Respiratory Care Therapeutics: Airway Clearance Therapy

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Questions and Answers

What is the primary function of the mucociliary blanket in the airway?

To regulate air pressure

To filter out particles and germs

To produce mucus

To move secretions upward toward the larynx (correct)

Which cells synthesize and secrete mucus into the airway?

Submucosal glands

Clara cells

Goblet cells (correct)

Ciliated cells

What is the average daily production of secretions in the airway of healthy individuals?

100-1000 mL

1-10 mL

10-100 mL (correct)

1000-2000 mL

What is the primary function of the mucus layer?

To filter out particles and germs Signup and view all the answers

What is the term for the wave-like motion of cilia that helps move secretions upward?

Mucociliary escalator Signup and view all the answers

What is the role of submucosal glands in airway clearance?

To produce mucus Signup and view all the answers

What is the term for the study of cilia and mucociliary clearance?

Cilia and mucociliary clearance Signup and view all the answers

What is the name of the mechanism that occurs from the larynx to the respiratory bronchioles?

Mucociliary clearance Signup and view all the answers

What is the minimum amount of sputum production required for CPT to be effective?

25-30 ml/day Signup and view all the answers

Which of the following conditions is NOT an indication for CPT in chronic conditions?

Pneumonia Signup and view all the answers

What is the potential benefit of combining PD/P/V with exercise in cystic fibrosis?

Maintaining normal lung function Signup and view all the answers

In which of the following conditions can CPT be used to prevent chest infections?

Neuromuscular Disorders Signup and view all the answers

What is the result of a large pressure gradient between the intrathoracic airways and atmospheric pressure during the expulsion phase?

A violent, expulsive flow of air from the lungs Signup and view all the answers

What is the primary goal of postural drainage in acute respiratory failure?

Removing excess secretions Signup and view all the answers

What is the primary goal of airway clearance therapy (ACT)?

To assist the patient to mobilize and remove retained secretions Signup and view all the answers

Which of the following is an indication for CPT in acute conditions?

Lobar atelectasis Signup and view all the answers

What can lead to mucus retention and worsening airway clearance?

Abnormalities in airway patency, mucociliary function, and strength of breathing muscles Signup and view all the answers

Which of the following diseases can impair airway clearance?

Foreign body, lung cancer, asthma, COPD, and kyphoscoliosis Signup and view all the answers

What is a result of mucus plugging?

Atelectasis, V/Q imbalances, and hypoxemia Signup and view all the answers

What is the effect of abnormal mucociliary clearance on the airways?

It leads to retention of secretions in the airways Signup and view all the answers

What is the expected outcome of airway clearance therapy (ACT)?

Improved gas exchange, promoted alveolar expansion, and reduced work of breathing (WOB) Signup and view all the answers

Where should you clap for drainage in the Upper Lobes Posterior apical Segment?

Over the area between the top of scapula on each side Signup and view all the answers

What angle should the patient be positioned at for the High Fowler's position?

30 degrees Signup and view all the answers

What is the mechanism by which mucus is displaced from the airway walls during the expulsion phase?

Shearing force created by the dynamic airway compression Signup and view all the answers

In what position should the patient be for draining the Upper Lobes Anterior Segment?

Lying flat on back with pillow under knees Signup and view all the answers

How should the bed or drainage table be positioned for the Upper Lobe Right Posterior Segment?

Flat Signup and view all the answers

What is the correct position for the patient to drain the Upper Lobes left posterior segment?

Lying on the right side and quarter turn towards prone Signup and view all the answers

What degree angle is needed to elevate the head and shoulders for the Upper Lobes left posterior segment?

30 degrees Signup and view all the answers

How much should the foot of table or bed be elevated for the Right Middle Lobe: lateral and medial segments?

14 inches Signup and view all the answers

When positioning a patient for drainage of the Right Middle Lobe, how should they position their knees?

Flexed Signup and view all the answers

What positioning of the hands is required for effective percussion?

Cupped position with thumb and fingers closed Signup and view all the answers

How long should percussion be applied over the specific segment if tolerated by the patient?

3-5 minutes Signup and view all the answers

What motion should be used for vibratory technique during expiration?

Rapid vibratory motion Signup and view all the answers

Where should the hands be placed for the vibration technique?

On either side of the chest Signup and view all the answers

Which type of clothing is recommended to improve patient comfort during percussion?

Hospital gown or bed sheet Signup and view all the answers

What control features do mechanical percussion and vibration devices typically have?

Frequency and percussion force control Signup and view all the answers

What is a potential hazard of using mechanical percussion and vibration devices?

Noise, excess force, mechanical failure and electrical shock Signup and view all the answers

Up to what frequency do most mechanical percussion units provide?

20 to 50 Hz Signup and view all the answers

Study Notes

Mucociliary Blanket

Primary function: To clear the airway of foreign particles and secretions
Mucus synthesis and secretion: Goblet cells and submucosal glands
Average daily production: 100 ml
Mucus layer function: Trap inhaled particles and pathogens
Wave-like motion of cilia: Ciliary beat
Submucosal glands role: Secrete mucus in the airway
Study of cilia and mucociliary clearance: Ciliary science
Mechanism from larynx to respiratory bronchioles: Mucociliary escalator

Airway Clearance Therapy (ACT)

Minimum sputum production for effective CPT: 10 ml
Non-indication for CPT in chronic conditions: Asthma
Potential benefit of combining PD/P/V with exercise in cystic fibrosis: Improved airway clearance and lung function
Conditions for CPT to prevent chest infections: Cystic fibrosis, bronchiectasis, and chronic obstructive pulmonary disease (COPD)
Result of pressure gradient during expulsion: Airway clearance
Primary goal of postural drainage in acute respiratory failure: Mobilize secretions
Primary goal of ACT: Improve airway clearance
Indication for CPT in acute conditions: Pneumonia
Causes of mucus retention and worsening airway clearance: Dehydration, medications, and inactivity
Diseases impairing airway clearance: Cystic fibrosis, chronic obstructive pulmonary disease (COPD), and bronchiectasis
Result of mucus plugging: Airway obstruction, atelectasis, and infection
Effect of abnormal mucociliary clearance: Chronic cough, recurrent respiratory infections, and impaired lung function
Expected outcome of ACT: Improved airway clearance, decreased cough, reduced respiratory infections, and improved lung function

Positioning for Airway Clearance

Upper Lobes Posterior apical segment: Clap on the back between the shoulder blades
High Fowler's position angle: 90 degrees
Mechanism of mucus displacement during expulsion: Coughing
Upper Lobes Anterior Segment: Patient in supine position with head and shoulders slightly elevated
Upper Lobe Right Posterior Segment: Bed or table tilted on the right side
Upper Lobe Left Posterior Segment: Patient lies on right side with head and shoulders elevated 45 degrees
Upper Lobe Left Posterior Segment angle: 45 degrees
Right Middle Lobe: lateral and medial segments: Foot of table or bed elevated 12-18 inches (30-46 cm)
Right Middle Lobe positioning: Patient lies on left side with knees bent and hips flexed
Effective percussion positioning: cupped hands
Percussion duration: 5-10 minutes
Vibratory technique motion: Rapid, vibrating movement
Vibration technique hand placement: Over the chest wall
Clothing for patient comfort during percussion: Loose-fitting clothing
Mechanical percussion and vibration devices control features: Frequency, intensity, and duration
Potential hazard of mechanical percussion and vibration devices: Skin irritation and bruising
Mechanical percussion units frequency: Up to 20 Hz

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Description

This quiz covers the principles and methods of airway clearance therapy in respiratory care, including the physiology of airway clearance, indications, and techniques.