week 9

Question 1

Describe Boyle’s law

Answer 1

Boyle’s law states that at a fixed temperature, the volume of gas is inversely proportional to the pressure exerted by the gas

Question 2

How much of our overall energy expenditure do we approximately use on breathing at rest?

Answer 2

2 to 5%

Question 3

In patients with COPD how much of their overall energy expenditure do they approximately use on breathing at rest?

Answer 3

it can increase up to 40%

Question 4

What is work of breathing?

Answer 4

the energy required by the respiratory muscles to breathe

Question 5

Name some signs and symptoms of increased work of breathing

Answer 5

high respiratory rate
high heart rate
mouth breathing
altered respiratory pattern
use of accessory muscles of respiration
shoulder fixation
reduced oxygen saturations
laboured breathing/forced exhalation
adopting an upper chest breathing pattern

Question 6

Name some causes of increased work of breathing

Answer 6

an increase in the load
a reduction in the capacity
an increase in demand

Question 7

What can sputum contain?

Answer 7

mucus, cellular debris, micro-organisms, pus, blood and foreign particles

Question 8

what is expectoration?

Answer 8

expulsion of mucus, sputum or fluids from the respiratory tract by coughing, clearing ones throat and spitting

Question 9

What is therapeutic positioning?

Answer 9

the deliberate placement of the patient or a body part to promote physiological and/or psychological well-being

Question 10

What does positioning affect?

Answer 10

tone
function
soft tissue integrity/viability
soft tissue length

Question 11

how can body positions affect the lungs?

Answer 11

Body positions can be manipulated to help move secretions nearer to the mouth to ease with expectoration
Body positions have profound effects on ventilation and perfusion matching in unilateral lung disorders
body position impacts on lung compliance and the work of breathing

Question 12

Why do physiotherapists manipulate body positions?

Answer 12

to optimise respiratory function

Question 13

How do specific positions reduce a patients work of breathing and sensation of breathlessness?

Answer 13

reduce the load
reduce energy demand
thereby improving efficiency of breathing

Question 14

Name some positions of ease

Answer 14

forward lean sitting supporting the shoulder girdle
standing (leaning onto a fixed surface)
side lying/high side lying

Question 15

How does supporting the shoulder girdle help with breathlessness?

Answer 15

It allows the accessory muscles to lift the ribs, increasing thoracic volume to improve ventilation without increasing consumption
It helps to stabilise the shoulders, reducing the load on the accessory muscles of respiration

Question 16

How do forward lean standing or sitting positions help with breathlessness?

Answer 16

This raises the anterior part of the diaphragm, lengthening it
this optimises its length-tension relationship, facilitating its contraction during inspiration
the diaphragm has more room to move, making breathing more efficient

Question 17

How do positions of ease prevent excess energy demand?

Answer 17

reducing active fixation of the shoulder girdle
reducing overuse of the accessory muscles
optimising respiratory muscle function
reducing the load on the respiratory muscles

Question 18

What does ventilation refer to?

Answer 18

the movement of air between the outside and alveoli
describes the process where alveoli are continually flushed with fresh atmospheric air to allow gas exchange

Question 19

What need to be in the same place for gas exchange to occur?

Answer 19

fresh air (ventilation) and blood (prefusion)

Question 20

When does a physiological mismatch occur?

Answer 20

when there is ventilation but no perfusion (increased dead space) or perfusion with no ventilation