pulmonary examination/interventions

Question 1

tidal volume

Answer 1

air inspired during normal relaxed breathing
500mL

Question 2

inspiratory reserve volume (IRV)

Answer 2

5 to 6x bigger than tidal volume
- additional air that can be forcibily inhaled after the inspiration of the normal tidal volume

Question 3

expiratory reserve volume, ERV

Answer 3

2-3x more than tidal volume
- additional air that can be forcibily exhaled after the inspiration of the normal tidal volume

Question 4

residual volume

Answer 4

volume of air remaining in the lungs after the expiratory reseve volume is exhaled

Question 5

vital capacity

Answer 5

total amount of air that can be expired after fully inhaling

total lung capacity - residual volume
or
VC=TV+IRV+ERV

Question 6

inspiratory capacity

Answer 6

max amount of air that can be inspired
IC=TV+IRV

Question 7

functional residual capacity

Answer 7

amount of air remaining in the lungs after normal expiration
- air in the lungs after your have expired TV

Question 8

restricted vs obstructive

Answer 8

restrictive - cant get air in
obstructive - cant get air out

Question 9

what volumetric measurements increase with obstructive diseases

Answer 9

tidal volume

residual volume
functional residual capacity
total lung capacity

Question 10

what volumetric measurements changes occur with restrictive diseases

Answer 10

they all decrease

Question 11

classifications of COPD severity

Answer 11

Stage 1: mild >80
Stage 2: mod 50-80
Stage 3: severe 30-50
Stage 4: very severe >30

Question 12

what does the FEV1/FVC have to be to be considered COPD

Answer 12

<70

Question 13

what are the normal breath sounds

Answer 13

vesicular
broncho-vesicular
bronchial
tracheal

Question 14

compare norma sounds
- vesicular
- bronchovesicular
- bronchial
- tacheal

Answer 14

vesicular:
- inspiration longer than expiratory
- soft and low
- heard over most lungs

bronchovesicular
- inspiratory and expiratory equal
- intermediate intensity and pitch
- between 1st and 2nd interspace anteriorly and between the scapule

bronchial
- expiratory longer than inspiratory
- loud and high
- heard over the manibrum

tracheal
- both inspiratory and expiratory are equal
- very loud and relative high
- heard over trachea

Question 15

what are the abnormal respiratory sounds

Answer 15

ronchi
wheeze
crackles
pleural rub

Question 16

compare abnormal respiratory sounds

Answer 16

• rhonchi: cont low pitched, rattling lung sounds that often resemble snoring
• wheeze: high pitched sound heard in expiration, caused by airway obstruction
• crackles: brief, discontinuous, popping lung sounds that are high pitched. can be heard in both phases of expiration
• pleural rub: auscultation in the loweer lateral chest areas it occurs with inspiration and expiration. It can be an indication or pleural inflammation

Question 17

s1
s2
s3
s4

Answer 17

s1 - lub
s2- dub
s3 - CHF, athletes, pregnancy
s4 - MI, HTN

Question 18

types of voice sounds

Answer 18

bronchophony
egophony
whispered pectoriloquy

Question 19

bronchophony

Answer 19

increased vocal resonance with greater clarity and loudness of spoken words
ex: 99

denver bronchos won the superbowl in 99

Question 20

egophony

Answer 20

a form of bronchophony in which the spoken long “E” sounds changes to a long, nasal sounding “A”

EA sports - E to A

Question 21

whispered pectoriloquy

Answer 21

an increased loudness of whispering. recognition of whispered words “1,2,3”

Question 22

ranges for blood gases

Answer 22

pH: 7.35-7.45
PaCO2: 35-45 mmHg
HCO3-: 22-26 mEq/L

Question 23

blood gases -“ROME”

Answer 23

ROME
respiratory = opp
metabolic = equal

Question 24

if pH drops into a more acidic range, what is contributing to it

Answer 24

respiratory related

Question 25

steps to consider when looking at blood gases

Answer 25

1. look at pH
   normal 7.35-7.45: answer is compensated
2. look at PaCO2
   normal 35-45: answer is metabolic
3. look at HCO3
   normal 22-26: answer is respiratory
4. none of these are normal
   answer is partially compensated

Question 26

COPD is what kind of blood gas derivative

Answer 26

respiratory acidosis

Question 27

key positions for postural drainage

Answer 27

superior segments of lower lobes= prone with 2 pillows under pelvis

posterior apical segments of upper lobes = sitting on a chair, leaning fwd over folded pillow

anterior apical segments of upper lobes = sitting in recliner, leaning slightly back

anterior segments of upper lobes = supine lying on bed with pillows under the knees

Question 28

contraindications and precautions to postural drainage

Answer 28

Question 29

diaphoresis

Answer 29

cold sweats

Question 30

when can you incorprate strength traininng in cardiac rehab - what phase

Answer 30

phase 3

you can begin with elastic bands and light hand weights, 1-3lbs or 30-50% of max weight used to complete 1RM

avoid UE resistance as soft tissue is still healing

Question 31

weight reduction guidelines for obesity

Answer 31