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Kin 187 > Pulmonary > Flashcards

Pulmonary Flashcards

(56 cards)

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1
Q

Two types of pulmonary disease

A

Obstructive

Restrictive

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2
Q

Obstructive disease is when

Examples

A

The air has trouble flowing out of the lungs due to RESISTANCE

Airway obstruction

Due to excessive contraction of the smooth muscle

e.g. Asthma, Bronchiectasis, COPD

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3
Q

Restrictive disease is when

Examples

A

The chest muscles cant expand enough which creates problems with air flow

e.g. pulmonary fibrosis, chest wall disease

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4
Q

Chronic obstructive pulmonary disease (COPD) is

A

Preventable and Treatable disease

Has some significant extrapulmonary effects which are characterised by an airflow limitation that is not fully reversible

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5
Q

Progressive disease involves

A

Emphysema

Chronic brochitis

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6
Q

Emphysema is due to

A

Breakdown/collaspe of lung tissue/alveoli

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7
Q

Chronic brochitis is due to

A

Excessive mucus blocks airway

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8
Q

Dynamic measures of spirometry are

A

Force vital capacity (FVC)

Forced expiratory volume 1 sec (FEV 1.0)

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9
Q

When do you know if airway is obstructed

A

FEV1.0/FVC <70%

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10
Q

Characteristics of COPD involve

A

Increased airway resistance

Reduced lung elastic recoil

Increased work of breathing

Ventilatory muscle weakness/fatigue

Ventilatory inefficiency

Ventilatory failure

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11
Q

What 3 things are affected by exercise intolerance due to respiratory disease

A

Altered breathing mechanics

Impaired gas exchange

Skeletal muscle dysfunction

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12
Q

What is the overall outcome of exercise intolerance due to respiratory disease

A

Decrease external work capacity

Decrease external work endurance

Decrease ability to support physical activity

Decrease quality of life

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13
Q

What are the treatments options for COPD (increasing in severity)

A

Self management education and smoking cessation

Bronchodilators

Inhaled corticosteroids

Pulmonary rehabilitation

Oxygen given

Surgery

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14
Q

What is the typical exercise response in COPD

A

Hyperinflation (air trapping)

Weaken diaphragm contraction

High CO2
Low O2 in blood

Abnormal Cardiac function

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15
Q

Exercise testing for COPD (aerobic)

A

Ramping cycle protocol

Treadmill

1-2 METs/stage

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16
Q

Exercise testing for COPD (endurance)

A

6 min walk

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17
Q

Exercise testing for COPD (strength)

A

Isokinetic or isotonic

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18
Q

Exercise testing for COPD (flexibility)

A

Sit and reach

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19
Q

Exercise testing for COPD (neuromuscular)

A

Gait analysis

Balance

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20
Q

Exercise testing for COPD (functional)

A

Sit to stand

Stair climbing

Lifting

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21
Q

What are the special considerations for exercise testing in COPD

A

Pulmonary function test required

Determine arterial blood gases or arterial oxyhemoglobin saturation > 90%

Perceptions of dyspnea

Modifications of traditional protocols

Not appropriate to use VO2 peak based on age predicted HRmax

6 min walk test for assessing functional exercise capacity with more severe disease

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22
Q

What is the FITT recommendation for aerobic for COPD patients

A

3-5 days/wk

Light (30-40%) improves symptoms and quality of life
Vigorous (60-80%) shows physiologic improvements (more encouraged)

Intermittent exercise/ interval training = A few mins then rest

Walking or cycling

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23
Q

What is the FITT recommendation for resistance for COPD patients

Study These Flashcards
A

Follow same FITT principle for healthy adults

Greater dyspnea means its more beneficial to work on muscles of shoulder girdle

Inspiratory muscle training

24
Q

What are the benefits from exercise in COPD

Study These Flashcards
A

Majority of research supports exercise as a supplementary treatment in individuals with COPD

Main beneficial effect involves adaptations in the musculoskeletal and cardiovascular systems which reduce stress on the pulmonary system during exercise

25
Adaptations in the musculoskeletal and cardiovascular systems that reduce stress on the pulmonary system consist of
Cardiovascular reconditioning Reduced ventilatory requirement Reduced hyperinflation Desensitisation to dyspnea Increased muscle strength, flexibility and body composition Better balance
26
Chronic restrictive pulmonary disease have a range of heterogeneous disorders that contribute to...
Low lung function and reduced thoracic compliance: Reducing tidal volume Increasing work of respiratory muscles Less efficient ventilation
27
CRPD instrinsic to the parenchyma of the lung involves
Pulmonary fibrosis As the disease progresses, the normal lung tissue is gradually replaced by scar tissue
28
What is pulmonary fibrosis
Scarring of the lung
29
CRPD extrinsic to the parenchyma of the lung involves
Disease restricting lower thoracic/abdominal volume Obesity? Kyphoscoliosis? Neuromuscular disease? Trauma?
30
Type 2 alveolar cells produce and secrete
Surfactant
31
What does surfactant do
Reduce the alveolar surface tension to prevent collapse
32
Exercise response to CRPD
Reduction in exercise tolerance and dyspnea Impairment in exercise capacity is associated with declines in exertional arterial oxygen tension and oxyhemoglobin saturation
33
The reduction in exercise tolerance and dyspnea from CRPD is due to
Inefficient ventilation with a high dead space Mechanoreceptor stimulation Heightened central respiratory drive
34
What are the potential alteration to the exercise response in CRPD
Bronchodilators Antihypertensive medications Systemic corticosteroid treatment Severe pulmonary arterial hypertension
35
Bronchodilators effect on exercise response
May improve ventilatory response, ventilation-perfusion matching and exercise capacity
36
Antihypertensive medication effect on exercise response involves
Beta blockers may blunt heart rate response during exercise
37
Systemic corticosteroid treatment effect on exercise response involves
May increase blood pressure and induce muscle weakness
38
Severe pulmonary arterial hypertension effect on exercise response involves
Increases risk of hypotension and arrhythmias upon exercise
39
Completion of 6 min walk test with measurement of pulse rate and oxygen saturation can provide information on
Disability due to pulmonary dysfunction Detect conexistent factors that aggravate disability Monitor progression of impairment and response to therapy
40
What is the consideration for exercise testing in CRPD
Worsening hypoxia should be monitored because it can contribute to chest pain and arrhythmias Oxygen saturation should be >90% Meter dosed inhalers should be evaluated for proper technique Avoid extreme temp or humidity
41
The main goals for exercise recommendations for CRPD patients involves
Learning efficient breathing techniques Improving ergonomics during ADLs
42
The initial period for exercise recommendations for CRPD patients involves
6 to 8 weeks 20 to 30 mintues 5 days/week Of intense training to establish baseline Session duration can be divided
43
What improvements *******
*************
44
What are the benefits of exercise for CRPD
Exactly the same as COPD
45
Intervention of Bronchodilators, its mechanism and effect
Increased peak ventilation Less dynamic hyperinflation Effect: ?
46
Intervention of repeated functional exercise stimulus, its mechanism and effect
Increased movement efficiency Decreased ventilation at iso-work Effect: Increase peak VO2 Increase Peak work rate ????
47
Intervention of repeated high intensity exercise stimulus, its mechanism and effect
???
48
Intervention of resistance training, its mechanism and effect
????
49
Fick's law of diffusion is (proportional and inversely proportional)
The rate of gas transfer is proportional to: Tissue area Diffusion coefficient of the gas The difference in the partial pressure of the gas on two sides of the tissue Inversely proportional to: Thickness
50
Ficks law equation
V gas = A/T x D x (P1 - P2)
51
What is the partial pressure of O2 and CO2 in air
PO2 = 159 mmHg PCO2 = 0.3 mmHg
52
What is the partial pressure of O2 and CO2 in deoxygenated blood
PO2 = 40 mmHg PCO2 = 46 mmHg
53
What is the partial pressure of O2 and CO2 in expired gas
PO2 = 116 mmHg PCO2 = 32 mmHg
54
What is the partial pressure of O2 and CO2 in oxygenated blood
PO2 = 95 mmHg PCO2 = 40 mmHg
55
Oxyhemoglobin dissociation curve shows that at PO2 in arteries
Around 100 mmHg % oxyhemoglobin saturation is around 100% Oxygen content is around 20ml/100ml blood
56
Oxyhemoglobin dissociation curve shows that at PO2 in veins
Around 40 mmHg % oxyhemoglobin saturation is around 75% Oxygen content is around 15ml/100ml blood

Kin 187 (21 decks)

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