Cardiopulmonary: Study Set 3 Flashcards
What are absolute indications to terminate an exercise stress test.
drop in SBP greater than ten mm Hg
mod angina - 3 on a scale of 4
increasing ataxia, dizziness, etc.
signs of cyanosis or pallor
sustained ventricular tachycardia - fast HR
how long is a normal PR interval
.12 to .2
what is a normal QRS interval
.O6 to .1O
What does homan’s sign testing for and how do you perform it
DVT
passively DF the foot at the ankle with the knee straight
What are the two major principles of exercise training that are applied to aerobic exercise training
overload principle and specificity
overload - a tissue must be exposed to a stress or load greater than normal to improve its function
specificity - long term adaptations to the metabolic and physiologic systems derived from exercise are specific to the exercises performed and the muscles involved.
What are the two methods of determining the level of intensity to set aerobic exercise training
Taking the upper and lower limits of
HR max and
HR reserve or Karvonen formula
What is the formula of finding the upper and lower limits of HR max
HRmax x 55% and HRmax x 90%
What is the formula for finding the upper and lower limits for HR reserve
[(HRmax - HR rest) x 40%] + HR rest
[(HRmax - HR rest) x 85%] + HR rest
True or False
When it comes to prescribing aerobic exercise, the intensity is dependent on the duration.
FALSE
the duration is dependent on the intensity.
how long should low intensity exercise be done for
greater than thirty minutes
how long should high intensity exercise be done for
twenty minutes or longer.
what intensity and duration for aerobic exercise is recommended for adults not competing in athletic competition
moderate intensity over longer duration.
How frequent should someone participate in aerobic exercise
3-5 times a week
What are normal cardiorespiratory responses to acute aerobic exercise
increase in blood flow and RR and tidal volume
linear increase in SBP with workload - 8 to 10 mmHg per MET
no change or moderate decrease in DBP
True or False
A stronger pulse will be felt when there is increased stroke volume
true
what fingers are used to asses peripheral arterial pulses
index or middle finger
How long should you count pulses when palpating peripheral arterial pulses in someone with regular rhythms and irregular rhythms
regular - count for 15 sec and multiply by four
irregular - count for sixty seconds
Where should you palpate to find the carotid pulse
the medial aspect of the SCM in the lower half of the neck
Where should you palpate to find the brachial pulse
medial to the biceps tendon and lateral to the medial epicondyle of the humerus
Where should you palpate to find the radial pulse
at the wrist lateral to the flexor carpi radialis tendon
Where should you palpate to find the ulnar pulse
at the wrist, between the flexor digitorum superficialis and the flexor carpi ulnaris tendons
Where should you palpate to find the femoral pulse
in the upper thigh, one third of the distance from the pubis to the anterior superior iliac crest
Where should you palpate to find the popliteal pulse
in the popliteal space of the posterior knee
Where should you palpate to find the posterior tibial pulse
in the space between the medial malleolus and the achilles tendon, above the calcaneus
Where should you palpate to find the Dorsalis pedis
Near the center of the long axis of the foot between the first and second metatarsal bones
What are the normal heart rates of
1. an infant
2. a child
3. adult
4. bradycardia
5. tachycardia
- an infant - 100 to 130
- a child - 80 to 100
- adult - 60 to 100
- bradycardia - less than 60
- tachycardia - more than 100
How would you grade the volume or amplitude of pulses
3+ for large or bounding pulses
2+ for normal
1+ small or reduced pulses
0 for absent pulses
if a PT wanted to auscultate the aortic valve, where would they place the stethoscope
2nd intercostal space at the right sternal border
if a PT wanted to auscultate the pulmonic valve, where would they place the stethoscope
2nd intercostal space at the left sternal border
if a PT wanted to auscultate the mitral valve, where would they place the stethoscope
5th intercostal space medial to the left midclavicular line
if a PT wanted to auscultate the tricuspid valve, where would they place the stethoscope
4th intercostal space at the left sternal border
what heart valves close to produce S1
mitral and tricuspid
what do s1 heart sounds sound like
high frequency sound with lower pitch and longer duration
what do s2 heart sounds sound like
high frequency sound with higher pitch and shorter duration
what heart valves close to produce S2 heart sounds
aortic and pulmonary
S3 heart sounds are known as (atrial/ventricular) gallop and S4 heart sounds are known as (atrial/ventricular)
S3 are ventricular
S4 are aortic
True or false
s3 heart sounds are normal in children but are abnormal in adults and is associated with heart failure.
true
True or false
heart murmurs are longer in duration than the heart sounds
true
What is an atherectomy
a surgical procedure similar to a balloon angioplasty except it has a rotating shaver to cute away plaque from the artery and increase blood flow
what is an automatic implantable cardioverter-defibrillator -AICD
another version of a pacemaker
what is a balloon angioplasty
inserting a balloon tipped catheter into an artery to expand is and decrease plaque build up
what is a balloon valvuloplasty
this is like a balloon angioplasty except its for the walls of stenotic heart valves
what is a cardiac ablation
this is a sx procedure that uses chemicals or radio frequencies to burn off areas of the myocardium that have been causing cardiac arrhythmias
What type of cardiac arrhythmia are cardiac ablation used for
tachycardia in which medicine isn’t helping or in wolff parkinson white syndrome
What is a cardioversion
electrical shocks are given through a diffibrillator and electrodes on the chest to restore normal heart rhythm for tachyarrhythmias
What is enhanced extracorporeal counterpulsation - EECP
pressure cuffs around the ankles are inflated to compress the veins and arteries with venous return to the heart
What is a VAD or ventricular assist device
a pump is placed in the chest to provide mechanical support to the ventricle. Typically used while a pt is waiting for a heart transplant or is permanently used for those with heart failure.
What is a bullae and what is a bullectomy
a bullae is a large air space that is created after alveoli are destroyed secondary to emphysema.
a bullectomy remove the bullae and improve breathing
what is lobectomy
removal of a lob of one lung
What pt conditions are at the top of the list to receive a lung transplant
end stage COPD
cystic fibrosis or pulmonary fibrosis
other serious lung diseases with no serious comorbidities
What is a lung volume reduction surgery
a sx procedure in which a portion of the lung is removed after it has been damaged by emphysema. this helps create space for the rest of the diaphragm to work more efficiently
When is oxygen therapy indicated
In patients with oxygen saturation less than 88% or with a PaO2 of 55mmHg or less
