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Cardiopulm JD > Cardiopulm Exam > Flashcards

Cardiopulm Exam Flashcards

1
Q

Do PTs routinely perform a CP screen on their patients?

A

No, but we should

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2
Q

Do PTs routinely take VS on patients?

A

Yes

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3
Q

What is Normal HR?

A

60-90 bpm

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4
Q

What HR is considered sinus tachycardia?

A

> 100 bpm

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5
Q

What are some things that can cause sinus tachycardia?

A

Anxiety, exercise, fever, anemia, hypoxia, meds

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6
Q

What HR is considered sinus bradycardia?

A

<60 bpm

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7
Q

What population is sinus bradycardia seen in?

A

Athletes and people who take beta blockers

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8
Q

How do you measure pulse rate?

A

Palpating peripheral artery

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9
Q

Where is the most accurate measurement for HR?

A

Auscultation of cardiac apex

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10
Q

Pulse deficit is…

A

The difference between the HR and pulse rate

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11
Q

When you have a pulse deficit, this means that…

A

Some heart beats have not caused sufficient blood flow to reach periphery

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12
Q

A pulse deficit is common in what population?

A

People with AFib or other dysrhythmias

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13
Q

HR ranges for newborn

A

120-170 bpm

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14
Q

HR ranges for 1 year old

A

80-160 bpm

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15
Q

HR ranges for 3 yo

A

80-120 bpm

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16
Q

HR ranges for 6 yo

A

75-115 bpm

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17
Q

HR for 10 yo

A

70-110 bpm

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18
Q

Where else can you take pulse rate?

A

Dorsalis pedis

Radial

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19
Q

Rating scale for pulse: 4+

A

Bounding

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20
Q

Rating scale for pulse: 3+

A

Increased

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21
Q

Rating scale for pulse: 2+

A

Brisk, expected

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22
Q

Rating scale for pulse: 1+

A

Diminished, weaker than expected

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23
Q

Rating scale for pulse: 0

A

Absent

Unable to palpate

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24
Q

BP-JNC8

BP values for healthy individuals is _______ except those >60 years old, it is ________

A

<140/90

<150/90

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25
Q

What do the JNC 8 guidelines advise?

A

Higher BP goals and less use of several types of antihypertensive meds

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26
Q

If your BP cuff is too short or too narrow, you may have a _________ reading

A

False high

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27
Q

What kind of cuff nears to be recalibrated regularly?

A

Aneroid

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28
Q

When taking BP, brachial artery should be at what level?

A

Heart level

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29
Q

A pressure difference of more than _____ mmHG suggests arterial compression or obstruction on the side with the lower pressure

A

10-15

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30
Q

A fall of SBP or DBP of 10 mmHg or more, especially when accompanied by symptoms indicates ___________ with the HR increasing by _______ bpm

A

Orthostatic hypotension

10-20 bpm

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31
Q

What is the minimal level of MABP?

A

65 mmHg

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32
Q

What is the normal range of MABP?

A

60/70-110 mmHg

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33
Q

How do you calculate MAP?

A

[SBP +2(DBP)] / 3

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34
Q

_____ is seen as perfusion pressure for organs in the body

A

MAP

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35
Q

Activity contraindications include when:
SBP is _____ or _____
DBP is ______

A

> 200 or <80

> 100

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36
Q

Terminate activity if SBP is ____ and DBP is _____

A

SBP >250

DBP >110

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37
Q

How do you calculate pulse pressure?

A

SBP-DBP

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38
Q

What do the values for pulse pressure range from?

A

30-50 mmHg

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39
Q

Pulse pressure ______ with age

A

Increases

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40
Q

Pulse pressure is considered abnormal if greater than _______mmHg in adults

A

60

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41
Q

If pulse pressure is low, it is a marker of low ___ in adults with heart failure

A

Q

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42
Q

Increased pulse pressure indicates ___________

A

Vascular wall stiffness

Predicts CV events

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43
Q

Increased pulse pressure can be found in……

A

Aortic valve disorders
Severe anemia
Overactive thyroid

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44
Q

What are better predictors of mortality? SBP, DBP, or PP?

A

SBP and DBP

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45
Q

Lung sounds: crackles (rales) are heard during what phase of breathing?

A

Inspiration

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46
Q

Fluid in the alveoli or caused by the opening of previously closed alveoli and small airways

A

Crackles

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47
Q

Patients in an exacerbation of CHF will have what kind of lung sound?

A

Crackers

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48
Q

This lung sound is associated with airway obstruction- constriction or mucous

A

Wheezes (rhonchi)

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49
Q

Wheezes (rhonchi) are heard during what breathing phase?

A

Exhalation

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50
Q

What is the normal ventilation rate in adults?

A

12-16 breaths/min

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51
Q

Tachypnea is considered a rate higher than ____

A

20 breaths/min

52
Q

Bradypnea is a rate lower than ____

A

10 breaths/min

53
Q

Dyspnea is the patients subjective report of ____

A

discomfort

54
Q

______ means increased rate and volume

A

Hyperventilation

55
Q

_____ is decreased rate and volume

A

Hypoventilation

56
Q

_______ is difficulty breathing while the patient is supine with easing of breathing with a more vertical position

A

Orthopnea

57
Q

Ventilation in newborn

A

30-80/min

58
Q

Ventilation in 1 year

A

20-40/min

59
Q

Ventilation in 3 years

A

20-30/min

60
Q

Ventilation in 6 years

A

16-22/min

61
Q

Ventilation in 10 years

A

16-20/min

62
Q

Ventilation in 17 years

A

12-20/min

63
Q

Adult ventilation

A

10-20/min

64
Q

Types of ventilation issues

A 
Orthopnea
Hyperventilation
Abdominal paradox
Rib retractions
Hypoventilation
65
Q

Cessation after expiration interrupted by eventual inspiration or becomes fatal

A

Apnea

66
Q

Cyclic waxing and waning of depth of breathing with periods of apnea- seen in severe CNS lesions

A

Cheyne-Stokes

67
Q

Irregular breathing with slow, shallow breaths and periods of apnea - seen in meningitis

A

Biot’s breathing

68
Q

Clusters of normal breaths separated by irregular pauses- seen in high medullary or low pontine lesion

A

Cluster breathing

69
Q

Marked continuous hyperventilation with increased rate and depth of breathing to eliminate excess CO2 - diabetic ketoacidosis

A

Kussmaul

70
Q

What will be seen in the hands if you have a high dose bronchodilator?

A

Fine tremor

71
Q

What will hands be like if you have an irregular flapping tremor due to acute carbon dioxide retention

A

Warm and sweaty

72
Q

Weakness and wasting of the small muscles in the hands may be an early sign of an _________ involving the _________

A

Upper lobe tumor

Involving the brachial plexus

(Pancoast’s Tumor)

73
Q

Palmar erythema is a sign of ____

A

Liver disease

74
Q

Finger pad is enlarged is called ____

A

Clubbing

75
Q

Clubbing indicates what?

A

Chronic tissue hypoxia

76
Q

What are the causes of clubbing?

A

Lung disease
Cardiac disease
Other
Exact cause - unknown

77
Q

Cough color- red

A

Blood

78
Q

Cough color- rust

A

Pneumonia

79
Q

Cough color- purple

A

Neoplasm (smells)

80
Q

Cough color- yellow/green

A

Infection

81
Q

Cough color- pink

A

Pulmonary edema

82
Q

Coughing only clears from the __________

A

6th or 7th generation up

83
Q

Edema in CHF will accumulate _______

A

Bilaterally

84
Q

Edema 1+

A

Barely perceptible depression

85
Q

Edema 2+

A

Easily identified depression (EID)

Skin comes back within 15 seconds

86
Q

Edema 3+

A

EID

Skin comes back within 15-30 sec

87
Q

Edema 4+

A

EID

Edema rebounds in >30 seconds

88
Q

Posture exam

A 
Anterior chest muscles tight
Hip flexors tight
Forward head
Rounded shoulders
Protect incision site
89
Q

Graphs can be taken from what (3) sites?

A

Radial artery
Saphenous vein
Left internal mammary artery

90
Q

Diaphragm movement for breathing efficiency

A

2-3 inches with deep inspiration

Expansion, not descent

91
Q

Palpation: Trachea:
Deviation occurs ______ (which way) when there is a loss of lung volume on one side - atelectasis, fibrosis, surgical excision of lung tissue

A

Towards the side of the lesion

92
Q

Palpation: Trachea
Deviation occurs in what direction where there is an INCREASE in lung volume - pneumothorax, pleural effusion, herniation of abdominal viscera

A

Away from the side of the abnormality

93
Q

Palpation: Chest wall

Look for these 5 things

A 
Normal
Pectus excavutum
Pectus carinatum
Symmetry of movement
Pain
94
Q

Pectus excavutum is

A

Funnel chest

95
Q

Pectus carinatum is

A

Pigeon chest

96
Q

BADCAT Alarming respiratory signs

A 
B- breathing that is audible
A- active accessory muscles
D- dyspnea
C- cyanosis or clubbing
A- A-P diameter >1.0
T- tracheal deviation from midline
97
Q

A measure of a persons body surface area; an indicator used to assess if a person is of health weight, OW, OB

A

BMI

98
Q

Does BMI measure body fat?

A

No, but correlated

99
Q

Does BMI predict mortality and morbidity?

A

Yes

100
Q

Underweight BMI

A

18.5 or less

101
Q

Normal BMI

A

18.5 to 24.9

102
Q

Overweight BMI

A

25.0-29.9

103
Q

Obese BMI

A

30-34.9

35-39.9

104
Q

Extremely obese BMI

A

40 or greater

105
Q

Facial characteristics during exericse

A 
Distress
Fatigue
Nasal flaring
Sweating
Paleness
Muscular effort to breathe
106
Q

Examples of non modifiable risk factors

A

Age
Sex
Family history
Genetics

107
Q

Modifiable risk factors

A 
Smoking
Diet
Alcohol intake
PA
Dyslipidemias
HTN
Obesity
Diabetes
Metabolic syndrome
108
Q

Dyspnea scale 1

A

Light, barely noticeable

109
Q

Dyspnea scale 2

A

Moderate, bothersome

110
Q

Dyspnea scale 3

A

Moderately severe, very uncomfortable

111
Q

Dyspnea scale 4

A

Severe difficulty

Patient cannot continue

112
Q

Clinical manifestations of respiratory muscle fatigue

A 
Rapid, shallow breathing
Paradoxical breathing
Increased accessory muscle activity
Dyspnea
Hypoxemia
Hypercapnia
113
Q

NYHA Functional Class of Heart Disease: Stage I

A

Patient with cardiac disease but NO PA LIMITATIONS

6-10 METS

114
Q

NYHA Functional Class of Heart Disease: Stage 2

A

Slight limitations
PA results in fatigue, dyspnea, palpitations, or anginal pain

4-6 METS

115
Q

NYHA Functional Class of Heart Disease: Stage 3

A

Marked limitations of PA
Less than normal PA causes symptoms

2-3 METS

116
Q

NYHA Functional Class of Heart Disease: Stage 4

A

Unable to carry out PA without discomfort

<2 METS

117
Q

Clinical Prediction Rule for DVT includes:

A

Cancer (treatment within 6 months)
Paralysis, paresis, immobilization
Bedridden for more than 3 days because of surgery within 4 weeks
Localized tenderness along distribution of deep veins
Entire leg swollen
U/L calf swelling of greater than 3 cm
U/L pitting edema
Collateral superficial veins
Alternative Dx as likely as or more likely than DVT

118
Q

Risk score interpretation (DVT): if you have >/= 3 points

A

High risk 75%

119
Q

Risk score interpretation (DVT): If you have 1 to 2 points

A

Moderate risk 17%

120
Q

Risk score interpretation (DVT): if you have <1 point

A

Low risk 3%

121
Q

What grade on MRC breathlessness scale? Not troubled by breathlessness except on strenuous exercise

A

Grade 1

122
Q

What grade on MRC breathlessness scale? Short of breath when hurrying on the level or walking up a slight hill

A

Grade 2

123
Q

What grade on MRC breathlessness scale? Walks slower than most people on the level, stops after a mile or so, or stops after 15 min walking at own pace

A

Grade 3

124
Q

What grade on MRC breathlessness scale? Stops for breath after walking about 100 yes or after a few minutes on level ground

A

Grade 4

125
Q

What grade on MRC breathlessness scale? Too breathless to leave the house, or breathless when undressing

A

Grade 5

126
Q

What is the abdominal paradox?

A

When the diaphragm doe not move right

127
Q

Who are in rib retractions mainly seen in?

A

Children- skin between intercostals get sucked in

Cardiopulm JD (12 decks)

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