Upper respiratory tract infections

Question 1

Which anatomical features of URT help rid particles and pathogens?

Answer 1

• Mucociliary lining in nasal cavity traps particles sized 5-10 micrometers in diameter.
• Airway direction from sinuses to pharynx – particles impinged at the back of the throat.
• Mucociliary escalator of lower respiratory tract – trapped particles in the mucus layer are swept upwards towards the throat and removed through coughing or swallowing

Question 2

Organisms need to overcome which obstacles to initiate an URTI?

Answer 2

o Avoid capture in the mucus layers in the nasal cavity
o Avoid the defence mechanisms of lower respiratory tract (mucociliary escalator – sweeping cilia on epithelial cells)
o Avoid phagocytosis (destruction) by the body’s white cells (immune system) in the lower respiratory tract

Question 3

How URT disease established?

Answer 3

• Infectious particles must be airborne.
• Infectious organism must remain alive and viable while in the air.
• Person must inhale sufficient number or “dose” of infectious agent.
• Organism must be deposited on susceptible tissue in the host.
• Colonize infected surfaces of the host and cause systemic reaction within the host’s body

Question 4

What are the risk factors for developing an URTI?

Answer 4

• Age – young children and the elderly.
• Medical conditions
• Immune suppression
• Chronic respiratory diseases
• Chronic cardiac diseases
• Diabetes
• Genetic disorders
• Weather
• Stress

Question 5

Name the diseases caused by smoking

Answer 5

Cancers, CV diseases, Respiratory diseases, reproductive effects,, low bone density, peptic ulcer disease, cataracts, diminished health status

Question 6

What are the goals of CP patient management?

Answer 6

• Prevent accumulation of secretions (phlegm) in the lower respiratory tract (LRT)
• Improve mobilisation and clearance of secretions from the LRT
• Promote efficient breathing patterns
• Improve the distribution of ventilation through the LRT
• Improve compliance of the lung tissue
• Improve the patient’s cardiopulmonary exercise tolerance

Question 7

What ACBT used to do?

Answer 7

• Normalise a patient’s breathing pattern.
• Normalise their lung volumes.
• Clear excessive bronchial secretions from the patient’s tracheobronchial tree

Question 8

What are the uses of placing a patient in gravity-assisted positions?

Answer 8

• Assist with the clearance of retained bronchial secretions from the airways
• Improve ventilation of the lungs
• The positions used are based on the anatomy of the tracheobronchial tree.
• Trendellenburg positions (head-down tilt positions) are used to clear secretions from the middle lobe, lingula and basal lobes.
• Modified positions (without head-down tilt) are used for those patients who can’t tolerate traditional PD positions

Question 9

What are the cautions/ CIs for postural drainage positions?

Answer 9

• Congestive cardiac failure
• Severe hypertension
• Cerebral oedema or raised intracranial pressure
• Aortic or cerebral aneurysms
• Frank haemoptysis
• Abdominal distension or obesity
• Gastro-esophageal reflux
• Recent surgery or trauma to the head and neck

Question 10

What are manual chest therapy techniques used for?

Answer 10

• Infants and small children who are unable to voluntarily perform breathing exercises.
• Patients with neuromuscular weakness or paralysis.
• Intellectually impaired patients.
• Patients with suppressed levels of consciousness.
• Mechanically ventilated patients who are unable to perform breathing exercises or are required to stay immobile due to the nature of their injuries.
• Patients with retained secretions (in combination with breathing exercises) who cannot clear secretions effectively on their own

Question 11

What are the cautions and contraindications for manual chest therapy techniques?

Answer 11

• Loss of skin integrity
• Excessive pain
• Frank haemoptysis
• Uncontrollable intracranial pressure in patients with traumatic brain injury
• Multiple rib # or flail rib #
• Acute bronchospasm that doesn’t respond to bronchodilator therapy
• Severe osteoporosis
• Severe clotting disorders (platelets < 50 x 109/L)
• Pulmonary embolism (not on anti-coagulant therapy)
• Subcutaneous emphysema
• Unstable angina or cardiac arrhythmias
• Caution with unstable spinal cord injury
• Pulmonary oedema or unstable pulmonary hypertension