Pulmonary Hygiene Lab 1

Question 1

Coughing - controlled

Answer 1

Take a deep breath and cough 3 times

Question 2

Coughing - splinted

Answer 2

holding a pillow and then coughing

helps for pain but can also help for weak abdominal muscles

Question 3

Coughing - assisted includes

Answer 3

1 Costophrenic cough or lateral costal cough
2 Heimlich in supine or sitting
3 Anterior chest compression cough

Question 4

Assisted cough - Costophrenic cough or lateral costal cough - what position is the patient in

Answer 4

Can be laying flat in supine or they can be in semi fowlers (40-45 degrees of head up)

Question 5

Assisted cough - Costophrenic cough or lateral costal cough - what do you do as the PT

Answer 5

Place hands over the lower ribs with thumbs pointing towards the xiphoid process
Have the pt take a few normal breaths and then have them take a deep breath in and hold it for count of 3 and then tell them to cough as you pull the rib cage down and in

Question 6

Assisted cough - Heimlich assisted cough in supine - what is the problem with this one

Answer 6

If someone has strong abdominals they will push you out

Works well for someone with weak abdominals though or SCI

Question 7

Assisted cough - Heimlich assisted cough in supine - what do you do as therapist

Answer 7

Place base of hands slightly above the belly button and then have them take 3 deep breaths and then inhale and hold it and then tell them to cough as you push down and up

Question 8

Assisted cough - Anterior chest compression cough - what position is the patient in

Answer 8

Supine with pillow under the legs

Question 9

Assisted cough - Anterior chest compression cough - what do you do as the therapist

Answer 9

Place one hand/forearm across the chest and the other hand at the lower rib area
Have them take 3 deep breaths and then hold inhale for 3 sec and tell them to cough as you push top hand down and bottom hand up

Question 10

Assisted cough - Anterior chest compression cough - who is it good for

Answer 10

patients who have a weak cough or are having trouble getting air into the lower portions of the lungs or who need to activate their abdominal muscles
You would want to teach this to their caregiver to help them cough things out while at home

Question 11

Huff

Answer 11

Deep Ha ha ha

Question 12

Active cycle of breathing

Answer 12

Controlled diaphragmatic breathing 5-10 sec
Thoracic ext ex
Controlled diaphragmatic breathing 5-10 sec
Thoracic ext ex 3-4 times
Breathing control 5-10 sec
Forced expiratory maneuver (1-2 HUFFS)
Diaphragmatic breathing 5-10 sec

Question 13

Pursed lip breathing

Answer 13

Have them inhale however and then exhale slowly for count of four out their mouth with pursed lips
Will help to dec work of breathing and RR

Question 14

How to facilitate diaphragmatic controlled breathing

Answer 14

1 scoop technique
2 position of pelvis
3 position of trunk
4 relaxation of upper chest and shoulders
5 sniffing
6 repatterning technique

Question 15

facilitate diaphragmatic controlled breathing - scoop technique - what position is the patient in

Answer 15

supine with pillow under knees

Question 16

facilitate diaphragmatic controlled breathing - scoop technique - what do you do as the therapist

Answer 16

Place hand over belly/diaphragm region - leave hand there for a 3 breaths or so and then at the end of the exhale of the 3rd you scoop your hand in and up quickly and then immediately after tell the patient to breathe in and fill their belly towards your hand

Question 17

facilitate diaphragmatic controlled breathing - what are you trying to do with the scoop technique

Answer 17

facilitate the diaphragm by giving it a little stretch

Question 18

facilitate diaphragmatic controlled breathing - scooping technique - what if the patient is having trouble activating the diaphragm?

Answer 18

You can place your hand/forearm over the chest to prevent them from using their chest muscles

Question 19

facilitate diaphragmatic controlled breathing - Position of the pelvis

Answer 19

Slight post tilt to facilitate diaphragmatic breathing

Question 20

facilitate diaphragmatic controlled breathing - position of trunk

Answer 20

usually want them in an upright position - but some will have an easier time breathing in a forward flexed position

Question 21

facilitate diaphragmatic controlled breathing - relaxation of upper chest and shoulders - what do you do as the therapist

Answer 21

Pt is seated - place your hands on their shoulders and then have them inhale and raise their shoulders into your hands (loud) and then calmly tell them to exhale and lower shoulders

Question 22

facilitate diaphragmatic controlled breathing - sniffing - what do you do

Answer 22

have your patient take three or four short sniffs - progress eventually to 1 long one - when they are sniffing though we want them to push out their tummy as they bring air in

Question 23

facilitate diaphragmatic controlled breathing - repatterning technique - what do you do

Answer 23

have the patient take deep breath in, hold for count of 3, and then a slow breath out to work on getting expiration longer and longer

Question 24

facilitate diaphragmatic controlled breathing - repatterning technique good for who

Answer 24

asthma, asthma attack, anxiety, COPD

Question 25

Segmental breathing - what do you do as therapist

Answer 25

Pt is can be sitting - place hand on side and have them breathe into your hand - can also do it with a towel or sheet so they can do it themselves

Question 26

Segmental breathing - what can you use it for

Answer 26

Cueing to use a certain segment for breath

Strengthening - apply resistance with it