Intrapulmonary Percussive Ventilator
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Intrapulmonary Percussive Ventilator
Airway clearance therapy is treatment that uses a number of airway clearance techniques to clear the respiratory airways of mucus and other secretions. Several respiratory diseases cause the normal mucociliary clearance mechanism to become impaired resulting in a build-up of mucus which obstructs breathing, and also affects the cough reflex. Mucus build-up can also cause infection, and inflammation, and repeated infections can result in damage to the airways, and the lung tissue. All airway clearance therapy involves the techniques of coughing, or huffing that need to be used in conjunction with another airway clearance technique. Respiratory therapists make recommendations and give guidance for appropriate airway clearance therapies. They also give instruction in the use of various airway clearance techniques. Clearance techniques Airway clearance therapy uses different airway clearance techniques (ACTs) in a number of respiratory disorders including, cystic fibrosis, bronchi ...
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Respiratory Tract
The respiratory tract is the subdivision of the respiratory system involved with the process of respiration in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa. Air is breathed in through the nose to the nasal cavity, where a layer of nasal mucosa acts as a filter and traps pollutants and other harmful substances found in the air. Next, air moves into the pharynx, a passage that contains the intersection between the oesophagus and the larynx. The opening of the larynx has a special flap of cartilage, the epiglottis, that opens to allow air to pass through but closes to prevent food from moving into the airway. From the larynx, air moves into the trachea and down to the intersection known as the carina that branches to form the right and left primary (main) bronchi. Each of these bronchi branches into a secondary (lobar) bronchus that branches into tertiary (segmental) bronchi, that branch into smaller airways called bronchioles th ...
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Percussion (medicine)
Percussion is a technique of clinical examination. Overview Percussion is a method of tapping on a surface to determine the underlying structures, and is used in clinical examinations to assess the condition of the thorax or abdomen. It is one of the four methods of clinical examination, together with inspection, palpation, auscultation, and inquiry. It is done with the middle finger of one hand tapping on the middle finger of the other hand using a wrist action. The nonstriking finger (known as the pleximeter) is placed firmly on the body over tissue. When percussing boney areas such as the clavicle, the pleximeter can be omitted and the bone is tapped directly such as when percussing an apical cavitary lung lesion typical of tuberculosis. There are two types of percussion: direct, which uses only one or two fingers; and indirect, which uses only the middle/flexor finger. Broadly classifying, there are four types of percussion sounds: resonant, hyper-resonant, stony dull or dul ...
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Functional Residual Capacity
Functional residual capacity (FRC) is the volume of air present in the lungs at the end of passive expiration. At FRC, the opposing elastic recoil forces of the lungs and chest wall are in equilibrium and there is no exertion by the diaphragm or other respiratory muscles. FRC is the sum of expiratory reserve volume (ERV) and residual volume (RV) and measures approximately 2500 mL in a 70 kg, average-sized male (or approximately 30ml/kg). It cannot be estimated through spirometry, since it includes the residual volume. In order to measure RV precisely, one would need to perform a test such as nitrogen washout, helium dilution or body plethysmography. A lowered or elevated FRC is often an indication of some form of respiratory disease. For instance, in emphysema, FRC is increased, because the lungs are more compliant and the equilibrium between the inward recoil of the lungs and outward recoil of the chest wall is disturbed. As such, patients with emphysema often have not ...
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Collateral Ventilation
Collateral ventilation (CV) is a back-up system of alveolar ventilation that can bypass the normal route of airflow when airways are restricted or obstructed. The pathways involved include those between adjacent alveoli (pores of Kohn), between bronchioles and alveoli (canals of Lambert), and those between bronchioles (channels of Martin). Collateral ventilation also serves to modulate imbalances in ventilation and perfusion a feature of many diseases. The pathways are altered in lung diseases particularly asthma, and emphysema. A similar functional pattern of collateralisation is seen in the circulatory system of the heart. Interlobar collateral ventilation has also been noted and is a major unwanted factor in the consideration of lung volume reduction surgery and some lung volume reduction procedures. Pathways In normal respiratory conditions airflow is through the pathway of least resistance offered by the bronchial tree, to the alveoli and back to the bronchi and trachea.I ...
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Biphasic Cuirass Ventilation
An iron lung is a type of negative pressure ventilator (NPV), a mechanical respirator which encloses most of a person's body, and varies the air pressure in the enclosed space, to stimulate breathing.Shneerson, Dr. John M., Newmarket General Hospital, ( Newmarket, Suffolk, U.K.)"Non-invasive and domiciliary ventilation: negative pressure techniques,"#5 of series "Assisted ventilation" in '' Thorax,'' 1991;46:131–35, retrieved April 12, 2020Rockoff, Mark, M.D."The Iron Lung and Polio," video (8 minutes), January 11, 2016, OPENPediatrics and Boston Children's Hospital on YouTube, retrieved April 11, 2020 (historical background and images, explanatory diagrams, and live demonstrations)Jackson, Christopher D., MD, Dept. of Internal Medicine, and Muthiah P Muthiah, MD, FCCP, D-ABSM, Assoc. Prof. of Medicine, Div. of Pulmonary / Critical Care / Sleep Medicine, Univ. of Tennessee College of Medicine-Memphis, et.al."What is the background of the iron lung form of mechanical venti ...
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Medication
A medication (also called medicament, medicine, pharmaceutical drug, medicinal drug or simply drug) is a drug used to diagnose, cure, treat, or prevent disease. Drug therapy ( pharmacotherapy) is an important part of the medical field and relies on the science of pharmacology for continual advancement and on pharmacy for appropriate management. Drugs are classified in multiple ways. One of the key divisions is by level of control, which distinguishes prescription drugs (those that a pharmacist dispenses only on the order of a physician, physician assistant, or qualified nurse) from over-the-counter drugs (those that consumers can order for themselves). Another key distinction is between traditional small molecule drugs, usually derived from chemical synthesis, and biopharmaceuticals, which include recombinant proteins, vaccines, blood products used therapeutically (such as IVIG), gene therapy, monoclonal antibodies and cell therapy (for instance, stem cell th ...
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Nebulizer
In medicine, a nebulizer (American English) or nebuliser (British English) is a drug delivery device used to administer medication in the form of a mist inhaled into the lungs. Nebulizers are commonly used for the treatment of asthma, cystic fibrosis, COPD and other respiratory diseases or disorders. They use oxygen, compressed air or ultrasonic power to break up solutions and suspensions into small aerosol droplets that are inhaled from the mouthpiece of the device. An aerosol is a mixture of gas and solid or liquid particles. Medical uses Guidelines Various asthma guidelines, such as the Global Initiative for Asthma Guidelines INA the British Guidelines on the management of Asthma, The Canadian Pediatric Asthma Consensus Guidelines, and United States Guidelines for Diagnosis and Treatment of Asthma each recommend metered dose inhalers in place of nebulizer-delivered therapies. The European Respiratory Society acknowledge that although nebulizers are used in hospitals and at ...
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Chest Wall Oscillation
Chest wall oscillation is when devices are used in airway clearance therapy to clear excess mucus from lung airways (bronchi and bronchioles). It is principally used in the treatment of cystic fibrosis, but is gaining use in the treatment of other diseases, such as bronchiectasis, COPD, cerebral palsy and muscular dystrophy, in which excessive mucus can block airways due to excessive production or impaired clearance. This "passive system" is not dependent on the effort of the patient. It uses a compressor to inflate and deflate the vest rhythmically at timed intervals and thus imposes high frequency chest wall oscillations (HFCWO) that are transferred to the lungs. These oscillations thin thixotropic airway mucus, facilitating its removal by coughing. Delivery of air to the vest can be controlled manually. History The Vest system was developed by Warren Warwick, a pediatrician and cystic fibrosis expert, and Leland Hansen MPH, a senior scientist at the University of Minnesota, w ...
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Insufflation (medicine)
Insufflation ( la, insufflare, lit=to blow into) is the act of blowing something (such as a gas, powder, or vapor) into a body cavity. Insufflation has many medical uses, most notably as a route of administration for various drugs. Medical uses Surgery Gases are often insufflated into a body cavity to inflate the cavity for more workroom, e.g. during laparoscopic surgery. The most common gas used in this manner is carbon dioxide, because it is non-flammable, colorless, and dissolves readily in blood. Diagnostics Gases can be insufflated into parts of the body to enhance radiological imaging or to gain access to areas for visual inspection (e.g. during colonoscopy). Respiratory assistance Oxygen can be insufflated into the nose by nasal cannulae to assist in respiration. Mechanical insufflation-exsufflation simulates a cough and assists airway mucus clearance. It is used with patients with neuromuscular disease and muscle weakness due to central nervous system injury. ...
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Postural Drainage
Postural drainage (PD) is the drainage of lung secretions using gravity. It is used to treat a variety of conditions that cause the build-up of secretions in the lungs. Uses Postural drainage is used to treat any condition that causes the build-up of secretions in bronchopulmonary segments. These include: * bronchiectasis * lung abscesses * cystic fibrosis * atelectasis * chronic obstructive pulmonary disease (COPD) * pneumonia * postoperative lung damage (after some thoracic surgery) * Covid 19 Patients must receive physiotherapy to learn to tip themselves into a position in which the lobe can be drained. Contraindications Postural drainage is often not suitable for infants in the neonatal intensive care unit, who may have lots of equipment attached to them. Postural drainage is more difficult if patients experience poor mobility, poor posture, pain, anxiety, and skin damage, usually requiring adaptations to the technique. Trendelenburg position which is head dow ...
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Chest Percussion
A respiratory examination, or lung examination, is performed as part of a physical examination, in response to respiratory symptoms such as shortness of breath, cough, or chest pain, and is often carried out with a cardiac examination. The four steps of the respiratory exam are inspection, palpation, percussion, and auscultation of respiratory sounds, normally first carried out from the back of the chest. Stages After positioning in which the patient sits upright with their arms at the side, with the chest clear of clothing, the four stages of the examination can be carried out. In order to listen to the lungs from the back the patient is asked to move their arms forward to prevent the scapulae (shoulder blades) from obstructing the upper lung fields. These fields are intended to correlate with the lung lobes and are thus tested on the anterior (front) and posterior (back) chest walls. Inspection The examiner then estimates the patient's respiratory rate by observing how many ...
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