Physiotherapy Techniques for Wound Healing and Pulmonary Care
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Questions and Answers

What is the primary purpose of performing a self-breast exam?

  • To diagnose palpable masses
  • To check for non-palpable masses
  • To monitor changes in breast tissue and identify potential abnormalities (correct)
  • To identify the exact location of a breast lump

    • What is the recommended frequency for women between 50 and 69 years old to undergo a mammogram?

  • Every 2 years (correct)
  • Every 5 years
  • Every year
  • Every 10 years

    • What is the purpose of a sentinel lymph node biopsy?

  • To identify the exact location of a breast lump
  • To diagnose palpable masses
  • To check for breast cancer spread to the lymph nodes (correct)
  • To monitor changes in breast tissue

    • What is the primary purpose of a breast MRI?

    <p>To evaluate an abnormal change on a mammogram</p> Signup and view all the answers

    What is the procedure duration of a mammography?

    <p>Approximately 15 minutes</p> Signup and view all the answers

    What type of radiation exposure is equivalent to a mammogram?

    <p>1 hour in the sun</p> Signup and view all the answers

    What is the purpose of a needle biopsy?

    <p>To determine if the lump is solid or fluid-filled</p> Signup and view all the answers

    What is a mastectomy?

    <p>Surgical excision of the breast tissue and sometimes nearby tissues</p> Signup and view all the answers

    What is the primary purpose of mastectomy in the context of breast cancer?

    <p>To remove the entire breast and prevent cancer development</p> Signup and view all the answers

    In which stage of breast cancer is mastectomy typically performed after chemotherapy?

    <p>Stage III</p> Signup and view all the answers

    What is a contraindication for mastectomy in elderly patients?

    <p>High risk of mortality associated with surgery or anesthesia</p> Signup and view all the answers

    What type of mastectomy involves removing the entire breast, underarm lymph nodes, and chest wall muscles?

    <p>Radical mastectomy</p> Signup and view all the answers

    What is the most extensive type of mastectomy?

    <p>Radical mastectomy</p> Signup and view all the answers

    Which type of mastectomy involves removing the breast tissue and nipple but leaving the skin intact?

    <p>Skin-sparing mastectomy</p> Signup and view all the answers

    What is the primary difference between a total mastectomy and a modified radical mastectomy?

    <p>Removal of chest wall muscles</p> Signup and view all the answers

    What is the term for breast-conserving surgery that involves removing the breast tumor and surrounding tissue?

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

    What is the purpose of assessing respiratory function in postoperative breast cancer patients?

    <p>To identify potential respiratory complications</p> Signup and view all the answers

    Which of the following is NOT a method for measuring lymphedema in the upper extremity?

    <p>Electroencephalography (EEG)</p> Signup and view all the answers

    What is the purpose of assessing pain levels in postoperative breast cancer patients?

    <p>To evaluate the effectiveness of pain medication</p> Signup and view all the answers

    What is the recommended method for assessing range of motion in postoperative breast cancer patients?

    <p>Active ROM assessment by goniometric measurements</p> Signup and view all the answers

    Which of the following is a component of the breast cancer pain questionnaire?

    <p>All of the above</p> Signup and view all the answers

    What is the purpose of assessing muscle strength in postoperative breast cancer patients?

    <p>To monitor the effectiveness of rehabilitation programs</p> Signup and view all the answers

    Which of the following is a method for assessing lymphedema in the upper extremity?

    <p>Figure of eight measurement for hands and feet</p> Signup and view all the answers

    What is the purpose of assessing the patient's personal history in postoperative breast cancer patients?

    <p>To develop an individualized treatment plan</p> Signup and view all the answers

    What is the primary reason for a double mastectomy?

    <p>As a preventive measure due to genetic features indicating a high risk of breast cancer</p> Signup and view all the answers

    What type of implant is used in artificial implant breast reconstruction?

    <p>Silicone or saline filled implant</p> Signup and view all the answers

    What is the name of the complication that occurs when there is pain in the chest wall, armpit, and/or arm after a mastectomy?

    <p>Postmastectomy pain syndrome</p> Signup and view all the answers

    What is the term for the formation of scar tissue in the incision site after a mastectomy?

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

    What is the name of the muscle that can be injured during a mastectomy, leading to winging of the scapula?

    <p>Serratus anterior muscle</p> Signup and view all the answers

    What is the term for the visible cords that form in the armpit and extend down to the elbow after a mastectomy?

    <p>Axillary web syndrome</p> Signup and view all the answers

    What is the name of the flap that can be used in breast reconstruction surgery?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the weakness and fatigue that occurs after a mastectomy due to inactivity?

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

    What type of ultrasound therapy is used to enhance wound breaking strength in an acute incisional wound?

    <p>Low dose ultrasound, pulsed mode, 1 MHz, 5 minutes</p> Signup and view all the answers

    Which breathing exercise is used in pulmonary physiotherapy?

    <p>Diaphragmatic breathing exercise and lateral costal (segmental emphasis on collapsed areas)</p> Signup and view all the answers

    What is the purpose of manual chest stretch in manual therapy?

    <p>To release scar tissue</p> Signup and view all the answers

    When should strengthening exercises be started after surgery?

    <p>4 to 6 weeks after surgery</p> Signup and view all the answers

    What is the goal of complete decongestive therapy (CDT)?

    <p>To reduce swelling</p> Signup and view all the answers

    What is included in the treatment phase of complete decongestive therapy (CDT)?

    <p>Exercises, manual lymphatic drainage (MLD), and compression therapy</p> Signup and view all the answers

    What is the purpose of lymph taping in the management of lymphedema?

    <p>To reduce swelling</p> Signup and view all the answers

    Study Notes

    Ultrasound Therapy

    • Low dose ultrasound: 0.5 W/cm2, pulsed mode, 1 MHz, 5 minutes
    • High dose ultrasound: 1.5 W/cm2, continuous mode, 1 MHz, 5 minutes
    • Enhances wound breaking strength in acute incisional wounds

    Pulmonary Physiotherapy

    • Diaphragmatic breathing exercises
    • Lateral costal breathing exercises with segmental emphasis on collapsed areas
    • Bronchial drainage and splinted coughing
    • Postural drainage
    • Incentive spirometer

    Manual Therapy

    • Manual chest stretch to release scar tissue
    • Shoulder mobilization exercises
    • Proprioceptive neuromuscular facilitation (PNF)
    • Myofascial release massage

    Exercise Therapy

    • ROM exercises: active ROM, active assisted, and pulley system or shoulder wheel
    • Stretching and flexibility exercises to lengthen shortened soft tissues
    • Strengthening exercises: starts with small hand weights, increased slowly over time
    • Pendulum exercises to control pain and increase ROM
    • Postural correction exercises: chin tuck, scapular retraction, shoulder shrug, seated row, and overhead reach

    Lymphedema Management

    • Complete decongestive lymphedema therapy (CDT)
    • Lymph taping
    • Positioning
    • Diet therapy

    Complete Decongestive Therapy (CDT)

    • Treatment phase: combination of exercises, manual lymphatic drainage, and compression therapy
    • Maintenance phase: follows treatment phase

    Breast Cancer Diagnosis and Treatment

    • Mammography: breast imaging technique to identify non-palpable masses and diagnose palpable masses
    • Procedure: approximately 15 minutes, breast compression, radiation exposure equivalent to 1 hour in the sun
    • Recommendations: Canadian Cancer Society recommends women between 50 and 69 years of age to have a mammogram every 2 years

    Other Investigations

    • Breast ultrasound: shows whether the lump is solid or fluid-filled
    • Breast biopsy: uses needle aspiration or open biopsy
    • Breast MRI: helps identify breast lump or evaluate abnormal changes on a mammogram
    • CT scan: checks if cancer has spread outside the breast
    • PET scan: checks if cancer has spread
    • Sentinel lymph node biopsy: checks if cancer has spread to lymph nodes

    Mastectomy

    • Surgical excision of breast tissue and sometimes nearby tissues
    • Indications: breast cancer, severe laceration of breast tissue, prophylactic (family history of breast cancer and high risk people)
    • Contraindications: patients with proven distant metastatic disease, elderly patients with significant medical comorbidities, patients with high risk mortality associated with surgery or anesthesia

    Types of Mastectomy

    • Total (simple) mastectomy: removes entire breast, leaving muscles under the breast and lymph nodes intact
    • Radical mastectomy: removes entire breast, underarm lymph nodes, and chest wall muscles
    • Modified radical mastectomy: removes entire breast and underarm lymph nodes, leaving chest wall muscles intact
    • Skin-sparing mastectomy: removes breast tissue and nipple, leaving skin intact
    • Lumpectomy (breast conserving surgery): removes breast tumor and some surrounding tissue

    Reconstructive Surgery

    • May be immediate or late
    • Artificial implant: silicone or saline filled implant
    • Breast reconstruction surgeries: transverse rectus abdominis muscle flap, latissimus dorsi myocutaneous flap, superior and inferior gluteal artery perforator flap

    Post Mastectomy Complications

    • Seroma or hematoma formation
    • Wound infection
    • Necrosis and adhesion
    • Postmastectomy pain syndrome
    • Respiratory complications
    • Scar tissue in the incision site
    • Neuropathy
    • Postural changes
    • Winging of scapula
    • Axillary web syndrome
    • Lymphedema
    • Restriction of shoulder ROM and functional deficits
    • Phantom breast pain
    • Weakness and fatigue (deconditioning)
    • Psychologic and socioeconomic dysfunction

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    Description

    This quiz covers various physiotherapy techniques used to enhance wound healing and pulmonary care, including ultrasound, diaphragmatic breathing exercises, and postural drainage. It also explores the use of manual therapy and incentive spirometers in treatment.

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