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NPTE Pulmonary PT > Physical Dysfunction/Impairments > Flashcards

Physical Dysfunction/Impairments Flashcards

(64 cards)

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1
Q

Acute disease - Bacterial pneumonia

A

an intra alveolar bacterial infection
Gram positive is usually acquired in the community
Gram negative is usually developed in a host with underlying chronic conditions

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2
Q

Acute disease - Bacterial pneumonia - most common gram positive is what

A

Pneumococcal pneumonia (strepococcal)

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3
Q

Acute disease - Bacterial pneumonia - gram negative infections usually result in

A

early tissue necrosis and abscess formation

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4
Q

Acute disease - Bacterial pneumonia - physical findings

A

fever, chest pain, cough can be productive of purulent blood streaked or rusty sputum
Dec bronchial breath sounds and/or crackles
Tachypnea, inc WBC
Hypoxemia, Hypocapnea initially

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5
Q

Acute disease - Viral pneumonia

A

an interstitial or intra-alveolar iflammatory process caused by viral agents (flu, adenovirus..)

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6
Q

Acute disease- viral pneumonia - physical findings

A

Recent URI
Fever, dry cough, HA, dec breath sounds and/or crackles
Hypoxemia and hypercapnea
Normal WBC count

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7
Q

Acute disease - aspiration pneumonia

A

aspirated material causes an acute inflammatory reaction within the lungs - usually in those with impaired swallowing, fixed neck extension, intoxication, impaired consciousness, neuromuscular disease, recent anesthesia

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8
Q

Acute disease - aspiration pneumonia - physical findings

A

cough can be dry at first and then produce putrid secretions
Dyspnea, Tachypnea, Cyanosis, Tachycardia, Wheezes and crackles with dec breath sounds
Hypoxemia, hypercapnea, chest pain, fever

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9
Q

Acute disease - TB

what is it, incubation, how long does primary dx last

A

spread by aerosolized droplets from an untreated infected host
incubation period 2-10 weejs
primary disease lasts 10 days to 2 weeks

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10
Q

Acute disease - TB medication taken fo rhow long

A

3 to 12 months

Gloves and special mask and pt in isolation during infectious stage

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11
Q

Acute disease - TB - physical findings of primary disease

A

go undiagnosed often because are mild

slight nonproductive cough, fever (low)

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12
Q

Acute disease - TB - physical findings of postprimary infection

A

Fever, weight loss, cough, hilar adenopathy, night sweats, crackles, blood streaked sputum, increased lymphocytes

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13
Q

Acute disease - Pneumocystis pneumonia

A

Pulmonary infection caused by a fungus in immunocompromised hosts
most often found after transplant, neonates, or those with HIV

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14
Q

Acute disease - Pneumocystis pneumonia - physical fingins

A

Insidious progressive SOB
nonproductive cough
crackles
weakness, fever

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15
Q

Acute disease - Severe acute respiratory syndrome (SARS)

A

an atypical respiratory illness caused by a coronovirus

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16
Q

Acute disease - Severe acute respiratory syndrome (SARS) - physical findings

A

High temp, dry cough, dec WBC, dec platelets, dec lymphocytes
increased liver function tests

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17
Q

Chronic obstructive diseases - COPD

A

characterized by airflow limitation that is not fully reversible
Airflow limitation is usually progressive and associated with an abnormal inflammatory response of lungs to noxious particles or gases

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18
Q

Chronic obstructive diseases - COPD stages - Stage 1

A

Mild
FEV1/FVC = less than 70%
FEV1 = over than 80% predicted
With or without chronic symptoms

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19
Q

Chronic obstructive diseases - COPD stages - Stage 2

A

Moderate
FEV1/FVC = less than 70%
FEV1 = greater than 50% but less than 80% predicted
Often with s/s of SOB with exertion

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20
Q

Chronic obstructive diseases - COPD stages - Stage 3

A

Severe
FEV1/FVC = less than 70%
FEV1 = greater than 30% but less than 50% predicted
Greater SOB, dec exercise capacity, exacerbation of disease

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21
Q

Chronic obstructive diseases - COPD stages - Stage 4

A 
Very Severe
FEV1/FVC = less than 70%
FEV1 = less than 30% predicted
FEV1 = less than 50% with chronic resp failure s/s
Impaired QOL
Exacerbations can be life threatening
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22
Q

Chronic obstructive diseases - COPD - physical findings

A 
Cough sputum production can see blood
Dyspnea with exertion
Breath sounds dec, maybe adventitious
Inc RR
Weight loss
Inc AP diameter of chest wall 
Cyanosis, clubbing, elevated shoulder girdle 
Hypoxemia, hypercapnea
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23
Q

Chronic obstructive diseases - asthma

A

Inc reactivity of the trachea and bronchi to various stimuli
Reversible in nature
Manifests by widespread narrowing of airways due to inflammation, smooth mm constriction, and inc secretions

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24
Q

Chronic obstructive diseases - asthma - physical findings

A

Wheezing, maybe crackles or dec sounds
Inc secretions
Dyspnea, inc acc mm use, anxiety, tachycardia, tachypnea, hypoxemia and hypercapnea
Cyanosis

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25
Chronic obstructive diseases - Cystic fibrosis
A genetically inherited disease characterized by thickening of secretion of all exocrine glands leading to obstruction Can present as an obstructive or restrictive or mixed diseases
26
Chronic obstructive diseases - CF - physical findings
Dyspnea, productive cough, hopoxemia, hypercapnea, cyanosis, clubbing, acc mm use, tachypnea crackles, wheezes and.or dec sounds
27
Chronic obstructive diseases - bronchiectasis
a chronic congenital or acquired disease characterized by abnormal dilation of the bronchi and excessive sputum production
28
Chronic obstructive diseases - bronchiectasis - physical findings
``` Cough and expectoration of large amounts of mucous Frequent secondary infections Hemoptysis (blood streak sputum) Crackles, dec breath sounds Cyanosis, clubbbing, hypoexmia, dyspnea ```
29
Chronic obstructive diseases - Resp Distress Syndrome (RDS)
Alveolar collapse n a premature infant resulting in lung immaturitym inadequate level of pulmonary surfactant
30
Chronic obstructive diseases - RDS physical fidnings
Resp distress, crackles, tachypnea, hypoxemia, cyanosis, acc mm use, flaring nares
31
Chronic obstructive diseases - RDS - PT considerations
Inc breathing effort caused by handling a premature infant must be weighed against possible benefit of PT
32
Chronic obstructive diseases - Bronchopulmonary Dysplasia
An obstructive pulmonary disease often a sequela of premature infants with RDS - results from high pressures of mechanical ventilation, high fractions of inspired oxygen and/ore infection Lungs will show areas of pulmonary immaturity
33
Chronic obstructive diseases - Bronchopulmonary dysplasia Physical findings
``` Hypoxemia, hypercapnea Crackles, wheezes and/or dec sounds Inc bronchial secretions Hyperinflation Frequent lower resp. infections Delayed growth and development Cor pulmonale ```
34
Chronic restrictive diseases - Restrictive disease due to alterations in lung parenchyma and pleura
Fibrotic changes within the pulmonary aprenchyma or pleura due to idiopathic pulmonary fibrosis, absetosis, radiation pneumonitis, oxygen toxicity
35
Chronic restrictive diseases - Restrictive disease due to alterations in lung parenchyma and pleura - physical fidnings
Dyspnea Hypoxemia, hypocapnea intiailly Crackles, clubbing, cyanosis
36
Chronic restrictive diseases - Restrictive disease due to alterations in chest wall
Restricted motion of bony thorax with diseases such as ankylosing sponylitis, arthritis, scoliosis, pectus excavatum, arthrogryposis, or integumentary changes of thoracic wall (scleroderma)
37
Chronic restrictive diseases - Restrictive disease due to alterations in chest wall - physical findings
Shallow, rapid breathing Dyspnea Hypoxemia, hypocapnea early on Cyanosis, clubbing, reduced cough effectiveness
38
Chronic restrictive diseases - Restrictive disease due to alteratiosn in the neuromuscular apparatus
Dec mm strength results in inability to expand rib cage seen in dx like MS, MD, parkinsons, SCI, CVA
39
Chronic restrictive diseases - Restrictive disease due to alteratiosn in the neuromuscular apparatus - physical findings
``` Dyspnea Hypoxemia, Hypocapnea initially Dec breath sounds, crackles Clubbing, cyanosis Reduced cough effectiveness ```
40
Bronchogenic Carcinoma - what is it
a tumor that arises from the bronchial mucosa
41
Bronchogenic Carcinoma - Characteristics - Cause
usually smoking and occupational exposures
42
Bronchogenic Carcinoma - characteristics - secondary changes due to tumor
obstruction or compression of an airway, blood vessel, or nerve
43
Bronchogenic Carcinoma - characteristics - metastasis
Local - to pleura, chest wall, mediastinal structures | Common distant metastasis to lymph nodes, liver, bone, brain, adrenals
44
Bronchogenic Carcinoma - physical findings
``` unexplained weight loss hemoptysis dyspnea, weakness, fatigue, wheezing pneumonia with productive cough hoarseness with compression of laryngeal nerve can get atelectasis ```
45
Bronchogenic Carcinoma - Management
Chemotherapy Radiation therapy Surgical resection if possible
46
Bronchogenic Carcinoma - PT considerations
Pneumonias that develop behind a completely obstructed bronchus cannot be cleared with PT techniques Hold tx until palliative therapy reduced tumor size and relieves bronchial obstruction Be aware of inc fx risk from metastasis, ecchynosis, and fatigue
47
Trauma - rib fracture/flail chest
fracture of the ribs usually to blunt trauma | flail chest is two or more fractures in two or more adjacent ribs
48
Trauma - rib fracture/flail chest - physical findings
shallow breathing splinting from pain crepitation might be felt Paradoxical movements of a flail section (inspiration flail pulled inward)
49
Trauma - Pleural injury - pneumothorax
Air in the pleural space usually through lacerated visceral pleura from a rib fracture of ruptured bullae
50
Trauma - Pleural injury - pneumothorax - physical findings
Chest pain, dyspnea, trachea and mediastinal shift AWAY from injured side absent or dec breath sounds Inc tympany with percussion Cyanosis, resp distress
51
Trauma - Pleural injury - hemothorax
blood in the pleural space usually from a laceration of the parietal pleura
52
Trauma - Pleural injury - hemothorax - physical findings
Chest pain, dyspnea, tracheal and mediastinal shift AWAY from the side of injury Absent or dec breath sounds, cyanosis, resp distres
53
Trauma - Pleural injury - lung contusion
Blood and edema within the alveoli and intersitial space due to blunt chest trauma with or without rib fractures
54
Trauma - Pleural injury - lung contusion - physical findings
Cough with hemoptysis Dyspnea, dec breath sounds or crackles Cyanosis
55
Pulmonary edema
excessive seepage of fluid from the pulmonary vascular system into the interstitial space May eventually cause alveolar edema
56
Pulmonary edema - Cardiogenic
Resutls from inc pressure in pulmonary capillaries associated with LV failure, aortic valvular disease, or mitral valve disease
57
Pulmonary edema - Noncardiogenic
Results from increased permeability of the alveolar capillary membranes due to inhalation of toxic fumes, jypervolemia, narcotic overdose, or ARDS
58
Pulmonary edema - physical findings
``` Crackles Tachypnea, Dyspnea Hypoxemia Peripheral edema fro cardiogenic Cough with pink frothy sputum ```
59
Pulmonary emboli
A thrombus from the peripheral venous circulation becomes embolic and lodges in the pulmonary circulation
60
PE - physical findings
Hx consitent with PE Sudden onset of dyspnea Tachycardia, hypoxemia, cyanosis V/Q - V is normal, but Q is not
61
Pleural effusion
Excessive fluid between the visceral and parietal pleura - caused mainly by an increased permeability to proteins from inflammatory diseases, neoplastic disease, inc hydrostatic pressure, dec osmotic pressure, peritoneal fluid in plerual space, tumor
62
Pleural effusion - physical findings
Dec breath sounds over effusion site Mediastinal shift AWAY from large effusion Breathlessness with large
63
Atelectasis
Collapsed or airless alveolar unit caused bby hypoventilation secondary to pain during the ventilatory cycle, internal bronchial obstructions, external bronchial compression, low tidal volumes, or neurologic insult
64
Atelectasis - physical findings
Dec breath sounds Dyspnea Tachycardia Inc temp

NPTE Pulmonary PT (5 decks)

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