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NPTE > Cardiopulmonary > Flashcards

Cardiopulmonary Flashcards

1
Q

why can you not do manual lymph drainage on a heart failure patient

A

the manual lymph drainage in the LE will push fluid back towards the trunk and to the heart and away from the LE. The heart already has a difficult time with the load of fluid on the heart, and this will further aggravate it and overload the heart even more.

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2
Q

name 3 conditions that manual lymph drainage is acceptable

A

edema
chronic venous insufficiency
CRPS (for the pain modulation)

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3
Q

normal range of WBC

A

4500-11,000

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4
Q

why must you withhold treatment for PT if the WBC count is over 11,000

A

signs of infection

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5
Q

what range of oxygen saturation will make you alter the exercises you do

A

90% or below

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6
Q

hemoglobin normal values in men and women

A

men: 13.3 - 16.2
women: 12 - 15.8

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7
Q

range of PaCO2 and Pa O2

A

PaCO2: 35-45 mmHg
PaO2: 80-100 mmHg

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8
Q

what kind of orthotic is useful when a person has a weak diaphragm

A

a corset, to hold contents in and support the diaphragm

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9
Q

why is sitting and bending forward while sitting not advantageous for the diaphragm

A

this will cause the diaphragm to move anteriorly and inferiorly making it even more in a disadvantageous position for proper use

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10
Q

what is egophony

A

(A sounds when the patient says E)

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11
Q

egophony voice sounds will increase in volume with a person with ___

A

consolidation

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12
Q

egophony voice sounds will decrease in a person with

A

atelectasis (b/c lung volume and tissues are deflated)

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13
Q

do you have voice sounds where a person has pleural effusion? why or why not

A

no, because the lung tissue is deflated in that area

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14
Q

will the voice sounds be increased or decreased in a person with pneumothorax

A

decreased because the lung is deflated

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15
Q

what is an objective measure to use when looking at diaphragm function in a patient

A

a tape measurement from the xiphoid to the umbilicus during inhalation

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16
Q

how should you measure chest excursion

A

take a tape measure and measure around the axilla and around the xiphoid

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17
Q

what is normal diastolic pulmonary arterial pressure

A

5-15 mmHg

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18
Q

what is normal ICP in adults and kids

A

adults: 0-10
kids: 0-5 mmHg

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19
Q

normal platelet count

A

165-415

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20
Q

why is percussion a precaution/contraindication (and at what levels) for coagulapathy

A

if platelets are below 20,000 units, may have impaired ability to heal, and percussion can cause micro-traumas

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21
Q

normal breathing rate

A

12-20 breaths per minute

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22
Q

what is Biot respirations

A

irregular breathing with highly variable respiratory depths and intermittent periods of apnea. Brain insults (strokes,…). Brain cannot regulate breathing, and is only kicked in when CO2 levels get too high. Cannot control normal breathing.

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23
Q

what is Cheyne -Stokes respiratory pattern

A

irregular respiratory pattern with periods of apnea followed by gradually increasing depths of respiration. Heart problems.

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24
Q

what is metropolol (Lopressor) and what does it do

A

a beta-blocker, which lowers the HR max so you need to use RPE to determine exercise intensity

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25
Q

what is very common in patients (95% of patients) who just underwent abdominal surgery (in terms of pulmonary conditions). How can we address this?

A

atelectasis.

deep breathing.

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26
Q

is excursion increased or decreased in a patient with COPD

A

decreased because there is hyperinflation of the lungs.

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27
Q

what is normal excursion of the diaphragm

A

1.2-2 inches (3-5cm)

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28
Q

how should systolic and diastolic pressures change when exercising

A

systolic should increase and diastolic should RTS.

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29
Q

what is stridor

A

Stridor is a continuous monophonic high-pitched crowing sound heard during inspiration. It is usually caused by upper airway obstruction.

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30
Q

what are wheezes

A

High-pitched wheezes are continuous musical sounds of variable pitch and duration that are heard on inspiration, expiration (most common), or both and are usually caused by narrow airways or stenosis (asthma/COPD)

31
Q

pleural rub?

A

A pleural rub is inspiratory and expiratory grating, creaking sound like sandpaper or leather being rubbed together, usually due to pleural inflammation

32
Q

what are crackles/rales?

A

Crackles (rales) are discontinuous, nonmusical, crackling sounds similar in sound to several hairs being rubbed together. It is most often heard on inspiration and usually caused by sudden opening of closed airways or movement of secretions. bronchitis

33
Q

Kussmaul breathing

A

in acidotic states, rapid and full in and rapid and full out.

34
Q

what condition (respiratory/metabolic and acid/alkalosis) would benefit from rebreathing

A

resp alk.

35
Q

list some aquatic therapy contraindications

A

seizures within the last year
water/airborne transmission infections
open wounds NOT covered by occlusive dressing.
vital capacity of 1 L or less.

36
Q

describe angina symptoms

A

transient pain that radiates down the left arm into the 4th and 5th digit. increases with exertion and decreases with rest.

37
Q

how does the diaphragm make the abdomen move when breathing in

A

it makes it move outward, because the diaphragm pushes abdominal contents outward.

38
Q

6MWT normative value for a 72 y/o with CHF should be able to walk roughly…

A

300 m

39
Q

for individuals with a diagnosis of heart failure, a 6MWT distance of less than ___ m has been shown to be predictive of readmission to the hospital.

A

390m

40
Q

the average distance for a 6MWT of a 70-79 y/o man should be

A

527 m

41
Q

p wave represents the

A

atrial depolarization

42
Q

QRS complex represents the

A

ventricular depolarization

43
Q

on an ECG, when does arterial repolarization happen

A

during the QRS complex, so you cannot see it on an exam.

44
Q

T wave represents

A

ventricular repoloarization.

45
Q

what does the test “tapping the great saphenous vein” test for

A

the competence of the vein valves of the LE.

46
Q

how do you preform the great saphenous vein percussion test

A

the patient is standing, and the therapist will have one hand on the proximal femoral-saphenous junction. The distal hand is on the distal great saphenous vein and starts to tap. If the tapping and percussion is felt proximally, there is dysfunction within the venous system valves.

47
Q

what is the single most effective intervention for COPD prevention and prevention of progression

A

smoking cessation. also breathing techniques to increase O2 in and increase CO2 out.

48
Q

difference between phase 1 and phase 5 korotkoff sounds?

A

phase 1 is the first distinct sounds heard, which is the systolic BP when deflating the cuff. Then phase 5 is the last sound heard, which is the diastolic BP.

49
Q

where do you find the dorsal pedialis pulse.

A

on the dorsum of the foot between the first metatarsal space.

50
Q

what is RDS

A

respiratory distress syndrome in infants due to a decrease in surfactant production. high respiratory rate, edema and nasal flaring with RR over 60. with less surfactant, the alveoli surface tension increases which will then lead to collapsing alveoli.

51
Q

what does surfactant do

A

decreases surface tension and allows alveoli to stay open.

52
Q

what is meconium aspiration

A

when the fetus breaths in amniotic fluid and meconium.

53
Q

what things should a post CABG patient not do when participating in PT

A

should not do MMT of UE, and should not use the arms to sit to stand.

54
Q

lingual lobe drainage

A

in a sidling position with legs evaluated 12inches

55
Q

posterior basal lobes

A

prone, trendeleberg with legs elevated 18-20 inches.

56
Q

posterior apical segments

A

sitting with knees and hips flexed to 90 degrees.

57
Q

superior portions of lower lobes

A

prone with pillow under abdomen.

58
Q

autogenic drainage

A

for CF. requires a lot of practice. controlled breathing at different lung volumes to mobilize secretions.

59
Q

BiPAP is used for

A

apnea

60
Q

abnormal BP changes in response to exercise

A

increase over 20-30mmHg for systolic and decrease over 10mmHg for diastolic

61
Q

if someone has an elevated hemi -diaphragm, what should you do

A

train inspiratory muscles.

62
Q

Brudzinski-Kernig test

A

for meningitis, brudzinski is when you do passive flexion of the neck and the knee bends
Kernig is a 90/90 position, and you raise the leg up to extend the knee and you have pain with the test.

63
Q

Lasegue’s SLR tests

A

L5-S1 nerve root

64
Q

bicycle test of van Gelderen

A

bike with backward lean to increase lordosis and bring symptoms on. Then you lean forward to see if they go away, then lean back to see if they come back. for intermittent neurological claudication.

65
Q

metabolic syndrome S+S and can lead to

A

insulin resistance, visceral adiposity, dyslipidemia, hypertension, and elevated blood pressure. leads to increased risk CVD or T2DM.

66
Q

if you have a pneumothorax there will be a shift _____ from eh injured side of the mediastinum and the trachea

A

away, not towards. you will also have dyspnea, chest pain and decreased absent breath sounds.

67
Q

rubor of dependency test, or Buerger’s test

A

for lower limb ischemia. you have the patient supine with legs straight and hips flexed to 45 degrees for 2 minutes. Then you lower legs down off the table. (+) if there is loss of color in the feet with elevation and then rubor or redness with the dependent position.

68
Q

bruce protocol stages are ___ minutes long

A

3

69
Q

when can an MI patient begin OP cardiac rehab

A

1 week post MI

70
Q

Swan-Ganz catheter

A

hemodynamic monitoring of the heart.

71
Q

what does cold air do to asthma

A

makes it worse.

72
Q

PLB PURSED LIP BREATHING which is twice as long as the other? inspiration or expiration

A

expiration is twice as long as inspiration

73
Q

difference between stable and unstable angina

A

the stable is predictable and alleviated with rest. Unstable, could happen at rest and is unpredictable.

NPTE (12 decks)

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