Cardiopulmonary implications of specific diseases Flashcards
What is associated with obesity?
Impaired: energy balance, cardiac function, pulmonary function
HTN, CV disease, OA, cancers, diabetes, pulmonary HTN, sleep apnea
Fatigue
Oxygen consumption: body mass vs. lean body mass, low resting oxygen consumption
What is role of exercise in helping obesity?
Weight loss: outcomes, lifestyle changes
Exercise: physiologic responses, exercise prescription (anaerobic threshold)
T/F: 5-10% reduction in weight loss has significant improvement on health?
True
What is peripheral arterial disease?
Plaques obstruct blood flow in large/medium sized arteries: noticed in LEs, legs>arms
Hemodynamics: severity of disease, collateral blood flow
What is intermittent claudication?
Pain with exercise
Pain with rest, skin changes= advanced
Necrosis: cell death from occlusion
How does PAD affect exercise?
Unable to increase blood flow to meet demands of exercise.
Lack of oxygen to working muscles.
Lactic acid- pain
Peak exercise capacity is reduced
What is exercise training for PAD?
Short intervals and progression
Claudication scale
Goal 30-60 minutes continuous
Longer warm up times (cold weather)
What are impairments in renal system?
Metabolic disturbances
Symptoms unnoticed in late stage: affects cardiovascular, neurologic, musculoskeletal, respiratory, and endocrine systems
What are major complications of chronic renal failure?
HTN, pericarditis, bleeding disorders, renal osteodystrophy (osteomalacia), proximal myopathy, peripheral neuropathy, immunosuppression
What is goal of treatment for chronic renal failure?
Diet, fluid balance, BP management, reduce symptoms of uremia.
Dialysis: most symptoms can be resolved with dialysis; anemia, vascular access infection, thrombosis, pericarditis, ascites
What is ESRD?
end stage renal disease
cardiovascular complications result in 50% of deaths: MI, CVA, heart failure, fluid overload (periphery, heart, lungs) increases pressure
What is relationship between ESRD and exercise?
Decreased exercise tolerance due to: decreased O2 consumption at higher levels, loss of muscle strength, sedentary, abnormal HR response (blunted despite higher levels of norepi and sharp increase in BP)
Dialysis: when to exercise
Role for PT
What are collagen vascular diseases?
Systemic diseases: RA, Lupus
Abnormalities of vasculature
Inflammatory lesions: joints, muscles, tendons
Cardiac and pulmonary manifestations: table 7.16, page 260 in book
What is PT role in systemic diseases?
Increase activity: monitor physiologic signs
Functional performance
Muscle strength: peripheral and core strength
RPE scale
What are characteristics of RA?
Chronic inflammatory disease Affects joints Long standing RA: impacts other symptoms Cardiovascular involvement Edema Pulmonary changes: pleura
What are characteristics of SLE?
Multisystem auto immune disease
Increased production of autoantibodies
Immune complexes with diffuse and widespread inflammation: joints, skin, brain, kidney, heart, lungs
Cardiac involvement: 18-56%, autopsy 90%
What body systems are affected by SLE?
Cardiovascular: HTN
Vascular system
Infections/wounds
Pulmonary involvement: HTN, fibrosis, diaphragmatic weakness, pneumonia, pleural effusion (c/o chest pain vs. xray)
What are affects of myasthenia gravis on the body systems?
Cardiac: drugs to treat may exacerbate MG disease
Respiratoyr involvement: muscle weakness, risk for mechanical vent
Muscular: ach receptor deficiency affects voluntary muscle system
What are affects of certain neuromuscular disease on the heart?
Stroke: same comorbid conditions as cardiovascular patient
SCI: depends on level, may have dysregulation of BP
ALS: aspiration pneumonia
GB syndrome: respiratory weakness, loss of swallow/aspiration pneumonia, mechanical vent
GB: start in LE and work its way up to diaphragm
Parkinson’s: meds can affect heart and can cause changes in response