RLD - Neuromuscular & Musculoskeletal Condition

Question 1

What is spinal cord injury?

Answer 1

Damage or interruption of neurologic pathways because of trauma or some pathological process

Question 2

What does cervical injuries lead to?

Answer 2

expiratory muscle paralysis or weakness
= poor cough will result weakness of inspiration muscles

Weak inspiration muscles = hypoventilation

Question 3

What is the goal of spinal cord injury?

Answer 3

Improving breathing efforts by reducing work breathing to keep airways open and clear of secretions

Question 4

How do PTs assist with SCI patients?

Answer 4

need with airway clearance with high-freq chest wall osicillation vest

= considered for patients as well as machines

Question 5

Clinical manifestations of spinal cord injury

Chart with findings

Answer 5

Question 6

What is the respiratory involvement will depend on level of SCI?

Answer 6

C1-2 = unable to breathe on their own

C3-4 = impaired ventilation due to diaphragm paralysis

C5-8 = retain diaphragm but accessory muscles are affected

Question 7

What is diaphragmatic paralysis of the top?

IDK what it means “top”

Answer 7

paradoxical breathing when the diaphragm is strong
BUT the accessory muscles are absent

Question 8

What is diaphragmatic paralysis of the bottom?

Answer 8

Paradoxical breathing during paralysis of the diaphragm

Question 9

What is the cause of loss of impairment of the diaphragm?

Answer 9

Lesion in the neurological or muscular system because of the phrenic nerve

Question 10

What does diaphragmatic paralysis lead to?

Answer 10

diaphragm being pulled upward and anterior ribs pulled inward = hypoventilation

Question 11

What is the treatment of diaphragmatic paralysis?

Unilateral or bilateral

Answer 11

Unilateral = usually no treatment

bilateral = requires a level of mechanical ventilation

Question 12

What is the clinical manifestation of the diaphragm?

Answer 12

Question 13

What is the effects of Amyotrophic Lateral Sclerosis (ALS)?

Answer 13

• reduced function
• RR reduced with weakness of ventilation muscles
• secretions or infiltrates results with poor airway clearance
• decreased breath sounds
• report dyspnea with mild exertion
• easily fatigue
• poor activity endurance

Question 14

What is the effects of poliomyelitis?

Answer 14

• reduced lung volumes
• diminished lung sounds (rhonchi)
• weak cough
• anxious
• poor airway clearance
• dyspnea
• easily fatigue
• poor activity endurace

Question 15

What are the effects of Guillain-Barre Syndrome?

Answer 15

• reduced lung volumes
• dimished breath sounds
• B LE weakness
• Dyspnea
• Anxious
• poor cough and poor airway clearance
• reduced endurance and increased fatigue
• poor activity endurance

Question 16

What is myasthenia gravis?

Answer 16

Chronic neuromuscular disease by progressive muscular weakness on exertion

Autoimmune disease

Question 17

What are the pulmonary sx of myasthenia gravis?

Answer 17

• all lung volumes are reduced
• diminished breath sounds
• poor airway clearance of secretions will hear adventitious sounds
• weakness and fatigue
• dyspnea
• weak
• ineffective cough

Question 18

What is ankylosing spondylitis?

Answer 18

Chronic inflammatory disease of the spine = immobility of SI and vertebral joints
- ossification of paravertebral ligaments
- inherited arthritic condition

Question 19

What is the pulmonary effects of ankylosing spondylitis?

Answer 19

Markedly decreased compliance of chest wall

Question 20

What is the treatment of ankylosing spondylitis?

Answer 20

no cure but keep body alignment and thoracic mobility

Question 21

What is the signs and sx of ankylosing spondylitis?

Answer 21

Question 22

What is kyphosis or scoliosis?

Answer 22

the combination of excessive antero-posterior and lateral curve of the T-spine

Idiopathic in 85% of cases

Question 23

When is pulmonary sx seen with kyphosis or scoliosis

Answer 23

significant curve needs to be seen for sx
- < 70 deg = no pulmonary dysfunction
- 70-120 = some dysfunction
- > 120 = severe RLD and failure

Question 24

What are the clinical manifestations of kyphoscoliosis?

Answer 24

Question 25

What is pectus excavatum?

Answer 25

Funnel chest
sternal depression
decreased A/P diameter

Severe deformity will restrict lung volumes

Question 26

What is pectus carinatum?

Answer 26

Pigeon breast and sternum protuding anteriorly

associated with prlonged childhood asthma

Question 27

Non-pregnant vs Pregnant

Lung volumes and capacities

Answer 27

Question 28

How does obesity affect the chest wall?

Answer 28

it restricts because of the fatty ass chest and abdomen areas = hard time expanding and diaphragm is hard to move

Question 29

What is the pulmonary effects due to obesity?

Answer 29

Volumes are reduced and shallow breathing is seen

Question 30

What are the common clinical presentations of pulmonary sx due to obesity?

Answer 30

Orthopnea
dyspnea with lite activity (wus)
wheezing

Question 31

What are the supportive measures for treatment of RLD?

Answer 31

• supplemental O2
• antibiotic threapy for secondary infection
• interventions to promote proper ventilation
• interventions to prevent accumulation of secretions
• good nutritional support

Question 32

Examples of restrictive and obstructive lung disease with general presentation and sx

Picture

Answer 32

Question 33

Comparison of obstructive and restrictive types of pulmonary diseases

Picture

Answer 33