Treatment

Question 1

List different treatments

Answer 1

Positioning
ACBT
Manual techniques
Exercise
Medical management

Question 2

Which treatment changes the V/Q relationship?

Answer 2

positioning

Question 3

What three manual techniques are there?

Answer 3

vibrations, percussion and shaking

Question 4

Why is positioning used?

Answer 4

It changes the V/Q relationship.

Uses gravity to assist drainage.

Question 5

How long and how many positions should a patient be put into?

Answer 5

10 mins each positions, X3 positions per session.

Question 6

During positioning, where does the area being drained need to be?

Answer 6

The uppermost

Question 7

What is the V/Q relationship like in the upper zone?

Answer 7

Good ventilation, but decreased perfusion.

Question 8

What is the V/Q relationship like in the middle zone?

Answer 8

Ventilation and perfusion are equal.

Question 9

What is the V/Q relationship like in the lower zone?

Answer 9

Decreased ventilation, but increased perfusion as it is easier for blood to floe to.

Question 10

What is the most dense part of the lung?

Answer 10

lower zone

Question 11

What does ACBT stand for?

Answer 11

Active cycle of breathing technique.

Question 12

What three stages does ACBT include?

Answer 12

breathing control, thoracic expansion and force expiratory technique.

Question 13

What does ACBT do?

Answer 13

Aids sputum clearance and improves lung function

Question 14

Describe breathing control as a part of ACBT

Answer 14

Diaphragmatic breathing.
Involves 5 breaths and encourages relaxation of upper chest.
Breathe in and stick tummy out.

Question 15

Describe thoracic expansion as part of ACBT

Answer 15

Movement of the ribs outwards, active inspiration with a three second hold and repeat with 3-4 breaths.
Can add a hold and sniff which increases tidal volume and hold sniff the improve collateral ventilation.

Question 16

Describe the forced expiratory technique as part of ACBT

Answer 16

Deep breath and long huff or short huff. Then cough to bring up sputum.

Question 17

Describe collateral ventilation and ACBT

Answer 17

Air enters alveoli through intrabronchiolar channels of martin, bronchiolar alveolar channels of lambert and alveolar pores of kohn. Thoracic expansion exercises facilitate collateral ventilation and get behind sputum to move it. Large volume=lower pressure=small huff, small volume=high pressure= long huff.

Question 18

How do manual techniques work?

Answer 18

Mechanical vibration helps loosen sputum out of bronchioles and alveoli and aid muscocilary transportation

Question 19

What medical management is available?

Answer 19

Oxygen to improve sats, but it does not treat the underlying pathology.
Drugs and nebulisers(bronchodilators).
Hypertonic saline is given to decrease viscosity of sputum.

Question 20

What does exercise do?

Answer 20

mobilisation increases tidal volume, increases HR cardiac output, can loosen sputum and maintains muscle strength.