Respiration and Lung disease

Question 1

purpose of respiratory system

Answer 1

exchange oxygen for carbon dioxide

-supply O2 to the blood and removes waste products (primarily CO2) from the blood

Question 2

Name components of the “pulmonary tree”

Answer 2

respiratory passageway (superior-inferior)

• 2 main bronchi (left and right)
• bronchioles
• alveolar ducts
• alveolar sacs

Question 3

during inspiration, muscle power for breathing air into lungs provided primarily by the _____

Answer 3

diaphragm (inferior border of thorax)

-innervated by left and right phrenic nerves

Question 4

Chronic lung disorders for which pulmonary rehab is typically prescribed

Answer 4

• COPD

- Asthma

Question 5

COPD

Answer 5

Chronic obstructive pulmonary disease

• characterized by “damage to the alveolar wall and inflammation of the conducting airways”
• includes: emphysema, peripheral airway disease, chronic bronchitis

Question 6

Emphysema

Answer 6

alveoli become enlarged or ruptured

• due to restriction during expiration or decrease in elasticity of the lungs
• most prevalent: men 45-65, h/o chronic bronchitis, smoking, working in areas with high pollution, exposure to cold/damp environments

Question 7

Peripheral airway disease

Answer 7

Inflammation, fibrosis (thickening of the connective tissue), narrowing of the terminal airways of the lungs

• smoking, environmental pollutants lead to abnormal terminal airways
• clinical: coughing, spitting up mucus
• can lead to emphysema or full COPD

Question 8

Chronic bronchitis

Answer 8

dx after 2 year period of repeated episodes, lasting longer than 3 months, of mucus-producing cough of unknown origin.
-can experience shortness of breath on exertion, or at rest if disease is progressed

Question 9

Asthma

Answer 9

irritability of the bronchotracheal tree, typically episodic in onset
-symptoms: wheezing, SOB

Question 10

Pulmonary risk factors

Answer 10

Smoking (primary), environmental irritants (air pollution), chemical exposure, dust

Question 11

Signs and symptoms of respiratory distress

Answer 11

dyspnea, extreme fatigue, nonproductive cough, confusion, impaired judgment, cyanosis (bluish skin color caused by insufficient O2 in blood)

• when SOB at rest, its more severe
• when reporting, note precipitating factors and associated circumstances

Question 12

Goal of pulmonary rehab

Answer 12

stabilize or reverse the disease process and return the pt’s function and participation in activity/occupation to highest capacity

Question 13

Pulmonary rehab: intervention techniques

Answer 13

• dyspnea control postures
• pursed-lip breathing
• diaphragmatic breathing (in supine)
• progressive muscle relaxation with breathing exercises
• considering environmental factors (pollution, humidity, etc)

Question 14

Cardiovascular & Pulmonary evaluation: interview

Answer 14

• review medical records
• interview (clarify MR, pt’s understanding of condition & tx, clarification of symptoms)
• describe typical day, what brings on symptoms, how does this interfere with occupations
• observe for signs of anxiety, SOB, confusion, difficulty comprehending, fatigue, abnormal posture, reduced endurance, reduced ability to move, stressful family dynamics

Question 15

Pulmonary & Pulmonary evaluation: clinical

Answer 15

• establish pt’s present functional ability and limitations
• monitor vitals (HR/BP) if cardiovascular condition
• assessment of tolerance to postural changes during functional task
• respiratory conditions: monitored for signs of respiratory distress
• ROM, strength, sensation grossly assessed in ADL context
• have O2 saturation monitor

Question 16

Cardiovascular and pulmonary Intervention

Answer 16

• Progression of energy costs (safe progression of activity/participation in occupations) according to MET table
• energy conservation
• lifestyle modification
• patient and family education