Chapter 44 – Airway Clearance Therapy (Vocabulary Flashcards)

Thirty vocabulary flashcards covering key terms, devices, techniques, indications, and assessment concepts from Chapter 44 on Airway Clearance Therapy.

Airway Clearance Therapy (ACT)

A group of non-invasive techniques used to mobilise and remove pulmonary secretions in order to improve gas exchange.

Mucociliary Escalator

The self-clearing mechanism of the airways that relies on cilia and mucus to move debris upward toward the pharynx.

Effective Cough

A forceful expiratory manoeuvre that propels mucus from lower to upper airways for expectoration.

Atelectasis

Collapse of alveoli, often caused by mucus plugging, leading to shunt-related hypoxaemia.

Ventilation-Perfusion (V/Q) Imbalance

Mismatch between air flow and blood flow in the lungs, which can be worsened by partial airway obstruction.

Cystic Fibrosis (CF)

Genetic disease characterised by thick, tenacious secretions and chronic airway infection requiring regular ACT.

Bronchiectasis

Permanent dilation of bronchi associated with chronic infection and copious sputum production; benefits from airway clearance.

Chest Physical Therapy (CPT)

Use of positioning, gravity, manual percussion, and vibration to loosen and drain pulmonary secretions.

Postural Drainage

Placing the patient in specific positions so gravity assists movement of secretions from peripheral to central airways.

Percussion

Rhythmic clapping of the chest wall (manual or mechanical) to loosen bronchial secretions.

Vibration

Rapid oscillatory pressure applied to the chest wall during exhalation to move mucus toward larger airways.

Directed Cough

Taught, supervised cough technique that mimics a normal cough through proper positioning and breathing control.

Forced Expiratory Technique (FET) / Huff Cough

One or two forced expirations from mid- to low-lung volume without glottic closure, designed to clear mucus with less airway collapse.

Manual Assisted Cough

External pressure applied to thorax or abdomen coordinated with exhalation to augment cough in neuromuscular patients.

Active Cycle of Breathing Technique (ACBT)

Sequence of breathing control, thoracic expansion exercises, and FETs to mobilise and clear secretions.

Autogenic Drainage (AD)

Self-drainage method using controlled diaphragmatic breathing at varied lung volumes to move mucus without coughing until the end.

Mechanical Insufflation-Exsufflation (MIE)

Device that delivers +30–50 cm H₂O then −30–50 cm H₂O to simulate a cough and clear secretions, especially for neuromuscular patients.

Positive Airway Pressure (PAP) Adjuncts

Techniques such as CPAP, EPAP, and PEP that apply positive pressure to airways to treat atelectasis and aid secretion clearance.

Positive Expiratory Pressure (PEP)

Breathing against a fixed/variable resistor to generate 10–20 cm H₂O during exhalation, helping to mobilise mucus.

Oscillatory PEP (Vibratory PEP)

PEP therapy that superimposes high-frequency flow interruptions to create oscillations, further loosening secretions.

High-Frequency Chest-Wall Oscillation (Vest)

External inflatable vest that rapidly compresses and releases the chest, generating oscillations to mobilise mucus.

Intrapulmonary Percussive Ventilation (IPV)

Pneumatic device delivering rapid mini-bursts of gas (100–225 cycles min⁻¹) directly into the airways to loosen secretions.

Continuous Positive Airway Pressure (CPAP)

Steady distending pressure applied throughout the respiratory cycle to splint airways open and help resolve atelectasis.

Expiratory Positive Airway Pressure (EPAP)

Positive pressure applied only during exhalation to improve airway stability and secretion movement.

Trendelenburg Position

Body position with head lower than feet; may enhance drainage but is poorly tolerated by dyspnoeic or hypotensive patients.

Mobilisation and Exercise

Physical activity that increases tidal volume, heart rate, and overall conditioning, aiding natural airway clearance.

Outcome Assessment (ACT)

Monitoring sputum volume, breath sounds, dyspnoea, vital signs, imaging, and ventilator data to judge therapy effectiveness.

Selection Factors (ACT)

Patient and caregiver goals, motivation, cognition, physical ability, cost, and disease severity that guide technique choice.

Endotracheal/Tracheostomy Tube

Artificial airway that can impair mucociliary clearance and necessitate more aggressive secretion-management strategies.