Pathologicalconditon
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| Asthma | chronic abnormal autonomic respons of the bronchial muscles that produce:intermittent acut bronchospasms, partial airway obstuction, chronic bronchial inflammation, edema-airway obstruction from the effects; inflammation, bronchospasm,
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| Asthma | involves narrowing of small air passages of lower resp system, affects b/w 5-10% cuased by various genetic and immune system factors, asthma can lead to a chornic reduction of air flow caused by:epithelial cell damage, fibrous changes in the bronchiols
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| Signs and Symptoms of Asthma | can last min hrs or days Dyspnea, chest tightness, fatigue, anxiety, coughing, wheezing, prolonged expiration, panting speech, cyanosis, practice may need to be altered peakflow of >80% good to go
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| asthma triggers, eval and diagnostic testing | Triggers:allergens, smoke, infection, cold or dry air, emotional state, ex-Eval:increassed Hr, resp rate, use of accessory muscles, ascultation(wheezing-experiation, rhonchi-inspiration, decreased breath sounds), diagnostic testing:peakflow meter
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| asthma treatment | Goal:limit bronchial inflammation, control symps, prevent exacerbation, maintain normal pulmonary function avoid triggers, ath instructed to sit, take deep breaths exhale through pursed lips keep them calm,
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| Administastration of bronchodilator | prescribed-metered dosed inhalers(mdi), 2 doeses administerd 5 min apart, good technique and timing is important recovery should occur gradually
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| Asthma management | antiinflammatory meds and bronchiodilator meds
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| Anti-inflammatory | corticosteriords, masst cell stabilizers, antileukotriends, controle underlying chornic inflammation, provide long term control, taken on a daily basis, noncomplicance leads to:more frequent attacks, more scarring within lungs
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| Bronchodilators | B2 agonists-provide quick relief, taken on an as needed basis, b2 goes to lunchs
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| Medication Pathway | 2 neurotransmitter recept involved in ANS resp control-adrenergic agonist, anticholinergic drugs, 2 classes of asthma drugs adrenegic agonist, anticholinergic drugs
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| Adrenergic Agonist | activate the receptor to promote muscle relaxation of smooth muscle-bronchodilation-beta-adrenergic receptors)aka beta 2 receptors
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| anticholinergic | Drugsbind with receptors w/ intent of blocking receptor activation that causes smooth muscle constriction-cronchoconstriction-anticholinergic drugs
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| NSAID asthma medication | arachidonic acid-lipogenase pathway-inflammation w/ asthma, leukotrienes:cause smooth muscle contraction in bronchial tissue, antileukotriene meds-singular, accolate
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| NATA reccomendations for managing asthma in ath | during PPE ath screened for asthma, AT aware of S/S suggesting ast:tight chest, cough, SOB, wheeze, limit physical activity due2 difficulty breathing, pulmonary testing indicated 4 ath w/ history of asth/athwho diagnosis of ast cant b excluded by med hist
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| NATA reccomendations cont | AT familar w/pharmacological interv 4 tx,plan incorporated into overal EAP sports med service, ath w/asth have rescue inhaler @alltimes,AT have access to nebulizer 4 emergencies, alt px sites considered when possible 2 avoid allergens that trigger attack
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| NATA reccomendatiosn 3 | pt w/asthma regular f/u visits w/ dr 2 monitor and mod tx regimen-proper w/u provide refractory period lasting up 2 2 hrs, ath educatedon asthma: s/s, triggers, spirometry, pharm and non parm supporitve tx, MDI& nebs, need not prevent participation
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| NATA recommendations 4 | AT aware of other med cond that may mimic s/s of asthma ievocal cord dysfunc & UR diseases, pt w/ astha should be encouraged to exercise, At able to differentiate b/w restricted, banned and permitted asthma meds relative to participation in org comp sport
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| MDI | prepare(shake, warm up), hold inhaler upright, tip head slightly, exhale slowly, place inhaler in mouth, seallips, prss down n inhaler-release meds @same time take slow deep breath, hold breath 10sec b4 exhaling, 2 puff wait 1-5min
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| Peak flow meter | measure lung volume w/ventilation-analog scale indicates volume of PEF, indic of airway function, monitors effectiveness of meds, manage asth-baseline recorded over several days, take PEF immediately be4 and after ex,<80%asthma attack, <50 med emergency
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| Peak Expiratory Flow | Pef- highest volume of air they can exhale
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| Peak flow meter instruction | stand upright, slide indicator to base, exhale completely, take a deep breath, place mouth piece in mouth, seal lips, blow as hard &fast as you can 1x, repeat w/rest of 1min, predict readings, clean w/ warm water and soap
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| Exercise induced Bronchospasm | most common affecting-15%of pop, 90% ppl w/ asthma, 40%ppl w. allergies, occurs-5-15 min after onset of exercise, gets progressively worse at ex continues, resolves-30-60min after stoping ex-does not produce chronic inflammation in bronchioles like asthma
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| Exercise induced bronchospasm defiend and triggered by | defined by:post exercise FEV more than 15% below pre-exercise value, Triggered by:cool,dryair, allergies, breathing through mouth, infection, pollution
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| Exercise induced bronchospasm, s/s, diagnosis | s/s:SOB, chest tightness, dry cough after exercise, diagnosis:easure PEF before and after exercise, post vlue is 15%less=EIA
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| Exercise induced bronchospasm tx | MDI before activity or @onset of symp, removed from activity, sit them down, calm reassure ath, monitor, refracory period
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| Refractory period | management-warm up 50-90% MHR, bring system close to threshold, stop activity, take MDI, rest 15-70 min, resume competition, last up to 3 hrs(inconsitent results)
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| exercise induced anaphylaxis | abnormal immune repsonse2 vigorus ex, hx breath probs w/ chronic NSAId use, reaction causes:weidespread realase of histamin, acute bronchospasm, s/s:fluch sensation to head and neck, rapidly followd by cough, stridor, shock, multple skin lesions-hives
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| bronchitis chronic-COPD | obstuction caused by mechanical insufficency, chonic inflammation decreases the functional diameter of the bonchi and impairs airflow, increased co2 decreased o2 , ultimately decreases gas exchange
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| emphysema | chronic bronchitis, complication of cpd and msoking, chronic inflammatory rxn to chemcials in smoke that destory the albeolar walls, capillaries, lung elasticity, decreases avaliable lung area, irreversible poor prognosis
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| Acute viral bronchitis | most common, self limiting, s.s rductive cough(clear, yellow) SOB, chest tightness, fever
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| Acute bacterial bronchitis | rarely in healthy adults, more common in CPD patients s.s fever chills, night swears in addition to acute s.s
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| Acute bronchitis eval diagnosis, treatment | eval:auscultation(rhonchi and crackles), Diagnosis:clinical, chest xray, cbc, tretment, mucolytics, couggh suppresants, NSAIDS, rest fluids antipyretics, nutrition
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| Pneumonia | condition that results in inflam of lung parenchyma-viral,bacteria,fungal,s/s:SOB chest p!, productive cough(dark, discolored sputum), lowlobes:ab/diaphragmic p!, Eval:resp midly elevated labored breathing, percussion dull, auscultation: rales and weeze
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| Pneumonia, diagnosis, tx, rtp | diagnosis-refer!, tx-antibiotics(zpack, biaxin), support w/ hydration, mucolytics, cough suppressant(robotussin), ATC refer back to Md if no improvment after 2-3 days of tx, RTP afevrile, 7-10 b/c of respiratory comprise
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| Upper Respiratory infection def, and s/s | upper respiratory tract-# of self limiting viral infections affecting URT nasopharynx, trachea, bronchii-s/s-rhinitis, rhinorrhea, sore throat, nonproductive cough, sneezing, HA, malaise, chills fever, laryngitis, complications:ear infection, sinusitis
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| Upper respiratory tract eval and tx | eval:clinic, dark prulent nasaldischarge, s/s last 7-10dys refer,Tx:1. support immunesystem w/ rest, fluid nutrition2.limit contact w/infected person-verycontagious, active8dys after infec, conta 1st 72hrs,3OTC meds used 2 treat symp and reduce discomfort
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| Cough and cold meds | analgesics, antihisamines, antitussives, decongestants, multisymptom releive products
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| analgesics | tylenol, ibu, headach and fever
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| antihistamines | runnny nose and sneezing, claritin, allegra, benadryl(1st generation)
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| antitussive | cough suppressant, cough drops, codine and hydrocodone(rx)
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| decongestants | reduce nasal congestion, pseudoephedrine, nasal sprays wiht caution
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| multisymptom releiver products | tylenol cold and sinus, nyquil
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| URI return to play | "neck rule"-above-runnynose, sore throat, no fever, ok to retun to play 10 min, below-cough, body aches, fever, no, not cleared to play, can RTP after symtom free for 24 hr
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| influenza | fall, WINTER, spring-2 recognized strainsA,B,C-strain most common mutates slightly each yr-contagious(incubation 2days)-inhailed airbone droplets, direct contact
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| influenza vaccination | only partially effective-injection of deavtivated virus antigen, stimulate antibody formation, high risk individuals-seniors, students, compromised immune system
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| Influenza s/s, eval, tx, | s/s:fever,HA,nausea,fatigue,body aches,URI eval:clinic,nasopharynx swab,cbc chest xray, tx:bedrest,analgesic,fluids,supportive drugs, AWAY from othershigh risk:antiviral-if caught in 1st 48hr, reduce symp1day,strain A/B
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| Influenza RTP | afebrile, no respiratory comprised, fueled
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| Tuberculosis | caused by bacterial organism-cyobacterium tuberculosis, very contagious bacterial infec affecting the lungs, most ppl will recover w.o further evidence of disease, comprised immune system-symptomatic
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| Tuberculosis(s/s, eval, tx, RTP) | s/s:fatigue,fever,weightloss,cough,hemoptysis,SOB,chestp!-Eval:+ skintest, referfever >100, chills night sweats,ausculation: crackles,wheezing-Tx:latent3-6mth antibiotics,active:3-4antibiotics-RTPLasymptomatic not contagious-report to local health dept
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| Pneumothorax | negative pressure(holds lungs) in pleural space is lost, air trapped b/w parietal and visceral pleura, mor common in tall thing men20-40yrs, rupture of bleb or bulls, truamatic, no truama spontaneous
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| Tension Pneumothorax | pleural space continues to collect air, increase in throacic pressure, trachea, mediastium may deviate to opposite side, pressure occludes major vessels, compression heart=death
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| Hemothorax | blood collects in pleural space, usually traumatic
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| pneumothorax s/s, eval | s.s:chest p!, SOB, dyspnea, respiration distress, little chest wall motion of affected side, shift in trachea-Eval:auscultation:decreased, absent breath sounds, percussion:hollow(puffed out chest), REFER!!!!
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| Pneumothroax tx, RTP | Tx:splint thorax-hug pillow, calm pt-control coughin &gasping 4air,vitals,emergency transport-remove air,aspriate air w/vacum, chest tube-days, RTPpheuno3-5dy, spontaneous-50%chance happen again, tension/hemo-recovery much longer and dependent on symp
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