Pulmoary

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Author:
hgienau
ID:
115512
Filename:
Pulmoary
Updated:
2011-11-08 19:27:25
Tags:
Med Cond 2011
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hg
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  1. Upper Respiratory Tract
    • Nasal Cavity
    • Pharynx
    • Larynx
  2. Lower Respiratory Tract
    • Trachea
    • Bronchi
    • Bronchioloes
    • Alveoli
  3. Right vs. Left Lobes
    • Right - 3 lobes, 10 segments
    • Left - 2 lobes, 8 segments
    • Visceral pleura - around the lungs
    • Parietal Pleura - lining the thoracic wall
    • Pleura space can get infected
    • Lower lobes get congested 1st and are harder to clear
  4. Function of Respiratory System
    • 1. conducts air to alveolar system for gas exchange
    • 2. Mucosal linging traps small particles
    • 3. Humidification
    • 4. Moves mucous upward with cilia
    • 5. Warms air with vascular supplu
    • 6. Elicits cough reflex
  5. Ventilation
    Movement of Air
  6. Respiratrion
    exchange of gas
  7. Airway Resistance
    • Increased when diameter of the airway is decreased due to mucous, edema, contraction or spasm of smooth muslces
    • Increases the energy cost of breathing
  8. Obstructive Pulmonary Disease
    • Obstruction of air flow in the respiratory tract
    • Affects ventilation and respiration
    • Ex: COPD, asthma, CF, Bronchiectasis
    • Problems include: DOE, Decreased exercise tolerance, chronic productive cough, frequent respiratory infections, postural defects
    • INSIDE THE LUNGS
  9. Restrictive Pulmonary Disease
    • Inability of he lungs to fully expand due to extrapulmonary or pulmonary restrictions
    • Ex: pleural disease, chest wall injury, ms. weakness, tumer, atelectasis, pulm ffusion
    • Problems include: SOB, increased RR, shallow breathing, increased use of accessory ms. ineffective cough, fatigue, weaknees, weight loss,
    • EXTERNAL TO TH LUNGS
  10. Pulmonary Meds
    • Bronchodilators - increased size of airway
    • Corticosteroids - decreases inflammation
    • Cromolyn Sodium - prevents bronchospasm
    • Mucolytics and Expectorants - results in thinner mucous, increased action of mucin which increases cough
  11. Total Lung Capacity
    • 6000ml
    • Th total amount of air contained in the lngs after a maximum inspiration
  12. Tidal Volume
    • 500 ml
    • Amount of air exchange during a relaxed inspiration followed by a relaxed expiration
  13. Residule Volume
    • 1500 ml
    • Amount of air left in the lungs after max expiration
  14. Vital Capacity
    • 4500 ml
    • The amount of air within lungs that is under volitional control
  15. Dyspnea
    Requires effort to breath
  16. Hyperventilation
    Deep rapids breathing
  17. Orthopnea
    Difficult breathing in supine
  18. Apnea
    no expiratory phase
  19. Apneusis
    No inspiratory phase
  20. Cheyn Stokes
    Gradual increas then decrease in TV followed by apnea
  21. General Goals of Treatment
    • Prevent accumulatin of secretions
    • Increases mobilization fo secretions
    • Increased breathing pattern & ventilation
    • Increased exercise tolerance
    • Improve overall function
  22. Indications for Therapy
    • Acute or chronic respiratory problems
    • Inability to expel secretions
    • Ineffective cough
    • Increase in secretions
    • Pneumonia or atelectasis
    • Neurological problems that affect swallowing and or breathing
  23. Contraindicationf for Thearpy
    • Recnet acute MI
    • Untreated pneumothorax
    • Unstable cardiac or neurological condition
    • Rib Fracture
    • Severe osteoporosis
    • Pulmonary Embolus
    • Bone Cancer
    • Skin Grafts
  24. Techniques of Treatment
    • Beathing Exercises
    • Percussion and postural drainage
    • Assisted coughing
    • Cardiopulmonary endurance training
    • Pt and Family education
  25. Diaphragmatic Breathing
    • Supine with HOB up
    • Hand on stomach
    • In through the nose and out through the mouth
  26. Ventilatory Muscle Training
    • Diaphragmatic Breathig with resistance
    • Resistors
    • Incentive spirometry
  27. Segmental Breathing
    Manual Contacts or tactile cues to increase breathing to certain parts of the lungs
  28. Forced Expiratory Techniques
    • Specific breathing sequence followed by a "huff" forced exhalation to clear secretions
    • 3-5 deep breaths
    • holds 1-3 secs
    • put through perced lips
    • normal inhale
    • "HUFF"
  29. Active Cycel of Breathing Technique
    • Relaxed diaphragmatic breathing follwed by deep inspirations relaxed exhalations
    • as secrestion move to larger airways, huff technique to clear the secretions
  30. Precautions for Therapy
    • No forced or prolonged expiration
    • Avoid use of accessory muscle for nspiration
    • Repeat only 3-4 times to avoid hyperventilation
  31. Postural Drainage Indications
    • Prevent accumulation of secretion
    • Remove those already accumulated
  32. Contraindications to Postural Drainag
    • Severe hemoptysis
    • Untreated acute conditions
    • Cardiovascular Instability
    • Recent nureosurgery - ICP > 20mm (normal =10)
  33. Manual Techniques for precussion
    • Percussion
    • Vibration
    • Shaking
  34. Parameters to Monitor
    • Sputum production
    • HR, BP, RR
    • Skin color
    • O2 saturation
    • ICP if applicable
    • any c/o discomfort
    • EKG

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