COPD Breathing Techniques

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Questions and Answers

What happens to the better ventilation of the dependent normal lung when lying with the affected lung uppermost?

It is reduced

It remains unchanged

It is matched with better perfusion (correct)

It is mismatched with perfusion

Why is postural drainage effective in facilitating the drainage of secretions from the bronchial airways?

Because of the effect of gravity (correct)

Because of increased ventilation

Because of increased perfusion

Because of better VA/Q match

What is the primary goal of postural drainage and manual therapy?

To improve ventilation

To increase perfusion

To reduce VA/Q mismatch

To help drain mucus from each of these lobes into the larger airways (correct)

What is the angle of tilt of the chest in the lying supine position with the body a quarter turned to the right?

15º Signup and view all the answers

In which position is the affected lung uppermost?

Lying supine with the body a quarter turned to the left Signup and view all the answers

What happens to VA/Q mismatch when the affected lung is dependent?

It is enhanced Signup and view all the answers

Why do adults have a higher risk of bronchial wall instability?

Due to more collapsible airways Signup and view all the answers

What is the goal of removing excess secretions from the lungs?

To improve lung function Signup and view all the answers

What is the purpose of taking 3-4 active deep inspirations with passive relaxed exhalation?

To improve breathing control Signup and view all the answers

What is the purpose of huffing in the autogenic drainage technique?

To start the secretion evacuation phase Signup and view all the answers

What is the main principle of autogenic drainage?

Using controlled breathing to maximize expiratory flow Signup and view all the answers

What is the first phase of the autogenic drainage breathing exercise?

Unsticking mucus in the smaller airways Signup and view all the answers

How is the 'unsticking' phase performed in autogenic drainage?

By exhaling completely and inhaling a small to normal breath Signup and view all the answers

What is the benefit of performing autogenic drainage exercises?

To move secretions from peripheral to central airways Signup and view all the answers

What is the purpose of manual upwards compression of the diaphragm in patients with spinal cord injury or neuromuscular disease?

To replace the work of the abdominals to facilitate a cough Signup and view all the answers

How do particles that escape filtration in the nose get cleared from the airways?

They are trapped by cilia and propelled out of the airways Signup and view all the answers

What is the function of the mucociliary blanket?

To clear secretions from the airways Signup and view all the answers

What can compromise the mucociliary clearance mechanism?

Dehydration, smoking, and hypoxia Signup and view all the answers

What is the speed of cilia beating in the airways?

20 strokes a second Signup and view all the answers

What is the function of mucus in the airways?

To protect the airways from infection and damage Signup and view all the answers

Why is positioning important in patients with respiratory problems?

It affects the VA/Q ratio Signup and view all the answers

How much secretions can the mucociliary blanket clear per day?

10-100 mL Signup and view all the answers

What is the purpose of Level Three in autogenic drainage?

To evacuate mucus in the central airways Signup and view all the answers

How long does each level of autogenic drainage take?

About 2-3 minutes Signup and view all the answers

When should coughing be avoided during autogenic drainage?

During Levels I and II Signup and view all the answers

What is the recommended age for patients to perform autogenic drainage?

Above 8 years old Signup and view all the answers

What is the goal of rhythmic clapping during percussion?

To minimize hypoxaemia Signup and view all the answers

What is a contraindication for percussion?

Over rib fracture Signup and view all the answers

What is the recommended position for performing autogenic drainage?

Sitting position Signup and view all the answers

What is the comparison between autogenic drainage and postural drainage?

Autogenic drainage is as effective Signup and view all the answers

At what angle is the chest tilted downwards in the lying prone position with a pillow under the abdomen?

15º Signup and view all the answers

Which of the following is a contraindication for postural drainage?

All of the above Signup and view all the answers

What is the purpose of providing visual cues in inspiratory muscle training?

To provide a goal for the patient to achieve Signup and view all the answers

What is the effect of sustained maximal inspiration on the pleural pressure?

It decreases well below normal Signup and view all the answers

What is the purpose of mechanical devices introduced in surgical patients?

To reduce postoperative complications Signup and view all the answers

How does a sustained maximal inspiration affect the alveoli?

It expands the alveoli Signup and view all the answers

What is the function of the device that allows patients to perform sustained maximal inspiration?

To present a visual quantitation of the inspiratory effort Signup and view all the answers

What is the purpose of holding at full inspiration for 2-3 seconds during inspiratory muscle training?

To sustain the transpulmonary pressure gradient Signup and view all the answers

Study Notes

Respiratory Care

Adults have more bronchial wall instability, making them more prone to collapse.
People with Chronic Obstructive Pulmonary Disease (COPD) have more collapsible airways.
Repeated coughing can cause fatigue and discomfort, so it's essential to save coughing for the final secretion evacuation phase.
Removing excess secretions (phlegm) from the lungs can help improve lung function.

Autogenic Drainage

Autogenic drainage is a system of breathing exercises developed in 1967 to move secretions from peripheral to central airways.
The technique uses controlled breathing to maximize expiratory flow with minimal airway closure.
There are three phases of the breathing exercise:
- "Unsticking" mucus in smaller airways by breathing in the base of the lungs.
- "Collecting" mucus in middle airways by breathing at low to mid-lung levels.
- "Evacuating" mucus from central airways by breathing at mid to high lung levels.

Breathing Exercises

Level One: "Unsticking" of mucus by low lung level breathing.
Level Two: "Collecting" the mucus in larger or mid-sized airways.
Level Three: "Evacuating" the mucus in central airways by breathing at normal to high volumes.
The full cycle takes 6-9 minutes.
Coughing should be avoided if possible in levels I and II.

Percussion and Vibration

Percussion is a technique used to help loosen secretions in the lungs.
Rhythmic clapping on the patient's chest with cupped hands or soft-rimmed face mask is a common method.
Contraindications include over rib fracture, direct surgical incision or graft, frank haemoptysis, severe osteoporosis, and severe clotting disorder.

Assisted Cough

Assisted cough is a technique used to help patients with spinal cord injury or neuromuscular disease cough effectively.
The physiotherapist provides manual upwards compression of the diaphragm to replace the work of the abdominals.
This helps facilitate a cough in patients with respiratory difficulties.

Mucociliary Clearance

Particles that escape filtration in the nose are trapped on a sticky mucus blanket lining the airways.
Cilia beat synchronously to propel the mucoid secretions to the pharynx and larynx, where they are swallowed or expectorated.
Secretions are propelled at speeds of between 0.5 mm/min in small airways and 20 mm/min in the trachea.
Impaired mucociliary clearance predisposes to infection.

Postural Drainage

Postural drainage is a technique used to facilitate the drainage of secretions from the bronchial airways.
Different positions are assumed to use gravity to move secretions to the trachea, making them easier to cough up.
The goal of postural drainage and manual therapy is to help drain mucus from each of the lobes into the larger airways of the lungs.

Indications and Contraindications

Indications for respiratory physiotherapy include sputum retention and exacerbation of bronchitis.
Contraindications include hypertension, severe dyspnoea, recent surgery, severe haemoptysis, nose bleeds, advanced pregnancy, hiatus hernia, cardiac failure, cerebral oedema, aortic aneurysm, head or neck trauma/surgery, and mechanical ventilation.

Inspiratory Muscle Trainer

An inspiratory muscle trainer is a device that allows patients to perform sustained maximal inspiration (SMI) while providing visual quantitation of the inspiratory effort.
The device helps increase the transpulmonary pressure gradient, which can help prevent or treat atelectasis.
It is commonly used in surgical patients to reduce postoperative complications by increasing inspiratory capacity.

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Description

Learn effective breathing techniques for individuals with Chronic Obstructive Pulmonary Disease (COPD). Discover how to manage symptoms and improve lung function.