Cardiopulm FF flaschards Flashcards
Restrictive lung disease with examples
difficulty breathing IN and expanding chest wall
examples: thoracic burns, asbestos, pulmonary fibrosis, asthma
obstructive lung disease with examples
difficulty getting air out/keeping airway open and trapping in CO2
ex: COPD, emphysema, cystic fibrosis, bronchiestasis, chronic bronchitis
treatments for obstructive
pursed lip breathing, huff cough
because want to keep airway open and breath out co2
breathing exercises for restrictive
diaphragmatic breathing, stacked breathing, incentive spirometry, segmental breathing
segmental breathing/lateral costal breathing
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
Difference between MI and HF
MI - heart (coronary circulation) is not getting enough blood=heart attack
HF- deficit with systemic circulation
R sided HF
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
L sided HF
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
biventricular heart failure
present with pulmonary and systemic signs of HF
CHF tx implications
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
Precautions for Trendelenburg postural drainage:
circulatory - CHF, hypertension
pulmonary - pulm edema, SOB made worse with trendelenburg
abdominal - obesity, abdominal distention, hiatial hermia, nausea, recent food consumption
precautions for side-lying postural drainage
vascular: axillofemoral bypass graft
musculoskeletal: arthritis, recent rib fx, shoudler bursitis, shoulder tendonitis
rate product pressure
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
cardiac output
SV x HR
amount of blood pumped per heart beat
stroke volume
mL of blood pumped per beat
how does HR change with exercise
increases linearly with increasing work rate
- reaches plateau at 100% VO2 max
How does CO change with exercise
increases linearly with increasing work rate
How does BP change with exercise
mean arterial pressure increases linearly
SBP increases linearly
DBP remains fairly constant
how long to wait between practice test and real trial for 6MWT?
at least 1hr
how does nervous system regulate heart
-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
VO2
-volume of O2 consumed per minute per liter of bodyweight (kG)
- indicator of cardio fitness, higher VO2max=more fit
What does VO2 at steady state indicate?
-ATP demand is being met aerobically
- aerobic exercise is happening
When does anaerobic exercise happen?
It happens within first few minutes of cardio
- lactic acid is produced
What happens when you train at altitude?
Due to lower amounts of O2, body works to produce more RBCs
