Chest Physical Therapy Flashcards
(52 cards)
Typical goals of chest PT
Prevent airway obstruction and ateclasis Improve airway clearance and ventilation thru drainage Improve endurance Reduce energy costs during respiration Prevent or improve postural deformities Improve cough Promote relaxation
What is ateclasis
Collapse of lung
Obstructive disorders
COPD Chronic bronchitis Emphysema Asthma Bronchiectasis Cystic fibrosis
COPD
Term used to describe chronic lung diseases that are characterized by progressive obstruction of airflow into or out of lungs and SOB
Usually combo including chronic bronchitis and emphysema
Chronic bronchitis
Airway narrowing, excessive mucus secretion, productive cough for 3+ months at a time over 2 consecutive yrs.
Blue bloaters Hypoxemia Inadequate gas exchange? Edema Mortality rate 2x as high as pink puffers
Thought to be related to long term irritation of tracheobronchial tree; most commonly smoking
Pt is stocky, breathes w accessory mm, may wheeze, & have neck vein distention
Emphysema
Disease of alveoli which become hyperinflated
Tend to become pink puffers who maintain near normal blood gases at the expense of breathlessness & weight loss
Pt is dyspneic (difficulty breathing), thin, used accessory mm, pursed lips in expiration, commonly with chronic bronchitis
Rare among non smokers
Males are more likely to get it
Asthma
Increased reactivity of tracheobronchial tree in presence of various stimuli manifested in episodic attacks of wheezing and dyspnea
Extrinsic stimuli- pollen, animals, feathers, molds, dust, food
Intrinsic stimuli- weather (high humidity, cold air), Resp. Infections, drugs, emotions, exercise.
1st attack is usually after age 35 & has evidence of chronic airway obstruction w/episodes of acute bronchospasm (abnormal contraction of smooth mm, causing obstruction if airway)
Lumen is narrowed or occluded b inflammation
Tachypnea, use accessory mm, audible wheezing, frequent unproductive cough, c/o chest tightness
Bronchiectasis
Chronically dilated airways as a result of damage manifested in obstructed airflow, excess mucus, frequent infections that destroy cilia
Cystic fibrosis
Inherited disorder of excess exocrine gland activity affecting many organ systems.
Viscous secretions obstruct airways and pancreatic ducts
Restrictive disorders
Differing etiologies result in difficulty expanding the lungs and reduction in lung volume
Anything that affects elasticity or compliance of lung
Acute restrictive disorders
Atelectasis
ARDS
Pulmonary edema
Pneumonia
Atelectasis
Aka pneumothorax
Collapse of segments of lobes or lungs
Can be caused by compression of lung tissue or obstructed airway with absorption of trapped air which collapses lung tissue distal to obstruction.
Common after thoracic or abdominal surgery
S/s: decreased chest movement, absent breath sounds over involved area, mediastinal shift to involved side, rapid breathing, cyanosis.m
ARDS - Acute or adult respiratory distress
Increased permeability of alveolar capillary membrane and sever hypoxemia
May show: Resp. Distress, severe hypoxia that doesnt respond to high O2 concentration, decreased lung compliance
Pulmonary edema
Accumulation of fluid in the extra vascular space, which can initially occur in the interstitium and then go to alveolar spaces
Chest PT not indicated
Pneumonia
Acute inflammation of lung parenchyma (abnormal tissue growth of a structure) which fills alveoli with exudates and leads to conSOLIDation
Chest PT possibly for obtaining sputum samples
Deep breathing and positioning to improve gas exchange
Supported caught to remove secretions
Pleural effusion
Restrictive disorder where fluid accumulates in pleural cavity and compresses lungs
Mobilization helps prevent undue atelectasis
Deep breathing for gas exchange
Interstitial lung disease
Restrictive disorder group if about 130 disorders associated with immune disturbances
Chest PT rarely indicated except for maintaining fx activities
Neuromuscular & skeletal disorders
Restrictive disorder with kyphoscoliosis, ankylosing spondylitis, rib fx, & other trauma
Obesity
Restrictive disorder limits diaphragm movement
Can include ascites which is abnormal accumulation of fluid in abdomen
S/P abdominal or thoracic surgery
Restrictive disorder where pain limits respiratory movement and coughing
CNS depression
Restrictive disorder where respiration is depressed
Abscess
Focal collection of pis caused by infection; deep breathing & positioning to improve gas exchange.
Pulmonary TB
Potentially serious infectious disease that affects mostly ur lungs.
Spread thru tiny droplets
External respiration
Exchange of gas at alveolar capillary membrane between atmospheric air and pulmonary capillaries
