Interventions

Question 1

Diaphragm aids in —– ?
innervation ?

Answer 1

inspiration
C3, C4, C5 keep the diaphragm alive

Question 2

Diaphragmatic Breathing Training utilizes —– and limits —– while during inhale

Answer 2

utilize diaphragm and limits accessory muscles

Question 3

Diaphragmatic Breathing Training is used for —- patients, —– at rest and —– during ADLs? ( 3 patient populations)

Answer 3

1. **post surgical **patients
2. Dyspnea at rest
3. SOB with ADLs ( inefficient breathing)

Question 4

Diaphragmatic Breathing Training (DBT) is not for this those with 1) this condition/ severity , 2) this type of breathing pattern, and 3) increase —- during DBT

Answer 4

1. moderate/ severe COPD ( due to hyperinflated lungs)
2. paradoxical breathing patterns
3. dyspnea during DBT

Question 5

3 Expected outcomes for DBT
decreases x and y
increases z

Answer 5

x= dec. respiratory rate
y = dec. reliance on accessory muscles
z = inc. tidal volume

Question 6

Pursed Lip breathing reduces x and decreases y by maintaining z pressure in the bronchioles

Answer 6

x= respiratory rate
y = dyspnea
z = positive pressure

Question 7

Pursed lip breathing is used for this conditions?
2 other indication

Answer 7

COPD
indications:
1. tachypnea
2. dyspnea

Question 8

Expected outcomes for pursed lip breathing:
reduces —–
improves —– stats
prevents —- —— in pts with emphysema

Answer 8

reduces PaCO2
improves O2 stats
prevents airway collapse

Question 9

Segmental breathing goal: —- / —— chest mvmts similar to this technique from neuro

Answer 9

facilitates and inhibitis chest wall mvmts
similar to PNF

Question 10

segmental breathing improves —- ventilation

Answer 10

improves regional ventilation

Question 11

Segmental breathing is used for decreased —- and —,
and ——–

Answer 11

decreased lung volumes and chest wall compliance
V-Q mismatch

treats hypomobility of lung due to chest wall compliance

Question 12

There are no contraindications for segmental breathing
T or F

Answer 12

True
precaution for pain and tenderness may be due to broken rib or chest tube

Question 13

basal atelectasis position for segmental breathing

Answer 13

sitting

Question 14

What side should patient be on when sidelying?

Answer 14

contralateral side ( affected lung facing up)

Question 15

bilateral expansion positions for segmental breathing

Answer 15

sitting or supine

Question 16

when should therapist apply pressure during segmental breathing technique

Answer 16

When: end of exhale
where: area that needs expansion

Question 17

3 outcomes for segmental breathing:
increased —– —— —–
expands —- ——
—- secretions and —- airway

Answer 17

1. increased chest wall expansion
2. expands collapsed alveoli
3. loosens secretions and clears airway

Question 18

This is very important to aid in airway clearance to help reduce risk of pneumonia.

Answer 18

cough

Question 19

What are the 5 stages of a cough?
know this

Answer 19

1. deep inhalation
2. glottis closes
3. increased pressure gradient
4. glottis opens
5. forceful movement

Question 20

Directed Cough can compensate for patient’s inability to elicit —- —– —–

Answer 20

maximum forced exhalation

Question 21

Huff cough uses forced —- maneuver with glottis ——

Answer 21

forced expiratory maneuver with glottis open

Question 22

What is the purpose of huff cough

Answer 22

decreases risk of airway collapse

pt. inhale with mouth open, contracts abs and with rapid exhale they say ha ha ha

Question 23

contraindications/ precautions for Huff cough

think nature of the intervention

Answer 23

1. droplet precautions **( COVID) **
2. doesn’t tolerate intracranial pressure ( Valsalva)
3. untreated pneumothorax
4. osteoporosis
5. flail chest

there’s more

Question 24

Percussion/ vibration uses patient posioning so that gravity can help with ———–

Answer 24

drainage of bronchial secretions

Question 25

percussion procedures ( 2 steps)

Answer 25

1. therapist rhythmically strikes the chest with a cupped hand for **2 -3 minutes ** 2. patient coughs after

Question 26

vibration procedure is performed in direction of rib movement during inhale - T or F

Answer 26

false - done during exhalation pt. coughs after

Question 27

precautions/ contraindications for percussion & vibration | why would you not want to decline pt.

Answer 27

1.** pulmonary edema related to CHF **( don't have pts decline head bc it increases workload on heart) 2. rib fracture 3. prolonged corticosteroid use 4. osteoporosis

Question 28

autogenic breathing and active breathing cycle would be good for what patient population? may not be as good in this population?

Answer 28

Good for those who don't need assistance with breathing/ secretion clearance Not as effective in Cystic Fibrosis

Question 29

outcomes: active breathing will ---- secretions and improve ---- in lungs, and improve effectiveness of -----

Answer 29

1. loosen / clear secretions 2. ventilation 3. cough

Question 30

autogenic drainage is ----- breathing at different ----- -----

Answer 30

staged breathing different lung volumes

Question 31

autogenic breathing outcomes: 1. mobilize secretions by creating ---- forces induced by airflow 2. speed of --- flow helps mobilize secretions 3. secretions travel from --- airways to ---- airways

Answer 31

1. shearing force 2. expiratory flow 3. peripheral to central airflow

Question 32

Incentive Spirometer is for this patient population

Answer 32

post surgical patients and those on prolonged bed rest

Question 33

Incentive Spirometer maximizes ----- expansion during sustained maximal -----

Answer 33

**alevolar expansion** during sustained maximal **inspiration**

Question 34

Inspiratory/ expiratory muscle trainer works on these muscles? creates ---- pressure when ---- to decrease air trapping

Answer 34

**inspiratory** muscles **positive** pressure when **exhalaing**

Question 35

Flutter device creates --- with lungs to allow for secretion mobilization. creates circuit with lungs to allow for ---- ------ end with ------

Answer 35

positive **expiratory** pressure with mechanical oscillation **secretion mobilization ** end with **cough**

Question 36

The vest is great for this patient population

Answer 36

Great for children along with those in need of more regular airway clearance (CF, COPD exacerbation, etc.)