Cardiac Rehab Lecture 1 Flashcards
What is Cardiopulmonary PT?
The purpose of CPPT is to prevent, mitigate, or reverse cardiopulmonary dysfunction, and hence, the impairment of or threat to oxygen transport
What is oxygen transport?
OT refers to the delivery, uptake, and extraction of oxygen at the tissue level, thus it reflects the adequacy of the structure and function of the airways, lungs, pulmonary circulation, blood, heart, peripheral circulation, microcirculation, and tissue
CPPT Interventions?
Include mobilization, exercise, body positioning, breathing control, coughing and airway clearance maneuvers, and manual techniques
Layers of cardiac tissue
Endocardium: innermost part of heart
Myocardium: middle layer of heart
Epicardium: Outer layer of heart
Pericardium: Fibrous sac that surrounds heart. Creates the pericardial cavity around the heart
Muscles of Inspiration
External Intercostals & Diaphragm
Secondary: SCM, Scalenes (ant, mid, post), pec major/minor, serratus ant, lat dorsi, serratus posterior anterior
Muscles of Expiration
Internal Intercostals, intercostalis intimi, and subcostals.
Acessory Muscles of Inspiration
Secondary: SCM, Scalenes (ant, mid, post), pec major/minor, serratus ant, lat dorsi, serratus posterior anterior
Accessory Muscles of Expiration
Rectus abdominis, external oblique, internal oblique, and transversus abdominis.
Pleura
Continuous membranous sacs, which cover each lung
Parietal Pleura
outer portion of pleural sac
Visceral Pleura
surface in contact with the lung tissue (parenchyma)
Pleural Space
Potential space between parietal and visceral pleurae
Primary Function of Lungs
Supply the body with O2 and remove CO2
In order for continuous gas exchange to take place there must be adequate ventilation, diffusion and profusion of the alveoli
Ventilation
Process by which air moves into the lungs
Normal Inspiration
Alveolar pressure less than or equal to atmospheric
Normal Expiration
Alveolar pressure greater than or equal to atmospheric
Compliance
Ease to which the lungs can be inflated during inspiration
Surfactant
Complex lipoprotein which lines the alveoli, it increases compliance by lowering surface tension. A decrease in surfactant causes alveoli to collapse. 28 weeks for infant to produce
Upper Airway
Nose, pharynx, larynx
Lower Airway
Trachea, primary bronchi, and lungs
Conductive Zone
Consists of the nose, pharnx, larynx, trachea, bronchi, and bronchioles. Forms continuous passageway for air
Respiratory Zone
Found deep inside the lungs and is made up of bronchioles, alveolar ducts, and alveoli. Allow for diffusion/perfusion and exchange of gasses
Diffusion
Oxygen movement across alveolar membrane into the pulmonary arterial circulation
5 Factors of Diffusion
- Area of alveolar capillary membrane
- Diffusion capacity of the alveolar capillary membrane
- pulmonary capillary blood volume
- Ventilation rate (oxygen)
- Perfusion rate (blood)
Perfusion (Q)
Refers to the process of providing blood to an area via capillaries
Voluntary Control of Breathing
Cerebral cortex, holding breath or hyperventilating will increase or decrease PaCO2
Involuntary Control
(Pons, medulla, and reticular formation): Mediate the basic sequence of breathing so that it is even and rhythmical. Unconciously adapt to changes in activity level mainting optimal PaO2 and PaCO2 levels
Neutral Control on Respiration
When respiration is controlled only from medulla: rate is slow and irregular, TV is low
Pons: responsible for maintenance of a normal pattern of respiration
Central Chemoreceptors
Located on the ventral lateral surface of the medulla.
Receptors respond to an increase in arterial PCO2 which increase rate and depth of ventilation
Peripheral Chemoreceptors
Are located along carotid bodies and aortic bodies.
Receptors respond to an increase in arterial PCO2 by increasing ventilation
Primary function of peripheral is to respond to hypoxemia by increasing ventilation
Joint and Muscle Receptors
Receptors located within these tissues respond to movement, increasing ventilation in anticipation of movement/activity
stroke may impact indirectly w/baroreceptors
Mechanoreceptors
Receptors in carotid and aortic sinuses experience corresponding pressure changes when there is change in the systemic blood pressure
Increased BP: hypoventilation
Decreased BP: hyperventilation
