormal breath sounds: (+) secretions
Crackes/Rales
Abnormal breath sounds: (+) asthma
Wheezes
The normal range of pH
7.35 - 7.45
Fully Compensated ABG
Normal pH and Abnormal PCO2 & HCO3
The normal range of HCO3
22-26
If pH is normal, the new baseline is?
7.40
Partially Compensated ABG
Abnormal pH, PCO2 & HCO3
The normal range of PCO2
35-45
Uncompensated ABG
Abnormal pH and Normal PCO2 & HCO3
Alkalosis or Acidosis: Increase pH
Alkalosis
Signs and symptoms of Respiratory Alkalosis
DENTS: Dizziness, Early Tetany, Numbness, Tingling system, Syncope
ABG s/sx due to increasing CO2
Respiratory Acidosis
Alkalosis or Acidosis: Decrease HCO3
Acidosis
Alkalosis or Acidosis: Decrease PCO2
Alkalosis
Cause of Metabolic Alkalosis
VDABS: Vomiting, Diuretic, Adrenal Disease, Bicarbinogestion, Steroids
Alkalosis or Acidosis: Increase HCO3
Alkalosis
ABG s/sx due to increasing hydrogen ions and chloride
Metabolic Acidosis
Alkalosis or Acidosis: Decrease pH
Acidosis
Signs and symptoms of Metabolic Alkalosis
We MeT: Weakness, Mental Dullness, Tetany
Alkalosis or Acidosis: Increase PCO2
Acidosis
ABG s/sx due to hyperventilation
Respiratory Alkalosis
Early signs and symptoms of Respiratory Acidosis
HARD: Headache, Anxiety, Restlessness, Dyspnea
Cause of Metabolic Acidosis
DAD SLUR: Diarrhea, Alcoholism, Diabetes, Starvation, Lactic Acid, Uremic Acid, Renal Failure
Late signs and symptoms of Respiratory Acidosis
ma SOso CO aCO: Somnolence, Confusion, Comatose
Signs and symptoms of Metabolic Acidosis
VoKU Na LoCoCa: Vomiting, Kussmaul breathing, Nausea, Lethargy, Comatose, Cardiac Dysrhythmia
ABG s/sx due to a gain of HCO3 and loss H+ & Cl
Metabolic Alkalosis
ABG s/sx due to decreasing renal function
Metabolic Acidosis
The normal range of FEV1
> 75-80%
GOLD Grade: (+) Minimal SOB with or without cough
Grade I
COPD vs RLD: Expiration problem
COPD
COPD vs RLD: Normal FRC
RLD
COPD vs RLD: Normal RV
RLD
GOLD Grade: seek medical attention
Grade II
GOLD Grade: <30%
Grade IV
COPD vs RLD: Normal TV
COPD
GOLD Grade: (+) multiple exacerbation + decrease QOL
Grade IV
GOLD Grade: >80%
Grade I
COPD vs RLD: Increase FRC
COPD
GOLD Grade: Decrease TV
RLD
COPD vs RLD: Inspiration
RLD
GOLD Grade: 30-49%
Grade III
COPD vs RLD: Increase TLC
COPD
GOLD Grade: 50-70%
Grade II
COPD vs RLD: Increase RV
COPD
COPD vs RLD: Decrease TLC
RLD
GOLD Grade: (+) decrease QOL
Grade III
Symptoms of asthma
CoWDys: Cough, Wheeze, Dyspnea
COPD vs RLD: Decrease TV
RLD
Cystic fibrosis is caused by a mutation of what chromosome?
Chromosome 7 (long arm)
COPD with (+) infection and increase secretion
Chronic Bronchitis, Cystic Fibrosis, Bronchictasis
Chronic bronchitis has a productive cough for how long?
3 months x 2 consecutive years
COPD with dry cough
Asthma
COPD: (+) exertional hyperventilation
Emphysema
COPD with (-) infection and decrease secretion
Asthma, Emphysema
Diagnostic tool for Cystic Fibrosis
Sweat Electrolyte Test
A medical emergency that has >24 hours bronchospasm
Status Asthmaticus
“Blue Bloaters”
Chronic Bronchitis
COPD: (+) hemoptysis
Bronchiectasis
Kartagener’s triad
Bronchiectasis, Chronic Sinusitis, Sinus Invetus
COPD: (+) Cyanosis and Bipedal Edema
Chronic Bronchitis
COPD: (+) Cachexia
Emphysema
Chromosome 7 produces what protein that regulates sodium and chloride molecules?
CFTR
Reversible COPD
Asthma
(+) Sweat Electrolyte Test
60 meq/L of Cl
“Pink Puffers”
Emphysema
Formation in the lungs due to destruction of alveoli
Bullae Formation
A term that describes extreme weight loss
Cachexia
The brain is responsive in what molecules?
Carbon DIoxide
COPD: (+) bulky foul-smelling stool
Cystic Fibrosis
COPD due to abnormal dilation of bronchioles
Bronchiectasis
“Smoker’s cough”
Chronic Bronchitis
COPD: (+) Infertility and sinusitis
Cystic Fibrosis
COPD: (+) fetid sputum
Bronchiectasis
COPD: (+) barrel chest
Emphysema
Emphysema is caused by what defective chromosome?
Chromosome 11
Chromosome 11 produces what protein?
Alpha 1 antitrypsin
What enzyme causes lung destruction?
Elastase
What is the function of Alpha 1 antitrypsin?
Decrease elastase
A pulmonary condition that causes decrease lung volume due to difficulty in expanding?
RLD
Conditions under alteration of lung parenchyma
TASI: TB, Asbestosis, Sarcoidosis, Interstitial Lung Disease
Conditions under alteration of the chest wall
Ankylosing Spondylitis, Scoliosis, Arthritis
What virus can cause COVID-19?
SARS-COV2
How many days of exposure before the COVID signs and symptoms come out?
2-14 days
Five general signs and symptoms of COVID?
Headache, loss of smell & taste, sore throat, dry cough, chest pain
COVID Category: Fatigue
Severe Level 1
COVID Category: Abdominal + Respiration sx
Severe Level 3
COVID Category III
GI
COVID Category Severe Level 2
Confusion
Two COVID Testing
RDT and PCR
Immunoglobulin that represents (+) history of covid
IgG
IgM + ; IgG -
Infectious
Three medications are given to COVID patients
Standard Antibiotics, Dexamethasone, Melatonin
Pro-inflammatory protein that signals cell self-destruction
Cytokine
IgM + ; IgG +
Infectious + Recovery
IgM - ; IgG -
No COVID
Bed position that helps the increase lung expansion
Prone & Side-lying
IgM - ; IgG +
Not infectious + Graduate
Removal of secretion used to patient’s with collapsable airways
Huffing
Postural Drainage: Quaterturn to (L) + Trendelenburg
Lower Lobe: R Middle Lobe
Removal of secretion used to patient’s who cannot cough on command
Tracheal Stimulation
Factors that decrease due to weak inspiration
Inspiratory Capacity
Postural Drainage: Side-lying (R) Head up
Upper Lobe: Left Posterior Lobe
Factors that decrease due to weak abdominals
Inability to forcibly expel air
Postural Drainage: Sitting + Lean Back
Upper Lobe: Anterior Apical Lobe
Postural Drainage: Supine + Trendelenburg
Lower Lobe: Anterior Basal Lobe
A breathing exercise that prevents hyperventilation
Diaphragmatic
Postural Drainage: Side-lying (L) bed flat
Upper Lobe: Right Posterior Lobe
Postural Drainage: Side-lying on C/L side + Trendelenburg
Lower Lobe: Lateral or Medial Basal Lobe
A breathing exercise that is used for hypoventilated segments
Segmental
Postural Drainage: Sitting + Lean Front
Upper Lobe: Anterior Apical Lobe
A breathing exercise that is used to decrease dyspnea by decreasing RR and increasing TV
Pursed Lips
Postural Drainage: Prone
Lower Lobe: Superior Bronchi Lobe
Postural Drainage: Prone + Trendelenburg
Lower Lobe: Posterior Basal Lobe
Pursed lips are performed during when?
Expiration
The pressure provided by segmental breathing provides what awareness
Sensory Awareness
“Controlled Breathing”
Diaphragmatic
“Localized Breathing”
Segmental
