RES 140 Exam 2 Lung Expansion UPDATED QUESTIONS AND CORRECT ANSWERS

RES 140 Exam 2 Lung Expansion
UPDATED QUESTIONS AND CORRECT
ANSWERS
What is lung expansion therapy used for? - CORRECT ANSWER it is utilized to
prevent or correct respiratory complications in postoperative period



Types of Lung Expansion Therapy: - CORRECT ANSWER 1. IPPB

2. IS

3. CPAP

4. PEP



The greater the transpulmonary pressure gradient.... - CORRECT ANSWER the
MORE the alveoli will expand



Transpulmonary Pressure Can be changed by: - CORRECT ANSWER 1. Decreasing
the surrounding pleural pressure by a DEEP spontaneous inspiration *(IS)*

- negative pressure


2. Increasing the ALVEOLAR pressure by applying *positive* pressure (IPPB, PEP, CPAP)



What is gas absorption atelectasis? - CORRECT ANSWER occurs when mucus plugs
block ventilation to selected regions of lung or if there is a significant shift in V/Q, gas distal
to obstruction is absorbed by passing blood



What is compression atelectasis? - CORRECT ANSWER It is caused by persistent
breathing with small tidal volumes and/or certain types of restrictive chest wall disorders



What factors can causes atelectasis? - CORRECT ANSWER -Obesity

-Neuromuscular disorders

,-Poor Cough

-Heavy sedation

-Surgery near diaphragm

-Bed rest
-Hx of lung disease

-Restrictive chest wall abnormalities



What does atelectasis cause? - CORRECT ANSWER ~Decreased FRC

~V/Q mismatch

~ Arterial hypoxemia

~Decreased surfactant production
~Ineffective cough



What does an ineffective cough lead to? - CORRECT ANSWER Retained secretions
and possible pneumonia



What are clinical signs of atelectasis? - CORRECT ANSWER ~Hx of recent major
surgery

~Tachypnea

~ Fine late inspiratory crackles

~Bronchial or diminished breath sounds
~Tachycardia

~Increased density

~Signs of volume loss on chest radiograph



How does lung expansion therapy work? - CORRECT ANSWER It works by
*INCREASING* the transpulmonary pressure gradient



-The GREATER the transpulmonary pressure gradient, the more alveolar expansion will
occur

, How can you increase the transpulmonary pressure gradient? - CORRECT
ANSWER It can be increased by *decreasing* the surrounding *pleural pressure* or
[increasing] the [alveolar] pressure



What therapy decreases pleural pressure? - CORRECT ANSWER Incentive Spirometry



What therapy increases alveolar pressure? - CORRECT ANSWER IPPB and positive
pressure therapies



What is another name for incentive spirometry? - CORRECT ANSWER Sustained
Maximal Inspiration (SMI)



How does incentive spirometry work? - CORRECT ANSWER IS mimics natural
sighing by encouraging patients to take slow deep breaths, they provide visual cues to patient
when desired inspiratory volume of flow is reached



What are indications for IS? - CORRECT ANSWER ~Presence of pulmonary
atelectasis

~Presence of conditions that could cause atelectasis like upper abdominal surgery

~Thoracic surgery

~Surgery in patients with COPD

~Presence of restrictive lung defect associated with quadriplegia or dysfunctional diaphragm



What are contraindications to IS therapy? - CORRECT ANSWER ~Unconscious
patients

~Those unable to cooperate

~Inability to comprehend instructions

~Patients unable to generate adequate inspiration less than 10 ml/kg