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INTERNATIONAL EDUCATIONAL RESOURCES, LTD. CARDIOPULMONARY 4 CONDITIONS AND INTERVENTION ie 2 reo at ei igre et aan ee mettre cs tor toons eeskybesht eens eal 6. Forced vital capacity (FV): the amount of air that is under volitional control. Equals the IRV + TV + ERWEe F lowing a full inspiration. Normally, at least 75% of FVC is exhaled within the first second x ity, TV + IRV + ERV + RVD of air remaining in the lungs following a normal expiration. ‘ced expiratory volume (FEV1): the volume of air that can be forcefully expelled in one second fa: al lung capacity: the sum of the residual volume and the forced vital capa ERV + RV General Information. Atelectasis Shrunken and aitless state of part of the lung, acute or chronic, complete or partial. bb. Often associated with infection. 4 c. Presents with pain on affected side, dyspnea, cyanosis, drop in blood pressure, tachycardia, dimin- shed or absent breath sounds, dull or flat to percussion, fever and reduced chest excursion on cted side, : Auscultation. Listening to the respiration for breath sounds using a stethoscope. q Normal sounds, called vesicular, are soft rustling sounds heard throughout all of inspiration and the beginning of expiration. . Breath sounds can be decreased or adventitious (extra) sounds such as crackles, wheezes, rhonchi, etc, See section D. | 148 4 EXAM REVIEW MATERIAL F Deconditioning Decrease in aerobic fitness, vital capacin muscle strength and range of motion as a result fed rest of inactiviy. 4 Occasionally, it may be accompanied by orthostatic hypotension. See #6 rentilation. Occurs when there isan increased inspiration and expiration of air asa resull of an increase in rate andor depth of respiration The result is depletion in carbon dioxide (respiratory alkalosis) with accompanying symptoms fallin blood pressure, vasoconstriction, sometimes syncope, marked anxiety, and west camping) ‘The immediate treatment involves having the patient breathe into a paper bag until the CO. content ‘of the biood returns to normal. ‘The patient wil also need to be reassured and calmed FOrthopnea: difficulty breathing except in the sitting or standing position, §G, Onhostatic hypotension (postural hypotension) oe 1a. Decrease in blood pressure upon assuming an erect posture. i. This is normal, but may be of such degree as to cause fainting, especially in persons who first stand tp ater Iying flat in bed for several days. © a. The use of fingertips to tap the body lightly but sharply to determine position, size, and consistency of an underlying structure and the presence of fluid or pus in a cavity. |b. The pitch of the sound emitted, vibration elicited, or resistance encountered determines possibility ‘of an underlying condition or problem. . Also used in treatment of pulmonary conditions (1) A force is rhythmically applied with the therapist’s cupped hands to the involved lung segment © (2) Used to increase the amount of secretions cleared from the tracheobronchial tree 1B. Perfusion, 2. The volume of blood that circulates through the lungs; itis gray b. Ifa patient has a perfusion problem in the lungs, treatment should occur with the involved side dow Sputum. 2. Substance expelled by coughing or clearing the throat, y dependent b. itmay contain a variety of materials from the respiratory tract e.g, cellular debris, mucus, bic pus, and microorganisms The amount, color and conditions ofthe sputum can be used inthe differential diagnosis conditions. For example (1) Foul smell means that there is an anaerobic infection, (2) Purulent (yellow or green) indicates an infection. 3) Frothy usually means that there is pulmonary edema. (4) Mucoid (clear, thick) is indicative of cystic fibrosis or conditions with a chronic cough. d. Hemoptysis means that there is blood in the sputum. 149 INTERNATIONAL EDUCATIONAL RESOURCES, LTD. Anticoagulants, a. Examples: Coumadin and Hey b. Increase blood-clotting time. ‘c. Could result in hemoptysis during percussion and shaking, d. Administered to patients with deep vein thrombosis (see Pathology chapter 3. Bronchodilators ‘a. Examples: Epinephrine, Alupent, Ventolin, Proventil Relax smooth muscle and open ainway lumen to assis in breathing, Often used prior to exercise or athletics to reduce the neg 4. Corticosteroids Je effects of disease proce: a. Examples: Prednisone and Conisol b. Decrease edema and inflammation associated with ch Cc. Side effects such as osteoporosis, muscle w asting D, Breath sounds upon auscultation. 1. Normal breath sounds are clear Adventitious sounds are abnormal and can help diagnose pulmonary conditions. 3. Rales (crackles) ath sounds associated with pathology. bb. Discontinuous sounds heard primarily durin, a. Extra bre spiration, eathiny c. Could be the result of air bubbles in secretions or movement of fibrotic tissue durin d. Basilar rales often accompany left ventricular congestive hea 4. Rhonchi. > %f * failure, ‘a. Continuous low pitched, sonorous breath sounds that are most prominent during expiratios b. Could be a result of air passing through airways narrowed by inflammation, bronchosp cc. Frequently present with asthma and chronic bronchitis. Stridor 2. Acontinuous adventitious sound of inspiration associated with upper airway obstruction. 6. Wheezes, 2, Continuous breath sounds that are high-pitched, sibilant and musical. b. Often associated with asthma, Friction rub, a. Caused by the rubbing of pleural surfaces against one another, usually as a result of inflammation « neoplastic processes. b. May be accompanied by pain during inspiration Il, SELECTED PULMONARY CONDITIONS. A. Chronic obstru: /¢ pulmonary diseases (COPD). 1. General signs and symptoms. a. Increased resistance to altflow b. Often a history of smoking ©. Abnormal breath sounds 4. Use of accessory breathing muscles. 2. Increased chest size £. Dry or product