Cardiopulmonary Lecture

Question 1

What biomechanical condition greatly inhibits cardiopulmonary function?

Answer 1

Scoliosis

Question 2

What are the angle ranges of mild, moderate and severe scoliosis?

Answer 2

5-15, 20-45, greater than 50

Question 3

Respiratory function is compromised if the Cobb angle is greater than what angle?

Answer 3

50

Question 4

Cardiovascular function is compromised if the Cobb angle is greater than what angle?

Answer 4

75

Question 5

What is the relationship between gait and cardiac workload in heart failure patients?

Answer 5

They adopt a short stepping gait which costs more oxygen

Question 6

What division of the ANS controls the thoracic duct and what does hyperactivity of this division lead to?

Answer 6

Sympathetic control, so if you had hyper sympathetic tone,

Question 7

What is the pathway of sympathetic innervation to the heart?

Answer 7

T1-5 spit out preganglionic fibers to upper thoracic sympathetic ganglia and the post ganglionic head to the cardiac plexus.

Question 8

What is the pathway of parasympathetic fibers to the heart?

Answer 8

Preganglionic fibers from the dorsal nuclues of vagus and NA go all the way and synapse on the cardiac plexus

Question 9

Talk about the splitting/dividing of the cardiac plexus to innervate the heart?

Answer 9

Cardiac plexus splits into superficial and deep cardiac plexus.
Deep cardiac plexus splits into a right and left half.
Left Left innervates AV node.
Right half splits off into right coronary plexus, left coronary plexus, and SA node.
Right coronary plexus goes to RA and RV
Left Coronary Plexus goes to LA and LV

Question 10

What two places in the heart are cholinergic and adrenergic fibers from the cardiac plexus most concentrated?

Answer 10

SA and AV node

Question 11

What is the arrhythmia at risk for with sympathetic hyperactivity at SA and parasympathetic hyperactivity at SA? Same question but at the AV node.

Answer 11

SVT
Sinus bradycardia

V fib
AV blocks

Question 12

What phase of the action potential determines HR and therefore is being affected by balances autonomics with OMT?

Answer 12

Phase 4

Question 13

Smooth muscle tone of the airways is mostly what division of the ANS?

Answer 13

Parasympathetic

Question 14

What is a visceral-visceral reflex they mention in the lecture with the heart and lungs?

Answer 14

Irritation of the pulmonary branches of the vagus nerve produce strong inhibitory reflexes on the heart.

Question 15

Patients with hypertension, what is the overarching problem that we are wanting to treat with our OMT plan?

Answer 15

Hyperactivity of sympathetic division, so we want to inhibit sympathetic activity.

Question 16

What would be a great respiratory circulatory treatment to do for CHF patients?

Answer 16

Rib raising

Question 17

What are we thinking for behavioral with all these cardiac and pulmonary patients?

Answer 17

Monitor fluid and salt intake because of edema and volume overload.

Question 18

What do we always do for arrhythmia patients?

Answer 18

ABC

Question 19

What are the three main goals of treatment for a person with pneumonia?

Answer 19

Reduce congestion, drop sympathetic tone to the parenchyma, and reduce mechanical restriction to the thoracic cage for respiratory motion.

Question 20

What is contraindicated in patients with COPD?

Answer 20

The vacuum thoracic pump lymphatic treatment

Question 21

3 cardiopulmonary considerations when treating patients?

Answer 21

1. Consider indirect treatments over direct
2. Don’t mobilize too much fluid to the center
3. Increasing sympathetic tone will constrict lymph and blood vessels