Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NPTE-PT > Cardiovascular > Flashcards

Cardiovascular Flashcards

1
Q

Right coronary artery

A

supplies right atrium, most of the right ventricle, and in most individuals, the inferior wall of the left ventricle, AV node, and bundle of His; supplies the SA node 60% of the time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Left coronary artery

A

supplies most of the left ventricle; has two main divisions:

  1. left anterior descending
  2. left circumflex artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Left anterior descending

A

supplies the left ventricle and the interventricular septum, and in most individuals, the inferior areas of the apex; it may also give off branches to the right ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Left circumflex artery

A

supplies blood to the lateral and inferior walls of the left ventricle and portions of the left atrium; supplies SA node 40% of the time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which aspect of the heart receives venous blood from the heart?

A

coronary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the impulse rate of the SA node?

A

60 – 100 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the impulse rate of the AV node?

A

40 – 60 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Cardiac Index

A

Cardiac output divided by body surface area; normal is 2.5 - 3.5 L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Ejection Fraction (EF)

A

SV/LVEDP

Normal = >55%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why might someone exhibit an irregular pulse?

A

variations in force and frequency; may be due to arrhythmias or myocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why might someone exhibit a weak, thready pulse?

A

low stroke volume or cardiogenic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why might someone exhibit a bounding, full pulse?

A

shortened ventricular systole and decreased peripheral pressure; aortic insufficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Where is the place to auscultate each of the heart valves?

A
  • aortic: right 2nd intercostal space at the sternal border
  • pulmonic: left 2nd intercostal space at the sternal border
  • tricuspid: left 4th intercostal space at the sternal border
  • bicuspid: right 5th intercostal space at the mid-clavicular border
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do the “lub-dub” sounds signify?

A

“lub” - closure of the tricuspid and mitral valves; marks the beginning of ventricular systole

“dub” - closure of the aortic and pulmonic valves; marks the end of ventricular systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

S3

A

associated with ventricular filling; occurs soon after S2; in older individuals may be indicative of congestive (left ventricular) heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

S4

A

associated with ventricular filling and atrial contraction; occurs just before S1. Indicative of pathology (i.e. CAD, MI, aortic stenosis or chronic hypertension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What conditions can cause arrhythmias?

A

ischemic conditions of the myocardium, electrolyte imbalance, acidosis or alkalosis, hypoxemia, hypotension, emotional stress, drugs, alcohol, caffeine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When are PVCs indicative of a serious cardiac event?

A

> 6 per minute, paired or in sequential runs, multifocal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Ventricular Tachycardia

A

a run of three or more PVCs occurring sequentially; very rapid rate (150-200 bpm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the influence of hyperkalemia on the ECG?

A

widens QRS, flattens P wave, T wave bceoms peaked

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the influence of hypokalemia on the ECG?

A

flattens T wave (or inverts), produces a U wave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the influence of hypercalcemia on the ECG?

A

widens QRS, shortens QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the influence of hypocalcemia on the ECG?

A

prolongs QT interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the influence of hypothermia on the ECG?

A

elevates the ST segment; slows rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the influence of digitalis on the ECG?

A

depresses the ST segment, flattents T wave (or inverts), QT shortens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the influence of quinidine on the ECG?

A

QT lengthens, T wave flattens (or inverts), QRS lengthens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the influence of beta blockers on the ECG?

A

decreases HR, blunts HR response to exercise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the influence of nitrates on the ECG?

A

increases HR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the influence of antiarrhythmic agents on the ECG?

A

may prolong QRS and QT intervals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Mean Arterial Pressure

A

[SBP + ( DBPx2 )] / 3

Normal MAP is 70 - 110 mmHg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

AHA Blood Pressure Guidelines

A

Normal: systolic <120 and/or diastolic <80

Prehypertension: systolic 120-139 and/or 80-89

Stage 1: systolic 140-159 and/or 90-99

Stage 2: systolic ≥160 and/or ≥100

Hypertensive crisis: systolic ≥180 and/or diastolic ≥110

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Pallor

A

an absence of rosy color in light-skinned individuals, associated with decreased peripheral blood flow, PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Rubor

A

dependant redness with PAD

34
Q

Stemmer’s sign

A

dorsal skin folds of the fingers and toes are resistant to lifting; indicative of fibrotic changes and lymphedema

35
Q

What are the three major types of angina?

A
  • stable angina
  • unstable angina
  • variant angina
36
Q

Stable angina

A

occurs at a predictable RPP; relieved with rest

37
Q

Unstable angina

A

unpredictable; difficult to control; chest pain increases in severity, frequency, and duration; refractory to treatment. Increases risk for future MI or lethal arrhythmia; pain is difficult to control

38
Q

Variant angina

A

caused by vasospasm of coronary arteries in the absence of occlusive disease; responds well to nitro or calcium channel blockers long-term

39
Q

What are the three zones associated with a myocardial infarction?

A
  1. zone of infarction
  2. zone of injury
  3. zone of ischemia
40
Q

What would an ECG look like over the zone of infarction?

A

pathological Q wave is present

41
Q

What would an ECG look like over the zone of injury?

A

elevated ST segment is observed

42
Q

What would an ECG look like over the zone of ischemia?

A

T wave inversion is present

43
Q

Left-sided heart failure

A

characterized by pulmonary congestion, edema, and low cardiac output due to the backup of blood from the left ventricle to the left atrium

44
Q

Right-sided heart failure

A

characterized by increased pressure load on the right ventricle with higher pulmonary vascular pressures; mitral valve disease or chronic lung disease; produces hallmark signs of jugular vein distension and peripheral edema

45
Q

Compensated heart failure

A

the heart returns to normal function with reduced cardiac output and exercise tolerance. Achieved by: SNS stimulation, LV hypertrophy, anaerobic metabolism, cardiac dilatation, arterial vasoconstriction, and medical therapy

46
Q

ACE inhibitors

A

inhibit the conversion of angiotensin I to angiotensin II, decreases Na retention and peripheral vasoconstriction in order to decrease blood pressure

47
Q

Angiotensin II receptor blockers

A

blocks binding of angiotensin II at the tissue/smooth muscle level, decreasing blood pressure

48
Q

Nitrates

A

decrease preload through peripheral vasodilation, reduce myocardial oxygen demane, reduce chest discomfort, may also dilate coronary arteries, improve coronary blood flow

49
Q

Beta-adrenergic blocking agents

A

reduce myocardial demand by reducing heart rate and contractility; control arrythymias, chest pain; reduce blood pressure

50
Q

Calcium channel blocking agent

A

inhibit flow of calcium ions, decrease heart rate, decrease contractility, dilate coronary arteries, reduce BP, control arrythmias, chest pain

51
Q

Antiarrhythmias

A

alter conductivity, restore normal heart rhythm, control arrhythmias, improve cardiac output

52
Q

Digitalis

A

increased contractility and decreases heart rate

53
Q

Diuretics

A

decrease myocardial work (reduce preload and afterload), control hypertension

54
Q

Aspirin

A

decreases platelet aggregation, may prevent MI

55
Q

Tranquilizers

A

decrease anxiety, sympathetic effects

56
Q

Hypolipidemia agents

A

reduce serum lipid levels when diet and weight reduction are not effective

57
Q

How long should activity be limited for patients following an MI?

A

should be limited to 5 METs or 70% of age predicted HRmax for 4-6 weeks

58
Q

Heteroptics

A

involves leaving the natural heart and piggybacking the donor heart

59
Q

Orthotopic

A

involves removing the diseased heart and replacing itwith a donor heart

60
Q

Heart and lung transplantation

A

involves removing both organs and replacing them with donor organs

61
Q

What is the grading scale for edema?

A

1+ = mild, barely perceptible indentation; < 1/4 inch pitting

2+ = moderate, easily identified depression; returns to normal within 15 seconds; 1/4-1/2 inch pitting

3+ = severe, depression takes 15-30 seconds to rebound; 1/2-1 inch pitting

4+ = very severe, depression lasts for >30 seconds or more; >1 inch pitting

62
Q

Wells Criteria for DVT

A
  • active cancer (treatment ongoing, or within 6 mo or palliative care) = +1
  • paralysis, paresis, or recent cast immobilization of the lower extremity = +1
  • bedridden recently for > 3 days or longer or major surgery within four weeks = +1
  • localized tenderness along the distribution of the deep venous system = +1
  • entire leg swollen = +1
  • calf swelling at least 3 cm larger than the asymptomatic side = +1
  • pitting edema, confined to the symptomatic side = +1
  • previously documented DVT = +1
  • alternative diagnosis to DCT as likely or more likely = -2
63
Q

Chronic postthrombotic syndrome

A

symptoms include pain, intractable edema, limb heaviness, skin pigmentation changes, and leg ulcers

64
Q

What are the grades of chronic venous insufficiency

A
  • Grade I: mild aching, minimal edema, dilated superficial veins
  • Grade II: increased edema, multiple dilated veins, changes in skin pigmentation
  • Grade III: venous claudication, severe edema, cutaneous ulceration
65
Q

Age predicted maximum heart rate

A

220 - 0.7(age)

66
Q

Submaximal heart rate testing

A

testing is stopped when 85% of maximal heart rate is obtained or patient reports symtoms of ischemia

67
Q

T/F: ST segment, horizontal or downsloping depression, greater than 1 mm below baseline is indicative of myicardial ischemia

A

True

68
Q

How should resistive exercise be prescribed in individuals during a cardiac rehab program?

A

60%-80% of 1 repetition or 10 repetition maximal voluntary contraction

69
Q

When progressing a training program for an individual in cardiac rehab how should you progress?

A

duration of exercises, followed by intensity

70
Q

When should exercise be terminated?

A

Abdolute indications:

  • drop in systolic BP > 10 mmHg with increased workload
  • moderate to severe angina
  • increasing nervous system symptoms (i.e. ataxia, dizziness, near syncope)
  • signs of poor perfusion
  • technical difficulties in monitoring ECG or BP
  • subject’s desire to stop
  • sustained VT
  • ST elevation ≥1.0 mm
71
Q

Relative indications for terminating exercise

A
  • ST or QRS changes
  • arrhythmias other than sustained VT
  • fatigue, shortness of breath, wheezing, leg cramps, or claudication
  • development of bundle branch block that can’t be distinguished from VT
  • increasing chest pain
  • hypertensive response (systolic BP >250 mmHg or diastolic >115 mmHg)
72
Q

What are the absolute contraindications for cardiac rehab?

A
  • acute MI (w/in 2 days)
  • unstable angina not previously stabilized by medical therapy
  • uncontrolled cardiac arrhythmias causing symptoms or hemodynamic response
  • acute PE or pulmonary infarction
  • acute myocarditis or pericarditis
  • acute aortic dissection
73
Q

What are the relative contraindications for cardiac rehab?

A
  • left main coronary stenosis
  • moderate stenotic valvular heart disease
  • electrolyte abnormalities
  • severe arterial hypertension
  • tachyarrythmias or bradyarrhythmias
  • hypertrophic cardiomyopathy and other forms of outflow tract obstruction
  • mental or physical impairment leading to inability to exercise adequately
  • high-degree AV block
74
Q

Cardiac Rehab: Phase 1

A
  • low-intensity (2-3 METs), progressing to ≥5 METs by discharge
  • limited to 70% max HR and/or 5 METs until 6 weeks post-MI
75
Q

Cardiac Rehab: Phase 2

A
  • 2-3 sessions per week
  • 30-60 minutes with 5-10 minutes of warm-up and cool-down
  • suggested exit point: 9 MET functional capacity
  • strength training is initiated after 3 weeks of cardiac rehab, 5 weeks post-MI, or 8 weeks s/p CABG
76
Q

Cardiac Rehab: Phase 3

A
  • entry level criteria: functional capacity of 5 METs, clinically stable angina, medically controlled arrhythmia
  • progression to 50%-85% of functional capacity 3-4 times per week, 45 minutes of more/session
  • regular medical check ups and periodic ETT generally required
  • discharge typically in 6-12 months
77
Q

Strength training for patients during cardiac rehab

A
  • start with low resistance (one set of 10-15 reps); progress slowly
  • weights, 50% of more of maximum weight used to complete 1 RM
  • RPE should not exceed 11-13
  • RPP should not exceed that prescribed during endurance exercise
78
Q

Signs of decompensated heart failure

A
  • increased SOB, sudden weight gain, increased LE edema or abdominal swelling, increased pain or fatigue, pronounced cough, lightheadedness or dizziness
79
Q

Signs of decompensated heart failure

A
  • increased SOB, sudden weight gain, increased LE edema or abdominal swelling, increased pain or fatigue, pronounced cough, lightheadedness or dizziness
80
Q

Walking program guidelines for arterial insufficiency

A
  • intensity such that patient report 1 on claudication scale after 3-5 minutes, stopping if they reach a 2 (until pain subsides), total of 30-60 minutes, 3-5 days per week
  • record time of onset and duration

NPTE-PT (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions