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PHTY205 - Cardiorespiratory Physio, Concepts: outcome measures etc.…

- - - - Reduced Ejection Fraction
      - Preserved Ejection Fraction
    - - Left Ventricular Failure
        
        Decreased cardiac output
        
        pulmonary congestion
      - Right Ventricular Failure
        
        congestion of peripheral tissues
        
        Weight gain, distension of abdomen (ascites) and jugular vein
- - - - Bronchial Breath Sounds
      - Reduced Breath Sounds
      - Absent Breath Sounds
    - - Fine Crackles
      - Course Crackles
      - Wheeze
      - Pleural Rub
      - Stridor
      - URT sounds
      - Mediastinal Crunch
  - - - Technical Details (name, date, view)
      - Image quality (inspiration level, rotation, exposure)
      - Extrathoracic structures (shoulder girdle, soft tissue, below diaphragm)
      - Thoracic cage (spine, ribs, diaphragm shape and angles)
      - Intrathoracic structures (mediastinum, lung fields)
      - Attachments/Foreign Bodies
      - Air bronchograms
      - Silhouette signs
      - common features of CXR
        
        Loss of volume (atelectasis/collapse)
        
        Consolidation
        
        Hyperinflation
        
        Acute pulmonary oedema
        
        Pleural effusion
        
        Pneumothorax
        
        Subcutaneous emphysema
        
        Collapse vs. Pneumothorax
        
        Pulmonary oedema vs, consolodation?
- - - - Cycles of Breathing Techniques ACBT (Active Cycle Breathing Techniques), FET
        
        Deep Breathing Exercises
        
        FET
        
        Breathing Control
      - Forced Expiration Technique (FET)
      - Autogenic Drainage (AD)
- - - - Abdominal Aorta Aneurysm
      - Upper GI
      - Lower GI
      - Bariatric
    - - Forms of Vascular Surgery
    - - Congenital defects
      - Coronary Bypass Grafting
      - Valve repair/replacement
      - other
    - - Lung parenchyma
      - Rib cage
      - Pleural disease/disorder
      - Other disorders
- - - - QoL Questionnaires (disease specific)
    - - Modified Borg (dyspnoea)
      - 6MWT
      - NYHA
      - MRC
    - - Questioning (Subjective)
      - Observation + Palpation
      - Auscultation
      - Cough
      - O2 Sat
      - CXR
      - Spirometry
      - ABGs
- - - - increased viscosity of mucus (pathogenesis continued)
        
        Impaired secretion movement
        
        Recurrent infections and further cilial damage
        
        Recurrent infections lead to airway
        damage (floppy & fibrosed)
        
        Destruction and dilation causes "floppy airways" --> obstruction
        
        decreased cough and increased airway resistance
        
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        Damage to lung parenchyma (fibrosis)
        
        Reduced lung compliance
        
        reduced inspiration volumes
        
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        Reduced gas exchange (O2)
        
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- - - - Thick Viscosity of Mucus
      - Cilia damage and reduced function
    - - Floppy and Narrow Airways
      - Gas trapping and hyperinflation
  - - - Lung Parenchyma Fibrosis = decreased O2 diffusion
      - Increased secretions = decreased ventilation
    - - Increased Respiratory Load = decrease in pump effectiveness
- - - - Modulator therapy (drug)??
      - Hypertonic Saline
      - Dornase Alfa (Pulmozyme)
      - Mannitol
    - - Infection control (isolation, discourage socialisation, pathogen specific clinics)
      - Antibiotics
    - - Peripherally inserted central line (PICC)
      - Portacath
- - - - infection/colonisation
        
        Destruction of airway tissue
        
        Dilation of airway
        
        Inflammation
- - - - Auscultation: wheeze, crackles, bronchial breath sounds,
        decreased breath sounds
    - - Medical Management
        
        specific antibiotics for pathogens
        
        drugs for reducing airway inflammation
        
        Supportive Therapies (depends on presentation/severity)
        
        O2 Therapy
      - Physio Management
        
        Airway Clearance techniques
        
        Cough Augmentation
        
        Positioning and deep breathing
        
        Exercise/mobilisation
    - - Fever, Malaise, Myalgia, Tachycardia