CP - 10 Obstructive Lung Disease

expiratory, premature closure

with obstructive disease, there is decreased airflow in the _________ phase, and _____________ of the airways

hyper

with obstructive diseases, there is (hypo/hyper)inflation of the lungs

hyperinflation

_______________ is incomplete emptying of the lung

traps air

premature closure of airways ___________ in the airways

decreased

there is (increased/decreased) elastic recoil of the lung tissue and/or chest wall with obstructive disease

• dyspnea

• hypoxia

• cough

• wheezing

• decr breath sounds

expected symptoms of obstructive diseases:

T

T/F: most obstructive diseases are progressive

F; REVERSIBLE

T/F: asthma is a irreversible disease

septic

(septic/non-septic) obstructive disease means there is a component of infection, usually has purulent sputum

non-septic

(septic/non-septic) obstructive disease means there is not an infection, usually does not have sputum

• increased residual volume

• increased functional residual capacity

• decreased vital capacity

• decreased expiratory reserve volume

with obstructive disease, there is:

• (increased/decreased) residual volume

• (increased/decreased) functional residual capacity

• (increased/decreased) vital capacity

• (increased/decreased) expiratory reserve volume

RV/TLC ratio (residual capacity/total lung capacity)

with progressing obstructive disease, all PFT tests have a decreasing trend except for _____ which has an increasing trend

• cardiovascular disease

• obesity

• DM

• osteoporosis

• lung cancer

• depression/anxiety

• cognitive impairments (reduced ability to manage meds)

some common comorbidities of obstructive diseases:

• muscle wasting

• barrel chest

• accessory muscle use

• forward leaning posture/protracted head

• thoracic kyphosis

• cyanosis

appearance and posture for obstructive disease: (6)

diaphragm

MSK changes to the _________ caused by obstructive dz cause an increase in type 1 muscle fibers and loss of sarcomeres

skeletal muscle

MSK changes to the __________ caused by obstructive dz cause a decrease in type 1 muscle fibers, an increase in type 2 muscle fibers, and muscle wasting

capillary density

in skeletal muscle, obstructive diseases can cause decreased _________ leading to lower endurance and less metabolism

frailty

_______ is a syndrome of physiological decline, characterized by marked vulnerability to adverse health outcome

• weakness & fatigue

• medical complexity

• reduced tolerance to medical/surgical interventions

symptoms of frailty include: (3)

asthma

_________ is the most common lung disease in the OP setting

hyperreactive to stimuli

asthma is caused because airways are _____________

expiration

with asthma, (inspiration/expiration) is harder

• mast cells

• eosinophils

• lymphocytes

• macrophages

• t-cells

• inflammatory cytokines

with asthma, underlying airway inflammation is caused by these types of cells (6):

asthma

signs and symptoms of _________ are:

• nonproductive cough

• dyspnea

• wheezing

• chest tightness

• tachypnea

• anxiety

• use of accessory muscles

atopy

_______ refers to the genetic tendency to develop allergic diseases such as allergic rhinitis, asthma, and eczema

triggers

with asthma, one of the goals of treatment is to help identify and reduce exposure to __________

bronchodilators

_____________ are a classifications of medications commonly used to treat asthma

short-acting beta-2 agonist

albuterol is an example of a _____________________ bronchodilator

• tremors

• palpitations

• headache

• nervousness

• nausea

• dizziness

• HTN

• tachycardia

symptoms/side affects of short acting beta-2 agonists are:

F; NOT A RESCUE

T/F: long-acting beta-2 agonists can be used as a rescue medication

anti inflammatory (corticosteroid)

long acting inhaled beta-2 agonists are often combined with a ___________ for long term control

corticosteroids

inhaled ____________ can help decrease eosinophil and lymphocyte activity and reduce inflammatory mediators

prednisone

oral corticosteroids like ________ can cause weight gain, nausea, acne, osteoporosis, restlessness, headaches, and muscle weakness

leukotriene pathway targeting

_______________ medications block action at the receptors to reduce leukotriene production and reduce bronchoconstriction

monoclonal antibodies

__________________ for IgE can be used to prevent binding to mast cell sites; medication via injection or infusion

• current air quality / pollen levels

• availability of rescue meds

• monitor symptoms

• address postural changes

PT implications for asthma include considering: (4)

COPD, variable presentation

_______ is a category consisting of asthma, emphysema, and chronic bronchitis and has a ________________

chronic bronchitis

the diagnostic definition of _____________ is a chronic cough WITH sputum production and increased mucus production

• shortness of breath

• productive cough with purulent (pus) sputum

• possible hypoxia

signs and symptoms of chronic bronchitis: (3)

T

T/F: crackles or rhonchi could be present when auscultating chronic bronchitis

emphysema

________ is the destruction of alveoli in the lung, and air spaces distal to the terminal bronchiole are enlarged

less surface area

emphysema causes ________________ in relation to gas exchange

CO2

obstructive diseases cause poor exhalation of _________

elastic recoil

obstructive diseases cause reduced ________ of lung tissue

• dyspnea on exertion

• possible hypoxia

• fatigue

signs and symptoms of emphysema: (3)

antibiotics, beta agonists, corticosteroids

treatment for COPD can include medications like _______, __________, and ___________

TYPICAL O2 LEVELS

with COPD, you need to know their _________________ in reference to supplemental O2

• pursed lip breathing

• paced breathing

• expiratory pressure devices

breathing exercises for COPD can include: (3)

cystic fibrosis

______________ is an autosomal recessive inherited disorder in caucasians

dehydrated hyperviscous mucus

CF causes the production of thick ______________________

infections

with CF there is recurrent _________ from the thick secretions

intestines, pancreas, gall bladder, reproductive system

CF does not only affect the lungs: it also affects the ______, _______, _______, _______

malnutrition

those with CF can also experience ___________ due to impaired pancreatic function and absorption issues

• barrel chest

• forward head

• hypertrophy of accessory muscles

• decreased core and spine stabilization

main appearance changes in those with CF: (4)

• chronic productive cough

• dyspnea

• nail clubbing

• weight loss

• chronic LBP

signs and symptoms of CF: (5)

CF

types of medications for ________ are antibiotics, bronchodilators, mucolytics, steroids, etc.

airway clearance

PT pulmonary interventions for those with CF focuses on _____________

bronchiectasis

____________ is the dilation and thickening of one or more bronchi with chronic infection and inflammation leading to reduced ciliary function and mucus clearance