Quiz 5: Pulmonary and Rehab Flashcards
What is the diaphragm?
domed muscle that
- contracts & flattens during inspiration (down)
- relaxes and rises during exhalation (up)
True or False:
The diaphragm is a very trainable muscle.
True
True or False:
The diaphragm is the primary muscle of inspiration.
True
What is spirometry?
Measurement of the volume and or speed of air that can be inhaled and exhaled.
(the most common tests used to measure lung function)
Total lung capacity (TLC)
total volume of gas in the lungs after a MAXIMAL FORCED INHALATION
Vital capacity (VC)
maximum volume of gas that can be EXHALED AFTER A MAXIMUM INHALATION
(indirect measure of lung size)
Tidal Volume (TV)
volume of gas inspired or expired during each NORMAL VENTILATION CYCLE (normal breathing)
Inspiratory capacity (IC)
maximum volume of gas that can be INHALED AFTER A NORMAL EXHALATION
Inspiratory reserve volume (IRV)
maximum volume of gas that can be FORCEFULLY INHALED AFTER A NORMAL INHALATION
Expiratory reserve volume (ERV)
maximum volume of gas that can be FORCEFULLY EXHALED AFTER A NORMAL EXHALATION
Functional residual capacity (FRC)
volume of gas remaining in the lungs AFTER A NORMAL EXHALATION
Residual Volume (RV)
volume of gas remaining in the lungs AFTER A MAXIMUM EXHALATION
Why do we need RV?
prevents collapsed lungs
What is COPD?
Chronic obstructive pulmonary disease
- composed of chronic bronchitis and emphysema
What is the issue with the lungs when it comes to COPD?
chronic obstruction of the flow of air through the airways and out of the lungs
True or False:
COPD is generally permanent and progresses over time.
True
What are the 5 risk factors for COPD?
- Smoking
- Age
- Heredity
- Environmental exposure
- History of childhood airway disorders
Smoking is responsible for ___% of COPD in the U.S.
90%
____% of smokers will develop COPD.
15%
Why do patients that smoke who have COPD have higher death rates than those with COPD who do not smoke?
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
What are bronchodilators?
A form of medication (typically seen as an inhaler) that helps open up narrowed airways
- Ex: albuterol
What are two medications that lessen inflammation of the airways?
Corticosteroids or steroids
What are some complications of corticosteroids or steroids during exercise?
tachycardia, heart palpitations, weight gain, muscle/bone wasting
For COPD, what are some of the main goals of exercising?
- BIG GOAL MAKE THEM MORE EFFICIENT
- Strengthen the respiratory muscles
- Improve capacity of heart to pump blood
What is “chronic lung hyperinflation” also known as?
Barrel chest
- also associated with osteoarthritis
What are the 4 abnormalities of gas exchange?
- The alveoli next to the capillaries are destroyed
- Reduces the internal surface area of the lung
- Reduces gas exchange across the membrane
- CO2 build up & reduction in available oxygen
< ____% O2 in blood stream = hypoxic
90%
Oxygen consumption can increase to ____ fold during physical activity.
20
What is the main concern of COPD response to exercise?
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%)
What is a pulse oximeter and what does it do?
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.
True or False:
In the exercise response of COPD, supported upper body activities allow accessory muscles to contribute more.
True
What are two breathing techniques for therapy for COPD?
- Pursed Lipped Breathing
- Diaphragmatic Breathing
What are some irritants that cause asthma? (6)
- Cig smoke
- Air pollution
- Cold air or changes in weather
- Strong odors from painting or cooking
- Scented products
- Strong emotions and stress
What is asthma?
an obstructive pulmonary disease
- frequent flare ups of inflammation in the lungs
What are some allergens that cause asthma? (5)
- Animal dander
- Dust mites
- Roaches
- Pollen
- Mold
What are some signs and symptoms of asthma?
- Coughing
- Wheezing
- Chest tightness
- SOB
- Faster/noisy breathing
- symptom timing may vary
What are the spirometry measurements for mild, moderate, and severe asthma?
Mild: FEV1 60-80%
Moderate: FEV1 40-60%
Severe: FEV1 <40%
What is exercise induced asthma (EIA)?
Airway obstruction that occurs 5-15 minutes following physical exertion; constriction of bronchioles can last up to 30 min
What is allergy induced asthma?
Due to pollution, pollen, food allergies, or any variety of environmental allergens that can induce bronchospasm.
What are some of the main testing precautions to take when it comes to asthma?
- 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
How does COPD differ from asthma? (ONSET)
Asthma: typically occurs during childhood or adolescence
COPD: most often develops in smokers and former smokers who are in their mid 40s
How does COPD differ from asthma? (TRIGGERS)
Asthma: often has identifiable triggers such as allergens, cold air or exercise
COPD: exacerbations in COPD patients are commonly caused by respiratory tract infections
How does COPD differ from asthma? (SYMPTOMS)
Asthma: have near-normal lung function and are symptom-free between exacerbations
COPD: rarely experience a day without symptoms.
True or False:
In healthy adults, their FEV1/FVC should be approximately 75-80%.
True
What is peak expiratory flow rate (PEFR)?
a basic measurement of the speed of expiration measure with a peak flow meter
What are normal O2 sat levels?
95-100%
What is the main goal of pulmonary rehab?
- to unclog airways and return to PA and exertion
- reduce hospitalizations
- improve QOL
True or False:
Entire rehab team generally works together to meet specific needs.
True
What are some of the measurable outcomes (objective)?
- change in sputum production
- change in breathing sounds
- change in vitals
What are 5 things pulmonary rehab includes?
- Education about condition, symptoms, meds, and O2
- Supervised exercise
- Breathing techniques
- Nutritional counseling
- Emotional health support
What are the other 5 breathing techniques?
- Mindful breathing
- Deep breathing
- Box breathing
- Alternate nostril breathing
- 4-7-8 breathing
What is postural drainage?
done by positioning the body so that your head is lower than your chest which allows mucus to drain from the bottom of lungs
For postural drainage, you should maintain position for at least __ minutes
5
There are at least. __ to __ different positions for postural drainage for certain parts of the lungs.
6 to 12
What are some contraindications for positioning?
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
What are some contraindications for manual?
- 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
