Breathing Exercises for Lung Health

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Questions and Answers

What is the primary purpose of sustained maximal inspiration (SMI)?

  • To expel carbon dioxide more effectively
  • To promote faster breathing
  • To decrease the rate of oxygen intake
  • To increase inhaled volume and restore functional residual capacity (correct)

Which procedure is involved in pursed-lip breathing?

  • Holding breath for extended periods before exhaling
  • Inhaling slowly through the nose and exhaling through pursed lips (correct)
  • Inhaling rapidly through the mouth and exhaling forcefully
  • Using an incentive spirometer to achieve maximal inspiration

In what situation would sustained maximal inspiration (SMI) be most appropriately utilized?

  • Patients with chronic obstructive pulmonary disease
  • Patients with allergic reactions causing airway obstruction
  • Patients post-surgery to prevent alveolar collapse (correct)
  • Patients experiencing dyspnea during exercise

What is a benefit of using an incentive spirometer during SMI?

<p>It encourages deep inspiration to achieve maximal inhalation. (A)</p> Signup and view all the answers

Which of the following is a key characteristic of pursed-lip breathing?

<p>It prevents early airway collapse by creating positive back pressure. (A)</p> Signup and view all the answers

What is the primary purpose of diaphragmatic breathing?

<p>To increase ventilation and improve gas exchange (A)</p> Signup and view all the answers

Where should the patient be positioned for effective diaphragmatic breathing?

<p>Supine, sitting, or in semi-Fowler position (C)</p> Signup and view all the answers

Which breathing technique is primarily used for localized lung consolidation?

<p>Lateral costal breathing (A)</p> Signup and view all the answers

When might segmental breathing be particularly useful?

<p>When there is decreased movement due to pleuritic or posttrauma pain (B)</p> Signup and view all the answers

What should be applied during exhalation in segmental breathing?

<p>Gentle pressure to the thorax over the area of hypoventilation (C)</p> Signup and view all the answers

What is a noted limitation of diaphragmatic breathing?

<p>It is not the best technique for chronic pulmonary dysfunction (B)</p> Signup and view all the answers

What is a key feature of lateral costal breathing?

<p>It involves the uninvolved side against the bed (D)</p> Signup and view all the answers

What additional technique can enhance diaphragmatic breathing?

<p>Sniffing three times followed by a slow exhale (D)</p> Signup and view all the answers

What is the main purpose of stacked breathing?

<p>To assist in effective cough and address atelectasis (B)</p> Signup and view all the answers

Which technique is used after all other techniques have been attempted for upper chest inhibition?

<p>Manual pressure application to the chest (B)</p> Signup and view all the answers

What does glossopharyngeal breathing help with?

<p>Facilitating effective cough for high-level cervical spine injuries (C)</p> Signup and view all the answers

Which positioning technique is recommended for relief from dyspnea?

<p>Leaning forward with arms supported (A)</p> Signup and view all the answers

What is the most accurate method for prescribing exercise intensity?

<p>Oxygen consumption (VO2 max) (A)</p> Signup and view all the answers

What does the Karvonen formula help calculate?

<p>Target heart rate (C)</p> Signup and view all the answers

When should abdominal strengthening exercises be implemented?

<p>When abdominal muscles are weak and can't support effective cough (C)</p> Signup and view all the answers

Which statement about heart rate reserve (HRR) is true?

<p>It can be monitored during physical performance (A)</p> Signup and view all the answers

What is the recommended duration for pursed-lip exhalation?

<p>4 to 6 seconds (D)</p> Signup and view all the answers

What limitation does dyspnea pose during exercise?

<p>Limiting factor in exercise capability (C)</p> Signup and view all the answers

Flashcards

Diaphragmatic Breathing

A breathing technique that increases ventilation, improves gas exchange, and reduces workload by focusing on diaphragm movement.

Diaphragmatic Breathing Procedure - Position

Patient should be positioned supine, sitting, or semi-Fowler.

Diaphragmatic Breathing Procedure - Hand Placement

Place your hand over the subcostal angle and apply gentle pressure during exhalation, gradually increasing pressure, and assisting patient in inhaling against resistance.

Lateral Costal Breathing

Breathing technique focused on one side of the chest to improve ventilation to one area, particularly useful to release localized lung consolidation or secretions.

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Segmental Breathing

Breathing technique used to target and improve ventilation in a specific, hypo-ventilated part of the lung, using gentle pressure to increase airflow in that segment.

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Segmental Breathing - Positioning

Position the patient to optimize inhalation to the targeted lung segment.

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Breathing Exercise Use Cases

Used for obstructive and restrictive pulmonary diseases, excessive secretions, tachypnea, postoperative care, and post-trauma treatment.

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Limitations of Diaphragmatic Breathing

While useful, not ideal for chronic pulmonary dysfunction.

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Sustained Maximal Inspiration (SMI)

A technique where a patient inhales against resistance, holds their breath, and then exhales passively; used for increasing lung volume and improving gas exchange.

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Pursed-lip breathing

Slow, deep breaths using pursed lips, reducing dyspnea (shortness of breath) by preventing early airway collapse and slowing breathing rate.

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Incentive spirometer

A device to encourage deep breathing, helping patients maximize inhalation during SMI.

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Obstructive disease

A condition hindering airflow out of the lungs.

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Increased inhaled volume

Breathing in a greater amount of air, which helps improve lung function and ventilation.

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Stacked breathing

A breathing technique used to improve ventilation by stacking breaths on top of each other. It involves a series of deep breaths without exhaling until the maximum volume is tolerated. Each inspiration is held momentarily.

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When to use stacked breathing

Stacked breathing is used for conditions like hypoventilation (low breathing rate), atelectasis (lung collapse), and ineffective cough.

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Upper chest inhibition technique

A technique used to limit upper chest movement during breathing. It's typically used when other techniques have failed to improve breathing.

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How upper chest inhibition works

Pressure is applied to the upper chest to limit its expansion, and the pressure is gradually increased with each breath to increase effort and control.

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Abdominal strengthening

A technique that focuses on strengthening abdominal muscles to improve breathing and coughing, especially useful for individuals with weak abdominal muscles.

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Abdominal support

A technique used to provide external support to the abdomen during exhalation, typically used when abdominal muscles are weak and cannot provide adequate support for passive exhalation.

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Glossopharyngeal breathing (air gulping)

A technique where air is 'gulped' into the lungs to assist with coughing, especially helpful for individuals with high-level cervical spine injuries.

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Positioning for dyspnea relief

Positioning the body in a way that helps ease breathing difficulty. Leaning forward with arms supported allows accessory muscles to assist in expanding the ribcage and enhancing breathing.

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Oxygen consumption (VO2 max)

A measure of the maximum amount of oxygen a person can utilize during exercise. It’s the most accurate method for prescribing exercise intensity.

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Study Notes

Breathing Exercises

  • Diaphragmatic Breathing: Increases ventilation, improves gas exchange, reduces workload, and facilitates relaxation. Improves chest wall mobility. Used for obstructive and restrictive lung diseases, excessive secretions, and post-surgical/trauma cases. It is less effective for chronic pulmonary issues.

  • Procedure: Patient positioned supine, sitting, or semi-Fowler's. Hand placed over the subcostal angle, gentle pressure during exhalation increasing to firm pressure. Patient inhales against resistance, then pressure released. Sniffing can aid diaphragm engagement.

  • Lateral Costal Breathing: Addresses asymmetrical chest expansion, used for localized lung consolidation or secretions. Commonly done side-lying with the uninvolved side against the bed and the involved arm over the head.

  • Segmental Breathing: Improves ventilation to hypo-ventilated lung segments. Maintains or restores functional residual capacity. Used for pleuritic, incisional, or post-trauma pain; preventing atelectasis.

  • Procedure: Patient positioned to facilitate inhalation to the specific segment. Apply gentle pressure over the hypo-ventilated area during exhalation, increasing to firm pressure before inhalation. The patient inhales against resistance and pressure is released.

  • Sustained Maximal Inspiration (SMI) or Inspiratory Hold: Increases inhaled volume and restores functional residual capacity. Used in acute cases - post-trauma pain, post-surgery, acute lobar collapse, and with ineffective coughs. Can be used with vibration techniques.

  • Procedure: Slow, deep inhalation through the nose or pursed lips, hold for three seconds. Passively exhale.

  • Pursed-Lip Breathing: Improves gas exchange, reduces respiratory rate, and lessens dyspnea. Used to reduce respiratory rate.

Stacked Breathing

  • Series of deep breaths that build upon previous breaths without expiration. Each inspiration is held with minor pause

  • Used to manage hypoventilation, improve atelectasis issues, assist with ineffective coughs, and deal with uncoordinated breathing patterns during activities of daily living (ADLs).

Upper Chest Inhibition Technique

  • Used when other techniques fail.
  • Pressure applied to upper chest to limit excursion, gradually increased in intensity.

Abdominal Strengthening/Support

  • Utilized when abdominal muscles are weak for effective cough support for passive exhalation. Relevant in high thoracic spine/cervical spine SCI cases

  • Support techniques, ensuring that binder does not restrict inspiration. Effective for high cervical SCI cases (e.g., C4).

Glossopharyngeal Breathing

  • Used to aid in coughing (air gulping).

Positioning for Dyspnea Relief

  • Leaning forward with arm support enables accessory muscles to assist rib cage expansion. This helps in inspiration.

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