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PT Hustle > Cardiopulmonary > Flashcards

Cardiopulmonary Flashcards

1
Q

If a patient is diagnosed with broca’s aphasia, which artery is likely to be effected

A

MCA

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2
Q

Where is broca’s aphasia located in the brain

A

premotor area of the left frontal lobe

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3
Q

Broca’s/Wernicke’s aphasia is described as slowed and hesitant speech pattern, where the pt’s vocabulary is limited. The pt might have trouble properly arranging words in well formed sentences.

A

Broca’s

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4
Q

What does the saying “BEN has Broca’s” mean

A

BEN is the acronym to help remember the other names of broca’s aphasia
Broca’s
Expressive
Non-fluent

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5
Q

If a patient is diagnosed with Wernicke’s aphasia, which artery is likely to be effected

A

MCA

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6
Q

Where is Wernicke’s aphasia located in the brain

A

auditory associated cortex in the left lateral temporal lobe

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7
Q

Broca’s/Wernicke’s aphasia is described as speech that flows smoothly with a preserved melody, however the speech makes no sense or is incoherent

A

Wernicke’s

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8
Q

True or False

if a pt has receptive aphasia, they may ot be able to comprehend written words as well as spoken words.

A

true - this pt will have trouble following commands.
spoken words are difficult to comprehend because the auditory comprehension is impaired

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9
Q

What is Wernicke’s aphasia also known as?

A

receptive, sensory, or fluent aphasia

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10
Q

If a patient is diagnosed with Global aphasia, which artery is likely to be effected

A

MCA

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11
Q

Where is global aphasia located in the brain

A

in the third frontal convolution and th eposterior aspect of the superior temporal gyrus

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12
Q

Will a patient with global aphasia has a better or poorer prognosis compared to the other forms of aphasia

A

significantly poorer prognosis with global aphasia

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13
Q

What intervention would be useful when practicing PACE - promoting aphasic’s communication effectiveness

A

playing charades to improve the patients conversational skills.

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14
Q

What is VAT or visual action therapy and what patient population is it used for

A

The pt begins by tracing objects followed by matching object to the tracing. Then the patient will use gestures to identify visible objects in the room, then use gestures to identify objects not in room.
-
used for pt’s with global aphasia

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15
Q

What is the most common type of SCI and its MOI

A

central cord syndrome, due to hyperextension of the cervical spine,
or it can be caused by stenosis which can create a hemorrhaging in the centermost aspect of the spinal cord

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16
Q

True or False

There is significant bowel and bladder impairments with central cord SCI

A

false, minimal to none

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17
Q

A patient with central cord syndrome asks if she is likely to walk again, what is her prognosis

A

it is common for patients to regain the ability to ambulate due to the UE being more impaired than the LE.

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18
Q

what does the 6MWT test for

A

functional endurance and aerobic capacity

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19
Q

How is the 6MWT performed

A

an open area at least 100ft long and markers every 3 meters.
pt walks for 6 minutes and the distance traveled is recorded.

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20
Q

According to Kyle Rice, what are some NPTE curveballs related to the 6MWT

A

The pt can use an AD but it should be the least restrictive without decreasing safety
The pt should be alerted how much time is left after every minute
Non-standardized encouragement is prohibited. You can say you are doing well or keep up the good work
The PT should walk half a step behind the pt and not beside or in front to avoid setting the pace

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21
Q

High altitude has a significant effect on the cardiopulmonary system, what height is considered to be high altitude

A

1500+ meters or 4900+ feet

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22
Q

At high altitudes, the atmospheric pressure is (low/high) and the partial pressure of (oxygen/carbon dioxide) is low.

A

low, PaO2

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23
Q

State a person’s acute reaction to high altitude in regards to heart rate, cardiac output, blood pressure, ventilation, exercise performance, stroke volume, PaCO2

A

Heart rate increasing
cardiac output increasing
blood pressure increase
ventilation increase
exercise performance decrease
stroke volume decrease
PaCO2 decreased

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24
Q

What are common signs and symptoms of altitude sickness

A

headache, nausea/vomiting, edema, dizziness, lethargy, dyspnea, epitaxis, insomnia

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25
Q

Why should patients with dyspnea avoid being submerged in water above the xiphoid process?

A

hydrostatic pressure increases the difficulty of breathing with will increased their respiratory rate

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26
Q

What are the benefits of using warm water during aquatic therapy

A

it increases vasodilation and reduces fatigue by increasing relaxation.

it will increase heart rate and decrease blood pressure

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27
Q

What are the benefits of using cold water during aquatic therapy

A

it can be stimulating and invigorating

it will increase blood pressure and decrease heart rate

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28
Q

Your patient with MS is interested in going to a spa and using the hot tub over the weekend. Is this a good idea or not

A

No because those with MS should avoid water temp above 84 degrees

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29
Q

What is the most effective intervention to try FIRST in regards to smoking cessation

A

smoking cessation education followed b exercise and weight control

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30
Q

What is the interpretation of an ABI of greater than 1.2

A

diabetes, arterial disease

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31
Q

What is the interpretation of an ABI of 1.19-0.95

A

normal

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32
Q

What is the interpretation of an ABI of 0.94-0.75

A

intermittent claudication, mild arterial disease

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33
Q

What is the interpretation of an ABI of 0.74-0.50

A

rest pain, moderate arterial disease

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34
Q

What is the interpretation of an ABI of less than .50

A

severe arterial disease

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35
Q

Use the mnemonic PALLOR to remember the signs and symptoms of arterial insufficiency.

A

Pale
Abnormal nail growth
Little leg hair
Lateral malleolus wounds
Overly dry skin
Rest pain

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36
Q

What mnemonic will you use to help remember signs and symptoms of respiratory acidosis

A

CARBS

Confusion, agitation, restlessness, blurred vision, seizures

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37
Q

What mnemonic will you use to help remember signs and symptoms of respiratory alkidocis

A

NO CARDS

Numbness/tingling
Orthostatic hypotension
Confusion
Anxiety
Rapid breathing
Dizziness
Seizures

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38
Q

What mnemonic will you use to help remember signs and symptoms of metabolic acidosis

A

Stupor
Hyperkalemia
Arrythmias
Muscles twitching
Emesis
Decreased cardiac output

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39
Q

What mnemonic will you use to help remember signs and symptoms of metabolic alkalosis

A

4-T’S

Tetany, tachycardia, tremors, tingling

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40
Q

What does an elevated ST segment mean

A

myocardial infarction especially if the elevation is greater than 1mm

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41
Q

What does an depressed ST segment mean

A

myocardial infarction or lack of blood flow to heart, greater depression than 2mm means the person should stop exercising due to MI

42
Q

Systolic blood pressure is the pressure on the arterial walls during ventricular (contraction/relaxation)

A

contraction

43
Q

Diastolic blood pressure is the pressure on the arterial walls during ventricular (contraction/relaxation)

A

relaxation

44
Q

Does the UE or LE demand less O2 during exercise

A

UE uses less O2 than LE

45
Q

What is a hypotensive response to exercise

A

a decrease in SBP/DBP greater than 10 with increasing workload

46
Q

A blunted response to exercise is when the SBP fails to increase with workload or increases less than 8 mmHg. Why would a pt have a blunted response

A

use of beta blockers

47
Q

What is a hypertensive response to exercise

A

DBP greater than 110 or an increase greater than 10
SBP greater than 260

48
Q

What are the classifications of blood pressure

A

normal - less than 120 AND less than 80
elevated - 120-129 AND less than 80
Hypertension stage 1 - 130-139 OR 80-89
Stage 2 - 140+ OR 90+
Hypertensive crisis - 180+ and/or 120+

49
Q

How is the S1 heart sound created, what does it sound like, and where can it be heard best

A

S1 is created when tricuspid and mitral valves close
Low pitched
Best heard over the apex of the heart

50
Q

How is the S2 heart sound created, what does it sound like, and where can it be heard best

A

S2 is created by the aortic and semilunar valves closing
No description
Best heard over the base of the heart

51
Q

How is the S2 heart sound created, what does it sound like, and where can it be heard best

A

S3 is created when a large amount of blood strike a weakened tissue as the mitral valve open
Heard right after S2
Best heard over the apex of the heart

52
Q

How is the S3 heart sound created, what does it sound like, and where can it be heard best

A

This is abnormal and occurs just before S1 when the atria contract.
This is always abnormal and is a sign of heart failure or MI

53
Q

S3 heart sound is called ventricular gallop. This is an abnormal sound, however can be normal is what patient populations

A

well trained athletes, children, and pregnant women

54
Q

You listen to your patient’s heart sounds and determine she has a pericardial friction rub. What would this sound like and what underlying condition will also be present

A

pericardial friction rub has a scratchy, leather-like sound and is caused exclusively by pericarditis on the NPTE

55
Q

If you suspect your patient has a pericardial friction rub caused by pericarditis, where would you auscultate to hear the heart sound

A

over the left sternal border

56
Q

Where are the auscultation sites to listen to heart sounds

HINT; use the pneumonic all people enjoy time magazine

A

Aortic valve - right 2nd intercostal at sternal border
Pulmonic valve - left 2nd intercostal at sternal border
Erb’s point - 3rd ICS of left sternal border
Tricuspid valve - 4th intercostal space at left sternal border
Mitral/bicuspid - 5th ICS at midclavicular line on left side

57
Q

If a patient has chronic ESRD, or end stage renal disease, what other common conditions do you expect to see due to inadequate filtration of toxins within the kidneys.

A

hypercalcemia, hyperkalemia, diabetic ketoacidosis, metabolic acidosi

58
Q

True or False:

Exercise is best performed on dialysis days.

A

false, on non-dialysis days
and NEVER immediately post hemodialysis

59
Q

What is the normal lab value range of glucose

A

100-250mg/dL

60
Q

What are contraindications to exercise in regards to glucose levels

A

Do not exercise if 100 or lower with symptoms, but
Exercise with caution if 70-100 and no symptoms.
Do not exercise if 250-300 and call EMS if there is presence of ketones, but exercise with caution without presence of ketones.
Call EMS if greater than 300

61
Q

What is the normal lab value range of hemoglobin for males and female

A

Male is 14-17 g/dL
Female is 12-16 g/dL

62
Q

What are the exercise guidelines in regards to hemoglobin lab values

A

No exercise is less than 8
Light exercise except avoid aerobic activity if 8-10
Low intensity, resistance training allowed if 10-12

63
Q

What is the normal lab value range of Hematocrit for male and female

A

male is 42%-52%
female is 37%-47%

64
Q

What are the exercise guidelines in regards to hematocrit lab values

A

Do not exercise if less than 25 percent
Avoid resistive exercise is greater than 25 percent
Gradually progress to resistive exercise if 30 percent or greater

65
Q

What is the normal lab value range of Internatioanl Normalized Ratio - INR

A

0.9-1.1

66
Q

What are the exercises guidelines in regards to INR lab values

A

> 2.5: Use extreme caution and guard against falls
3.0: Risk for hemarthosis
4.0: Progression of exercise contraindicated; discuss with physician

67
Q

What is the normal lab value range of platelets

A

150,000-450,000

68
Q

What is the normal lab value range of white blood cells

A

5.0-10.0 x 10^9 L

69
Q

When does the protein, troponin, enter the body and what does its lab values indicate?

A

Troponin enters the bloodstream after a myocardial infarction. Increased levels of .1 or greater indicate MI

70
Q

What are normal levels of troponin

A

zero to 0.03
0.10 indicates MI

71
Q

When does brain natriuretic peptide or BNP released into the body and what do its lab values indicate?

A

BNP is released during volume expansion and stress on the walls of the heart. Higher levels of BNP indicate heart failure

72
Q

What are normal lab values for BNP

A

less than 100

73
Q

When does the body release C-reactive protein or CRP into the body and what do these lab values indicate?

A

CRP is released into the body during an inflammatory condition such as arthritis, RA, meningitis. Lab value greater than 3 indicates elevated CRP

74
Q

What is ESR or erythrocyte sedimentation rate, and what does elevated levels indicate?

A

ESR is the measurement of how fast RBC’s fall in a sample of anticoagulated blood. The rate is increased in the presence of rheumatic conditions, HIV, systemic infections, and collagen vascular diseases

75
Q

What are normal ESR ranges for males and females

A

males 0-15
females 0-20

75
Q

Alanine amino transferase or ALT is an enzyme that is found within liver cells and is released into the bloodstream in alcoholism, celiac disease, cirrhosis, and liver cancer. What are normal ranges of ALT

A

7-55

76
Q

When is creatine kinase released into the bloodstream and what are its normal lab values

A

CK is released in the heart, brain, and skeletal tissue when muscle is damages extensively. Normal ranges are 22-198 and elevated.

77
Q

_____ is an inflammatory reaction of the distal airways from inhalation of bacteria, viruses, microorganisms, foreign substances, gastric contents, dust, or chemicals/radiation therapy.

A

pneumonia

78
Q

what are the four types of pnuemonia

A

bacterial
viral
fungal
aspiration

79
Q

What will the clinical presentation of pneumonia look like in regards to observation, palpation, auscultation, and cough

A

observation- tachypnea, fever, fatigue, chest discomfort
palpation- tachycardia, decreased chest wall expansion
auscultation- crackles, rhonchi
cough- sputum, dry to productive cough

80
Q

What would treatment look like for pnuemonia

A

education, incentive spirometer, early mobilization, hygiene

81
Q

Why would a patient have an arterial line

A

to measure arterial blood pressure in real time and to obtain samples for blood gas analysis

82
Q

True or False:

Arterial lines are typically used to administer medications

A

false, the use of a venous catheter would be used to administer medications.

83
Q

Where is a peripherally inserted central catheter or PICC line inserted at and what is its purpose

A

the PICC line is inserted into a peripheral vein and advanced into the superior vena cava.

used to administer chemotherapy, parenteral nutrition, administer drugs/antibiotic therapy

84
Q

What is another name for the central venous catheter and where does it insert at

A

the CVC or hickman’s catheter is inserted into the jugular vein or other large vein and advanced into the superior vena cava

85
Q

What is the function of a hickman catheter

A

deliver chemotherapy, withdrawal blood, monitor central venous pressure

86
Q

True or false

Hickman catheters or central venous lines are utilized when the pt will be in long term care

A

true

87
Q

What is another name for the swan ganz catheter and where is it inserted at

A

the swans ganz or pulmonary artery catheter/PAC is inserted into the right side of the heart to monitor pulmonary artery pressure, effectiveness of cardiovascular medications, dx right heart failure

88
Q

What drug class does albuterol belong to and what is the action of the drug

A

albuterol is a bronchodilator that stimulates adrenergic receptors to relax smooth muscle tissue

89
Q

What drug class does Ipratropium belong to and what is the action of the drug

A

this is a bronchodilator and inhibits vagally mediated reflexes by blocking acetylcholine in turn relaxing smooth muscle

90
Q

What drug class does aminophylline or theophylline belong to and what is the action of the drug

A

this is a bronchodilator used to treat wheezing, sob, and difficulty breathing by obstructive conditions.

91
Q

What are common side effects of bronchodilators

A

dizziness, tremors, flu like symptoms

92
Q

What is diaphragmatic breathing and when is it indicated

A

this is a deep inhalation technique to breath more with the belly than the chest.

This is used to improve O2 stats, atelectasis, anxiety, or mobilize secretions

93
Q

What is pursed lip breathing and when is it indicated

A

inhaling through the nose and exhaling through pursed lips

indicated for relieving dyspnea, activity tolerance, and reduce wheezing

94
Q

Asthma, bronchitis, cystic fibrosis, and emphysema are all (obstructive/restrictive) conditions.

A

obstructive

95
Q

Sarcoidosis, pulmonary fibrosis, acute respiratory distress, pneumonia are all (obstructive/restrictive) conditions.

A

restrictive

96
Q

What is cheyne-stokes breathing pattern and when is it seen

A

deep and faster breathing that has a temporary stop in breathing called apnea that last thirty seconds to two minutes at a time.

This is seen is end of life, stroke, TBI, CHF, and drug use

97
Q

What is apneustic breathing

A

slow, deep gasping inspiration with apnea at full inspiration and insufficient expiration due to damage of the pons/upper medulla

98
Q

What is paradoxical breathing pattern

A

a reversal of normal breathing where the chest contracts during inspiration and expands during expiration.

This is normal in some infants but is pathological in adults and is a serious medical condition.

99
Q

Gerdy is being treated for chronic emphysema in the outpatient clinic. After a trial of sit to stand transfers, the patient is seen hyperventilating. Which of the following breathing techniques is most recommended.

A. Pursed lip breathing
B. Diaphragmatic breathing
C. Active cycle of breathing
D. Postural draining

A

A. pursed lip breathing - this is utilized in obstructive conditions like emphysema.

diaphragmatic breathing is for restrictive conditions
active cycle of breathing is used when there is secretion issues such as bronchitis

PT Hustle (6 decks)

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