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NPTE > Cardiopulm PT Tests and Measures > Flashcards

Cardiopulm PT Tests and Measures Flashcards

1
Q

Angina pain scale

A

1: Mild, barely noticeable
2: Moderate, bothersome
3: Moderately severe, very uncomfortable
4: Most severe or intense pain ever experienced

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2
Q

ABI procedure

A

Use sphygmomanometer and Doppler ultrasound device
Measure brachial and tibialis posterior arteries on both sides
Divide higher ankle measurement over higher brachial measurement

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3
Q

ABI Interpretation

A

1.3+ Rigid arteries, need ultrasound test to check for peripheral artery disease
1-1.3 Normal
0.8-0.99 Mild blockage
0.4-0.79 Moderate blockage, may have intermittent claudication during exercise
<0.4 Severe blockage, may have claudication at rest

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4
Q

BP Measurement Procedure

A
  • Use appropriate size cuff (if in doubt, use larger cuff)
  • Bladder should encircle 80% of arm in adults, 100% of arm in children
  • Inflate to above anticipated systolic pressure
  • Deflate 2-3 mmHg/second
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5
Q

Korotkoff sounds

A

1: First appearance of sounds = SBP
2: Sounds get softer/longer
3: Sounds get crisper/louder
4: Sounds get muffled/softer
5: Sounds disappear = DBP

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6
Q

BP Interpretation (age 3-17)

A

Normal: SBP and DBP <90th percentile
Pre-HTN: SBP and DBP 90-94 percentile
Stage 1 HTN: SBP and DBP 95-99 percentile
Stage 2 HTN: SBP and DBP >99 percentile

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7
Q

BP Interpretation (adults)

A

Normal: <120/80
Pre-HTN: 120-139/ 80-89
Stage 1 HTN: 140-159/ 90-99
Stage 2 HTN: >160/100

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8
Q

Auscultation Procedure

A
  • Hold bell directly on bare skin, enough pressure to provide a skin seal
  • Patient breathes quietly through nose (heart sounds). Through the mouth and slightly deeper than normal for lung sounds.
  • Listen over designated auscultatory sounds (4 for heart, 16 for lungs)
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9
Q

4 Auscultation areas for heart

A

Aorta: 2nd intercostal, right sternal border
Pulmonary Artery: 2nd intercostal, left sternal border
Mitral Valve/Apex: 5th intercostal space, medial to left midclavicular line
Tricuspid Valve: 4th intercostal space, left sternal border

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10
Q

Heart Sounds (Normal)

A

S1: Ventricular Systole (AV valves closing) - Lower pitch and longer duration

S2: Ventricular diastole (semilunar valves closing) - Higher pitch and higher duration

^Both sounds are high frequency

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11
Q

Heart Sounds (Abnormal)

A

S3 (Normal in children - “physiologic” 3rd heart sound): Vibration of distended ventricle walls during diastole. AKA Ventricular gallop. Can indicate HF.

S4: Vibration of ventricular wall with ventricular filling. Associated with HTN, stenosis, myocardial infarction, hypertensive heart disease. AKA atrial gallop.

Murmurs: Vibrations of longer duration than the heart sounds. Due to disruption of blood flow past a stenotic or regurgitant valve.

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12
Q

Tracheal/Bronchial Breath Sounds

A

(Normal)

  • Loud, tubular
  • Inspiration < expiration, slight pause between the two

*Bronchial sounds over distal airways are abnormal – indicate consolidation/ compression of lung tissue. E.g. pneumonia

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13
Q

Vesicular Breath Sounds

A

(Normal)

  • High pitched, breezy
  • Heard over distal airways
  • Inspiration > expiration, no pause between the two
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14
Q

Crackles (Rales)

A
  • More often during inspiration
  • Restrictive or Obstructive Disorders
  • Wet: Movement of fluid during inspiration
  • Dry: Sudden opening of closed airways
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15
Q

Pleural Friction Rub

A
  • Dry, crackling during inspiration and expiration
  • Indicates inflamed visceral and parietal pleurae rubbing together
  • Heard over spot where the patient feels pleuritic pain
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16
Q

Ronchi

A
  • Continuous, low pitch sound (“snoring” or “gurgling”)
  • During inspiration and expiration
  • Air passing through airway that is obstructed
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17
Q

Stridor

A
  • Continuous high-pitched wheeze
  • Inspiration and Expiration
  • Indicates upper airway obstruction
18
Q

Wheeze

A
  • Continuous musical/ whistling sound of a variety of pitches
  • Variable from minute to minute and area to area
  • Turbulent airflow and vibration of walls of small airways
19
Q

Voice Sounds

A

Normal: muffled.
Consolidation, atelectasis, fibrosis improve transmission of vibrations through lung tissue.

Bronchophony (99)
Egophony (E sounds like A)
Whispered pectoriloquy

Voice sounds somewhat more valuable than breath sounds for detecting pulmonary consolidation, infarction, atelectasis.

20
Q

BMI Interpretation (adults)

A 
< 18.5 Underweight
18.5-24.9 Normal
25-29.9 Overweight
30-34.9 Obesity (Class 1)
35-39.9 Obesity (Class 2)
40+ Obesity (Class 3)

Overestimates body fat in athletes
Underestimates body fat in older adults who’ve lost muscle

21
Q

BMI Interpretation (<18 years old)

A

85-95 percentile: At risk for becoming overweight

>95th percentile: Overweight or obese

22
Q

Capillary Refill

A

Normal: Full color returns in <2 seconds

23
Q

Claudication Cause

A

Occurs when skeletal muscle O2 demand during exercise exceeds blood O2 supply.

Location of sxs often corresponds to site of most proximal stenosis

  • butt/hip/thigh = aorta or iliac arteries
  • calf = femoral, popliteal arteries
  • ankle/foot = tibial or peroneal arteries
24
Q

Claudication Test Procedure

A

Patient walks on a flat track at max speed
OR
Patient walks on a treadmill at 2.0 mph at a constant grade between 0-12%

Initial Claudication Distance = pain-free walking distanc
Absolute Claudication Distance = Max distance walked when test is terminated due to pain

Also measure walking speed

25
Q

Grading scale for claudication pain

A

1: Mild
2: Moderate, patient can be distracted
3: More intense, patient’ can’t be distracted
4: Excruciating and unbearable

26
Q

Borg Dyspnea Scale

A

0-10

27
Q

Homan’s Sign

A

Passively DF ankle with knee straight
Positive: Pain in calf or popliteal space
Insensitive and nonspecific

28
Q

Mediate Percussion

A

Percuss at each intercostal space, compare bilaterally

Normal in lung: “resonance” sound

Tympany = echoing sound. Indicates pneumothorax

29
Q

Measuring HR procedure

A

Regular rhythm: 15 seconds x4

Irregular rhythm: 60 seconds

30
Q

Pulse scale

A

0: Absent
1: Small/ reduced
2+: Normal
3+: Large/bounding

31
Q

PFT Results for Obstructive Impairment

A
  • Decreased expiratory flows
  • FEV1/FVC <70% primary indicator of obstructive impairment
  • asthma, emphysema, chronic bronchitis
32
Q

PFT Results for Restrictive Impairment

A
  • Reduced lung volumes
  • Relatively normal expiratory flow rates
  • FVC reduced, FEV1/FVC is normal or >80%
  • Interstitial lung disease, pleural disease, obesity, pregnancy, neuromuscular disease, tumor, chest wall deformity.
33
Q

SpO2 when to stop activity

A

<90% in acutely ill patients

<85% in patients with chronic lung disease

34
Q

Rate Pressure Product

A

Index of myocardial O2 consumption and coronary blood flow.
Easy to measure physiologic correlate to onset of angina
= HR x SBP
Reported as 2-digit number x10^3

35
Q

RPE Interpretation

A

13-14: 70% HR max

11-13: Upper limit for prescribing intensity early in cardiac rehab.

36
Q

4 Parameters to consider for respiratory assessment

A

Rate
Rhythm
Depth
Character (effort, sounds produced)

37
Q

Normal respiratory rhythm

A

Inspiration: Expiration ratio is 1:2

38
Q

Respiratory rhythm with COPD

A

Inspiration: Expiration 1:3 or 1:4

39
Q

Biot’s breathing pattern

A

Irregular breathing
Breaths vary in depth and rate, periods of apnea

Often associated with increased ICP or damage to medulla

40
Q

Kussmaul’s breathing pattern

A

Deep and fast breathing

Often associated with metabolic acidosis

41
Q

Waist circumference vs. Waist to hip ratio

A

No advantage of one over the other

42
Q

Waist circumference indicating increased risk for disease

A

> 102 cm/ 40 in for men

> 88 cm/ 35 in for women

NPTE (24 decks)

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