Pulmonary TB is a bacterial infection of the lungs that can cause a range of symptoms, including chest pain, breathlessness, and severe coughing. Pulmonary TB can be life-threatening if a person does not receive treatment. People with active TB can spread the bacteria through the air.So. After pulmonary TB exercise is needed for better lungs function.

1. Pulmonary TB
Dr.Arjun Patel MPT, DNHE

2. General
assessment
• Side:- upper lobe or upper part of lower
lobe any side is affected.
• History:- disease like DM, congenital heart
disease, leukemia, long term corticosteroid,
immunosuppressive drug.
• Personal history:- smoking and alcohol.

3. Subjective assessment
• Breathlessness:- present.
• Compression of trachea and bronchus by
enlarg lymph nodes.
• Cough:- productive. Paroxysmal noctural
cough
• Sputum:- present.
• Color:- yellow
• Hemoptysis:- present
• Wheeze:- present some time stride
heard.

4. • Chest pain:- dull chest pain/ tightness and
discomfort if pleural involvement pleuritic
chest pain.

5. Objective assessment
• On observation:-
• General health (
observation)
•
• General health and appearance:- fever,
malaise, weight loss, anorexia, night sweat.
• Cynosis:- not present in some cases
peripheral cynosis seen.
• Clubbing:- present in severe case.
Level of consciousness:-
conscious

6. • Observation of chest:-
• Shape:- initially no change later long
narrow or decreased AP diameter ( flat chest)
• Breathing pattern:- rapid shallow breathing
• Use of accessory muscle:- present.
• Chest symmetry:- decrease chest expansion
on affected side.

7. On palpation
• Trachea:- midline
• Chest rib seen more vertically in directly than
in normal.
• Marking costeophernic angle more accute and
winging of scapula seen.
• VF:- increased

8. Percussion
• Dull note

9. On examination
•
•
• Vital signs :- RR : increased (
trachepnea) PR : increased BP (
trachycardia) Temperature:-
increasd.
• Auscultation:-
• Breath sound:- bronchial, wheeze, with
crackle, Ronchi.
• Pleural rub:- present if pleura involved
• Chest expansion:- decreased
• ROM :- decreased shoulder and thorax spine.

10. • Exercises tolerance test:-
decrease

11. Investigation
• Chest x-ray:-patchy solid lesion in upper
lobe
• Area of affection:- fibrosis
• Cavitation:+ irregular area of calcification
• Hilar lymphnode enlargement.
• Pleural effusion :- rare.
• PFT:- reduced TLC
•
Reduced FEV1/
FVC

12. • ABG analysis:- acute
• PH increased,Pao2
decrease, paco2 decrease, HCO3
decrease.
• Chronic:- PH normal
• Pao2 decrease, paco2
increase,HCo3 increase.
• Sputum culture:- mycobacterium tuberculosis
• Biopsy:- m.tb
• Tuberculi testing:-montox test positive.

13. Prevention
• Vaccination
• Management :- drug therapy
• Straptomycin, ethambutol,
rifampicin.
• Surgical try:- lobectomy in very small portion of
parth

14. Physiotherapy
• PT is not indicated in treatment of TB but is any
associated condition or complication occur PT
is required.

15. THANK YOU