Acute W1 Flashcards
lung disease (113 cards)
1
Q
What is the angle of the right bronchus compared to the left bronchus?
A
20-30 degrees for the right bronchus and 45-55 degrees for the left bronchus
2
Q
How many lobes does the right lung have?
A
3 lobes
3
Q
How many lobes does the left lung have?
A
2 lobes
4
Q
What separates the right middle and lower lobes?
A
Oblique fissure
5
Q
What separates the right upper and middle lobes?
A
Transverse fissure
6
Q
What is the cardio-thoracic index?
A
Size of heart in relation to thorax
7
Q
How is the cardio-thoracic index measured?
A
On a PA chest x-ray
8
Q
What is a normal cardio-thoracic index measurement?
A
<0.5
9
Q
What is the normal respiration rate for adults?
A
12-20 breaths per minute
10
Q
What is the tidal volume (TV) at rest?
A
500 mL
11
Q
What is the formula for calculating Vital Capacity (VC)?
A
IRV + TV + ERV
12
Q
What is the residual volume (RV)?
A
Volume that remains in the lungs after a maximal expiration
13
Q
What is the approximate volume of the anatomical dead space?
A
150 mL
14
Q
What is the Forced Expiratory Volume in 1 Second (FEV1)?
A
The volume of air that can be expired in 1 second after a maximal inspiration
15
Q
True or False: In obstructive lung disease, FEV1 is reduced more than FVC.
A
True
16
Q
What are the two types of dead space in the lungs?
A
- Anatomic Dead Space
- Physiologic Dead Space
17
Q
What is pneumonia?
A
Acute inflammation of lungs in which some or all of alveoli are filled with fluid or cells
18
Q
List the three categories that can cause pneumonia.
A
- Inhalation
- Hematogenous
- Aspiration
19
Q
What is atelectasis?
A
Collapse of normally expanded and aerated lung tissue
20
Q
List the possible causes of atelectasis.
A
- Blockage of bronchus/bronchiole
- Compression
- Post-anesthetic effects
- Poor Ventilation
21
Q
What is Acute Respiratory Distress Syndrome (ARDS)?
A
Acute respiratory failure with severe hypoxemia as a result of pulmonary or systemic problem
22
Q
What is a key feature on X-ray for ARDS?
A
WHITE OUT
23
Q
What is the treatment for Infant Respiratory Distress Syndrome (IRDS)?
A
Deliver artificial surfactant
24
Q
What is a lung abscess?
A
Infection leading to necrosis of lung tissue and cavity formation
25
What are the signs and symptoms of a lung abscess?
* Purulent and foul-smelling sputum
* Cough
* Fever
* Chest pain
26
What is the treatment for a lung abscess?
* Prolonged antibiotic use
* Drainage of abscess
* Deep breathing exercises
* Supplemental Oxygen if required
* Mobility as tolerated
* Secretion removal if abscess is draining into airway
27
What is tuberculosis and where might it spread to?
Inflammatory systemic disease that affects lungs
* may spread to involve kidneys, growth plates, meninges, vascular necrosis of hip jt, lymph nodes and other organs.
28
What type of disease is tuberculosis?
Airborne disease
29
What are common signs and symptoms of tuberculosis?
* Productive cough lasting 3+ weeks
* Weight loss
* Fever
* Night sweats
* Fatigue
* Bronchial breath sounds
30
What is the recommended duration for tuberculosis medication?
6-9 months
31
What precautions should HCP take for tuberculosis?
Self-protection using N95 masks, gloves, and gowns
32
What is a pneumothorax?
Collapse of the lung due to air gathering in the pleural space
33
What are the signs and symptoms of pneumothorax?
* Sudden chest pain
* Shortness of breath
* Hyper-resonant percussion
34
What does a chest X-ray show in the case of pneumothorax?
Hyperlucent lung with mediastinal shift away from the side of pneumothorax
35
What is tension pneumothorax?
A form of closed Pneumothorax that is life-threatening with increased pressure on the heart that can cause it to stop beating
36
What is the medical treatment for moderate tension pneumothorax?
Aspirate with catheter needle (remove air in pleural space)
37
What is hemothorax?
Collapse of the lung due to blood gathering in the pleural space, usually due to trauma
38
What is flail chest?
Multiple rib fractures with a free-floating rib section
39
What happens to the flail segment during inspiration?
Flail segment sucks in, causing mediastinal shift away and reducing air entry into the unaffected lung
40
What is the definition of asthma?
Chronic inflammation of airways with variable airflow limitation and airway hyper-responsiveness *often reversible with bronchodilator
41
What is the 'Triad of Asthma'?
* Allergies
* Eczema
* Asthma
42
What are the two types of asthma?
* Extrinsic: allergic or atopic - in response to specific trigger (usually childhood onset)
* Intrinsic: non-allergic - hypersensitivity to bacteria, virus, drugs, cold air, exercise, stress (adult onset)
43
What are acute signs and symptoms of asthma?
* Shortness of breath
* Increased respiratory rate
* Wheezing
44
What is a common treatment for asthma?
Inhaled corticosteroids and bronchodilators
45
What is exercise-induced asthma?
Acute, reversible airflow obstruction occurring 5-15 minutes after exercise
46
What are the signs and symptoms of exercise-induced asthma during exercise?
* Coughing
* Wheezing
* Prolonged expiration
* Accessory muscle use
47
What is Chronic Obstructive Pulmonary Disease (COPD)?
Chronic respiratory condition characterized by progressive airway obstruction that is not fully reversible
48
What are the two types of COPD?
* Emphysema
* Chronic Bronchitis
49
What is emphysema characterized by?
Destruction of alveolar septa causing merging of alveoli, reducing surface area for gas exchange
50
What are the primary signs and symptoms of chronic bronchitis?
* Productive cough lasting 3 months/year for 2 consecutive years
* Increased mucus production
* Decreased vital capacity
51
What is the primary diagnostic test for COPD?
Spirometry
52
What type of medication focuses on bronchial smooth muscle relaxation in COPD treatment?
Bronchodilators
53
What is the purpose of corticosteroids in COPD treatment?
To reduce airway inflammation
54
What is pursed lip breathing?
Breathing out through pursed lips to slow airflow and prevent airway collapse during exhalation
55
What pulmonary function test finding is typical for patients with COPD?
* Increased functional residual capacity
* Increased total lung capacity
* Increased residual volume
* FEV1 less than 70% of forced vital capacity
56
What is a key difference between COPD and asthma regarding FEV1 reversibility?
COPD is never completely reversible; asthma is partially to completely reversible
57
What is the age of onset for COPD?
Middle aged (35+) to older adults
58
What are common risk factors for developing COPD?
* Age
* Smoking
* Occupational exposures
* Biomass smoke
* Genetic susceptibility
59
What is the cause of Cystic Fibrosis?
Autosomal, recessively inherited genetic disorder
## Footnote
Cystic Fibrosis is caused by a mutation in the CFTR gene affecting ion transport.
60
What is the abnormality in Cystic Fibrosis?
Abnormality in chloride (Cl-) and sodium (Na+) ion transport across the epithelium of the respiratory, digestive, and genital tracts
61
What are the results of the ion transport defect in Cystic Fibrosis?
Defective Cl- excretion and Na+ absorption leading to thick mucus and scarring in affected organs
62
What is a key diagnostic test for Cystic Fibrosis?
Sweat test: Chloride content of sweat
63
What are common findings on a Chest X-ray for Cystic Fibrosis?
Linear opacities, thickened bronchial walls, consolidation due to atelectasis
64
What is the most critical part of treatment for Cystic Fibrosis?
Secretion removal, needed 2-3 times a day
65
What are bronchodilators used for in Cystic Fibrosis treatment?
To open the airways and improve breathing
66
What are the airway clearance techniques for patients aged birth to 5 years?
Aggressive bronchial drainage, chest vibration & percussion
67
What are the airway clearance techniques for patients aged 6 years and older?
Use of acapella device (handheld dynamometer), flutter device, PEP mask, Active Cycle of Breathing, Autogenic drainage
68
What is Bronchiectasis?
Irreversible destruction and dilation of the airways associated with chronic bacterial infection
69
What results from excess mucus production in Bronchiectasis?
Narrowed airways and history of repeated respiratory infections
70
What are intrinsic causes of Restrictive Pulmonary Disease?
Pulmonary Fibrosis and other scarring disorders
71
What are the signs of Restrictive Pulmonary Disease?
Stiff, less compliant lungs, decreased FEV1 and FVC
72
What is the treatment for Restrictive Pulmonary Disease?
O2 therapy, lung transplant, pulmonary rehab
73
What is Pleural Effusion?
Accumulation of fluid in the pleural space due to disease
74
What are the two types of Pleural Effusion?
* Transudate: High fluidity and low protein
* Exudate: Low fluidity and high protein/cells
75
What are the common IPPA signs and symptoms of Pleural Effusion?
SOB, chest pain, dull percussion note, decreased or absent breath sounds
76
What is Pulmonary Edema?
Increased fluid in extravascular spaces of the lungs
77
What is a classic sign of Pulmonary Edema?
Cough that produces a frothy pink-tinged sputum
78
What are the goals of Diaphragmatic Breathing?
Increase ventilation, prevent atelectasis, decrease work of breathing, assist in secretion removal
79
What is Pursed Lip Breathing primarily used for?
Individuals with COPD
80
What is the technique for Pursed Lip Breathing?
Inhale through nose for 2 seconds, exhale through pursed lips for 4 seconds
81
What is Incentive Spirometry used for?
To sustain inspiration effort for ~3 seconds followed by relaxed expiration
82
What is the purpose of Breathing Exercises in respiratory therapy?
Increase ventilation, prevent atelectasis, decrease work of breathing, assist in secretion removal
83
What are common medical treatments for Pulmonary Edema?
Oxygen, mechanical ventilation if severe, vasodilators, diuretics
84
Will an overexposed x-ray be more black or more white?
More black
85
What is the definition of Obstructive Lung Disease?
Characterized by airway obstruction leading to difficulty exhaling
86
What is the definition of Restrictive Lung Disease?
Characterized by a loss of lung compliance and difficulty inhaling
87
Fill in the blank: The FEV1/FVC ratio is typically ______ in Obstructive Lung Disease.
decreased
88
Fill in the blank: The FVC value is typically ______ in Restrictive Lung Disease.
decreased
89
What is the primary purpose of coughing in respiratory therapy?
Removing secretions out of larger airways
## Footnote
Coughing is often reflexive and can be forceful and fatiguing for the patient.
90
What is Huffing or Forced Expiratory Technique (FET) best used for?
Removing secretions out of smaller airways
## Footnote
Huffing is less forceful than a cough and less tiring for the patient.
91
What is a contraindication for Assisted Cough?
Ruptured diaphragm
## Footnote
Also, consider inferior vena cava filter.
92
List some special considerations when performing manual secretion clearance techniques.
* Pregnancy
* Abdominal Aortic Aneurism
* Cardiac instability
* Fragile or rigid rib cage
* Elevated ICP
* Post-surgical
* Thorax/spinal trauma
93
What is Postural Drainage used for?
To favor gravity-directed movement of secretions toward the airway opening
## Footnote
It is used to drain individual segments of the lobes.
94
What positions are used for Right Upper Lobe drainage?
Apical: Patient sits upright at 60 degrees
Anterior: Patient lies supine with knees elevated
Posterior: Patient lies on left side, rolls right shoulder forward 45 degrees
95
What is the purpose of percussion in secretion clearance?
To shake loose secretions and allow easier expectoration
## Footnote
Percussion lasts for 30-60 seconds followed by huffs or coughs.
96
What is the technique of vibrations in respiratory therapy?
Application of vibrations over affected lobes during exhalation
## Footnote
Mechanical vibration can also be used through rib springing.
97
What is a PEP Mask used for?
Creates resistance to keep airways open, allowing air to get behind mucus
## Footnote
Helps push mucus forward to be secreted.
98
What is the Active Cycle of Breathing (ACB)?
Cycles of breathing exercises, forced expiration, and relaxed breathing
## Footnote
It mobilizes secretions towards the upper airway.
99
What are the three phases of Autogenic Drainage (AD)?
* Un-sticking: Loosens mucus in small lower airways
* Collecting: Moves mucus into middle airways
* Evacuating: Moves mucus out with huff coughing
100
What is the role of exercise in secretion clearance?
Mobilization helps with secretion clearance
## Footnote
An individualized exercise program is key for improving pulmonary function and quality of life.
101
What are the passages involved in suctioning?
* Indwelling
* Tracheostomy Tube
* Oropharyngeal
* Nasopharyngeal (NP)
102
What are indications for suctioning?
* Patient unable to clear secretions
* Sputum sample
* Lung pathology
* Loss of airway control
103
What is the recommended suctioning time for Endotracheal suctioning?
10-15 seconds
## Footnote
This is crucial to prevent complications.
104
What are contraindications for Nasopharyngeal suctioning?
* Nasal bleeding
* Croup (viral throat infection)
* Basal skull fracture
* Acute head/facial injury
* CSF leak
* Nasal stenosis
* Nasal pathology
105
what are the 3 stages of pneumonia and which stage does PT have the most impact?
1. engorgement
2. consolidation
3. resolution - PT can aid in secretion clearance
106
what are the IPPA findings for pneumonia?
see notes.
107
what do you expect to find on auscultation of someone with atelectasis?
fine crackles.
108
what 2 areas can cause restrictive lung disease?
1. lung tissue - fibrosis
2. chest wall - obesity, paralysis, etc.
109
T or F: static lung volumes are helpful in characterizing restrictive diseases?
true - as static volumes are more concerned with the elastic properties of lung tissue (ie. Vt, ERV, IRV, etc)
110
list the pulmonary causes of restrictive lung diseases.
atelectasis
* pulmonary edema
* ARDS
* lung resection
* pulmonary embolism
* pneumonia
* ILD
111
list the extra-pulmonary causes of restrictive lung diseases.
obesity
* phrenic nerve injury
* pneumo/hemothorax
* neuromuscular disorders
* subcutaneous emphysema
* pleural effusion
112
What are some potential causes of arteriosclerosis?
high cholesterol, high BP, diabetes, and in some cases genetic link
113
what is Ascites?
fluid build up in abdomen which can lead to damage to the organs (ie. liver & spleen)
