Clinical Reasoning in Cardiorespiratory Physiotherapy Quiz
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Questions and Answers

Which cardiorespiratory problem can lead to impaired gas exchange?

  • Decreased exercise tolerance
  • Respiratory muscle dysfunction
  • Impaired airway clearance
  • Low lung volumes (correct)

    • What is a common cardiorespiratory problem related to increased work of breathing?

  • Decreased exercise tolerance
  • Dyspnea (correct)
  • Decrease mobility
  • Pain

    • Which factor can cause low lung volumes in cardiorespiratory patients?

  • Dyspnea
  • Impaired gas exchange
  • Pain
  • Decreased mobility (correct)

    • What problem is commonly associated with impaired airway clearance in cardiorespiratory physiotherapy?

    <p>Respiratory muscle dysfunction</p> Signup and view all the answers

    Which aspect is considered when using clinical reasoning in cardiorespiratory physiotherapy?

    <p>Main and Denehy clinical reasoning table</p> Signup and view all the answers

    What is a direct benefit of using the problem lists flow chart in cardiorespiratory clinical reasoning?

    <p>Clear identification of specific problems</p> Signup and view all the answers

    What does the term 'atelectasis' refer to in the context of cardiorespiratory physiotherapy?

    <p>Collapsed alveoli</p> Signup and view all the answers

    How is positive end-expiratory pressure (PEEP) used in cardiorespiratory physiotherapy?

    <p>To encourage recruitment of all alveoli</p> Signup and view all the answers

    Which of the following problems are commonly encountered in cardiorespiratory physiotherapy?

    <p>Impaired airway clearance and Respiratory muscle dysfunction</p> Signup and view all the answers

    What is the primary function of removing secretions in cardiorespiratory physiotherapy?

    <p>Improving gas exchange</p> Signup and view all the answers

    How can low lung volumes impact cardiorespiratory function?

    <p>By impairing gas exchange</p> Signup and view all the answers

    In what way does 'atelectasis' affect alveoli?

    <p>It collapses them</p> Signup and view all the answers

    'Equal pressure point theory' is related to the concept of:

    <p>Critical opening pressure</p> Signup and view all the answers

    'Closing capacity (CC)' is a term commonly associated with:

    <p>'Atelectasis'</p> Signup and view all the answers

    What is the main purpose of using 'Collateral ventilation' in the context of respiratory therapy?

    <p>To improve gas exchange in alveoli</p> Signup and view all the answers

    Which clinical finding is associated with atelectasis on palpation?

    <p>Decreased chest wall movement unilaterally or bilaterally</p> Signup and view all the answers

    What are the signs of atelectasis on chest X-ray?

    <p>Increased density (darkness) of collapsed lobe</p> Signup and view all the answers

    Why does being in a supine position increase the risk of atelectasis?

    <p>Reduced FRC due to position</p> Signup and view all the answers

    What is the volume of gas in the lung after a normal expiration?

    <p>Functional Residual Capacity (FRC)</p> Signup and view all the answers

    Which lung capacity is required to produce an effective cough?

    <p>Inspiratory Reserve Volume (IRV)</p> Signup and view all the answers

    What law determines airway resistance in the respiratory tract?

    <p>Poiseuille’s Law</p> Signup and view all the answers

    Which factor influences a patient's work of breathing besides lung compliance?

    <p>Airway resistance</p> Signup and view all the answers

    'Closing volume' is a critical value within which lung capacity?

    <p>Functional Residual Capacity (FRC)</p> Signup and view all the answers

    What are the three important processes to reverse atelectasis?

    <p>Critical opening pressure, slow laminar flow, inspiratory hold</p> Signup and view all the answers

    Which lung volume is essential to maintain distal lung patency on expiration?

    <p>Functional Residual Capacity (FRC)</p> Signup and view all the answers

    Why is it important for physiotherapists to encourage an upright position in post-operative patients?

    <p>To promote secretion movement due to equal pressure points</p> Signup and view all the answers

    What is the significance of equal pressure points in the context of lung health?

    <p>They assist in mobilizing secretions to larger airways</p> Signup and view all the answers

    How does pursed lip breathing benefit patients with COPD?

    <p>By creating equal pressure points for better secretion movement</p> Signup and view all the answers

    Which factor contributes to the closing capacity in the lungs during expiration?

    <p>Equal pressure points causing airway collapse</p> Signup and view all the answers

    What is the primary purpose of maintaining the movement of air by utilizing equal pressure points?

    <p>To mobilize secretions in the airways</p> Signup and view all the answers

    How does a low vital capacity affect a patient's ability to maintain spontaneous ventilation?

    <p>It increases work of breathing</p> Signup and view all the answers

    What is the meaning of atelectasis?

    <p>Partial lung collapse</p> Signup and view all the answers

    Which pressure is used to achieve complete recruitment of alveoli in atelectasis?

    <p>PEEP</p> Signup and view all the answers

    What is the main role of PEEP in the context of atelectasis?

    <p>Encourage alveolar recruitment</p> Signup and view all the answers

    Which is NOT a type of atelectasis?

    <p>Dilation</p> Signup and view all the answers

    What is a common clinical sign of atelectasis?

    <p>Hypercapnia</p> Signup and view all the answers

    How does atelectasis affect oxygen levels in the blood?

    <p>It decreases PaO2 levels</p> Signup and view all the answers

    Which term describes the imperfect expansion of alveoli in atelectasis?

    <p>Atelectasis</p> Signup and view all the answers

    What does Positive End-Expiratory Pressure (PEEP) help achieve in the alveoli?

    <p>Aiding in the recruitment of alveoli</p> Signup and view all the answers

    Which term describes a condition where alveoli do not fully expand, causing collapsed air sacs?

    <p>Compressive atelectasis</p> Signup and view all the answers

    What does Surfactant Impairment contribute to in the context of lung function?

    <p>Reduced lung compliance</p> Signup and view all the answers

    Which type of atelectasis occurs due to the effects of gravity on the lungs?

    <p>Plate atelectasis</p> Signup and view all the answers

    In what way does Positive End-Expiratory Pressure (PEEP) affect alveolar pressure?

    <p>It increases alveolar pressure above atmospheric pressure</p> Signup and view all the answers

    Study Notes

    Atelectasis

    • Atelectasis refers to collapsed alveoli
    • The word "atelectasis" means: "Atel" = imperfect, "ectasis" = expansion
    • Atelectasis can involve small groups of alveoli, or a lung segment or lobe, or it can reference the whole lung
    • Palpation signs: decreased chest wall movement, increased temperature
    • Auscultation signs: decreased or absent breath sounds, end-inspiratory crackles
    • CXR signs: shift of structures, fissures, diaphragms, mediastinum, trachea, crowding of vessels, increased density, silhouette sign, separation of lung markings
    • Risk factors: surgical incision, previous respiratory condition, smoking history, obesity, age, impaired cognitive function, monotonous pattern of mechanical ventilation, body position

    Reversing Atelectasis

    • Three important processes: critical opening pressure, slow laminar flow, inspiratory hold
    • Critical opening pressure: necessary to open collapsed alveoli
    • Slow laminar flow: helps to maintain airway patency
    • Inspiratory hold: helps to recruit collapsed alveoli

    Airway Resistance

    • Influences work of breathing (WOB)
    • References the resistance of the respiratory tract to airflow during inspiration and expiration
    • Determined by Poiseuille's Law: directly proportional to the fourth power of the internal radius, inversely proportional to its length, inversely proportional to the viscosity of gas
    • Clinical note: too much resistance can restrict airflow, too little resistance can stop airflow

    Functional Residual Capacity (FRC)

    • Volume of gas in the lung after a normal expiration
    • Continues to participate in gas exchange during inspiration and expiration
    • Balance between the inward recoil of the lungs and the outward recoil of chest wall
    • Clinical note: low lung volumes can lead to impaired gas exchange, decreased exercise tolerance, and increased work of breathing

    Lung Volumes and Capacities

    • Tidal Volume (TV): necessary to maintain oxygenation and CO2 clearance
    • Inspiratory Reserve Volume (IRV): required to produce an effective cough and necessary to sustain increased level of activity or exercise
    • Expiratory Reserve Volume (ERV): extra volume of air that can be forcefully expelled after passive/normal expiration
    • Residual Volume (RV): increased in obstructive lung disease due to air trapping
    • Vital Capacity (VC): a VC of 1L is the critical value used to identify if a patient is able to maintain spontaneous ventilation

    Equal Pressure Point Theory

    • Equal pressure point (EPP): point in an airway where the pressure on the outside is equal to the pressure on the inside
    • Creates a "squeeze point" to milk secretions from smaller airways to larger central airways and mouthward for clearing
    • Clinical note: EPP is one of the factors that maintains the movement of air

    Problem-Solving Framework

    • Problem lists: impaired airway clearance, dyspnea/increased work of breathing, decreased exercise tolerance, low lung volumes, impaired gas exchange, decreased mobility, respiratory muscle dysfunction, pain
    • Flow chart: shows how various cardiorespiratory problems are connected to each other
    • Clinical reasoning table: used to determine interventions needed

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    Description

    Test your knowledge on clinical reasoning in cardiorespiratory physiotherapy, focusing on problem lists and important concepts such as impaired airway clearance, dyspnea, and decreased exercise tolerance. Explore common cardiorespiratory physiotherapy problems and their management.

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