week 1

Question 1

what is atelectasis

Answer 1

Condition in which the alveoli collapse either partially or completely, collapse impairs the lungs ability to exchange O2 and CO2→reduced lung function

Question 2

what is the anatomic alterations of the lungs

Answer 2

1.Partial or total collapse of the expanded alveoli:
-Primary lobules (distal to bronchioles)
Most common
-Lung segment- fairly common
-Lung lobe- less common
-Entire lung- rare

2.prevents O2 and CO2 gas exchange in specific area of the lung

3.Reduces lung compliance

Question 3

associated disorders that result in collapse of alveoli

Answer 3

-Bronchiectasis
-Pulmonary edema
-Flail chest
-Pneumothorax
-Kyposcoliosis
-Acute respiratory distress syndrome
-Near drowning
-Meconium aspiration syndrome
-Bronchopulmonary dysplasia

Question 4

associated disorders pt.2

Answer 4

-Cystic fibrosis
-Pulmonary embolism
-Fluid overload
-Pleural diseases
-Lung cancer
-Guillain barre/myasthenia gravis
-Smoke inhalation/thermal injuries
-Respiratory distress syndrome
-Respiratory syncytial virus
-Diaphragmatic hernia

Question 5

3 main categories of causes

Answer 5

-reduce alveolar ventilation
-promoted alveolar degassing secondary to airway obstruction
-compress the lung tissue

Question 6

explain post operative atelectasis

Answer 6

thoracic or abdominal surgery

-hypoventilation due to:
*sedation
*wound dressing
*pain
*inadequate ventilator settings
nothing wrong with lungs, normal A-a gradient

Question 7

what is the first line of therapy for post operative atelectasis

Answer 7

incentive spirometry

Question 8

what are the physical examination of atelectasis

Answer 8

*Vital signs
-Tachypnea
-Tachycardia
-Hypertension

*Cyanosis

*Breath sounds
-Diminished
-Fine crackles

*Chest assessment
-Increased fremitus
-Dull percussion note

Question 9

is atelectasis an obstructive or restictive disease

Answer 9

restrictive

Question 10

what are the PFT findings

Answer 10

↓: FVC
N or ↓: the rest
Nor increases:Fev1/fvc ratio

Question 11

PFT: lung volume and capacities

Answer 11

↓: IRV,ERV,RV,VC,IC,FRC,TLC
N :RV/TLC ratio

Question 12

ABG findings

Answer 12

At start of problem
-acute respiratory alkalosis
(acute alveolar hypervent w/hypo)
pH ↑ ,PaCO2↓, HCO3↓, PaO2↓, SaO2/SpO2↓

prolong problem
-acute respiratory acidosis (acute ventilatory failure w/hypo)
pH↓, PaCO2↑, HCO3 ↑ PaO2↓, SaO2/SpO2↓

Question 13

what are the chest radiograph of atelectasis

Answer 13

-increased densities in areas of atelectasis
-elevation of the hemidiaphragms on affected side
-mediastinal shift towards the affect side

Question 14

what is the general management of atelectasis

Answer 14

-High risk patients should be monitored closely

-Preventive measures should be prescribed for high risk patients

-Treatments of the underlying cause of atelectasis

-RT protocols

Question 15

what are the RT protocols for atelectasis

Answer 15

1. oxygen therapy protocol
2. airway clearance therapy
   -atelectasis caused by mucus plugs
   -therapy depends on the area of the lungs affected
3. lung expansion therapy
   -reinflation of collapsed alveoli
   -IS vs IPPB

4.mechanical ventilation
-increase FRC
-correct ventilator settings