Cardiopulmonary: Study Set 2 Flashcards
9What are the three types of breath sounds that could be heard when auscultating the lungs
vesicular, bronchovesicular bronchial, and absent
(Tracheal and bronchial/vesicular) breath sounds are loud, tubular sounds normally heard over the trachea
Tracheal and bronchial
True or False:
Bronchial sounds heard over distal airways are abnormal because it represents consolidation or compression of lung tissue that facilitates transmission of sound
True, bronchial sounds are heard more proximal over the trachea
(Tracheal and bronchial/vesicular) breath sounds are low pitched, breezy sounds normally heard over the distal airways in healthy lung tissue
vesicular
(Tracheal and bronchial/vesicular) has a shorter inspiratory phase and a longer expiratory phase
tracheal and bronchial
(Tracheal and bronchial/vesicular) breath sounds have a longer inspiratory phase and a shorter expiratory phase
vesicular
(Tracheal and bronchial/vesicular) breath sounds have a small pause between inspiratory phase and expiratory phase
tracheal and broncial
(Tracheal and bronchial/vesicular) breath sounds do not have a pause between the inspiratory phase and expiratory phase
vesicular
Upon auscultating a patient’s lung sounds, you find discontinuous high pitched popping sounds that occur more with inspiration. What is this abnormal sound referred as
crackles
Upon auscultating a patient’s lunch sounds, you find dry crackling sounds directly over the spot your patient is complaining of pain. What is this abnormal sound referred as
pleural friction rub
Upon auscultating a patient’s lunch sounds, you find continuous low pitched sounds that sound similar to snoring or gurgling sounds. What is this abnormal sound referred as
Rhonchi
Upon auscultating a patient’s lunch sounds, you find continuous high pitched wheeze. What is this abnormal sound referred as
stridor
Upon auscultating a patient’s lunch sounds, you find continuous musical sounds that vary in pitch. What is this abnormal sound referred as
wheeze
Upon auscultating a patient’s lunch sounds, you find there are absent lung sounds. What is this idicitative of
pneumothorax aka lung collapse
What does bronchophony mean
increased vocal resonance with greater clarity or loudness of spoken word
like saying 99
what does egophony mean
a form of bronchophony where a long E sound turns into a long nasal sounding A
what does whispered pectoriloquys mean
recognition of whispered words
What are the contraindications for using diaphragmatic breathing
moderate to severe COPD
marked hyperinflation of the lungs without DB movement
pts with paradoxical breathing patterns
pts who need increased muscle effort to perform DB
Pts with increased dyspnea with DB movement
what position should diaphragmatic breathing be done in
semi fowlers
legs extended with upper body/trunk at 30-45 degree incline
(like a patient sitting in a hospital bed)
What is inspiratory muscle training
attempts to strengthen the diaphragm and intercostal muscles by using either resistive breathing or threshold breathing
what is paced breathing
a breathing technique to decrease the work of breathing and prevent dyspnea during activity
what is exhale with effort breathing
a technique that helps prevent someone from holding their breath during activity. Inhale on rests, and exhale during exertion or movement
How should paced breathing and exhale with effort be performed while walking
inhale every two steps and exhale every four
How should paced breathing and exhale with effort be performed while climbing stairs
inhale while standing, exhale while ascending or descending stairs. stay on one stair until inhalation is complete and continue with stairs during expiration only
what is pursed lip breathing
a breathing technique that can be used by anyone with dyspnea by breathing in slowly through the nose for two counts, then breathing out with lips puckered for four counts
what is segmental breathing
used as a breathing technique after surgery and to prevent complications. Pts will either sit or use postural drainage positions. PT will apply firm pressure at the end on exhalation only to assist with secretion removal
What are some position that help relieve dyspnea
sitting down and leaning forward with arm support if available
reverse trendelenburg - head above legs and trunk which reduces weight of abdominal contents on diaphragm
semi-fowlers position with pillows under knees
what is tachycardia/pnea
what is bradycardia/pnea
tachy is fast
brady is slow
what are some contraindications for participating in cardiac rehab
unstable angina
systolic pressure above 200 or diastolic above 110
orthostatic drop of 20 or more
recent embolism
resting ST segment greater than 2
If a patient is participating in exercise at a cardiac rehab facility, the PT should discontinue the activity if the HR goes above ______ bpm or above ____ bpm above the pts resting HR
130, 30
If a patient is participating in exercise at a cardiac rehab facility, the PT should discontinue the activity if the diastolic BP is greater than ____ mmHg or if the systolic BP drops more than ____ mmHg.
110
drops more than 10
During phase I of cardiac rehab, what should the patients RPE stay under on the 6-20 scale
below 13
What is an adequate response in systolic BP with activity
an increase of 10-40bpm
A patient is asking his PT for guidance on how much he should exercise following cardiac surgery. This patient is in phase I of rehab. What is the appropriate response given by the PT
walk 5-10 minutes a day or 1000ft, four times a day
On average, how long does phase one of cardiac rehab last
3-5 days
On average, how long does phase two of cardiac rehab last
Up to 12 weeks
What is the equivalent of 1 MET
3.5 mL O2/kg/min or 1 kcal/kg/h
How long should a patient in phase II of cardiac rehab exercise for
15-20 minutes during the first month
25-30 minutes during the next three or four months
40 minutes or longer after six months
what are the signs and symptoms of heat stroke
dizziness, disorientation, nausea, vomiting, dry skin, hyperventilation
what are the signs and symptoms of heat exhaustion
low bp, wet and pale skin, elevated HR and RR
what are the signs and symptoms of heat syncope
decreased HR and RR, pale skin, vertigo, nausea
What is an angiography
a contrast dye is put into the blood vessels to show the location of plaques in the arteries and the extent of the occlusion
What is a bronchoscopy
a direct visualization of the bronchial tree to identify tumors, bronchitis, bleeding, and foreign bodies
What is a cardiac catheterization
The act of a thin catheter is inserted into an artery in the leg or arm and for it to reach the coronary arteries for a contrast medium to be used like in an angiography
What is a carotid ultrasound
Ultrasound that screens for blockages and can indicate increased risk for stroke. It can also be used to elevate the placement of a stent
What is a computed tomography
known as a CT scan, this machine uses x ray machine that rotates around the patient and takes pictures in slices to create a 3D image
What is an echocardiography
this uses high frequency sound waves to evaluate the function of the heart. This can be done via TTE which in transthoracic and non invasive or TEE which is transesophageal and is invasive but more detailed due to the proximity of the esophagus to the heart
What is fluoroscopy
this is a continuous x ray of the heart and lungs but is not used often due to the high radiation exposure
What is invasive hemodynamic monitoring
this is when intra-arterial and intravenous lines are placed in the heart to monitor blood pressure
What is an MRI used to image in cardiopulmonary PT
size and function of the chambers, the destruction done after a MI or masses in the chest
What is a PET scan
an image test where a small amount of radioactive material is swallowed. The radioactive material accumulates in areas with high levels of chemical activity indicating the presence of cancer or heart disease
What is a thoracentesis
a procedure that includes removal of fluid from the pleural space with a needle for microbiologic cytologic studies
How does a pulse ox work
the sensor measures the light absorbed by oxygenated and deoxygenated hemoglobin, which gives a percentage of partial pressure of oxygen in the arterial blood
In an electrocardiogram, what is the P wave
atrial depolarization
In an electrocardiogram, what is the PR interval
the conduction time from the SA node to the AV node
What is a normal PR interval
0.12 to 0.20 seconds
In an electrocardiogram, what is the QRS complex
ventricular depolarization and atrial repolarization
What is a normal QRS complex
0.06 to 0.10 seconds
In an electrocardiogram, what is the QT interval
The time for ventricular depolarization and repolarization
What is a normal QT interval
between .20 and .40 seconds
In an electrocardiogram, what is the ST segment
isoelectric period when the ventricles are depolarized
In an electrocardiogram, what is the T wave
ventricular repolarization
What is a premature atrial contraction
the atrium initiates an impulse to contract before the SA node, typically due to caffeine, alcohol, smoking, or stress
What is an atrial flutter
very rapid tachycardia with a rate of 250-350 bpm that may indicate MI, heart disease, chronic lung disease, pulmonary emboli
What is atrial fibrillation
the atria are depolarized up to six hundred times per minute
What atrial dysrhythmia does this picture indicate
atrial flutter
What atrial dysrhythmia does this picture indicate
atrial fibrillation
What atrial dysrhythmia does this picture indicate
premature atrial contraction
What is premature ventricular complex
premature depolarization arising in the ventricles due to ectopic focus
What is ventricular tachycardia
three or more premature ventricular contractions with a rate of 150 or more. Pts are not able to maintain bp and become hypotensive
What is ventricular fibrillation
ventricles do not beat in a coordinated fashion resulting in no cardiac output, pt will become unconscious
What ventricular arrhythmia does this picture indicate
premature ventricular contraction
What ventricular arrhythmia does this picture indicate
ventricular tachycardia
What ventricular arrhythmia does this picture indicate
ventricular fibrillation
If a patient has suffered from an MI, the ST segment will be elevated or depressed by ___ mm,
The Q wave will be longer than ___ seconds or ____ larger than the R wave.
The T wave inversion will occur ____ after the event.
ST will be 1-2 mm elevated or depressed
Q wave will be longer than 0.04 or larger than one-third of the R wave
The T wave inversion can occur hours or days after
