Term
| Diseases of airways, which produce obstruction of expiratory flow |
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Definition
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Term
| Airflow obstructions an be related to what 4 things? |
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Definition
1. Retained secretions
2. Inflammation of mucosal lining of airway walls
3. Bronchial constriction
4. Weakening of support structure |
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Term
| Conditions that lead to decreased size of bronchial lumen and increased resistance to expiratory airflow |
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Definition
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Term
| Name 4 signs of lung hyperinflation |
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Definition
1. Elevation of shoulder girdle
2. Horizontal Ribs
3. Barrel-shaped thorax
4. Low-flattened diaphragms |
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Term
| Lung __ affects both the mechanical function of respiratory muscles and gas exchange. |
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Definition
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Term
| How do you know if you have abnormal gas exchange? |
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Definition
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Term
| Name 3 symptoms associated with obstructive lung diseases |
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Definition
1. Dyspnea on exertion, especially during functional activities
2. May have increased anxiety level
3. Secretion production and cough |
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Term
| What do spirometry tracings measure in the lung? |
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Definition
| Time-volume relationships |
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Term
| Characterized by delayed and incomplete emptying of the lung during exhalation |
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Definition
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Term
| Name 2 forced expiratory volumes monitored in pulmonary function testing |
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Definition
Forced expiratory volume in 1 sec
Forced vital capacity |
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Term
| FEV1/FVC ratio ___ is normal. This number gets lower as the patient becomes more involved. |
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Definition
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Term
| Used to quantify degrees of airway obstruction, document improvements, follow progression |
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Definition
| Pulmonary Function Testing |
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Term
| COPD is associated with a larger amount of what 2 lung volumes? |
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Definition
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Term
| A multisystem disorder affecting both children and young adults. Mainly involves the lungs and pancreas. Affects organs with epithelial surfaces, primarily pulmonary and pancreatic. |
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Definition
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Term
| Mucus stasis in conducting airways of lung, nasal sinuses, sweat glands, small intestine, pancreas, and biliary system. Mucus is very thick with this dz. There will be abnormal salt and water transport. |
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Definition
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Term
| Results in a failure of airways to clear mucus normally. A persistent cough becomes productive with tenacious, purulent, green sputum. |
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Definition
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Term
| Recurrent lung infiltrates. Meconium ileus at birth. Malabsorption of nutrients in intestinal tract. Maldigestion and fecal impaction in terminal ileum. Failure to thrive with steatorrhea. Pancreatic insufficiency |
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Definition
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Term
| Black tar feces stuck in ileum. Causes baby to throw up. |
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Definition
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Term
| Usually diagnosed very early on (before 2 y/o) Pt tends to be very thin |
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Definition
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Term
| Excess fat in feces, stool will be oily and very large. |
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Definition
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Term
| What 2 diagnostic tests can be done with cystic fibrosis? |
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Definition
Newborn screen- CFTR mutation scree
Sweat test- elevated chloride levels (>60) |
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Term
| Name 4 things done in the physical examination for cystic fibrosis |
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Definition
Diagnostic tests
Radiographic tests
Pulmonary function tests
ABGs |
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Term
| Name 4 aspects of medical management with cystic fibrosis |
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Definition
1. Guideline of CF care
2. Goals include controlling lung infection, promoting mucus clearance, improving nutritional status
3. Pulmonary infection
4. Pancreatic status and nutritional supplementation |
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Term
| What is the prognosis for cystic fibrosis? |
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Definition
| Dramatic increase in median age of survival |
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Term
| Name 2 ways to prevent cystic fibrosis |
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Definition
Genetic counseling
Screening for CF carrier status |
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Term
| Name 6 implications for physical therapy treatment in pts with cystic fibrosis. |
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Definition
1. Secretion clearance techniques
2. Controlled breathing techniques
3. Exercise and strength training
4. Inspiratory ms training
5. Thoracic stretching exercises
6. Postural re-education |
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Term
| A chronic inflammatory disorder of airways. "Episodic" obstructive lung condition. Abnormal accumulations of eosinophils, lymphocytes, mast cells, macrophages, dendritis cells, and myofibroblasts. |
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Definition
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Term
| If your pt has asthma, what are 2 major precautions to take. |
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Definition
Make sure rescue inhaler is with them
Know what triggers them |
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Term
| Causes of this include viral or allergen exposures, exercise, inhalation of cold air. Symptoms include wheezing, chest tightness, and shortness of breath. |
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Definition
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Term
| What diagnostic tests can be performed for patient's with asthma? |
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Definition
| PFTs to evaluate current function and any reversibility of airway obstruction after bronchodilator administration |
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Term
| Name 3 specific types of asthma |
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Definition
Seasonal (pollen, mold)
Exercise-induced
Asthmatic bronchitis |
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Term
| Name 5 medical management techniques for pts with asthma |
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Definition
1. Emphasize long term control
2. Objective measures to assess function and monitor
3. Identification and elimination of causes
4. Comprehensive pharmacological therapy
5. Therapeutic partnership |
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Term
| What is the prognosis for asthma patients? |
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Definition
| 50% who have asthma as a child will continue to have symptoms as adult |
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Term
| How can asthma be prevented? |
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Definition
| Adhere to medical and pharmacological recommendations. Avoid personal triggers |
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Term
| Name 6 implications for PT treatment with asthma patients. |
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Definition
1. Interventions should not begin until medication regime is established
2. Secretion clearance
3. Controlled breathing
4. Exercise and strength
5. Thoracic stretching
6. Postural reeducation |
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Term
| What is the 4th leading cause of death |
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Definition
| Chronic Obstructive Pulmonary Dz |
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Term
| Is COPD preventable or treatable? |
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Definition
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Term
| What is a major cause of COPD? |
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Definition
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Term
| Chronic airflow limitation caused by a mixture of parenchymal alveolar disease and small airway dz |
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Definition
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Term
| A condition of the lung characterized by destruction of alveolar walls and enlargement of air spaces distal to terminal bronchioles. Role of inflammatory cells. |
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Definition
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Term
| What is a major cause of emphysema? |
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Definition
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Term
| Name 3 subtypes of emphysema |
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Definition
Centrilobular Emphysema
Panlobular Emphysema
Distal Acina |
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Term
| Presence of chronic productive cough for 3 months in each of 2 successive years. Hypersecretion of mucus begins in large airways and progress to smaller airways. Hypertrophy of submucosal glands. |
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Definition
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Term
| What are some risk factors for COPD (the combination dz) |
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Definition
Cigarette smoking
Air pollution |
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Term
| Inhalation of smoke or noxious particles results in inflammation of lung. Structural changes and narrowing of small airways. Destruction of lung parenchyma, respiratory bronchioles, alveoli - decrease lung recoil |
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Definition
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Term
| The gold standard for diagnosing COPD |
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Definition
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Term
-Decreased FEV1 and FEV1/FVC
-Symptoms - coughing, dyspnea, SOB
-Physical Exam
- Diagnostic Tests - auscultation (prolonged expiration); forward-leaning posture, CXR, PFTs |
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Definition
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Term
| Name 6 medical management techniques for COPD (combo dz) |
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Definition
1. Smoking cessation
2. Pharmacotherapy for COPD
3. Influenza vaccine
4. Treatment of sleep disorders
5. Pulmonary rehab and exercise training
6. Surgical excision of bullae or lung volume reduction surgery (LVRS) |
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Term
| What are 3 tips to prognosis for COPD |
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Definition
1. Progressive dz with expected worsening over time
2. BODE index - body mass, obstruction, dyspnea, exercise, score of 7 to 10 is associated with high mortality rate of 80% in 52 months
3. End-stage COPD results in cor pulmonale |
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Term
| How can you prevent COPD? |
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Definition
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Term
| Name 8 implications for PT treatment in patients with COPD |
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Definition
-Secretion Clearance
-Controlled breathing at rest and with activity
-Ambulation with rolling walker
-Education in use of recovery from SOB positions
-Endurance exercise training
-Strength training
-Thoracic stretching
-Postural re-education |
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Term
| Dilation of the bronchia - irreversible with chronic inflammation and infection. Distortion of conducting airways, thickening, herniation, or dilation |
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Definition
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Term
| Name 3 mechanisms of bronciectasis |
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Definition
-Bronchial wall injury/structural weakness
-Traction from adjacent lung fibrosis
-Bronchial lumen obstruction |
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Term
| Name 5 symptoms of bronchiectasis |
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Definition
1. Cough with sputum production in small to large quantities of mucopurulent secretions
2. Secretions layers (white frothy, mucoid inner, purulent bottom, composed of thick yellow-green plugs
3. Sputum greatest in morning
4. Recurrent, chronic, or recurring lung infections
5. Hemoptysis |
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Term
| Name 5 diagnostic tests for bronchiectasis |
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Definition
1. CT scans - signet red sign; classified as cylindrical, varicose, and saccular
2. PFTs
3. Blood work - blood gases become abnormal
4. Sputum testing - H influenzae and P aeruginosa
5. Evaluation of gastroesophageal reflux dz |
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Term
| What is included in the physical exam portion for bronchiectasis? |
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Definition
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Term
| Name 5 medical management techniques for Bronchiectasis |
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Definition
1. Goal is to reduce the number of exacerbations and improve quality of life
2. Management underlying condition
3. Management of acute exacerbations
4. Long-term management
5. Surgery |
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Term
| What is the prognosis for bronchiectasis? |
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Definition
Depends on underlying dz or condition
CF and bronchiectasis have poorest prognosis |
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Term
| What type of screening can be used to prevent bronchiectasis? |
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Definition
|
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Term
| Name 3 pt implications for pts with bronchiectasis. |
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Definition
Secretion clearance
Controlled breathing
Strength and endurance training |
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