Questions
2 questions per theory paper
Difficulty
Medium
Importance
High yield for BPT and Nursing practical and theory exams
Overview
Chest physiotherapy (CPT) encompasses techniques used to enhance airway clearance by mobilizing secretions from the lungs. It is a high-yield clinical topic for physiotherapy and nursing exams, focusing on the mechanical principles of clearing retained mucus. Students must master the indications, contraindications, and specific patient positioning protocols for clinical accuracy.
Postural Drainage
Postural drainage utilizes gravity to assist in moving pulmonary secretions from smaller airways to larger airways for easier expectoration. The patient is placed in various positions based on the anatomical segment of the lung requiring drainage.
- Uses gravity-assisted positioning
- Positions are held for 5 to 15 minutes
- Requires anatomical knowledge of bronchopulmonary segments
- Contraindicated in unstable head/neck injuries
- Avoid immediately after meals to prevent aspiration
Percussion
Percussion involves rhythmically striking the chest wall with cupped hands to create a mechanical wave that loosens secretions. This technique increases the efficiency of cough-related airway clearance.
- Hands must be cupped to create an air cushion
- Performed over the affected lung segment
- Avoid direct contact with bare skin
- Contraindicated over fractures or surgical sites
- Duration typically 3 to 5 minutes per segment
Vibration and Shaking
These are gentle oscillatory techniques applied to the chest wall during the expiratory phase of breathing. They help move secretions toward the central airways by creating shearing forces.
- Applied only during exhalation
- Requires isometric contraction of therapist's arms
- Shaking is more vigorous than vibration
- Often performed immediately after percussion
- Useful for patients unable to cough effectively
Exam Tip
Always link the lung segment anatomy to the specific postural drainage position, as this is the most frequently tested practical application.
Common Mistakes
- Failing to mention contraindications like rib fractures or acute hemoptysis
- Confusing percussion with tapping, forgetting that hands must be cupped
- Performing vibration during inhalation instead of expiration
More Revision Notes
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