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OS3 Exam 1 > (5) [DSA] Cardio-Pulm > Flashcards

(5) [DSA] Cardio-Pulm Flashcards

(52 cards)

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1
Q

Scoliosis is a _____ consideration in a cardiopulmonary patient

A

Biomechanical

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2
Q

What are the Cobb classifications used for? What are they?

A

Scoliosis classification

  1. Mild - 5-15 degrees
  2. Moderate - 20-45 degrees
  3. Severe - >50 degrees
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3
Q

What is the Cobb angle formed by?

A

Intersection of a line parallel to the superior end plate of the most CEPHALAD vertebra with the line parallel to the inferior end plate of the most CAUDAD vertebra of the curv

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4
Q

Respiratory function is compromised if the Cobb angle is ___

A

>50 degrees

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5
Q

Pulmonary edema, ascites, hepatomegaly, and peripheral edema are consequences of impaired _____

A

Lymphatics

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6
Q

The thoracic duct is under ______ control, which can affect lymphatic flow how?

A

Sympathetic control

Hypersympathetic tone => decreased lymphatic flow

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7
Q

Sympathetic innervation of the heart

Preganglionic axons come from where? Synapse on what?

A

Interomediolateral column of T1-T6

Synapse on corresponding upper thoracic sympathetic ganglia and cervical ganglia

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8
Q

Sympathetic innervation of the heart

Postganglionic fibers form what?

A

Sympathetic cardiac nerves => converge at the cardiac plexus

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9
Q

Parasympathetic innervation of the heart

Preganglionic axons from where?

A

Dorsal nucleus of the Vagus N.

Nucleus ambiguus => synapse on cardiac plexus

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10
Q

Cholinergic and adrenergic passing through the cardiac plexus are most strongly concentrated where?

A

SA and AV nodes

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11
Q

Sympathetic fibers have what effect on HR and coronary artery?

A

Increased HR

Coronary artery dilation

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12
Q

Parasympathetic fibers have what effect on HR and coronary artery?

A

Decreased HR

Coronary artery constriction

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13
Q

Sympathetic hyperactivity at the SA node has what effect?

A
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14
Q

Right vagal hyperactivity at the SA node has what effect?

A
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15
Q

Sympathetic hyperactivity at the AV node has what effect?

A
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16
Q

Left vagal hyperactivity at the AV node has what effect?

A
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17
Q

Smooth muscle tone of the airways is predominantly _____

A

Parasympathetic

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18
Q

Cholinergic (M3) innervation controls what pulmonary responses?

A

Bronchoconstriction

Mucus secretion

Bronchial vasodilation

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19
Q

______ innervation controls bronchodilation

A

Non-cholinergic (NO and VIP)

Still parasympathetic

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20
Q

Anterior/Posterior chapman’s points for myocardium?

A

A: 2nd ICS along sternal border

P: Intertransverse space b/w T2-3

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21
Q

Anterior/Posterior Chapman’s Point for Bronchus?

Study These Flashcards
A

Anterior: 2nd ICS along sternal border

Posterior: Lateral to T2 SP

22
Q

Anterior/Posterior Chapman’s Point to Upper Lung?

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A

Anterior 3rd ICS along sternal border

Posterior: Intertransverse space between T2-3 AND T3-4

23
Q

Anterior/Posterior Chapman’s Point for Lower Lung?

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A

Anterior: 4th ICS along sternal border

Posterior: Intertransverse space b/w T4-5

24
Q

Non-modifiable risk factors for cardiopulmonary disease (2)

25
Modifiable risk factors for cardiopulmonary disease (4)
Diet Smoking Immobility Stress
26
What is the goal of the **biomechanical** model fo OMT?
Improve thoracic cage compliance and skeletal motion
27
What is the goal of the **neurological** model of OMT?
Normalize autonomic tone
28
What is the goal of the **respiratory-circulatory** model of OMT?
Maximize efficiency of the diaphragm and enhance lymphatic return
29
What is the goal of the **metabolic-energetic-immune** model of OMT?
Enhance self-regulatroy and self-healing mechanisms
30
What is the goal of the **behavioral** model of OMT?
Improve psychosocial components of health
31
Vascular and cardiac ________ is seen in most pts with hypertension
Hyperreactivity to **sympathetic** stimuli
32
Due to the widespread distribution of the sympathetic nervous system, _________ can be used to decrease SVR
Generalized paraspinal inhibition
33
What model in the 5 model approach is targeted in HTN cases?
Neurological GOAL: **Decrease sympathetic tone, paraspinal inhibition, Tx OA/AA**
34
What model in the 5 model approach is targeted in CHF?
Respiratory-Circulatory **Rib raising** to improve breathing, lymphatics Neurological - Suboccipital release (PNS) - Paraspinal inhibition to **T1-6** (SNS) - Chapman's point
35
In the setting of arrhythmias, OMT should be directed where?
**Toward reduction of segmental facilitation in the upper thoracics and modification of vagal tonicity**
36
What model in the 5 model approach is targeted in arrhythmias?
Neurological - Tx OA/AA - Paraspinal inhibition to T1-6 - Chapman's
37
3 main goals of Pneumonia Treatment
1. Reduce congestion 2. **Reduce sympathetic hyperactivity to pulmonary parenchyma of the lung** **3. Reduce mechanical impediments to thoracic cage respiratory motion** *also applicable to COPD pt*
38
What models are targeted in the 5 model approach to pneumonia?
Neurological: **paraspinal inhibition T1-7, CV4, tx OA/AA to normalize parasympathetic** Respiratory/Circulatory: **Rib raising, treat zink, lymphatics**
39
What treatment is contraindicated in COPD?
Thoracic Vacuum
40
What models of the 5 model approach are targeted in COPD?
**Neurological: T1-7 (SNS), OA/AA (PNS), Chapman's** **Respiratory-Circulatory: Rib raising, Zink patterns, doming the diaphragm**
41
Specific cardiopulmonary considerations (3)
1. Consider **indirect \> direct** to avoid unnecessary strain on pt 2. Mobilizing too much fluid from periphery to central circulation =\> high volume stress to CO 3. Increasing sympathetic tone can lead to **constriction** of lymph and systemic blood vessels
42
Summary of OMM tx in cardiopulmonary pt
1. Tx OA/AA using appropriate modality 2. Open thoracic inlet 3. Rib raising/tx ribs 4. Tx diaphragms 5. Lymphatic pumps (where appropriate) 6. Treat T1-7 dysfunctions
43
Thoracic Inlet MFR
44
Doming the Diaphragm
45
What is the rate for pedal pump?
120x/min
46
What direction should seated rib raising be directed?
Start at rib angle with T12, pull superiorly and toward the physician
47
What force is applied with effleurage?
**Stroking** force distally to proximally
48
What force is applied with petrissage?
**Kneading/twisting force** distally to proximally
49
Where are the quadratus lumborum tenderpoints?
50
Anterior/Posterior Adrenal Chapman's point?
Anterior: **2cm lateral, 2 cm superior to umbilicus** Posterior: lateral to **spinous process of T11**
51
Viscerosomatic - **sympathetic** region for lungs?
T1-T7
52
Viscerosomatic **parasympathetic** region - lungs?
Vagus N.

OS3 Exam 1 (14 decks)

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