Pulmonary Flashcards Preview

NPTE > Pulmonary > Flashcards

Flashcards in Pulmonary Deck (37):
1

What are the upper airways?

nose, mouth, pharynx, larynx

2

What are the lower airways?

trachea, terminal bronchioles (conducting airwyas, transport air, nil gas exchange)

respiratoy unit - resp bronchiles, alveolar ducts, alveolar sacs, alveoli (diffusion of gas)

3

What are primary and accessory muscles to inspiration?

Primary - diaphragm, external intercostals

accessory - scalenes, SCM, levator costarum, serratus, traps, pecs

4

What are expiratory muscles of ventilation?

used in exs or disease states

QL, internal intercostals, abs, triangularis sterni

5

What is normal HR?

60-100bpm

6

What is normal BP?

120-80

7

What is normal RR?

12-20

8

What is normal PaO2

80-100mmHg

9

What is normal PaCO2?

35-45 mmHg

10

What is normal pH?

73.5-7.45

11

What are crackles indicative of?

usually on inspiration

atelectasis, fibrosis, PE

12

What are wheezes indicative of?

during expiration

airway obstruction (asthma, COPD, foreign body aspiration)

13

What are normal hemoglobin levels?

12-16 g/dL

14

What is respiratory alkolosis and acidosis?

alkolosis - increased pH, decreased PaCO2, WNL HCO3; alveolar hyperventilation; dizziness, syncope, tingling, numbness

acidosis - decreased pH, increased PaCO2, NWL HCO3; alveolar hypoventilation; anxiety, restlessness, dyspnea, HA, confusion, coma

15

What is metabolic alkolosis and acidosis?

alkalosis - increased pH, increased HCO3, WNL PaCO2; bicarb ingestion, vomiting, duretics, steroids, adrenal disease; vauge symptoms of weakness, mental dullness

acidosis - decreased pH, decreased HCO3, WNL PaCO2; diabetic, lactic, prolonged diarrhea; secondary ventilation, nausea, lethary, coma

16

What is normal WBC count

4,000-11,000

17

What is normal hematocrit levels?

35-48%

18

What is the classification sclae GOLD for obstructive lung disease?

1 mild - 80% predicted, with/without chronic symptoms; unaware of lung function

2 moderate - 50-80%, SOB on exertion

3 severe - 30-50%, decreased exs capacity, exacerbations, heaps of SOB

4 very severe -

19

What are the Graded Exs Test termination criteria?

maximal SOB
cardiac ischemia
symptoms of fatigue
incrase of diastolic pressure of 20, systolic hypertension >250, decrease in blood pressure with increasing workloads
leg pain
total fatigue
signs of insufficient CO
reaching ventilatory max

20

What are the types of pneumonia?

bacterial - intra-alveolar bacterial infection. gram positive (community) and gram negative

viral - interstitial or intra-alveolar inflammatory process caused by viral agents

aspiration pneumonia

21

What are physical findings of COPD?

cough sputum
dyspnea on exertion
decreased breath sounds
increased RR
wt loss/ anorexia
increased AP diameter of chest wall
cyanosis
clubbing
postures to elevate shoulder girdle
CXR showing hyperinflamtion, flattened diaphragm, hyperlucency
hypoxemia, hypercapnea
increased FRC and RV
decreased FEV1, FVC

22

What is asthma?

obstructive disease
reversible in nature
reactivity of trachea and bronch to various stimuli (allergens, exs, cold)
widespread narrowing of ariways due to inflammation
smooth muscle constriction, increased secretions

23

What are physical findings of asthma?

wheezing, crackels, decreased breath dounds
increased secretion
dyspnea
increased accessory muscle use
anxiety
tachycardia
hypoxemia
hypocapnea, then hypercapnea
cyanosis
impaired flow rates
CXR hyperlucency and flattened diaphragm

24

What is cystic fibrosis?

geneticlaly inherited disease characterised by thickening of secretions of all exocrine glands

25

What is bronchiectasis?

chronic congenital or acquired disease characterised by abnormal dilation of bronchi and excessive sputum production

26

What is resp distress syndrome/ RDS?

alveolar collapse in premature infant

*PT consideration: increased breathing effort casued by handling premature infant must be carefully weighed against possible benefits of PT

27

What is bronchopulmonary dysplasia?

obstructive pulmonary disease, often a sequela of premature infants with resp distress syndrome

Results from high pressures of mechanical vent, high fractions of inspired O2 and/or infection

28

What types of restrictive pulmonary diseases are there?

due to alterations in lung parenchyma and pleura - fibrotic changes

due to alterations in chest wall - restricted bony throax; ankylosing spond, scoliosis, arthritis, pectus excavatum, arthrogryposis, skin changes due to burns or scleroderma

due to neuromuscular apparatus - decreased muscle strength results in inability to expand ribs; MS, MD, PD, SCI, CVA

29

What postural drainage position do you use for upper lobes (apical segment)?

Pt sitting, leaning back 30degrees
PT clpas of apices

30

What postural drainage position do you use for upper lobes posterior seg?

leans forward over pillo 30 degrees
PT claps over upper back

31

What postural drainage position do you use for upper lobes anterior?

supine pillow under knees, PT claps between clavicle and nipple

32

What postural drainage position do you use for right middle lobe?

foot of table elevated 16in
patient head down on left side rotates 1/4 bakcward, knees flexed
PT claps over right nipple area

33

What postural drainage position do you use for left upper lobe lingular seg?

foot of table elevated 16 in
patients head down on right side and rotates 1/4 turn bakcward
PT claps over left nipple area

34

What postural drainage position do you use for lower lobe ant basal seg?

foot of table elevated 20 in
lie on side, head down, pillow under knees
PT claps over lower ribs

35

What postural drainage position do you use for lower lobes lateral basal seg?

foot of table elevated 20 in
lie on abdo, head down, then rotate 1/4 turn upward
PT claps over uppermost portion of lower ribs

36

What postural drainage position do you use for for lower lobes posterior basal seg?

foot of table elevated 20 in
prone, head down, pillow under hips
PT clasp over lower ribs close to spine on each side

37

What postural drainage position do you use for lower lobes superior seg?

table flat
prone, two pillows under hips
PT claps over middle back at tip of scap on either side of spine