Respiratory physiotherapy
Inhoud
1. Refreshment basic concepts respiratory physiotherapy................................................................. 2
1.1 Anatomy respiratory system ................................................................................................... 2
1.2 Spirometry ............................................................................................................................... 3
2. Cystic fibrosis (CF)............................................................................................................................ 4
2.1 Introduction ............................................................................................................................. 4
2.2 Etiology .................................................................................................................................... 5
2.3 Diagnosis.................................................................................................................................. 6
2.3.1 Sweat test ....................................................................................................................... 6
2.3.2 Guthrietest ...................................................................................................................... 7
2.3.3 DNA – analysis................................................................................................................. 7
2.4 Clinical manifestation .............................................................................................................. 7
2.4.1 Respiratory symptoms .................................................................................................... 7
2.4.2 Gastrointestinal symptoms ............................................................................................ 8
2.4.3 Fertility problems............................................................................................................ 8
2.5 Treatment ................................................................................................................................ 8
2.5.1 Medication ...................................................................................................................... 8
2.5.2 Respiratory physiotherapy ........................................................................................... 10
3. Respiratory diseases & physiotherapy in babies and children ...................................................... 12
3.1 Differences in anatomy ......................................................................................................... 12
3.2 Differences in clinical examination........................................................................................ 13
3.3 RSV......................................................................................................................................... 13
3.4 False Croup ............................................................................................................................ 15
3.5 PCD ........................................................................................................................................ 16
4. Respiratory physiotherapy in neurological diseases ..................................................................... 17
5. COPD.............................................................................................................................................. 20
6. Principles of Autogenic Drainage (AD) .......................................................................................... 24
7. Assisted Autogenic Drainage (AAD) – non-cooperative patients .................................................. 31
8. Neonatology – physical therapy in the neonatal unit ................................................................... 33
8.1 Neonatal Unit ........................................................................................................................ 33
8.2 Premature birth ..................................................................................................................... 34
8.3 Neonatal patients .................................................................................................................. 34
8.4 Physiotherapy at N(I)CU ........................................................................................................ 37
9. Hyperventilation ............................................................................................................................ 40
,1. Refreshment basic concepts respiratory physiotherapy
All material from last year is regarded as common knowledge (cardiorespiratory physiotherapy 1)!
1. Anatomy respiratory system
2. Spirometry
➔ Nog eens bekijken!
1.1 Anatomy respiratory system
Upper respiratory tract
- Nasal cavity
- Sinusses: frontal, ethmoid
- Spehnoidal, maxillary
- Pharinx
- Larynx with vocal cords
Lower respiratory tract
Upper airways → terminal bronchioles: conducting zone
Respiratory bronchioles → alveolar sacs: respiratory zone: gasexchance
,1.2 Spirometry
Lung volumes
- TV – tidal volume
- IRV – inspiratory reserve volume
- ERV – expiratory reserve volume
- RV – residual volume
Lung capacities
- IC – inspiratory capacity FRC – functional residual
capacity
- VC – vital capacity
- IVC & EVC
- TLC – total lung capacity
F/V curve
- PEF – Peak Expiratoy flow (L/s) (geeft informatie over obstructie in de grotere luchtwegen)
- FVC – Forced Vital Capacity
- FEV 1 – Forced Expiratoy Volume in the 1st second
- Tiffeneau – index (%) = FEV1/FVC ratio
, FV loops
FVC is less in de restrictive pathology
2. Cystic fibrosis (CF)
2.1 Introduction
- Most common genetic disease of the Caucasian race.
- In Belgium:
1/2000 births → 30-60 new cases/year
1/22 carrier
- Exocrine organs form though secretions. (Exocrine organen bij CF gaan heel erg taaie slijmen
vormen)
- Inheritance is autosomal recessive.
- Life expectation and QOL ↑
As often in men and women.
Je kan enkel ziek zijn als je het abnormale gen van beide ouders krijgt. De ouders kunnen dragen zijn,
maar de ziekte niet hebben. Kans= ¼ dat het kind ziek wordt. Als je een drager bent, heb je geen
enkel symptoom en ben je niet ziek.
Worden 46 jaar of ouder
Je kan naar school gaan, sporten, werken,… maar niet bij iedereen, sommigen zijn echt heel ziek.
Inheritance of the disease. Can you get CF if you inherit another mutation from both parents?
Yes.
You only have CF if you inherit the faulty CFTR gene from both parents (No matter which mutation)
Inhoud
1. Refreshment basic concepts respiratory physiotherapy................................................................. 2
1.1 Anatomy respiratory system ................................................................................................... 2
1.2 Spirometry ............................................................................................................................... 3
2. Cystic fibrosis (CF)............................................................................................................................ 4
2.1 Introduction ............................................................................................................................. 4
2.2 Etiology .................................................................................................................................... 5
2.3 Diagnosis.................................................................................................................................. 6
2.3.1 Sweat test ....................................................................................................................... 6
2.3.2 Guthrietest ...................................................................................................................... 7
2.3.3 DNA – analysis................................................................................................................. 7
2.4 Clinical manifestation .............................................................................................................. 7
2.4.1 Respiratory symptoms .................................................................................................... 7
2.4.2 Gastrointestinal symptoms ............................................................................................ 8
2.4.3 Fertility problems............................................................................................................ 8
2.5 Treatment ................................................................................................................................ 8
2.5.1 Medication ...................................................................................................................... 8
2.5.2 Respiratory physiotherapy ........................................................................................... 10
3. Respiratory diseases & physiotherapy in babies and children ...................................................... 12
3.1 Differences in anatomy ......................................................................................................... 12
3.2 Differences in clinical examination........................................................................................ 13
3.3 RSV......................................................................................................................................... 13
3.4 False Croup ............................................................................................................................ 15
3.5 PCD ........................................................................................................................................ 16
4. Respiratory physiotherapy in neurological diseases ..................................................................... 17
5. COPD.............................................................................................................................................. 20
6. Principles of Autogenic Drainage (AD) .......................................................................................... 24
7. Assisted Autogenic Drainage (AAD) – non-cooperative patients .................................................. 31
8. Neonatology – physical therapy in the neonatal unit ................................................................... 33
8.1 Neonatal Unit ........................................................................................................................ 33
8.2 Premature birth ..................................................................................................................... 34
8.3 Neonatal patients .................................................................................................................. 34
8.4 Physiotherapy at N(I)CU ........................................................................................................ 37
9. Hyperventilation ............................................................................................................................ 40
,1. Refreshment basic concepts respiratory physiotherapy
All material from last year is regarded as common knowledge (cardiorespiratory physiotherapy 1)!
1. Anatomy respiratory system
2. Spirometry
➔ Nog eens bekijken!
1.1 Anatomy respiratory system
Upper respiratory tract
- Nasal cavity
- Sinusses: frontal, ethmoid
- Spehnoidal, maxillary
- Pharinx
- Larynx with vocal cords
Lower respiratory tract
Upper airways → terminal bronchioles: conducting zone
Respiratory bronchioles → alveolar sacs: respiratory zone: gasexchance
,1.2 Spirometry
Lung volumes
- TV – tidal volume
- IRV – inspiratory reserve volume
- ERV – expiratory reserve volume
- RV – residual volume
Lung capacities
- IC – inspiratory capacity FRC – functional residual
capacity
- VC – vital capacity
- IVC & EVC
- TLC – total lung capacity
F/V curve
- PEF – Peak Expiratoy flow (L/s) (geeft informatie over obstructie in de grotere luchtwegen)
- FVC – Forced Vital Capacity
- FEV 1 – Forced Expiratoy Volume in the 1st second
- Tiffeneau – index (%) = FEV1/FVC ratio
, FV loops
FVC is less in de restrictive pathology
2. Cystic fibrosis (CF)
2.1 Introduction
- Most common genetic disease of the Caucasian race.
- In Belgium:
1/2000 births → 30-60 new cases/year
1/22 carrier
- Exocrine organs form though secretions. (Exocrine organen bij CF gaan heel erg taaie slijmen
vormen)
- Inheritance is autosomal recessive.
- Life expectation and QOL ↑
As often in men and women.
Je kan enkel ziek zijn als je het abnormale gen van beide ouders krijgt. De ouders kunnen dragen zijn,
maar de ziekte niet hebben. Kans= ¼ dat het kind ziek wordt. Als je een drager bent, heb je geen
enkel symptoom en ben je niet ziek.
Worden 46 jaar of ouder
Je kan naar school gaan, sporten, werken,… maar niet bij iedereen, sommigen zijn echt heel ziek.
Inheritance of the disease. Can you get CF if you inherit another mutation from both parents?
Yes.
You only have CF if you inherit the faulty CFTR gene from both parents (No matter which mutation)
