Skill Check #2

Question 1

branches of the upper lobes of the lung (bilateral)

Answer 1

apical segment
posterior upper segment
anterior upper segment
lingual segment (L only)

Question 2

branches of the middle lobe (R lung only)

Answer 2

middle segment
Lateral segment

Question 3

branches of the lower lobe branch (bilateral)

Answer 3

anterior basal segment
lateral basal segment
posterior basal segment
superior segment

Question 4

position to drain apical segment

Answer 4

sitting with head of bed propped up

Question 5

position to drain apico-posterior segment

Answer 5

forward lean

Question 6

position to drain anterior upper segment of lung

Answer 6

supine

Question 7

position to drain R posterior segment

Answer 7

lying on left side

positioned between L side lying and prone

Question 8

position to drain R middle segment

Answer 8

foot of bed raised 12 inches

laying on left side

positioned in between L side lying and supine (can put a pillow under patients right side to elevate slightly)

Question 9

position to drain L lingual lobe

Answer 9

foot of bed raised 12 inches

laying on right side

positioned in between R side lying and supine (can put a pillow under patients left side to elevate slightly)

Question 10

position to drain anterior basal segment

Answer 10

foot of bed raised 18 inches

lying supine with legs propped

Question 11

position to drain R lateral segment

Answer 11

full L side lying with feet elevated

foot of bed raised 18 inches

Question 12

position to drain L lateral segment

Answer 12

full right side lying with feet elevated

foot of bed raised 18 inches

Question 13

position to drain posterior basal segment

Answer 13

fully prone with legs elevated

foot of bed raised 18 inches

Question 14

position to drain superior segments

Answer 14

fully prone with flat table

Question 15

when to perform vibration/percussion

Answer 15

30 seconds of percussion to each lobe during rested breathing

vibration to each lobe during EXHALE

Question 16

describe the huffing technique

Answer 16

alterantive to coughing

helps prevent bronchoconstriction and collapse of weak airways

stabilized bronchial walls and support structures

less stress/pain with cough and more control

technique:
- mouth open, O shape
- glottis doesn’t close over trachea
- chest and abdominal mm contraction
- forced exhale that sounds like forced sigh

long/slow exhale= moves secretions in from distal periphery

short/strong/forced exhale = moves secretions more proximally to cough

Question 17

steps of active cycle of breathing

Answer 17

1. breathing control
   - normal breathing
   - in through nose, out mouth
   - pursed lip if needed
   - eyes closed can help focus/relax
2. thoracic expansion
   - 4-5 deep inhales with hand on lower ribs to feel expansion
   - percussion/vibration with exhale
3. forced expiratory technique
   - 1-2 deep huff cough techniques with strong abdominal contraction