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THY 414 Ex. Pres. Chronic Diseases > Quiz 5: Pulmonary and Rehab > Flashcards

Quiz 5: Pulmonary and Rehab Flashcards

1
Q

What is the diaphragm?

A

domed muscle that
- contracts & flattens during inspiration (down)
- relaxes and rises during exhalation (up)

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2
Q

True or False:
The diaphragm is a very trainable muscle.

A

True

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3
Q

True or False:
The diaphragm is the primary muscle of inspiration.

A

True

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4
Q

What is spirometry?

A

Measurement of the volume and or speed of air that can be inhaled and exhaled.
(the most common tests used to measure lung function)

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5
Q

Total lung capacity (TLC)

A

total volume of gas in the lungs after a MAXIMAL FORCED INHALATION

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6
Q

Vital capacity (VC)

A

maximum volume of gas that can be EXHALED AFTER A MAXIMUM INHALATION
(indirect measure of lung size)

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7
Q

Tidal Volume (TV)

A

volume of gas inspired or expired during each NORMAL VENTILATION CYCLE (normal breathing)

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8
Q

Inspiratory capacity (IC)

A

maximum volume of gas that can be INHALED AFTER A NORMAL EXHALATION

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9
Q

Inspiratory reserve volume (IRV)

A

maximum volume of gas that can be FORCEFULLY INHALED AFTER A NORMAL INHALATION

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10
Q

Expiratory reserve volume (ERV)

A

maximum volume of gas that can be FORCEFULLY EXHALED AFTER A NORMAL EXHALATION

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11
Q

Functional residual capacity (FRC)

A

volume of gas remaining in the lungs AFTER A NORMAL EXHALATION

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12
Q

Residual Volume (RV)

A

volume of gas remaining in the lungs AFTER A MAXIMUM EXHALATION

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13
Q

Why do we need RV?

A

prevents collapsed lungs

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14
Q

What is COPD?

A

Chronic obstructive pulmonary disease
- composed of chronic bronchitis and emphysema

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15
Q

What is the issue with the lungs when it comes to COPD?

A

chronic obstruction of the flow of air through the airways and out of the lungs

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16
Q

True or False:
COPD is generally permanent and progresses over time.

A

True

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17
Q

What are the 5 risk factors for COPD?

A
  1. Smoking
  2. Age
  3. Heredity
  4. Environmental exposure
  5. History of childhood airway disorders
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18
Q

Smoking is responsible for ___% of COPD in the U.S.

A

90%

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19
Q

____% of smokers will develop COPD.

A

15%

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20
Q

Why do patients that smoke who have COPD have higher death rates than those with COPD who do not smoke?

A

Chemicals in cigarettes irritate and inflame the alveoli in the lungs which causes the cells to release an enzyme called elastase that breaks down elastic fibers over time

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21
Q

What are bronchodilators?

A

A form of medication (typically seen as an inhaler) that helps open up narrowed airways
- Ex: albuterol

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22
Q

What are two medications that lessen inflammation of the airways?

A

Corticosteroids or steroids

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23
Q

What are some complications of corticosteroids or steroids during exercise?

A

tachycardia, heart palpitations, weight gain, muscle/bone wasting

24
Q

For COPD, what are some of the main goals of exercising?

A
  1. BIG GOAL MAKE THEM MORE EFFICIENT
  2. Strengthen the respiratory muscles
  3. Improve capacity of heart to pump blood
25
Q

What is “chronic lung hyperinflation” also known as?

A

Barrel chest
- also associated with osteoarthritis

26
Q

What are the 4 abnormalities of gas exchange?

A
  1. The alveoli next to the capillaries are destroyed
  2. Reduces the internal surface area of the lung
  3. Reduces gas exchange across the membrane
  4. CO2 build up & reduction in available oxygen
27
Q

< ____% O2 in blood stream = hypoxic

A

90%

28
Q

Oxygen consumption can increase to ____ fold during physical activity.

A

20

29
Q

What is the main concern of COPD response to exercise?

A

Lungs have difficulty keeping up with the demand of PA and hypoxemia results
- ventilation increases greatly due to very inefficient breathing
- abnormal deficiency in the concentration of oxygen in arterial blood (norm is 97%)

30
Q

What is a pulse oximeter and what does it do?

A

it is the gadget you put on your finger to look at O2 levels
- uses red & infrared wavelengths to measure the amount of oxy- & deoxyhemoglobin in the arterial blood, and also reads HR.

30
Q

True or False:
In the exercise response of COPD, supported upper body activities allow accessory muscles to contribute more.

A

True

30
Q

What are two breathing techniques for therapy for COPD?

A
  1. Pursed Lipped Breathing
  2. Diaphragmatic Breathing
30
Q

What are some irritants that cause asthma? (6)

A
  1. Cig smoke
  2. Air pollution
  3. Cold air or changes in weather
  4. Strong odors from painting or cooking
  5. Scented products
  6. Strong emotions and stress
30
Q

What is asthma?

A

an obstructive pulmonary disease
- frequent flare ups of inflammation in the lungs

30
Q

What are some allergens that cause asthma? (5)

A
  1. Animal dander
  2. Dust mites
  3. Roaches
  4. Pollen
  5. Mold
31
Q

What are some signs and symptoms of asthma?

A
  1. Coughing
  2. Wheezing
  3. Chest tightness
  4. SOB
  5. Faster/noisy breathing
    - symptom timing may vary
31
Q

What are the spirometry measurements for mild, moderate, and severe asthma?

A

Mild: FEV1 60-80%
Moderate: FEV1 40-60%
Severe: FEV1 <40%

32
Q

What is exercise induced asthma (EIA)?

A

Airway obstruction that occurs 5-15 minutes following physical exertion; constriction of bronchioles can last up to 30 min

33
Q

What is allergy induced asthma?

A

Due to pollution, pollen, food allergies, or any variety of environmental allergens that can induce bronchospasm.

34
Q

What are some of the main testing precautions to take when it comes to asthma?

A
  • Running more readily provokes EIA than jogging and jogging more than walking.
  • Clients have a higher risk for CAD
  • Testing mid-late morning or early afternoon is desirable; avoid early mornings
35
Q

How does COPD differ from asthma? (ONSET)

A

Asthma: typically occurs during childhood or adolescence
COPD: most often develops in smokers and former smokers who are in their mid 40s

36
Q

How does COPD differ from asthma? (TRIGGERS)

A

Asthma: often has identifiable triggers such as allergens, cold air or exercise
COPD: exacerbations in COPD patients are commonly caused by respiratory tract infections

37
Q

How does COPD differ from asthma? (SYMPTOMS)

A

Asthma: have near-normal lung function and are symptom-free between exacerbations
COPD: rarely experience a day without symptoms.

38
Q

True or False:
In healthy adults, their FEV1/FVC should be approximately 75-80%.

A

True

39
Q

What is peak expiratory flow rate (PEFR)?

A

a basic measurement of the speed of expiration measure with a peak flow meter

40
Q

What are normal O2 sat levels?

A

95-100%

41
Q

What is the main goal of pulmonary rehab?

A
  • to unclog airways and return to PA and exertion
  • reduce hospitalizations
  • improve QOL
42
Q

True or False:
Entire rehab team generally works together to meet specific needs.

A

True

43
Q

What are some of the measurable outcomes (objective)?

A
  • change in sputum production
  • change in breathing sounds
  • change in vitals
44
Q

What are 5 things pulmonary rehab includes?

A
  1. Education about condition, symptoms, meds, and O2
  2. Supervised exercise
  3. Breathing techniques
  4. Nutritional counseling
  5. Emotional health support
45
Q

What are the other 5 breathing techniques?

A
  1. Mindful breathing
  2. Deep breathing
  3. Box breathing
  4. Alternate nostril breathing
  5. 4-7-8 breathing
46
Q

What is postural drainage?

A

done by positioning the body so that your head is lower than your chest which allows mucus to drain from the bottom of lungs

47
Q

For postural drainage, you should maintain position for at least __ minutes

A

5

48
Q

There are at least. __ to __ different positions for postural drainage for certain parts of the lungs.

A

6 to 12

49
Q

What are some contraindications for positioning?

A

All positions:
- intracranial pressure >20mmHg
- unstabilized head or neck
- active hemorrhage
- recent spinal surgery
- large pleural effusion (swelling)
- PE
- rib fracture

Trendelenburg position:
- intracranial pressure >20mmHg
- patients in which increased intracranial pressure is to be avoided
- uncontrolled HTN
- distended abdomen
- uncontrolled airway

50
Q

What are some contraindications for manual?

A
  • subcutaneous emphysema
  • recent epidural or spinal anesthesia
  • recent skin graft in area
  • burn, open wound, infection in area
  • recently placed pacemaker
  • suspected TB
  • Lung contusion
  • osteomyelitis of ribs
  • osteoporosis
  • chest wall pain

THY 414 Ex. Pres. Chronic Diseases (6 decks)

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