Asthma and Chronic Bronchitis Flashcards Preview

CardioPulm Lecture 8 - Pulmonary Risk Factors and Disease > Asthma and Chronic Bronchitis > Flashcards

Flashcards in Asthma and Chronic Bronchitis Deck (21)
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1

ASTHMA is

Episodic in nature

Acute episodes alternate with symptom free periods

Chronic inflammatory disease

Airways narrow in response to a stimulus

2

What occurs during an Acute Attack

↑ mucosal edema
↑ secretions,
hyperactive airways (bronchospasm)
Loud audible wheezes, rales and rhonchi

3

Can asthma be life threatening

Yes!

Status Asthmaticus: severe asthmatic attack that does not respond adequately to usual therapy and may require hospitalization

4

Acute asthma attack episodes can be triggered by

Allergens
Infection
Environmental Stress (esp cold)
Emotional Stress

EXERCISE

5

Exercise Induced Bronchospasm is defined as

EIB (exercise induced bronchospasm) is defined as transitory constriction of the lower airways following strenuous exercise

6

Exercise Induced Bronchospasm is caused by

Caused by loss of heat and water from the lungs during exercise due to hyperventilation of dry cool air

7

*How is EIB managed

Pre-exercise warm up
Avoidance of environmental triggers (including cold)

Pharmacology (adherence)

Diet: sodium restriction and hydration, fish oil supplements (anti-inflammatory), Vitamin C (thought to ↓ oxidative damage but evidence is weak)

Preventing SOB is better than managing SOB

8

Asthma Meds - Quick relief (rescue) medications
(relievers)

Short acting beta agonists
– Commonly albuterol

Anticholinergics (Ipratropium) (blocks acetylcholine, more often rx for COPD than asthma)

Oral corticosteroids (for severe attacks
(prednisone) )

9

Asthma Meds - Long term asthma control medications
(preventors)

Inhaled corticosteroids
Long acting beta agonists (LABAs)

Theophylline (taken in pill form)

Leukotriene modifiers (↓ immune response)

Combination drugs (corticosteroids + LABAs)

10

How are bronchodilators delivered

via Metered Dose Inhalers (MDIs)

11

As a therapist you should advocate pts with asthma

warm up and cool down

chest wall stretching - so chest can expand

pacing of activities

energy conservation

proper hydration - can be from dryness

avoidance of triggers (smoke, dust mites, pollution, pets (dander), mold, cold)

reinforce use of meds

12

Can you outgrow asthma

no, it just goes into remission

13

What is Bronchial Thermoplasty

procedure to help asthma where lungs are heated up

14

What is bronchitis (what happens to the lungs)

Hypertrophy of the mucous glands and increase in goblet cells

Loss of ciliary action

Thickening of bronchial wall

Obstruction

inflammation

Inc. secretions

Thick, tenacious, mucopurulent secretions

15

Chronic Bronchitis breath sounds

Prolonged phase of expiration

Coarse rales, rhonchi, and wheezes

16

pts with chronic bronchitis present

Chronic productive cough with morning expectoration
Sputum: clear, mucoid, may be purulent
Recurrent chest infections
Overweight, cyanotic (CO2 retention)
LE edema, R sided ♥ failure
BLUE BLOATERS

17

Role of PT for pts with chronic bronchitis

Advocate for smoking cessation, infection prevention and proper hydration

You can provide education about airway clearance techniques

18

What are Bronchiectasis

Permanent abnormal dilation and distortion of bronchi caused by destruction of the elastic and muscular components of the bronchial walls

Describes an anatomic abnormality NOT
a single disease

seen in CF and chronic bronchitis

19

Bronchiectasis are Commonly caused by:

Necrotizing infections of the trachea and bronchial tubes
Necrotizing PNA (remember, recurrent infections are typically seen in chronic bronchitis and CF)
TB
Pertussis (whooping cough and vaccine has short term life)
Decreased incidence with vaccinations for pertussis, and use of antibiotics (Pertussis is resurgent, new guidelines recommend reimmunization of whole family expecting birth)

Chronic gastroesophageal reflux with aspiration

Foreign body aspiration

Lung diseases that upset the pressure balance that keeps the lungs open
Sarcoidosis
Interstitial Fibrosis
TB

Smoke or other inhalation injury

Immotile cilia syndrome

20

Bronchiectasis: Clinical Features

Patients will present with: Cough, copious mucopurulent sputum, fetid breath (bad breath), recurrent pulmonary infections
Frequently seen in conjunction with:
Cystic Fibrosis
Immotile Cilia Syndrome
Kartagener’s Syndrome [which consists of bronchiectasis, sinusitis, situs inversus (heart on the right side)]

21

Bronchitis Signs

Purulent Sputum: separates into 3 layers upon standing
Upper: frothy, white or greenish/brown
Middle: thin mucoid
Lower: thick plugs

Clubbing

Bronchial Breath Sounds