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FSBPT > Cardiovascular/Pulmonary System > Flashcards

Cardiovascular/Pulmonary System Flashcards

0
Q

Individuals with a total serum cholesterol >____mg/dl increases the relative risk of developing CAD

A

200

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1
Q

What is the established risk age threshold for males and females for developing CAD?

A

55 years females, 45 years males, males more likely to have CAD

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2
Q

Individuals with HD levels <____mg/dl increases the relative risk of developing CAD

A

40

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3
Q

Is pleural effusion restrictive or obstructive?

A

Restrictive: total lung volume decreased, so FEV1/FVC most likely won’t be affected.

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5
Q

If pt’s exercise program is for weight loss what is the weekly minimum calorie expenditure?

A

2000 kcal/week

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6
Q

Which artery supplies the R atrium?

A

Sinus node

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7
Q

Which artery supplies the R ventricle

A

R marginal

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8
Q

Which artery supplies the inferior walls of both ventricles and IV septum?

A

Post. descending artry

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9
Q

What does the circumflex artery supply?

A

L atrium, L ventricle

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10
Q

Which artery supplies the anterior portion of the IV septum?

A

L anterior descending artery

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11
Q

How does the sympathetic N.S. influence the heart?

A

stimulate chambers to beat faster (chonotropic), and increase the force of the contraction (inotropic effect)

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12
Q

How does the parasympathetic influence the heart?

A

Slow the HR on by acting on SA node

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13
Q

Bainbridge reflex

A

increase in venous return sends vagal signals to medulla which inhibits PS activity, resulting in increased HR

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14
Q

What happens when arterial PPO2 of less than 50mmHg or conditions of acidosis?

A

Stimulates respiratory centers to increase depth and rate of ventilation. Then the para slows down HR and myocardial contractility. If persistent hypoxia, CNS will be directly stimulated and will increase sympathetic activity.

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15
Q

Which white blood cells participate in allergic responses?

A

Eosinophils (also kill parasites and destroy cancer cells) and basophils

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16
Q

Which white blood cells ingest damaged cells?

A

Monocytes

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17
Q

Which white blood cells ingest bacteria?

A

neutrophils

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18
Q

Which ribs articulate with only 1 vertebra?

A

1, 10, 11, 12

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19
Q

The R superior lobar bronchus divides into which 3 segmental bronchi

A

apical, anterior, and posterior

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20
Q

The R middle lobar bronchus divides into which 2 segmental?

A

medial and lateral

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21
Q

The R inferior lobar bronchus divides into which 5 segmental bronchi

A

superior, medial basal, anterior basal, lateral bases, and posterior basal

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22
Q

The anterobasil L segmental corresponds to which 2 R segmental?

A

medial basal, lateral basal

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23
Q

the apical posterior l L segmental corresponds to which 2 R segmental?

A

posterior and apical

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24
Q

Medications to treat dilated cardiomyopathy

A

ACE inhibitors, beta blockers, digoxin, diuretics.

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25
Q

Medications to treat hypertrophic cardiomyopathy

A

Medications to slow the HR and stabilize rhythm, e.g. Lopressor and calcium channel blockers

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26
Q

Medications to treat restrictive cardiomyopathy?

A

diuretics, antihypertensives, and antiarrhythmics.

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27
Q

What is the tetralogy of Fallot?

A

1) ventricular septal defect
2) pulmonary stenosis
3) R ventricular hypertrophy
4) Aorta overriding the ventricular septal defect

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28
Q

What is Cor Pulmonale

A

Hypertrophy of the R ventricle, from chronic R pulmonary circa. resistance.

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29
Q

Arterial hypertension in adults DP and SP, what is it for children?

A

Adults: DP >/=140, SP >/=90
Children: > than the 95th percentile

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30
Q

Which S sound is an early heart sound of hypertension complications?

A

S4

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31
Q

Sever HTN DP value

A

> 120 bpm, can cause confusion, cortical blindness, hemiparesis, seizures

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32
Q

Stage 1 vs Stage 2 hypertension

A

1: 140-159/90-99
2: >/=160/>/=100

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33
Q

Endocarditis vs Myocarditis vs Pericarditis: location, etiology, signs/symptoms

A

Endo: bacteria, can damage heart valves, fever/chills, murmur, SOB, skin petechiae.
Myo: viral or bacterial, arrhythmias, angina, SOB, fever, fatigue
Peri: viral, bacterial, fungal, angina,SOB, dry cough, anxiety, fatigue, fever. The amount of fluid between the 2 layers increases (pericardial effusion) If severe cardiac tamponade (pressure prevents heart from properly filling with blood, sharp drop in BP)

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34
Q

Supervised exercise training for PAD recommendations

A

30-45 minutes, at least 3x/wk, at least 12 weeks.

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35
Q

Rheumatic Fever

A

From untreated strep throat (Strep A)

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36
Q

Etiology of valvular heart disease

A

congenital, calcific degeneration, infective endocarditis, CAD, MI, and rheumatic fever

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37
Q

Acute Respiratory Distress Syndrome: etiology, causes, fatality rate

A

Fluid leaks from the smaller vessels in the lungs, into the alveoli. Fatal in 25-40%. Caused by sepsis, HF, severe pneumonia, serious head/chest injury, drug overdose (e.g. heroin), shock, near drowning, adverse reaction to cancer drugs, prolonged use of large volumes of supplemental O2

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38
Q

Bronchiectasis vs Bronchitis

A

Ectasis: obstructive, abnormal dilation of the bronchus, due to injury of the airways or lung infection
Itis: Inflammation of the bronchi, productive cough for 3 months over the course of 2 consecutive years. Cough worse in morning and in damp weather

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39
Q

What are the 2 main obstructive lung disorders? What happens to lung capacity?

A

Bronquitis and emphysema. Increase in total lung capacity, increase in residual volume.

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40
Q

Signs and symptoms of acute pulmonary edema, call 911?

A

It is life threatening! Extreme SOB, bubbly wheezing, gasping, frothy sputum, cyanosis, rapid irregular pulse, hypotension

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41
Q

Pulmonary fibrosis: restrictive or obstructive, type of cough

A

Restrictive, non-productive cough

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42
Q

RLDs: etiology

A

Abnormal lung parenchyma, eg atelectasis, pneumonia, pulmonary fibrosis, pulmonary edema, ARDS, pleural effusion-fibrosis, pneumothorax, hemothorax

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43
Q

Arterial Blood Gas, mean range of adult normal values, conventional order

A 
In this order
pH: 7.4
PaCO2: 40 (35-45) at sea level
PaO2: 97 at sea level
HCO3-: 24 (22-26) mEq/L
eg. 7.4/40/97/24
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44
Q

Eucapnia, hypercapnia, hypo

A

normal level of PaCo2, to much, too little

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45
Q

Mild hypoxemia value

A

PaO2 of 60-79 mmHG, SPO2 90-95%, if no shift in the oxyhemoglobin curve

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46
Q

Moderate hypoxemia

A

40-59, SPO2 60-80%, if no shift in the oxyhemoglobin curve

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47
Q

Severe Hypoxemia

A

<60%, if no shift in the oxyhemoglobin curve

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48
Q

Hypoxia

A

low level of O2 in the tissue despite adequate tissue perfusion

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49
Q

Which tests specific for MI

A

CK-MB, peaks at 12-24 hours following MI, declines over 2-3 days
Cardiac Troponin-I, remains elevated for 5-7 days

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50
Q

PaCO2 > 45 and pH < 7.4 indicates what?

A

respiratory acidosis

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51
Q

PaCO2 > 45 and pH > 7.4 indicates what?

A

retention of CO2 to compensate for metabolic alkalosis

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52
Q

PaCO2 < 35 and pH > 7.4 indicates what?

A

respiratory alkalosis

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53
Q

PaCO2 < 35 and pH < 7.4 indicates what?

A

retention of CO2 to compensate for metabolic acidosis

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54
Q

HCO3- < 22 and pH < 7.4 indicates what?

A

metabolic acidosis

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55
Q

HCO3- < 22 and pH > 7.4 indicates what?

A

Renal compensation for respiratory alkalosis

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56
Q

HCO3- > 26 and pH > 7.4 indicates what?

A

metabolic alkalosis

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57
Q

HCO3- > 26 and pH < 7.4 indicates what?

A

renal compensation for respiratory alkalosis

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58
Q

Conventional and SI hematology value for erythrocytes:

A

Males: 4.3-5.6 x 10^6/ml (conventional) or 10^12/L
Females: 4.0-5.2

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59
Q

Conventional and SI hematology value for total leukocytes:

A

3.54-9.0 x 10^3/mm^3 or 10^9/L

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60
Q

Conventional and SI hematology value for neutraphils

A

.4-.7 or 40-70%

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61
Q

Conventional and SI hematology value for lymphocytes

A

.2-.5 or %

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62
Q

Conventional and SI hematology value for monocytes

A

.04-.08 or %

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63
Q

Conventional and SI hematology value for eosinophils

A

.0-.06 or %

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64
Q

Basophils

A

.0-.2 or %

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65
Q

Conventional and SI hematology value for platelet count

A

165-415 x 10^3/mm^3 or 10^9/L

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66
Q

Conventional and SI hematology value for PTT

A

26.3-39.4 sec

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67
Q

Conventional and SI hematology value for hematocrit

A

Males: .3388-.464 or %
Females: .354-.444 or %

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68
Q

Conventional and SI hematology value for hemoglobin

A

Males: 13.3-16.3 gm/dL
Females: 12.0-15.8 gm/dL

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69
Q

Conventional and SI hematology value for borderline total serum cholesterol

A

200-239 mg/dL or 5.17-6.20mmol/L

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70
Q

Conventional and SI hematology value for borderline LDL and very high LDL

A

Borderline: 130-159 mg/dL or 3.36-4.12 mmol/L

Very high: >/= 190mg/dl or 4.91 mmol/L

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71
Q

Conventional and SI hematology value for low and high HDL

A

Low: /= 60mg/dL or 1.55 mmol/L

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72
Q

Conventional and SI hematology value for borderline and very high triglycerides

A

Borderline: 150-159mg/dL or 1.7-2.25 mmol/L

>/= 500 mg/dL or 5.64 mmol/L

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73
Q

Which clotting time is more sensitive for detecting minor deficiencies? (PTT or PT)

A

PTT

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74
Q

What is a Holter Monitor?

A

Ambulatory ECG-worn for 24-48 hours to monitor someone

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75
Q

What is electrophysiologic testing?

A

using 3-5 catheters inserted into a blood vessel and threaded to the heart, evaluates the rhythm or electrical conduction abnormalities of the heart, to locate abnormal tissue that causes arrhythmias

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76
Q

Swan-Ganz catheter where? measures what?

A

Pulmonary artery, measures pulmonary artery wedge pressure and L atrial pressure

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77
Q

Thermodilution catheter measures what?

A

cardiac output

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78
Q

CVP line where? measures what?

A

vena cava or R atrium, pressure in either

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79
Q

What is myocardial perfusion imaging?

A

Also known as a radionuclide stress test, injected into blood at rest and at max execs to show how well heart muscle is perfused under these conditions.

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80
Q

What is phonocardiography?

A

makes a graph of heart sounds, supplements auscultation, improves detection of S3 and S4

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81
Q 
Alpha Adrenergic Antagonist Agents:
Action
Indications
Side Effects
Implications for PT
Examples (all end in "   "):
A

Action: reduces peripheral vascular tone by blocking alpha-1-adrenergic receptors
Indications: hypertension, BPH
Side Effects: dizziness, ortho. hypotension, drowsiness
Implications for PT: careful supine to sit/stand
Examples: “osin”Cardura (doxazosin), Minipress (prazosin), Hytrin (terazosin)

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82
Q 
ACE Inhibitor Agents:
Action
Indications
Side Effects
Implications for PT
Examples (all end in "   ")
A

Action: Suppress the enzyme that converts antiotensin I to II, therefore decreases BP and after-load
Indications: HTN, CHF
Side Effects: hypotension, dizziness, DRY COUGH, HYPERKALEMIA
Implications for PT: Avoid sudden changes in posture and with CHF, avoid rapid increases in physical activity.
Examples (all end in “ “): phil Capoten (captorpril), Vasotec (enalapril), Prinivil (lisinopril), Altace (ramipril)

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83
Q 
Angiotensin II Receptor Antagonist Agents:
Action
Indications
Side Effects
Implications for PT
Examples (all end in "   "):
A

Action: Block II receptors which limits vasoconstriction and limits stimulation of vascular tissue
Indications: HTN, CHF
Side Effects: dizziness, BACK AND LEG PAIN, ANGINA
Implications for PT: Minimal
Examples (all end in “ “): arran Cozaar (losartan), Atacand (candesartan), Diovan (valsartan)

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84
Q 
Antiarrhythimic Agents
The 4 Classes, and each's action, which class considered most effective?

Indications
Side Effects
Implications for PT
Examples (all end in “ “)

A

I: Sodium channel blockers, control cardiac excitation and conduction
II: beta blockers, inhibit sympathetic activity
III: prolong repolarization by inhibiting both potassium and sodium channels, most effective.
IV: Calcium channel blockers, depress depolarization and slow conduction through the AV node

Indications: arrhythmias
Side Effects: exacerbation of arrhythmias, hypotension, dizziness
Implications for PT: its should adhere to dosing schedule
Examples (all end in “ “):
I: Quinidine (generic), xylocain (lidocaine)
II: Tenormin (atenolol)
III: Cordarone (amiodarone)
IV: Cardizem (diltiazem”

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85
Q 
Anticoagulant Agents:
Action
Indications
Side Effects
Implications for PT
Examples (all end in "   "):
A

Action: Inhibit platelet aggregation and thrombus formation.
Indications: prevention of embolism
Side Effects: bleeding
Implications for PT: avoid injury
Examples (all end in “ “): Heparin, Coumadin (warfarin), Lovenox (enoxaparin)

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86
Q 
Antihyperlipidemia Agents:
Action
Indications
Side Effects
Implications for PT
Examples (all end in "   "):
A

Action: 5 categories, statins most common, inhibit enzyme action in cholesterol synthesis, and break down LDLs, decrease trig. increase HDL
Indications: hyperlipidemia, atherosclerosis, prevent coronary events in ppl with CAD, diabetes, PVD
Side Effects: headache, GI, MYALGIA, rash
Implications for PT: Exercise good for HDLs
Examples (all end in “ “): Lipitor (atorvastatin) Zocor (simvastatin), Tricor (fenobibrate)

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87
Q 
Antithrombotic Agents
Action
Indications
Side Effects
Implications for PT
Examples (all end in "   "):
A

Action: Inhibit platelet aggregation and clot formation
Indications: post-MI, a-fib, prevent thrombus
Side Effects: bleeding, thrombocytopenia, liver toxicity with use of aspirin, GI
Implications for PT: avoid injury
Examples (all end in “ “): Bayer (aspirin), Plavix (clopidogrel), Persantine (dipyridamole)

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88
Q 
Calcium channel blocker agents: 
Action
Indications
Side Effects
Implications for PT
Examples (all end in "   ")
A

Action: Decrease entry of calcium into vascular smooth muscle, causing vasodilation, decreased myocardial contractions, decreased oxygen demands of the heart.
Indications: HTN, angina, arrhythmias, CHF
Side Effects: dizziness, headache, hypotension, PERIPHERAL EDEMA
Implications for PT: HR and BP response to exercise will be blunted
Examples (all end in “ “) Norvasc (amlodapine) Procardia (nifedipine) Calan (verapamil) Cadizem (diltiazem)

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89
Q

3 types of diuretics, and examples of each

A

Thiazide: Diuril (chlorothiazide)
Loop: Lasix (furosemide)
Potassium-sparing: Dyrenium (triamterene)

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90
Q 
Nitrate Agents:
Action
Indications
Side Effects
Implications for PT
Examples (all end in "   ")
A

Action: decrease ischemia through smooth muscle relaxation and dilation of peripheral vessels
Indications: angina
Side Effects: headache, dizziness, hypotension, REFLEX TACHYCARDIA
Implications for PT: Sublingual administration of nitroglycerin is the preferred method to treat an acute angina attack.
Examples (all end in “ “) Nitrostat (nitroglycerin), Isordil (isosobide dinitrate), Amyl nitrate solution for inhalation.

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91
Q 
Positive Ionotropic Agents
Action
Indications
Side Effects
Implications for PT
Examples (all end in "   ")
A

Action: Increase force and velocity of myocardial contraction, slow HR, and decrease conduction velocity through AV node, and decrease sympathetic NS activation.
Indications: HF, Afib
Side Effects: arrhythmias, GI, dizziness, blurred vision
Implications for PT: Monitor HR during activity, SEEK MD ADVICE FOR HR100
Examples (all end in “ “): Lanoxin (digoxin)

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92
Q 
Thrombolytic Agents:
Action
Indications
Side Effects
Implications for PT
Examples (all end in "   ")
A

Action: Facilitate clot dissolution through conversion of plasminogen to plasmin.
Indications: Acute MI, pulmonary embolism, ischemic stroke, A or V throbosis
Side Effects: intracranial hemorrhage, allergy, arrhythmia
Implications for PT: avoid injury
Examples (all end in “ “): Linlytic (urokinase), Activase (alteplase)

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93
Q

What is amiodarone?

A

Class III Antiarrhythmic Agent (Cordarone)

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94
Q

What is Lovenox?

A

Anticoagulant agent (enoxaparin)

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95
Q

What is digoxin?

A

Positive ionotropic agent (Lanoxin)

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96
Q

What is triamteren?

A

Potassium sparing diuretic (Dyrenium)

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97
Q

What is dipyridamole?

A

Antithrombotic agent (Persantine)

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98
Q

What is diltiazem?

A

Calcium channel blocker agent (Cardizem)

99
Q

What is alteplase?

A

Thrombolytic agent (Activase)

100
Q

What is nifedipine?

A

Calcium channel blocker agent (Procardia)

101
Q

What is Isordil?

A

Nitrate agent (isosorbide dinitrate)

102
Q

What is amlodipine?

A

Calcium channel blocker agent (Norvasc)

103
Q

What is quinidine?

A

Sodium channel blocker (Quinidine-generic is same thing)

104
Q

What is lidocaine?

A

A sodium channel blocker also (Xylocain)

105
Q

What is clopidogrel?

A

Antithrombotic Agent (Plavix)

106
Q

Angiotensin II Receptor Antagonist Agents are gents that end in “ “

A

“sartan”

107
Q

Thrombolytic agents are agents that end in “ “

A

“ase”

108
Q

alpha-1 adrenergic antagonist agents are agents that end in “ “

A

“zosin”

109
Q

Anticoagulant agents are agents that end in “ “

A

“in”

110
Q

ACE inhibitor agents are agents that end in “ “

A

“pril”

111
Q

Calcium channel blocker agents are agents that end in “ “

A

“dipine”

112
Q

What is an artherectomy?

A

similar to an angioplasty except the catheter has a rotating shaver to cut away plaque.

113
Q

What is an AICD?

A

Automatic Implantable Cardioverter-Defibrillator. Similar to a pacemaker but also a defibrillator

114
Q

What is cardiac ablation for?

A

to remove parts of the myocardium that are causing cardiac arrhythmia

115
Q

What is enhanced extracorporeal counterpulsation

A

Inflation of pressure cuff at the LEs to increase venous return

116
Q

NBG Pacemaker Code: I

A 
Chamber paced
V
A
D
O
117
Q

NBG Pacemaker Code: II

A 
Chamber sensed
V
A
D
O
118
Q

NBG Pacemaker Code: III

A 
Response Sensed
T (triggered)
I (inhibited
D
O
119
Q

NBG Pacemaker Code: IV (rate)

A

Rate modulation
R
O

120
Q

NBG Pacemaker Code: IV (multisite)

A 
Multisite Pacing 
V
A
D
O
121
Q

Antihistamines:
Ends in:
Examples

A

“ine”

diphenhydramine, fexofenadine, cetirizine, loratadine

122
Q

Implications for PT for Anti-inflammatory agents that are inhaled: corticosteroids, leukotriene modifiers, mast cell stabilizers.

A

Advise pt to rinse mouth out after use to avoid irritation of local mucosa, advise them that they should not be used to treat acute episodes of asthma as they are not bronchodilators.

123
Q

What is flunisolide?

A

Corticosteroid

124
Q

What is cromolyn sodium?

A

Mast-cell stabilizer

125
Q

What is belomethasone diopropionate?

A

Corticosteroid

126
Q

What is zileuton?

A

Leukotriene modifier

127
Q

What is budesonide?

A

Corticosteroid

128
Q

The 3 primary classifications of bronchodilators

A

Anticholinergic, sympathomimetics, xanthine derivatives

129
Q

What is albuterol?

A

Sympathomimetic

130
Q

What is ipatropium?

A

Anticholinergic

131
Q

What is theophylline?

A

Xanthine derivative

132
Q

What is tiotropium?

A

Anticholinergic

133
Q

What is Aminophylline?

A

Xanthine derivative

134
Q

What is salmeterol?

A

Sympathomimetic

135
Q

What do guaifenesin and terpin hydrate do?

A

Expectorants (gua is Mucinex)

136
Q

What do dornase alpha and acetylcysteine do?

A

Mucolytic Agents

137
Q

What is a bullectomy?

A

Surgical procedure where bullae are removed (formed from destroyed alveoli)

138
Q

Oxygen therapy recommended for pts with PaO2 </= ____ at rest, or _____ _____ in the presence of cor pulmonale or polycythemia

A

55, 88, 56-59, 89

139
Q

The Angina Pain Scale:

A

1 to 4, mild to moderate/bothersome to moderately severe to most severe

140
Q 
ABI interpretation: 
>/= 1.3
1-1.3
.8-.99
.4-.79
<.4
A 
>/= 1.3 indicates rigid arteries and need for U/S to check for PAD
1-1.3 is normal, no blockage
.8-.99 is mild blockage
.4-.79 is moderate
<.4 is severe
141
Q

How slowly should the pressure cuff be deflated when taking BP?

A

2-3 mmHg/sec

142
Q

The 5 phases of BP

A 
I:  First appearance of clear tapping sounds, SBP
II: Sounds become softer and longer
III: Sounds become crisper and louder
IV: Sounds become muffled and softer
V: Sound disappear completely, DBP
143
Q

Prehypertension, Stage 1, and Stage 2 hypertension for kids

A

> /= 90th percentile to 99th plus 5 mmHg

144
Q 
Auscultation of heart sounds:  
Aortic area
Pulmonic area
Mitral
Tricuspid
A

Aortic: 2nd intercostal space at R sternal border
Pulmonic: 2nd ICS at L sternal border
Mitral: 5th IC space, medial to L midclavicular line
Tricuspid: 4th intercostal space at L sternal border

145
Q

What is an S3 sound? Associated with?

A

Vibrations of the distended ventricle during diastole normal in healthy young children (physiologic 3rd HS), in adults may indicate HF (ventricular gallop)

146
Q

What is an S4 heart sound? Associated with?

A

“atrial gallop” pathological, vibration of the ventricular wall with ventricular filling and atrial contraction, may be assoc. with atrial contraction. HTN, stenosis, hypertensive HD, MI,

147
Q

Normal bronchial sounds: is inspiration or expiration longer?

A

Expiration w/ pause between

148
Q

Normal vesicular sounds: is inspiration or expiration longer?

A

Inspiration w/out pause

149
Q

Crackles (formerly called _____) may be associated with which types of respiratory disorders

A

Formerly Rales. Obstructive and restrictive, more often heard during inspiration
Dry or wet, if heard at during the later half of inspiration, represent atelectasis, fibrosis, pulmonary edema, or pleural effusion.

150
Q

Pleural friction rub

A

both insp and exp, when inflamed visceral and parietal pleura rub together.

151
Q

Rhonchi

A

“snoring” or “gurgling”, both insp and exp, caused by air passing through an airway that is obstructed by inflamm. or liquic.

152
Q

Stridor

A

Cont. high-pitched wheeze, insp or exp

153
Q

Wheeze:

A

insp and/or exp, variable from minute-minute/area-area.

154
Q

Bronchial breath sounds

A

Heard in area where vesicular sounds normally present

155
Q

Bronchophony, egophony, whispered pectoriloquy

A

increased clarity of spoken words eg 99, spken E sounds like nasal A, recognition of whispered words 1, 2, 3

156
Q

Underweight adult BMI

A

<18.5

157
Q

Obesity class I BMI

A

30-34.9

158
Q

Normal BMI

A

18.5-24.9

159
Q

Normal capillary refill time

A

<2 secondsq

160
Q

Lymphedema: circumference measurements differences for unaffected/affected limbs

A

Mild: 5

161
Q

Procedure and grading scale for the claudication test

A

Pt walks on flat track at max speed or treadmill at 2mph between 0-12 percent
ICD is initial pain free distance
ACD is maximum distance before terminated due to pain
Grade 1: initial/modest discomfort
2: Mod
3: Intense, pt can’t be diverted from pain
4. Excruciating/unbearable

162
Q

Borg Dyspnea Scale

A

0
3 Moderate
7 Very Severe
10 Maximal

163
Q

Which is the ground electrode for an ECG?

A

R Leg (R side of abdomen)

164
Q

P Wave

A

Atrial depol

165
Q

PR Interval

A

Atrial depol and SA to AV node conduction time .12 to .2s

166
Q

QRS complex

A

ventrical depol .06-.1

167
Q

QT interval

A

ventricular depol and repol .2-.4s

168
Q

ST segment

A

isoelectric period when ventricles depolarized

169
Q

T wave

A

ventricular repolarization

170
Q

What represents contraction of the L ventricle?

A

R

171
Q

What represents contraction of the R ventricle

A

S

172
Q

What represents ventricle relaxation?

A

T wave

173
Q

With a premature ventricular contraction, which wave is usually absent?

A

P wave

174
Q

Bigeminy vs trigeminy?

A

Bi: Sinus pulse followed by PVC
Tri: 2 sinus followed by PVC

175
Q

What defines V-tac?

A

3 or more consecutive PVCs at a ventricular rate of >150 bpm if >30s life-threatening, can turn into v -fib too which causes cardiac arrest.

176
Q

A depressed ST segment can be a result of which 3 things?

A

Subendocardial ischemia, digitalis toxicity, hypokalemia.

177
Q

An elevated ST segment indicates what 2 things?

A

Earliest sign of acute transmural infarction, benign early repolarization pattern in a normal heart,

178
Q

What does a Q wave signify?

A

A characteristic marker of infarction-.4 ms sand larger and 1/3 the amplitude of the R wave.

179
Q

What 4 things can a T wave inversion signify?

A

Hours/days after an MI, or R and L bundle branch blocks, after a CVA, and as a normal juvenile T wave pattern in children and some adults.

180
Q

Absolute indications for terminating an exercise test: 6

A

1) Drop in SBP > 10mmHg with other evidence of ischemia
2) Moderately severe angina (3/4)
3) Increasing NS symptoms such as ataxia and dizziness
4) Signs of poor perfusion (cyanosis, pallor)
5) Sustained v-Tac
6) 1.0 mm ST elevation in leads without diagnostic Q waves

181
Q

Relative indications for terminating an exercise test:

A

1) Drop in SBP >10mmHg from baseline despite increase in workload but without other evidence of ischemia
2) >2 mm ST segment depression
3) Fatigue, SOB, wheezing, leg cramps
4) Development of bundle branch block or IV conduction delay
5) SBP >250 and/or DBP > 115

182
Q

Normal infant and child HR

A

infant: 100-130
Child: 80-100

183
Q

FEV1/FVC <___ % is the primary indicator of an obstructive lung disease

A

70%

184
Q

If SPO2 <____% in patients with chronic lung disease, activity should be stopped

A

90, 85

185
Q

RPP=

A

HR x SBP

An easy to measure physiologic correlate to the onset of angina-ischemia usually occurs at this reproducible value

186
Q

Original and Revise RPE values: very hard/strong

A

17, 7

187
Q

Original and Revise RPE values: very light/weak

A

9, 1

188
Q

Original and Revise RPE values: Somewhat hard/strong

A

13, 4

189
Q

Original and Revise RPE values: Very very hard/strong

A

19, 10

190
Q

Original and Revise RPE values: Hard/strong

A

15, 5

191
Q

Original and Revise RPE values: very very light/weak

A

7, 0.5

192
Q

Original and Revise RPE values: fairly light/moderate

A

11, 3

193
Q

RPE of 13-14 represent about ____% of max HR

A

70%

194
Q

Newborn, 1 y/o, and 10 y/o RR

A

33-45, 25-35, 15-20

195
Q

Biot’s breathing pattern

A

vary in depth and rate with periods of apnea, often associated with increase IC pressure of damage to the medulla

196
Q

Cheyne-Stokes (periodic) breathing pattern

A

decreasing rates and depth with periods of apnea, can occur with CNS damage

197
Q

Kussmaul’s breathing pattern

A

deep and fast, assoc. with metabolic acidosis

198
Q

Increased risk for DM2 etc in women w/ waste circumference of ___cm/___in in men and ___cm/___in

A

102, 40
88, 35
If BMI >35 won’t do much good to do this, know they are already at risk

199
Q

Normal inhalation to exhalation ratio vs obstructive ratio

A

1:2, 1:3/4

200
Q

Active cycle breathing technique-used to be called

A

forced expiratory technique

201
Q

The 3 phases of autogenic drainage

A

Unsticking: exhale at low volume, 2-3 second hold, then exhale down to expiratory reserve
Collecting: Breathe at tidal volume, with interspersed 2-3 second holds
Evacuation: deeper inspirations from low to mid insp. RV, with breath holding followed by a huff.

202
Q

Why would you choose to do a huff instead of a cough for a patient?

A

less potential for airway collapse.

203
Q

All positions contraindicated for postural drainage: 9 reasons

A

1) IC pressure >20
2) Head/neck injury not stabilized
3) recent spinal surgery
4) Hemoptysis
4) Empyema (pus between chest wall and pleura)
5) Bronchopleural fistula (abnormal space between lung and pleura)
6) Pulmonary edema assoc. with CHF
7) Pulmonary embolism
8) Rib Fx
9) Surgical wound

204
Q

Contraindications for Trendelenburg position: 5

A

Feet higher than head

1) HTN (uncontrolled)
2) Distended abdomen
3) Esophageal surgery
4) Recent gross hemoptysis related to lung carinoma treated surgically or with radiation therapy
5) Uncontrolled airway at risk for aspiration

205
Q

Semi-Fowler’s position

A

supine, head/chest elevated to 30 degrees

206
Q

The 2 types of inspiratory muscle training

A

1) Flow resistive breathing: gradual narrow diameter of mouthpiece they have to breathe in.
2) Threshold: build up of negative pressure before flow occurs through a valve that opens at a critical pressure.

207
Q

Phase I cardiac (inpatient) rehab: Discontinue if any of the following adverse responses: Heart rate post surgery, HR post infarction

A

> 130 or >30 above resting HR, if post-infarctions should be <120/20 above resting. also if any ECG signs or symptoms suggestive of ischemia

208
Q

Phase I cardiac rehab: Discontinue if any of the following adverse responses: DBP >/=

A

110 mm Hg

209
Q

Phase I cardiac rehab: Discontinue if any of the following adverse responses: Decrease in SPB > ___

A

10

210
Q

Active upper and LE exercises may begin how long after bypass graft surgery and how long after infarction?

A

1 day, 2 days

211
Q

Phase I cardiac rehab: MET levels, RPE levels

A

1-4 METs, RPE<13

212
Q

Phase I cardiac rehab: Duration of exercises, frequency

A

3-5 minutes, progressing to 10-15 minutes

3-4 times per day first few days, 2 times per day after

213
Q

Phase II (immediate outpatient) cardiac rehab: for low risk pts or pts with known stable CAD, how many ECG/BP monitoring sessions? How many for pts with mod/high risk or unable to self-regulate/understand recommended activity levels?

A

6-12 sessions

Usually >/= 12 sessions

214
Q

A rating of ___ on the angina scale is the recommended end-point to cease activity during Phase I and II cardiac rehab

A

1

215
Q

If angina is not relieved by stopping activity or by ___ sublingual nitroglycerin tablets, take to ED

A

3

216
Q

The exercise target HR should be >/= ____ below the known ischemic or anginal threshold

A

10 bpm

217
Q

Karvonen formula

A

HR reserve: ([HRmax-HRrest] x___%) + HR rest

218
Q

ST elevation/depression of ____ is a contraindication for inpatient and outpatient cardiac rehab, while elevation/depression of ____ is a sign to stop stop activity with pt in cardiac rehab

A

2mm, 1mm

219
Q

An RPE of 12-16 corresponds with ___ to ____ % of max capacity

A

40-85%

220
Q

An RPE of ___ to ___ is appropriate for pts duing initial outpatient cardiac rehab, while ___ to ___ for pts later with no signs of ischemia or dysrhythmias

A

11-13

14-16

221
Q

Phase II (immediate outpatient) cardiac rehab: Duration of exercise

A

15-20 minutes (first month)
25-30 (next 3-4 months)
40+ (after 6 months)
intervals may be appropriate for patients who can’t exercise continuously.

222
Q

Approximate METs: Toileting

A

1-2

223
Q

Approximate METs: light gardening

A

3-4

224
Q

Approximate METs:Washing windows or car

A

3

225
Q

Approximate METs: Cooking

A

2-3

226
Q

Approximate METs: Walking 3mph

A

3-4

227
Q

Approximate METs: Walking 4 mph

A

4.5-7

228
Q

Approximate METs: Jogging 5 mph

A

8

229
Q

Approximate METs: Shoveling

A

7

230
Q

Approximate METs: making bed/washing dishes

A

2

231
Q

Approximate METs: sweeping/vacuuming

A

3-3.5

232
Q

Bathing

A

2-3

233
Q

If exercising in heat, weigh pt, then replace fluids, ____ (amount) for every pound loss

A

1 pint

234
Q

Lung sound: dry crackling sound heard during insp and exp

A

pleural friction

235
Q

Continuous low-pitches sounds resembling snoring or gurgling during insp/exp

A

Rhonchi

236
Q

Continuous high-pitched wheeze heard during insp/ex

A

Stridor

237
Q

Discontinuous high-pitched popping heard during insp

A

crackles

238
Q

Continuous musical or whistling sound composed of a variety of pitches

A

wheeze

239
Q

The radial artery pulse is (medial/lateral) to the flexor carpi radialis tendon,

A

lateral

240
Q

The brachial pulse is (medial/lateral) to the biceps tendon

A

medial

241
Q

The ulnar pulse is between which two tendons?

A

FDS andFCU

242
Q

How is minute volume ventilation calculated?

A

tidal volume x RR

243
Q

Eupnea

A

normal breathing

FSBPT (7 decks)

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