Pulmonary physical therapy-I

Question	Answer
What are the commmom Acute Pulmonary diseases?	Bacterial Pneumonia, Viral Pneumonia, Aspiration Pneumonia, Tuberculosis, Pneumocytis Carinii Pneumonia and SARS( Severe Acute Resp. Synd.)
Pneumocytis Carinii pneumonia is most found in :	Patients following transplantation, neonates or patients infected w HIV.
Crackles can be heard usually	inspiration
Wheezes can be heard usually	expiration, with severe airway constriction, it maybe heard on inspiration as well.
Bronchial can be heard usually	a more hollow, echoing sound normally found only over the right superior or anterios thorax. Heard on ALL expiration and most of expiration.
What is an Ventilation perfusion scan(V/Q)	it maches the ventilation pattern of the lung to the perfusion pattern to indentify the presence of pulmonary emboli
COPD:	Asthma, Cystic fibrosis, Bronchiectasis, Hyaline membrane disease, bronchopulmonary diplasia
Chronic Restrictive Diseases due by:	-Due to alterations in lung-Due to alterations in the chest wall-Due to alterations in the neuro musc. apparatus
Duration and procedure per postural drainage	up to 20 min
Indications for the use postural drainage	Increased pulmonary secretions, aspiration, atalectasis or collapse.
Class I 0% ImpairmentsRX	Usually NL, may be evidence of healed or inactive chest
Class I 0% ImpairmentsDyspnea	when it occurs it is consistent with the circunstances or activity.
Class I- 0% ImpairmentFEV1, FVC, MMV	not >85% of predicted
Class II- 20-30% ImpairmentDyspnea	not occur at rest, seldom occurs during ADL's
Class II- 20-30% ImpairmentRX	NL or Abnormal
Class II- 20-30% ImpairmentFEV1, FCV, MMV	70-85% of predicted
Class III- 40-50% ImpairmentRX	may be NL but usually it is not
Class III- 40-50% ImpairmentDyspnea	not occur at rest, occurs during the usual ADL's
Class III- 40-50% ImpairmentFEV1, FVC, MMV	55-70% of predicted
Class III- 40-50% ImpairmentART. O2 Sat	88% or >at rest and after exercise
Class IV -60-90% ImpairmentRX	abnormal
Class III- 40-50% ImpairmentDyspnea	occurs climbing one flight of stairs or walking 100 yeards on level ground. Even at rest.
Class III- 40-50% ImpairmentFEV1, FCV, MMV	<55% of predicted
Class III- 40-50% ImpairmentArt. O2 sat	<88% rest and after exercise.
Manual secretion removal techniques	Postural drainage,percussion, vibration.
Airway clearance techniques	Cough, Huff, assisted cough,tracheal stimulation, endotracheal suction.
Independent secretionremoval	Active cycle of breathing, Autogenic drainage, The futter device.
Class IV- 60-90% ImpairmentRX	occurs on activ. like climbing one flight of stairs or walking 100 yards on level ground or even at rest.
Class IV- 60-90% ImpairmentFEV1, FCV, MMV	<55% of predicted
Class IV- 60-90% ImpairmentO2 Sat	<88% at rest and after exercise.
Breathing exercises	Diaphragmatic breathing, segmental breathing,Sustained maximal inhaled volume, pursed lip breathing,abs strengthening
Beta 2 agonists (sympathomimetics)	Ventolin, Alupent, Maxair and Albuterol
Beta 2 agonists (sympathomimetics)Action:	mimics the activity of sympathetic NS which will produce bronchodilatation. Increase HR and BP.
Anticholinergics Action:	inhibit the parasympathetic NS, can lead to increase in HR and BP. Drug: ATROVENT
Methylxanthines Action	Produce smooth muscle relaxation, limited use due to serious toxicityof Inc. BP, Inc. HR.
Anti-inflamatory agents:	used to decrease mucosal edema, decreaseinflamation and reduce air way reactivity.
Types of anti- inflammatory	Steroids, Leukotriene receptor Atagonist, Leukotriene receptor antagonist, cromolyn Sodium.
Steroids action:	used to maintenance of airway and should be taken regularly.
Side effects of systemic administration Steroids:	increase blood pressure, sodium rotation, muscle wasting,osteoporosis, GI irritation