Exam 1 Flashcards
(114 cards)
1
Q
A decrease in lung capacities and volumes
A
Restrictive Lung disease
2
Q
Difficulty getting air in, inability to fill the alveoli
A
Restrictive Lung disease
3
Q
Is FEV1/FVC normal or abnormal with restrictive dz
A
normal
4
Q
Is FEV1/FVC normal or abnormal with obstructive dz
A
abnormal
5
Q
Increased airway resitance =
A
Obstructive lung disease
6
Q
Is inspriation or expiration the issue with restrictive dz
A
inspriation
7
Q
Is inspiration or expiration the issue with obstructive dz
A
expiration
8
Q
Are flow rates abnormal with obstructive or restrictive dz
A
Obstructive
9
Q
Are volumes/capacities abnormal with restrictve or obstructive dz
A
Restrictive
10
Q
Treatment for permanent restrictive lung dz
A
Exercise, supplemental O2, (supportive measures)
11
Q
Treatment for reversible restrictive lung dz
A
Corrective measures (chest tube or mechanical ventilation)
12
Q
a disorder characterized by airflow obstruction
A
COPD
13
Q
Describe the check valve effect (COPD)
A
During inspriation the airways open to allow air entry
But during expiration they prematruely close and air becomes trapped in the alveoli
This leads to an incr in TLC
14
Q
What are 2 conditions included in COPD
A
- ) Chronic Bronchitis
2. ) Emphysema
15
Q
True or false: COPD results in air trapping, alveolar hyperinflation and destruction, and weakened bronchiolar walls
A
True
16
Q
Clinical presentation for COPD
A
Digital clubbing Barrel chest Decr FEV1 Dyspnea Incr in RV
17
Q
What is used to diagnose the prescence and severity of COPD?
A
Pulmonary Function Testing (PFT)
18
Q
What is normal tidal volume
A
500 mL
19
Q
What is normal TLC
A
6L
20
Q
A FEV1/FVC below ____ is considered abnormal
A
70%
21
Q
What is a prognostic indicator of COPD
A
FEV1
22
Q
COPD often leads to what
A
Cor Pulmonale (right sided heart failure)
23
Q
Pursed lip breathing helps those with COPD
A
true
24
Q
Cough and excpectoration of at least 3 months duration, occuring for at least 2 consecutive years =
A
Chronic bronchitis
25
What usually leads to chronic bronchitis
smoking
26
Blue bloater =
chronic bronchitis
27
Pink puffer =
emphysema
28
Why is there an incr in hematocrit in those with Chronic Bronchitis
the body is fighting chronic hypoxia so the kidneys are incr their production of EPO
29
Abnormal enlargement of the respiratory unit accompanied by destructive changes to the alveolar walls
Emphysema
30
What is caused by alpha-1 antitrpsin deficiciency or cigarettte smoking
Emphysema
31
Which has a better long term prognosis chronic bronchitis or emphysema
Emphysema
32
Incr in the reactivity of tracheobronchial tree
Asthma
33
characterized by a permanent dilation and inflammation of one or more bronchi resulting from destruction of elastic and muscular components of the bronchial wall
Bronchietasis
34
What is the BODE index
Prognostic tool used to categorize and predict outcomes in individuals with COPD
35
What is included in the BODE Index
```
B = BMI
O = degree of obstruction
D= Dyspena
E = Exercise capacity
```
36
Is high or low BMI worse for those with COPD
Low
37
Most common way pulmonary meds are administered
Inhalation
38
Drugs that stimulate the Sympathetic NS or inhibit the Parasympathetic NS
Bronchodilators
39
Type of Bronchodilator that mimics the effects of SNS by increasing cAMP levels thru stimulation of beta receptors
Sympathomimetics
40
Are Sympathomimetics fast or slow acting
fast
41
Example of Sympathomimetics
Albuterol
42
Slow acting bronchodilators
Methylzathines
43
Example of Methylzathines
Theophylline
44
Type of bronchodilator that blocks muscarinic cholinergic receprots, therby decreasing parasympathetic tone
Anticholinergics
45
Example of Anticholinergic
Sprivia
46
Are anticholinergics fast acting
No
47
What is a side effect of anticholinergics
drying out
48
potent anti-inflammatory drugs, help to maintain/increase airway diameter
corticosteroids
49
Name a corticosterioid
Prednisone
50
The side effects of corticosteroids (HTN, Gi irritation, moon face, skin breakdown, etc) are assocaited with which mode of ingestion
oral
51
Name a combination drug
Advair
52
Are combination drugs good for controlling acute events
no
53
what are leukotrienes
inflammatory agents that cause smooth muscle hypertrophy and increased mucus secretion
54
What is an example of a Leukotriene Inhibitor
Singulair
55
used prophylactically to prevent bronchial inflammation and constriction. Used to prevent allergy induced asthma, blocks the effects of histamine
Cromolyn Sodium
56
Used to prevent and treat pulmonary infections
antibiotics
57
How do mutant CFTR Channels lead to CF?
The channels do not move chloride ions well which leads to a build up of sticky mucous on the outside of the cell
58
Clinical Presenation of someone with CF?
- chronic productive cough
- barrel chest
- dyspnea with accessory muscle use
- inspiratory crackles and wheezing
- clubbing of nail beds
- pancreatic insufficiney
- weight loss
- decr activity tolerance
- hemoptysis - coughing up blood
59
What type of precautions should be used when entering room with someone who has CF
Contact Precautions
60
CPT Contraindications
1. ) Head and/or neck injury that has not been stabilized
| 2. ) Active hemorrhage with hemodynamic instability
61
Inhaled Medications used for CF
1. ) Meter Dose Inhaler (MDI)
| 2. ) Handheld Nebulizer (HHN)
62
3-7% Hypertonic Saline (NaCl) helps those with CF how?
helps restore the liquid layer that lines the lungs
63
Flattened diaphragm on chest radiography =
COPD
64
What is the gold standard for diagnosis of a pulmonary embolism
CT Scan
65
What is best identified using an MRI
Tumors
66
Allows the bronchial tree to be visualized and a biopsy can be taken
Bronchoscopy
67
What imaging technique in commonly done in those with CF
Bronchoscopy
68
Measures lung volumes, capacities, and flow rates. Diagnostic and prognostic tool for a variety of pulmonary conditions including COPD
Pulmonary Function Testing (PFTs)
69
A concavity will be seen on PFT graph with which kind of disease
obstructive disease (flow issue)
70
FEV1/FVC ratio under _____% suggests underlying obstructive pathology
70%
71
Most common dx in pulmonary rehab
COPD
72
How frequent should Pulmonary rehab programs be
3-5 days/wk
73
How intense should Pulmonary rehab programs be
40-50% of VO2 Max as minimal threshold level OR RPE of 11-14
74
Is it ok to continue if someone has 3/4 dyspnea
Yes
75
How long should a pulmonary rehab program last for
20-30 min of physical activity
76
What is the mode that most pulmonary rehab should be
Aerobic activity (involving the LE).....walking is great
77
Supplemental O2 should be given when below what level
Below 90%
78
What can an incentive spirometer help do
Strengthen ventilatory muscles
79
Incentive spirometer is contraindicated in what types of people
Those with evidence of hyperinflation on chest x ray
80
When during an exercise program are thoracic mobility exercises to be included
Cool down
81
How many inspirations per hour with the incentive spirometer
10
82
Often used to help with breathing after thoracic surgery
Incentive Spirometer
83
P flex device is used for what
Increasing strength of inspiratory muscles
84
Breathing technique taught to those who may complain of dyspnea and display a rapid and ineffective breathing pattern.
Pursed lip breathing
85
Progressions with teaching diaphragmatic breathing
1. ) Therapist hands in supine
2. ) Patient's hands in supine
3. ) Patient's hands in sitting
4. ) Patient's hands in standing and walking
86
soft rustling during inhalation with a quiet or inaudible expiratory phase
Vesicular breath sound
87
Often heard in patients with pulmonary edema, pneumonia, chronic bronchitis, bronchiectasis or other conditions that lead to secretion production.
Crackles (rales)
88
Heard as previously closed/collapsed small airways pop open during inhalation
Crackles (rales)
89
Commonly noted on expiration in individuals experiencing an acute asthmatic episode, as well as in individuals with concomitant asthma and COPD.
Wheezes (ronchi)
90
Heard as air moves thru constricted airways
Wheezes (ronchi)
91
Can be heard without stethoscope
Stridor
92
Signifies an upper airway obstruction, thus it is best ausultated at the trachea. Common causes include croup, epiglottitis, bronchitis, foreign body obstruction.
Stridor
93
Intense continuous wheezes heard mainly during inspiration
Stridor
94
6 sites (2 on each side) to ausculatate on anterior side
1. ) 1st IC space, medial 1/3 of clavicle
2. ) 5th IC space, mid-clavicular
3. ) 6 IC space, anterior axiallary
95
8 sites (2 on each side) to auscultate on posterior side
1. ) Above spine of scapula (T3)
2. ) Mid scapula (T6)
3. ) Tip of medial scapula (T9)
4. ) Tip of lateral scapula (T9)
96
separates the upper and middle lobes anteriorly on the right lung
horizontal fissure
97
separates the upper and lower lobes posteriorly on the right lung
oblique fissure
98
separates the upper and lower lobes of the left lung
oblique fissure
99
Which mainstem bronchi is shorter, wider, and less angular which leads to aspiration
R mainstem bronchi
100
Process of moving air in and out of the lungs
Ventilation
101
Actual gas exchange at the level of the lung or the level of the tissue
Respiration
102
Changes in lung volumes and capacities related to aging:
1. ) Incr in Residual Volume
2. ) Decrease in Inspiratory reserve volume
3. ) Decrease in vital capacity
103
Refers to the amount of gas moved per unit of time, and is related to resistance to airflow and elasticity of the lung parenchyma
Flow rate
104
True or false: There is an incr in TLC with obstructive disease (COPD)
True (due to incr in RV)
105
Pulmonary artery pressure =
25/10
106
What doe hypoxia/hypercapnia lead to in the lungs
Vasoconstriction in an effort to shunt blood to better ventilated portions of the lungs
107
Normal Ventilation-Perfusion Ratio (V/Q)
4/5 (.80)
108
Sympathetic stimulation does what to rate and depth of breathing
increases it
109
Does sympathetic stimulation lead to bronchodilation or constriction
bronchodilation
110
Central response to ______appears to be most important in terms of driving ventilation
CO2
111
Receptors respond to stretch in the lungs and limit inhalation
Hering Breuer reflex
112
If BP is high then what happens do ventilation
The depth and rate of ventilation is slowed down
113
Where are the respiratory centers
Medulla and Pons
114
PaO2 of 95-100 mHg =
normal
