question

Which muscle is called the primary muscle of inspiration?

answer

Diaphragm

question

When is accessory muscles of inspiration most likely to be used?

answer

When more rapid or deeper inhalation is required or in disease states

question

Special population such as patients with spinal cord injury lack functional abdominal musculature. What characteristic this population exhibit in terms of resting position of the diaphragm and inspiratory reserve volume?

answer

Resting position of the diaphragm is lower in the thorax decreasing the inspiratory reserve volume

question

Defined as: volume of gas inhaled (or exhale) during a normal resting breath

answer

Tidal volume

question

Defined as: volume of gas that can be inhaled beyond a normal resting TIDAL VOLUME

answer

Inspiratory reserve volume

question

Defined as: volume of gas that can be exhaled beyond a normal resting TIDAL VOLUME

answer

Expiratory reserve volume

question

Defined as: volume of gas that remains in the lungs after ERV (maximal exhalation) has been exhale

answer

Residual volume

question

Defined as: two or more lung volume added together (i.e. TV + IRV, etc...)

answer

Lung capacities

question

Defined as: The amount of air that can be inhaled from Resting End Expiratory Pressure (REEP) TV + IRV

answer

Inspiratory capacity

question

Defined as: The amount of air that is under volitional control conventionally measured as forced expiratory vital capacity (IRV + TV + ERV)

answer

Vital Capacity

question

Defined as: The amount of air that resides in the lungs after normal resting Tidal Exhalation ( ERV + RV)

answer

Functional Residual Capacity

question

Defined as: ( IRV + TV + ERV + RV). The amount of air that is contained within the thorax during a maximum inspiratory effort.

answer

Total lung capacity

question

The amount of air exhaled during the first second of Forced Expiratory Vital capacity (Vital capacity)

answer

Force Expiratory volumen in 1 second (FEV₁)

question

Which population is FEV₁at least 70% of FVC? (FEV₁/FVC x 100 > 70%)

answer

Healthy population

question

A young individual PaO₂is measured to be < 90mmHg, what is this condition called?

answer

Mild hypoxemia

question

Defined as: When PaO₂> 100mmHg

answer

Hyperoxemia

question

A recently diagnosed pulmonary patient has a documented PaO₂< 55 mmHg. What can be concluded about this patient before therapy session is initiated?

answer

Supplemental oxygen is needed

question

Defined as: the ability to remove carbon dioxide from the pulmonary circulation and maintain pH

answer

Alveolar ventilation

question

Defined as: The diffusion of gas across the alveolar capillary membrane

answer

Respiration

question

What does pH indicates?

answer

Free floating hydrogen ions in the body

question

What normal range for pH?

answer

7.35-7.45

question

What's the normal value of PaCO₂within arterial blood in healthy individuals?

answer

35-45mmHg

question

When PaCO₂> 45mmHg, this condition is called:

answer

hypercapnea

question

When PaCO₂< 35mmHg, this condition is called:

answer

Hypocapnea

question

If there is removal of CO₂in the blood, what happens to the pH value?

answer

Increases

question

If there is retention (increased) of CO₂in the blood, what happens to the pH value?

answer

Decreases

question

What is the normal value of Bicarbonate (HCO₃) within arterial blood?

answer

22-28 mEq/mL.

question

Defined as: anatomical conducting airways or physiological (disease such as pulmonary emboli). it is a space that is well ventilated but no respiration (gas exchange) occurs

answer

Dead space

question

Defined as: no respiration occurs because of a ventilation abnormality. Complete atelectasis of a respiratory unit allows the blood to travel through the pulmonary capillary without gas diffusion occuring.

answer

Shunt

question

Common complaints expressed amoung pulmonary diagnosed patients during a physical therapy examination usually include:

answer

decreased ability to perform ADLs or shortness of breath

question

Medications within pulmonary population that usually mask vital signs are:

answer

steroids

question

Medications within pulmonary pupulation that usually alter vital signs are:

answer

betal blockers, bronchodilators

question

What's the normal value of HR for infants?

answer

120bpm

question

What's the normal value of HR for adults?

answer

60-100bpm

question

What's the normal value of BP for infants (mmHg)?

answer

75/50

question

What's the normal value of BP for adults (mmHg)?

answer

120/80 or less

question

What's the normal value of Respiratory Rate for infant?

answer

40br/min

question

What's the normal value of Respiratory rate for adults?

answer

12-20br/min

question

What's the PaO₂normal value for infant (mmHg)?

answer

75-80

question

What's the PaO₂normal value for adults (mmHg)?

answer

80-100

question

What's the PaCO₂normal value for infants (mmHg)?

answer

34-54

question

What's the PaCO₂normal value for adults (mmHg)?

answer

35-45

question

What's the normal pH value for infants?

answer

7.26-7.41

question

What's the normal pH value for adults?

answer

7.35-7.45

question

What's the tidal volume normal value for infants?

answer

20mL

question

What's the tidal volume normal value for adults?

answer

500mL

question

An adventious sound: a crackling sound heard usually during inspiration that indicates pathology (atelectasis, fibrosis, pulmonary edema). this is aka rales, crepitations

answer

Crackles

question

Crackles or rales, repitations is an adventitious sound heard during inspiration. what pathology would these sounds indicate?

answer

Atelectasis, fibrosis, pulmonary edema

question

A musical pitched sound, usually heard during expiration caused by airway obstruction (asthma, chronic obstructive pulmonary disease, foreign body aspiration).

answer

Wheezes

question

Wheezes is normally heard during expiration, but which condition is wheezes may also be heard heard during inspiration?

answer

Severe airway obstruction

question

It is a nasal or bleating sound heard during auscultation. "E" sound are transmitted to sound like "A".

answer

Egophony

question

A sound characterized by an intense, clear sound during auscultation, even at the lung bases.

answer

Bronchophony

question

Occurs when whispered sounds are heard clearly during ausculation

answer

Whispered pectoriloquy

question

It is a cause for respiratory alkalosis

answer

Alveolar hyperventilation

question

It is a cause for respiratory acidosis

answer

Alveolar hypoventilation

question

Sign & symptoms of respiratory alkalosis include:

answer

Dizzness, syncope, tingling, numbness, early tetany

question

Early signs & symptoms of respiratory acidosis include?

answer

Anxiety, restlessness, dyspnea, headache

question

Late signs & symptoms of respiratory acidosis include:?

answer

Confusion, somnolence, coma

question

The following may be cause of: - Bicarbonate ingestion, vomiting, diuretics, sterioids, adrenal disease

answer

Metabolic alkalosis

question

What are the causes of Metabolic alkalosis?

answer

Bicarbonate ingestion, vomiting, duirectis, steroids, adrenal disease

question

Signs & Symptoms of metabolic alkalosis are?

answer

Vague symptoms: weakness, mental dullness, possibly early tetany

question

The following may be described as a cause for a condition that increases the pH in blood. What is this condition called? - Diabetic, lactic or uremic acidosis,prolonged diarrhea

answer

Metabolic acidosis

question

Signs & Symptoms of metabolic acidosis are?

answer

Secondary hyperventilation (Kussmaul breathing), nausea, lethargy, and coma

question

A patient is in the cardiopulmonary lab at a local hospital. A Graded Exercise Test (GET) is being administered in order to find his functional exercise capacity. During the test, the PT notices that the patient is showing signs of Maximal Shortness of Breath. What is the most appropriate course of action to take?

answer

Terminate GET

question

A patient is in the cardiopulmonary lab at a local hospital. A Graded Exercise Test (GET) is being administered in order to find his functional exercise capacity. During the test, the PT notices that PaO₂has increased to > 20 mmHg. The most appropriate course of action to take is:

answer

Terminate GET

question

A patient is in the cardiopulmonary lab at a local hospital. A Graded Exercise Test (GET) is being administered in order to find his functional exercise capacity. During the test, the PT notices that PaO₂has decreased to < 55mmHg. The most appropriate course of action to take is:

answer

Terminate GET

question

A patient is in the cardiopulmonary lab at a local hospital. A Graded Exercise Test (GET) is being administered in order to find his functional exercise capacity. During the test, the patient is showing signs of exercise discomfort. The Pt suspects that the patient's PaCO₂has either increased to > 10mmHg or is in fact > 65mmHg. If the PT does confirm that either of the two condtions is true, what is the next thing to do?

answer

Terminate GET

question

A patient is in the cardiopulmonary lab at a local hospital. A Graded Exercise Test (GET) is being administered in order to find his functional exercise capacity. During the test, the PT notices that the ECG readings shows Cardiac Ischemia and/or arrhythmias. The most appropriate course of action to take is:

answer

Terminate GET

question

A patient is in the cardiopulmonary lab at a local hospital. A Graded Exercise Test (GET) is being administered in order to find his functional exercise capacity. During the test, the PT notices that the patient developed symptoms of fatigue. The most appropriate course of action to take is:

answer

Terminate GET

question

A patient is in the cardiopulmonary lab at a local hospital. A Graded Exercise Test (GET) is being administered in order to find his functional exercise capacity. During the test, the PT checks for Blood pressure. If the patient SBP is either > 250mmHg, or DBP increases to > 20mmHg from baseline or BP decreases with increasing workload. What should the PT do if any of these conditions is confirmed to be true?

answer

Terminate GET

question

If a patient while performing a Graded Exercise Test shows any of these conditions, what should the PT do? - Leg pain, TOTAL fatigue, sings of insufficient cardiac output - Reaching a ventilatory maximum

answer

Terminate GET

question

A patient is being administered a Graded Exercise Test in order to find his functional exercise capacity. if a PT confirms that the patient's PaCO₂has risen to > 10mmHg or is in fact > 65mmHg, what can be concluded in this situation?

answer

Patient has developed respiratory acidosis, and GET should be terminated

question

A condition where interstitial or intra-alveolar inflammatory process caused by viral agents (influenza, adenovirus, cytomegalovirus, herpes, parainfluenza, respiratory syncytial virus, measles)

answer

Viral Pneumonia

question

Aspirated material causes an acute inflammatory reaction within the lungs. Usually found in patients with impaired swallowing (dysphagia), fixed neck extension, intoxication, impaired consciousness, neuromuscular disease, recent anesthesia

answer

Aspiration pneumonia

question

In addition to common signs & symptoms such as fever, chills, dry cough, headaches, hypoxemia and hypercapnea, tachypnea, cyanosis etc. A pertinent finding that may not be found in viral pneumonia but found in aspiration pneumonia is:

answer

Wheezes and crackles with decreased breath sounds

question

If a chest X-ray confirms the presence of interstitial infiltrate, What conditions is this finding associated with?

answer

viral pneumonia or pneumocystis pneumonia

question

If a chest x-ray initially shows pneumonitis, and in the chronic stage of disease shows necrotizing pneumonia with cavitation. What conditions is this finding associated with?

answer

Aspiration pneumonia

question

Pulmonary function tests showing decreased FEV₁, decreased FVC, increased FRC and RV, and decreased FEV₁/FVC ration are most likely associated with

answer

Chronic Obstructive Diseases

question

Condition that shows increased reactivity of the trachea and bronchi to various stimuli such as allergens, exercise, cold , and manifests by widespread narrowing of the airways due to inflammation, smooth muscle constriction, and increased secretions that is reversible in nature. The patient with this condition may show wheezing, possible crackles and decreased breath sounds.

answer

Asthma

question

A genetically inherited disease characterized by thickening of secretions of ALL exocrine glands (glands that secrete their producs to ducts to a specific location), leading to obstruction of, for example, pacreatic, pulmonic, gastrointestinal.

answer

Cystic Fibrosis

question

This condition may present as an obstructive, restrictive or mixed disease. Clinical s/s include: - meconium ileus, frequent respiratory infections (especially staphylococcus aureus and pseudomonas aeruginosa) - Inability to gain weight despite adequate caloric intake. - Diagnosis made post natally by a blood test showing the presence of trypsinogen or later by a positive sweat electrolyte test

answer

Cystic Fibrosis

question

A chronic congenital or acquired disease characterized by abnormal dilatation of the bronchi and excessive sputum production

answer

Bronchiectasis

question

Formerly known as hyaline membrane disease. Alveolar collapse in premature infant resulting from lung inmaturity, inadequate level of pulmonary surfactant

answer

Respiratory Distress Syndrome

question

In addition to pertinent found in most respiratory diseases such as cyanosis, clubbing, hypoxemia, dyspnea, tachypnea, a distinguishing finding in Bronchiectasis is/are

answer

Hemoptysis, and Cough and expectoration of LARGE amounts of mucopurulent secretions

question

It is caused by a blockage of the air passages (bronchus or bronchioles) Lung Collapse or by pressure on the outside of the lung. Signs & symptoms include: - Difficulty breathing, Chest pain, Cough

answer

Atelectasis

question

If a Chest X-ray does confirm the presence of the classic granular pattern ("ground glass") caused by distended terminal airways and alveolar collapse. What condition is this finding associated with?

answer

Respiratory Distress Syndrome

question

This condition is typified by difficulty expanding the lungs causing a reduction in lung volumes

answer

Chronic Restrictive Disease

question

This condition is characterized by airflow limitation that is not fully reversible. The airflow limitation is usually both progressiveand associated with an abnormal inflammatory response of the lungs to noxious particles or gasses. A typical characteristic found is increased A-P diameter of chest wall.

answer

Chronic Obstructive Disease

question

Pulmonary function tests usually reveal a: - reduction in Vital capacity (VC), Functional residual capacity (FRC), and Total lung capacity (TLC)

answer

Chronic Restrictive Disease

question

Bronchogenic Carcinoma referes to a tumor which arises from the brochial mucusa. Smoking and occupational exposures are the most frequent causal agents. A pertienent finding during examination of this condition in addition to dyspnea, weakness, fatigue, wheezing, atelectasis or bacterial pneumonia will include:

answer

Unexplained weight loss, and Hemoptysis

question

One physical therapy consideration with regards to pneumonias of carcinogenic origin is that if they develop behind a COMPLETELY obstructed brochus, they CANNOT be cleared with physical therapy techniques. If a PT finds this condition to be true in a patient, What is the next thing to do if the PT needs to perform Chest PT?

answer

Hold Treatment until palliative therapy reduces the tumor size and relieves the bronchial obstruction

question

One reason for which a PT may not perform chest compressive manuevers and coughing in a patient with pneumonia of carcinogenic origin is:

answer

Possible fractures from thoracic bone metastasis

question

One reason for which a PT may not perform chest compressive manuevers and coughing in a patient with low platelet count is:

answer

Possible Ecchymosis (bruising)

question

Description: A condition where air is in the pleural space, usually through a lacerated visceral pleura from a rib fracture or rupture bullae

answer

Pneumothorax

question

Description: Blood in the pleural space usually from a laceration of the parietal pleura

answer

Hemothorax

question

Description: Blood and edema within the alveoli and interstitial space due to blunt chest trauma with or without rib fractures

answer

Lung contusion

question

A pertinent finding with lung contusion during a physical examination is

answer

Cough with hemoptysis

question

Description: Excessive seepage of fluid from the pulmonary vascular system into the interstitial space. May be of cardiogenic or non cardiogenic origin

answer

Pulmonary edema

question

Description: A thrombus from the peripheral venous circulation becomes embolic and lodges in the pulmonary circulation. A small emboli does not necessarily cause infarction

answer

Pulmonary emboli

question

Description: Excessive fluid between the visceral and parietal pleura. The main cuases of this condition are increased pleura permeability to proteins from inflammatory diseases such as : pneumonia, rheumatoid arthritis, systemic lupus, neoplastic disease, increased hydrostatic pressure within pleural space (CHF), decreased in osmotic pressure (hypoproteinemia), pertoneal fluid within the pleural space (ascites, cirrhosis) or interference of pleural re-absorption from tumor invading pleural lymphatics

answer

Pleural effusion

question

A pertinent finding of pleural effusion during a physical examination is

answer

Decreased breath sounds over effusion, bronchial breath sounds may be present around the perimeter of the effusion. Pleural friction rub may be possible with inflammatory process

question

Description: Collapse or airless alveolar unit, caused by hypoventilation secondary to pain during the ventilatory cycle (pleuritis, post operative pain, or rib fracture), internal bronchial obstruction (aspiration,mucus plugging). external bronchial compression (tumor or enlarged lymph nodes), low tidal volume (narcotic overdose, inappropriately low ventilator settings) or neurlogic insult

answer

Atelectasis

question

What are the indications for postural drainage?

answer

Increased pulmonary secretions, Aspiration, Atelectasis or collapse

question

A PT who works in acute care at a local hospital is given a patient with increased pulmonary secretions and/or aspiration or atelectasis or collapse. What physical therapy intervention will be appropriate for any of these indications?

answer

Postural drainage

question

A PT who works in acute care at a local hospital is given a patient with increased pulmonary secretions/Aspiration/Atelectasis or collapse. According the patient's chart the Right middle lobe is the site of treatment. The PT is thinking of using the trendelenburg position to perform his treatment. If the patient is know to have any of the conditions below, what will be the next thing to do? - Circulatory system : Pulmonary edema, CHF, Hypertension - Abdominal problems: Obesity, ascites,pregnancy, hiatal hernia,nausea and vomiting, recent food consumption - Neurologicl system: Recent neurosurgery, increased intracranial pressure, aneurysm precautions - Pulmonary system: Shortness of breath

answer

Perform treatment in the horizontal plane to accomodate for present condition

question

The best position for airway clearance techniques such as coughing is:

answer

Upright sitting position

question

Technique that is more effective in patients with collapsible airways, such as patients with chronic obstructive diseases (Asthma, cystic fibrosis,Bronchiectasis, Respiratory distress syndrome, Bronchopulmonary dysplagia). It prevents the high intrathoracic pressure which causes premature airway closure

answer

Huffing

question

The technique that will be a more effective airway clearance technique in patients with COPD such as asthma, cystic fibrosis, bronchiectasis, bronchopulmonary dysplagia, respiratory distress syndrome is:

answer

Huffing

question

What air clearance technique is being used here? - Ask patient to inhale deeply, and immediately the patient forcibly expels the air saying "ha..ha..ha.."

answer

Huffing

question

This technique is used when the patient's abdominal muscles cannot generate an effective cough. (i.e. spinal cord injury)

answer

Assisted cough

question

What air clearance technique is being used here? - Patient is positioned against a solid surface in supine with head of bed in trendelenburg position or sitting with wheelchair against the wall or agains the therapist - The therapist's hand is placed below the patient's subcostal angle (similar to heimlich maneurver) - The patient inhales deeply, and as the patient attempts to cough, the therapist pushes inward and upwardly assisting the rapid exhalation of air

answer

Assisted cough

question

After performing assisted cough on a spinal cord injury patient, the PT notices that expectoration for this patient is problematic (has difficulty clearing secretions), what equipment should be used to help this patient?

answer

Suction Catheter

question

This airway clearance technique is used with patients who are unable to cough on command, such as infants, and patients following brain injury or stroke

answer

Tracheal Stimulation

question

What airway clearance technique is being used here? - The therapist's finger or thumb is placed just above the suprasternal notch and quick inward and downward pressure on the trachea elicits the cough reflex

answer

Tracheal Stimulation

question

This airway clearance technique is used ONLY when regular cough technique, huffing, assisted cough and tracheal stimulation has failed to adequately remove secretions

answer

Endotracheal suctioning

question

What kind of medical asepsis should be used when performing endotracheal suctioning?

answer

Sterile gloves/clean gloves

question

Suction system should be set approximately at how may mmHg?

answer

120mmHg

question

The usual suctioning time is between?

answer

10-15 seconds

question

What position should be used when performing diaphragmatic breathing?

answer

Semi-Fowler's position

question

What type of breathing exercise is used best to increase ventilation, improve gas exchange, decrease work of breathing, facilitate relaxation, maintain or improve MOBILITY of chest wall?

answer

Diaphragmatic breathing

question

What breathing exercise is being used here? - Position the patient semireclined (semi-fowler's position) - Place the therapist's hand gently over the subcostal angle of the patient's thorax - Apply gentle pressure throughout the exhalation phase of breathing - Ask patient to inhale against resistance of the therapist's hand - Release pressure allowing a full inhalation - Progress to independence of therapist's hand, in upright sitting, standing, walking and stair climbing

answer

Diaphragmatic breathing

question

This breathing exercise can be used with: - Post operative patients, post trauma patients, - Patients with obstructive or restrictive pulmonary lung diseases

answer

Diaphragmatic breathing

question

This breating exercise is used to: - Improve ventilation of hypoventilated lung segments - Alter regional distribution of gas - Maintain or restore residual capacity - Maintain or improve mobility of chest wall and prevent pulmonary compromise

answer

Segmental breathing

question

This breathing exercise is used with patients who have pleuritic, incisional or posttrauma pain that is causing a decreased movement in a portion of the thorax or are at risk for developing atelectasis

answer

Segmental breathing

question

A pulmonary patient at a local hospital is at risk for developing atelectasis or collapse. What breathing exercise is most appropriate to address this condition?

answer

Segmental breathing

question

What condition renders the use of segmental breathing inappropriate?

answer

Intractable hypoventilation

question

What breathing exercise is being used here? - Position patient to facilitate inhalation to a certain segment, such as postural drainage postions, Upright sitting - Apply gentle pressure to the thorax over the area of hypoventilation during EXHALATION - Increase to firm pressure just prior to inspiration - Ask patient to breathe in against resistance of the therapist's hand - Release resistance allowing a full inhalation

answer

Segmental breathing

question

This breathing exercises is used to increased inhaled volume, sustain or improve alveolar inflation, maintain or restore functional residual capacity

answer

Sustained maximal inspiration

question

What breathing exercise is being used here? - Inspire slowly through nose or pursed lips to maximal inspiration - Hold maximal inspiration for 3 seconds - Passively exhale the volume

answer

Sustained maximal inspiration

question

What medical device can assist a patient with an acute condition such as post trauma pain, or post operative pain, or acute lobar collapse to measure and encourage deep inspiration thereby assisting with achieve maximal inspiration during sustained maximal inspiration exercise?

answer

Incentive Spirometer

question

It is used in acute situations for patients with post trauma pain, post operative pain, acute lobar collapse

answer

Sustained maximal inspiration

question

This breathing exercise is used to reduce the respiratory rate, increase tidal volume, reduce dyspnea, decrease mechanical disadvantage of an impaired ventilatory pump, improve gas mixing at rest for patient with COPD, and facilitate relaxation

answer

Pursed lip breathing

question

It is primarily for patients with OBSTRUCTIVE disease who experience dyspnea at rest or with minimal activity/exercise or who use an ineffective breathing pattern during activity/exercise

answer

Pursed lip breathing

question

What breathing exercise is being used here? - Slowly inhale through nose or mouth - Passively exhale (position the mouth as if you were blowing out candles) - Additional hand pressure from the therapist applied to abdomen can be used to gently prolong expiration - Abdominal muscle contraction can be used judiciously to increase exhale volume. Care must be taken NOT to increase intra thoracic pressure which might produce airway collapse.

answer

Pursed lip breathing

question

This exercise is used when abominal muscles are too weak to provide an effective cough

answer

Abdominal strengthening

question

What type of physical therapy intervention can be used for high cervical or high thoracic spinal cord injury patients whose abdominal muscles are too weak to provide the necessary support for the abdominal contents needed for passive exhalation? (be sure that binder does not restrict inspiration)

answer

Abdominal splinting

question

At what percentage range should a pulmonary patient exercise intensity be calculated if using the Karvonen's formula?

answer

40%-85%

question

This breathing technique is used to spread out the metabolic demands of any activity over time by slowing its performance. It is used when patients who becomes dyspneic during the performance of an activity or exercise

answer

Paced breathing or activity pacing

question

What technique is being used here? - Break down any activity into manageable components that can be performed within the patient's pulmonary system's abilites. - Inhale at rest, and upon exhalation with pursed lips, complete the first component of the desired activity. - Stop the activity, and inhale at rest - Upon exhalation with pursed lips, complete the next component of activity - Repeat the above steps involving inhalation/ exhalation until activity is completed without shortness of breath. (This technique provides performance of activity on exhalation phase and rest on inhalation phase)

answer

Paced breathing or activity pacing

question

A PT at a local hospital is working with a pulmonary patient who lives on the 2nd. floor in a two story appartment building with no elevator. The patient presents with difficulty ascending a flight of stairs (12 steps). The PT instructs the following: - Before ascending the first step, inhale deeply and exhale slowly with pursed lips. Upon exhalation, ascend two steps and stop. Inhale again, and exhale with pursed lips. Upon exhalation, advance another two steps, etc. until you have reach the end. What techniques is being used here?

answer

Paced breathing or activity pacing

question

What will be an appropriate assistive device(s) for energy conservation for a pulmonary patient who finds showering very difficulty due to the activity itself and the humid environment that accompanies this task?

answer

Provide a shower seat, hand held shower, and use of terry cloth robe after showering, so the patient does not have to stand, hold his/her breath as often, or dry off in the humid environment, thus reducing the energy cost of activity

question

Anti-inflammatory agaents such as steroids, are used to decrease muscosal edema, decrease inflammation, reduce airway reactivity. Steriods can be administered either systemically or topically. what are the common side effects of systemic administration of steriods?

answer

Increased blood pressure, sodium retention, muscle wasting, osteoporosis, GI irritation, and hypercholesteremia

question

Two pulmonary patients have been prescribed two different medications to treat their airway reactivity and decreased mucosal edema. One of them is taking Vanceril (beclomethasone, MDI) and the other Azmacort (triamcinolone, MDI) What is the main side effect of inhaled steroids?

answer

Thrust

question

Inhale steriods such as Vanceril and Azmacort main side effect is called thrust. what is it?

answer

fungal infection of the mouth and throat

question

Regardless of activity, if Oxygen saturation levels decrease to less than 88% or PaO₂is less than 55mmHg, then:

answer

Supplemental Oxygen is indicated

question

Medical equipment that is used to evacuate air or fluid trapped in the intrapleura space. (Usually found in post operative patients)

answer

Chest Tubes

question

Atrovent is an anticholinergic drug that inhibit the parasympathetic nervous system which causes an increase in the HR, BP and bronchodilation. What the known side effects of this type of drugs?

answer

lack of sweating,dry mouth, delusions

question

Drains the Anterior R or L apical segments (upper lobes

answer

Sitting upright in bed or chair

question

Drains the Posterior R or L apical segments (upper lobes)

answer

Leaning forward in sitting position

question

Drains Anterior R or L segments (upper lobes)

answer

Lying flat on back (pillow under knees)

question

Drains Posterior R or L segments (upper lobes aka superior segments)

answer

Lying on abdomen (pillow under abdomen)

question

In trendelenburg position tilted R or L, Drains Middle lobes (R or L)

answer

Lying on back (trendelenburg)

question

Drains Anterior Basal Segments (R or L)

answer

Sidelying in trendelenburg

question

Drains Posterior Basal Segment (R or L)

answer

Lying on abdomen in trendelenburg

question

A type of COPD defined as hypersecretion of mucus sufficient to produce a productive cough on most days for 3 months during 2 consecutive years. Hypersecretion of mucus usually begins in the large airways and is not associated with airway obstruction. Later hypersecretion progresses to the smaller airways, where airway obstruction begins initially. This is called:

answer

Chronic Bronchitis

question

The inflamed bronchi produce a lot of mucus. This leads to cough and difficulty getting air in and out of the lungs. This is called

answer

Chronic Bronchitis

question

A form of COPD, a condition that limits the flow of air when you breathe out. It occurs when the air sacs at the ends of your smallest air passages (bronchioles) are gradually destroyed. Smoking is the leading cause.

answer

Emphysema

question

What Pulmonary condition presents clinically with Shortness of breath, scant sputum production and barrel-shaped configuration of the chest wall, with increased subcostal angle?

answer

Emphysema

question

What lung segment is being drained here? - Patient is in upright position in bed or chair leaned back at 30° angle - Therapist clasps markedly cupped hand over area between clavicale and top of scapula on each side

answer

Apical segments

question

What lung segment is being drained here? - Patient is sitting leaning forward with forearm resting against a pillow at 30° angle - Therapist stands behind and claps over upper back on both sides

answer

Posterior segments

question

What lung segment is being drained here? - Patient is lying flat on back with pillows under the knees, hips are approximately at 45° angle - Therapist claps between clavicle and nipple on each side

answer

Anterior segments

question

What lung segment is being drained here? - Patient in trendelenburg postion with head down on left side and rotates 1/4 turn backward. Pillow may be placed from behind from shoulder to hip. Knees should be flexed - Therapist claps over right nipple area.

answer

Right middle lobe

question

What lung segment is being drained here? - Patient in trendelenburg postion with head down on Right side and rotates 1/4 turn backward. Pillow may be placed from behind from shoulder to hip. Knees should be flexed - Therapist claps over Left nipple area.

answer

Lingular segments

question

What lung segment is being drained here? - Patient in trendelenburg, and sideline position, pillow under knees. - therapist claps with slightly cupped hand over lower ribs

answer

Anterior basal segments

question

What lung segment is being drained here? - Patient in trendelenburg and lying on abdomen, with pillow under hips. - Therapist claps over lower ribs close to spine on each side

answer

Posterior basal segments

question

What lung segment is being drained here? - Patient in trendelenburg, and lying on abdomen, then rotates 1/4 turn upward. Upper leg is flexed over a pillow for support - Therapist claps over uppermost portion of lower ribs

answer

Lateral basal segments

question

What lung position is being drained here? - Patient lying on abdomen with pillows under hips (which position hips approximately 45° angle) - Therapist claps over middle of back at tip of scapula on either side of spine

answer

Superior segments

question

A patient visits for the first time The Cardiopulmonary Rehabilitation Unit at a local hospital for his first appoiment. Before the examination as the PT walks towards waiting area, the patient is observed assuming the professorial position (leaning forward on knees or some object) and is demonstrating increased effort with breathing and increased used of accessory muscles. What can be concluded in this situation?

answer

The patient has Chronic obstructive disease

question

Which postion patient with cardiopulmonary dysfunction can not tolerate?

answer

lying in bed with the head flat

question

Which positions are most commonly found in patients with cardiopulmonary dysfunction?

answer

Semi-fowler's position in bed or sitting over the side of the bed or chair

question

During examination, a patient presents with jugular venous distention (veins are distended above the level of the clavicles), what is this condition indicative of?

answer

Increased volume in the venous system and may be an early sign of R side Heart Failure (cor pulmonale)

question

Which technique is being demonstrated here? - Patient is asked to say "E" aloud, but the sound that is auscultated over the chest is "A"

answer

Egophony

question

Which technique is being demonstrated here? - Patient is asked to say "99", and the words are auscultated clearly over the entire chest

answer

Bronchophony

question

Which technique is being demonstrated here? - Patient is asked to whisper a word. whisper "99", and the whispered words are clearly and distinctly heard through the stethoscope.

answer

Whispered pectoriloquy

question

At what percentage range should a cardiac patient exercise intensity be calculated if using the Karvonen's formula?

answer

60%-80%

question

Defined as the vibration felt while palpating over the chest wall as a patient speaks

answer

Tactile fremitus

question

what is being performed on the following procedure? - place the palms of your hands lightly on the chest wall ande ask the patient to speak a few words or say 99 several times

answer

Tactile fremitus

question

Normal abdominal tone holds the abdominal contents directly under the diaphragm, assisting the return of the diaphragm to the normal high domed position. When a patient lacks functional abdomina musculature such as SCI patient, the diaphragm is lower in thorax dcreasing inspiratory reserve (IRV). The more upright body posiiton the lower the diaphragm and the lower the inspiratory capacity. what position is most advantageous for the diaphragm?

answer

Supine position

question

Normal abdominal tone holds the abdominal contents directly under the diaphragm, assisting the return of the diaphragm to the normal high domed position. When a patient lacks functional abdomina musculature such as SCI patient, the diaphragm is lower in thorax dcreasing inspiratory reserve (IRV). The more upright body posiiton the lower the diaphragm and the lower the inspiratory capacity. What can be used to assist such a patient to maintain or support the abdominal vicera to assist in ventilation?

answer

Abdominal binder

question

Defined as no respirations

answer

Apnea

question

Defined as a deep and labored breathing secondary to metabolic acidosis e.g., Diabetic ketoacidosis but also renal failure. It is a form of hyperventilation, which is any breathing pattern that reduces carbon dioxide in the blood due to increased respiratory rate and depth of respiration.

answer

Kussmaul breathing

question

A therapists is getting ready to assist in performing a Graded Exercise Test (GET). Keeping in mind normal adult levels of PaO2. Baseline PaO2 = 90mmHg for this patient. During the test, the PaO2 is measured to be 68 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T?

answer

Terminate GET

question

A therapists is getting ready to assist in performing a Graded Exercise Test (GET). Keeping in mind normal adult levels of PaO2. Baseline PaO2 = 90mmHg for this patient. During the test, the PaO2 is measured to be 54 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T?

answer

Terminate GET

question

Keeping in mind normal adult levels of PaCO2, a therapist is getting ready to assist in performing a G.E.T. Baseline of PaCO2 = 40mmHg. During the test, the PaCO2 = 52mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T?

answer

Terminate GET

question

Keeping in mind normal adult levels of BP a therapist is getting ready to assist in performing a G.E.T. Baseline of BP 122/84 mmHg. During the test, the BP = 140/106mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T?

answer

Terminate GET

question

Keeping in mind normal adult levels of BP a therapist is getting ready to assist in performing a G.E.T. Baseline of BP 122/84 mmHg. During the test, the BP = 144/88 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T?

answer

Continue GET

question

Keeping in mind normal adult levels of BP a therapist is getting ready to assist in performing a G.E.T. Baseline of BP 122/84 mmHg. During the test, the BP = 244/82 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T?

answer

Continue GET

question

Keeping in mind normal adult levels of BP a therapist is getting ready to assist in performing a G.E.T. Baseline of BP 122/84 mmHg. During the test, the BP = 254/82 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T?

answer

Terminate GET

question

Keeping in mind normal adult levels of BP a therapist is getting ready to assist in performing a G.E.T. Baseline of BP 122/84 mmHg. During the test, the BP = 108/84 mmHg. What is the next thing to do based on guidelines of termination criteria for G.E.T?

answer

Terminate GET

question

If an Arterial line gets dislodge during treatment, what is the next thing to do?

answer

Apply pressure immediately to or above the arterial insertion site to stop bleeding

question

If a patient either O2sat < 88% or PaO2 < 55 mmHg, what is the next thing to do?

answer

Supplemental Oxygen

question

Chronic Restrictive Diseases have different etiologies which is typified by difficulty expanding the lungs causing a reduction in lung volumes Which statement is true about Chronic Restrictive Disease a) Restrictive disease can be due to alterations in lung parechyma and pleura b) Restrictive disease can be due to alteration in the chest wall c) Restrictive lung disease can be due to alterations in the neuromuscular apparatus d) All of the above statements are true

answer

d

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