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NPTE > Cardiopulm FF flaschards > Flashcards

Cardiopulm FF flaschards Flashcards

1
Q

Restrictive lung disease with examples

A

difficulty breathing IN and expanding chest wall
examples: thoracic burns, asbestos, pulmonary fibrosis, asthma

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2
Q

obstructive lung disease with examples

A

difficulty getting air out/keeping airway open and trapping in CO2
ex: COPD, emphysema, cystic fibrosis, bronchiestasis, chronic bronchitis

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3
Q

treatments for obstructive

A

pursed lip breathing, huff cough
because want to keep airway open and breath out co2

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4
Q

breathing exercises for restrictive

A

diaphragmatic breathing, stacked breathing, incentive spirometry, segmental breathing

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5
Q

segmental breathing/lateral costal breathing

A

usage: improve hypoventilation, for chest wall fibrosis, pain, m guarding after surgery, atelectasis, PNA
Procedure: start in hook lying - can improve to sitting
apply pressure to ribs during exhalation and reduce inhalation
just before inhalation provide quick downward/inward stretch to chest - gives external intercostals quick stretch to facilitate contraction

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6
Q

Difference between MI and HF

A

MI - heart (coronary circulation) is not getting enough blood=heart attack
HF- deficit with systemic circulation

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7
Q

R sided HF

A

aka cor pulmonale
blood gets pushed back from RV>RA>body and venous vasculature
signs/sxs: jugular vein distention, peripheral edema, ascites (accumulation of fluid in abdominal region), enlarged liver and spleen
can be from increase PA pressure> increased afterload placing greater demands on RV

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8
Q

L sided HF

A

backflow LV>LA>lungs
decreased CO
sxs: SOB, cough, crackles, bloody sputum, tachypnea (rapid breathing), pulm edema, paroxysmal nocturnal dyspnea (SOB in night), orthopnea (SOB while lying down), exertional dyspnea, cyanosis
severe LV pathology: increased pulm artery pressure leads to back up into R side of heart and systemic venous vasculature >biventriculater failure

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9
Q

biventricular heart failure

A

present with pulmonary and systemic signs of HF

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10
Q

CHF tx implications

A

Intensity: begin with 40-60%
time: gradually increase duration with frequent rest episodes
Type: low level aerobic, gradual increaseIncreased warm up and cool down
Use RPE - HR can br impaired
At risk of hypotension with late state HF

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11
Q

Precautions for Trendelenburg postural drainage:

A

circulatory - CHF, hypertension
pulmonary - pulm edema, SOB made worse with trendelenburg
abdominal - obesity, abdominal distention, hiatial hermia, nausea, recent food consumption

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12
Q

precautions for side-lying postural drainage

A

vascular: axillofemoral bypass graft
musculoskeletal: arthritis, recent rib fx, shoudler bursitis, shoulder tendonitis

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13
Q

rate product pressure

A

HR x systolic BP
- to get idea of metabilic demand of heart
- myocardial O2 demand
- use to determine myocardial O2 demand of pateint at onset of chest pain sxs

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14
Q

cardiac output

A

SV x HR
amount of blood pumped per heart beat

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15
Q

stroke volume

A

mL of blood pumped per beat

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16
Q

how does HR change with exercise

A

increases linearly with increasing work rate
- reaches plateau at 100% VO2 max

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17
Q

How does CO change with exercise

A

increases linearly with increasing work rate

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18
Q

How does BP change with exercise

A

mean arterial pressure increases linearly
SBP increases linearly
DBP remains fairly constant

19
Q

how long to wait between practice test and real trial for 6MWT?

A

at least 1hr

20
Q

how does nervous system regulate heart

A

-SNS (sympathetic nerve) stimulates to increase HR: SA node>AV node>perkinje fibers>ventricles
- PNS stims to slow HR with Vagus N and same system as SNS

21
Q

VO2

A

-volume of O2 consumed per minute per liter of bodyweight (kG)
- indicator of cardio fitness, higher VO2max=more fit

22
Q

What does VO2 at steady state indicate?

A

-ATP demand is being met aerobically
- aerobic exercise is happening

23
Q

When does anaerobic exercise happen?

A

It happens within first few minutes of cardio
- lactic acid is produced

24
Q

What happens when you train at altitude?

A

Due to lower amounts of O2, body works to produce more RBCs

25
Q

initial altitude changes

A

“anxious first date”
HR: increased
BP: increased
CO: increased
SV: no change

26
Q

acclimatizationed altitude changes (after few days)

A

HR: increased
BP: normal
CO: normal
SV: decreases

27
Q

aquatic therapy: cardio effects

A

heart is happy!
- SV increases due to increased venous return
HR: decreases
BP: decreases
SV: increases
CO: increases

28
Q

aquatic therapy: respiratory effects

A

vital capacity: decreased
- due to increased hydrostatic pressure (water on chest)
work of breathing: increased

29
Q

Aquatic therapy: MSK effects

A

weight bearing: decreased
edema: decreased

30
Q

beta blockers on HR

A
  • BBs compete with epinephrine and norepinephrine (increase HR) for beta adrenergic receptors in heart
  • BBs block epi and norepi from getting to the heart>
  • BBs lower HR and contractility
  • they lower myocardial O2 demand
  • will lower HR during submaximal and maximal exercise
31
Q

beta blockers indications

A

coronary artery disease and hypertension

32
Q

End diastolic volume

A

Amount of blood left in ventricles after diastole
- If its increased, can help blood pump for systole
- at end of diastole, right before systole
- aka preload

33
Q

Mean arterial pressure

A
  • aka afterload
    -Amount of Pressure heart requires to eject blood during ventricular contraction
34
Q

Frank Sterling effect

A
  • little bit of stretch can help with contraction
35
Q

Factors that regulate CO

A
  • Cardiac rate:
    -parasympathetic NS: decrease
  • sympathetic NS: increase

-Stroke volume:
-Sympathetic NS: increase
-MAP: decrease
-Frank sterling: increase
-End diastolic volume: increase
- strength of contraction: increase

36
Q

Best way to assess change in fitness from pre and post fitness changes?

A

Amount of time it takes for HR to return to baseline
- more fit=less time itll take

37
Q

Heart sounds Auscultation landmarks

A

Aortic: 2nd IC space on R sternal border
Pulmonic: 2nd IC space on L sternal border
Tricuspid: 4th IC space on L sternal border
Mitral: 5th IC space, midclavicular line on L

38
Q

S1 heart sound

A

“lub”
Onset of systole (early systole)
- tricuspid and mitral valves closing

39
Q

S2 heart sound

A

“dub”
Onset of diastole (late systole)
- pulmonary and aortic valves closing

40
Q

S3 heart sound

A
  • in early diastole
  • aka ventricular gallop
  • Abnormal:Common in CHF
  • ventricular filling
  • normal: with athletes and pregnancy
41
Q

S4 heart sound

A
  • In late diastole
  • “atrial gallop/kick”
  • ventricular filling and atrial contraction
  • rapid influx of blood during atrial contraction
  • common for MI, pulm HTN, L ventricular hypertrophy, L ventricular end diastolic pressurepulm stenosis
42
Q

Where to auscultate for S2 sounds

A

base of heart (top)
- aortic and pulmonic sites

43
Q

where to auscultate for S1 sounds

A

Apex of heart (bottom)
-tricuspid and mitral sites

44
Q

Where to auscultate to hear S1 and S2 sounds equally

A

Erb’s point
- 3rd intercostal space, L sternal border

NPTE (60 decks)

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