Table of Contents

Dedication
Acknowledgments
About the Editors
Contributing Authors
Introduction
Abbreviations

SECTION I CARDIOPULMONARY ASSESSMENT AND MANAGEMENT
PATHOPHYSIOLOGY OF THE RESPIRATORY AND CARDIOVASCULAR SYSTEMS
Chapter 1 Anatomy and Physiology of the Respiratory and Cardiovascular Systems
Cristiane Yamabayashi, BSc(PT), PhD and W. Darlene Reid, BMR(PT), PhD
Chapter 2 Respiratory Conditions
Patricia G. Camp, PhD, PT; W. Darlene Reid, BMR(PT), PhD;
Frank Chung, BSc(PT), MSc; and Kylie Hill, BSc(Physiotherapy), PhD
Chapter 3 Cardiovascular Conditions
Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT)
Chapter 4 Surgical Interventions
Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT)
Chapter 5 Conditions That Can Compromise the Respiratory System
W. Darlene Reid, BMR(PT), PhD and Frank Chung, BSc(PT), MSc

CARDIOPULMONARY ASSESSMENT
Chapter 6 Clinical Decision Making
Kylie Hill, BSc(Physiotherapy), PhD and W. Darlene Reid, BMR(PT), PhD
Chapter 7 Chart Review and Patient Interview
Kylie Hill, BSc(Physiotherapy), PhD and W. Darlene Reid, BMR(PT), PhD
Chapter 8 Arterial Blood Gas Interpretation
W. Darlene Reid, BMR(PT), PhD and Frank Chung, BSc(PT), MSc
Chapter 9 Chest Imaging
W. Darlene Reid, BMR(PT), PhD
Chapter 10 Pulmonary Function Testing
W. Darlene Reid, BMR(PT), PhD
Chapter 11 Laboratory Investigations
Frank Chung, BSc(PT), MSc
Chapter 12 Electrocardiogram Interpretation
Sandy Gilmour, BSc, RN and W. Darlene Reid, BMR(PT), PhD
Chapter 13 Physical Examination 187
Kylie Hill, BSc(Physiotherapy), PhD; Frank Chung, BSc(PT), MSc;
Lori Roy, BSc(PT); and W. Darlene Reid, BMR(PT), PhD
Chapter 14 Surface Anatomy and Auscultation
W. Darlene Reid, BMR(PT), PhD and Mireille Landry, BSc(PT), MSc
Chapter 15 Screening and Exercise, Strength, and Functional Performance Tests
W. Darlene Reid, BMR(PT), PhD and Kylie Hill, BSc(Physiotherapy), PhD
Chapter 16 Oxygen Therapy, Noninvasive Ventilation, and Mechanical Ventilation
Shane Patman, BAppSc(Physiotherapy), MSc, PhD and
Kylie Hill, BSc(Physiotherapy), PhD

CARDIOPULMONARY MANAGEMENT
Chapter 17 Adult and Patient Education
Judy King, PhD, MHSc, BHSc(PT)
Chapter 18 Breathing Strategies and Exercises
Kylie Hill, BSc(Physiotherapy), PhD; Frank Chung, BSc(PT), MSc;
and W. Darlene Reid, BMR(PT), PhD
Chapter 19 Positioning
Kylie Hill, BSc(Physiotherapy), PhD; Frank Chung, BSc(PT), MSc;
and W. Darlene Reid, BMR(PT), PhD
Chapter 20 Airway Clearance Techniques
Jamie Wood, BSc(Physiotherapy); Frank Chung, BSc(PT), MSc;
and Nola Cecins, BAppSc, MSc
Chapter 21 Mobilization and Exercise for Hospitalized Patients
Megan Harrold, BSc(Physiotherapy); Frank Chung, BSc(PT), MSc;
and Kylie Hill, BSc(Physiotherapy), PhD
Chapter 22 Exercise Training in Cardiac Rehabilitation
Mireille Landry, BSc(PT), MSc and Andrew Maiorana, BSc, MSc, PhD
Chapter 23 Exercise Training in Pulmonary Rehabilitation
Sunita Mathur, BSc(PT), MSc, PhD and Dina Brooks, BSc(PT), MSc, PhD

SECTION II CARDIOPULMONARY CASES
Preamble to Cases
SURGICAL CONDITIONS
Case 1 Atelectasis—Postoperatively in an Obese Patient—Deep Vein Thrombosis and Pulmonary Embolus
Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT)
Case 2 Metabolic Syndrome
Kylie Hill, BSc(Physiotherapy), PhD
Case 3 Postoperative Laparotomy in an Older Patient
Simone Gruenig, BSc, MSc(PT) and W. Darlene Reid, BMR(PT), PhD
Case 4 Postoperative Thoracotomy in a Smoker
Simone Gruenig, BSc, MSc(PT) and W. Darlene Reid, BMR(PT), PhD
Case 5 Acute Myocardial Infarction—Coronary Artery Bypass Graft
Frank Chung, BSc(PT), MSc
Case 6 Left-Sided Congestive Heart Failure—Pulmonary Edema
Frank Chung, BSc(PT), MSc and W. Darlene Reid, BMR(PT), PhD
Case 7 Atelectasis—Postoperatively in an Older Patient—Hypotensive and Atrial Fibrillation
Frank Chung, BSc(PT), MSc

MEDICAL CONDITIONS
Case 8 Aspiration Pneumonia and Acute Respiratory Distress Syndrome
Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT)
Case 9 Elderly Patient With a Pleural Condition
Simone Gruenig, BSc, MSc(PT); Frank Chung, BSc(PT), MSc;
and W. Darlene Reid, BMR(PT), PhD
Case 10 Amyotrophic Lateral Sclerosis in the Intensive Care Unit
Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT)

TRAUMA
Case 11 Chest Trauma—Pneumothorax/Fractured Ribs 3
Frank Chung, BSc(PT), MSc; Kylie Hill, BSc(Physiotherapy), PhD;
and W. Darlene Reid, BMR(PT), PhD
Case 12 Acute Cervical Spinal Cord Injury
Kylie Hill, BSc(Physiotherapy)

CHRONIC RESPIRATORY CONDITIONS
Case 13 Restrictive Lung Disease
W. Darlene Reid, BMR(PT), PhD and Frank Chung, BSc(PT), MSc
Case 14 Stable Chronic Obstructive Pulmonary Disease
W. Darlene Reid, BMR(PT), PhD; Frank Chung, BSc(PT), MSc;
and Kylie Hill, BSc(Physiotherapy), PhD
Case 15 Cystic Fibrosis and Lung Transplant
W. Darlene Reid, BMR(PT), PhD and Sunita Mathur, BSc(PT), MSc, PhD

CHRONIC RESPIRATORY CONDITIONS WITH AN ACUTE EXACERBATION
Case 16 Asthma—Acute Exacerbation
W. Darlene Reid, BMR(PT), PhD and Frank Chung, BSc(PT), MSc
Case 17 Acute Exacerbation of Chronic Obstructive Pulmonary Disease
W. Darlene Reid, BMR(PT), PhD and Frank Chung, BSc(PT), MSc

CARDIAC CONDITIONS
Case 18 Acute Myocardial Infarction—Good Recovery
Frank Chung, BSc(PT), MSc
Case 19 Chronic Heart Failure—Post-Myocardial Infarction—Class III/IV
Frank Chung, BSc(PT), MSc
Case 20 Chronic Heart Failure—Cardiomyopathy—Class I/II
Frank Chung, BSc(PT), MSc
Case 21 Peripheral Vascular Disease
Frank Chung, BSc(PT), MSc and Lori Roy, BSc(PT)
Case 22 Exercising Outpatient—Arrhythmia and Hypotension
W. Darlene Reid, BMR(PT), PhD

RESPIRATORY AND CARDIAC CONDITIONS
Case 23 Lobar Pneumonia and Angina
Frank Chung, BSc(PT), MSc and W. Darlene Reid, BMR(PT), PhD
Case 24 Pleural Effusion Complicated by Cardiac Effusion and Cardiac Tamponade
Frank Chung, BSc(PT), MSc and W. Darlene Reid, BMR(PT), PhD

SECTION III ANSWER GUIDES
Answer Guides: Chapters
Answer Guides: Cases

Appendix: Summary of Common Laboratory Values and Clinical Implications
Financial Disclosures
Index

About the Author

W. Darlene Reid, BMR(PT), PhD is a Professor in the Department of Physical Therapy at the University of British Columbia, Vancouver, British Columbia, Canada. She earned her physical therapy degree from the University of Manitoba in Winnipeg, Manitoba in 1979. She went on to complete graduate studies in pathology at the University of British Columbia and obtained her PhD in 1988.

Dr. Reid performs graduate professional entry-level and graduate research teaching related to physical therapy respiratory care and muscle injury, and she supervises research by graduate and undergraduate students in the Rehabilitation Sciences, Kinesiology, and the Experimental Medicine programs at the University of British Columbia. Physical therapy teaching is focused on research design, exercise physiology, and physical therapy management of patients with cardiopulmonary conditions. Research graduate teaching is related to exercise physiology, advanced techniques in the management of cardiovascular and respiratory patients, and research design. In addition, Dr. Reid is involved in continuing education related to these areas.

Dr. Reid has held scholarship salary awards from the B.C. Health Research Foundation and the Killam Foundation. Her areas of research interests include muscle injury, muscle performance, and pulmonary rehabilitation. Clinically, she has specialized in physiotherapeutic treatment for patients with chronic pulmonary disease. Her clinical research has focused on the understanding of mechanisms contributing to poor muscle performance and noninvasive measures of muscle dysfunction in people with chronic disease.

Dr. Reid has published more than 90 peer-reviewed manuscripts in addition to abstracts, review papers, and chapters. She has been an invited speaker at a number of national and international conferences related to physical therapy, intensive care, and pulmonary medicine in Canada, the United States, Japan, Belgium, and Mexico.

Dr. Reid has served on several national and local committees related to cardiorespiratory physical therapy and research including the Cardiorespiratory Division Executive of the Canadian Physiotherapy Association, the Executive of the Canadian Physiotherapy Cardiorespiratory Society of Lung Association, and Co-chair of the Scientific Program for the Canadian Respiratory Conference. She is also Associate Editor of the Cardiopulmonary Physical Therapy Journal.

Frank Chung, BSc(PT), MSc graduated with a BSc (Physical Therapy) degree from McGill University in Montreal, Quebec, Canada in 1981 and obtained an MSc degree in interdisciplinary studies (respiratory and exercise physiology) from the University of British Columbia in 1989.

He has taught at the School of Rehabilitation Sciences at the University of British Columbia, instructed postgraduate physical therapy courses, engaged in research and knowledge transfer, contributed as manuscript reviewer for Physiotherapy Canada, and published more than 20 papers in peer-reviewed journals in areas related to physical therapy practice. Frank was a member of the national examination test construction and implementation subcommittee of the Canadian Alliance of Physiotherapy Regulatory Boards. He is also an examiner of the Canadian Physical Therapy National Examination. He works as a physical therapist at Burnaby Hospital in British Columbia, Canada.

Kylie Hill, BSc(Physiotherapy), PhD is an Associate Professor at the School of Physiotherapy and Exercise Science, Curtin University in Perth, Western Australia. She graduated from Curtin University with a BSc (Physiotherapy) degree in 1994 (with distinction). She has more than 10 years of clinical experience and has worked as a senior physiotherapist across 3 states in Australia. Her main areas of clinical experience include the management of patients admitted to the intensive care unit as well as following cardiothoracic and major abdominal surgery. In 2006, Dr. Hill completed a PhD (with commendation from the chancellor) in the area of pulmonary rehabilitation. In 2009, she completed 3.5 years of ­postdoctoral study at the University of Toronto, with Professor Dina Brooks and Roger Goldstein.

She is currently involved in teaching undergraduate and graduate entry master's physical therapy students at Curtin University. She is also heavily involved in the supervision of masters by research and doctoral students at Curtin University. She is a member of the Australian Physiotherapy Association and the European Respiratory Society and was the national convenor of the Physiotherapy Special Interest Group for the Thoracic Society of Australia and New Zealand. She has presented at several national and international scientific meetings and has published more than 50 papers in peer-reviewed journals in areas related to physical therapy practice.