Chapter 3b

Question 1

What are the four components of body composition

Answer 1

Weight
BMI
Waist Girth
% Body Fat

Question 2

Where would you put the stethoscope to hear the aortic valve

Answer 2

The second rib interspace on the right side of the patient’s sternum

Question 3

Where would you put the stethoscope to hear the pulmonic valve

Answer 3

The second rib interspace on the left side of the patient’s sternum

Question 4

Where would you put the stethoscope to hear the tricuspid valve

Answer 4

The fourth rib interspace on the left side of the patient’s sternum

Question 5

Where would you put the stethoscope to hear the mitral valve

Answer 5

The fifth rib interspace in the midclavicular line

Question 6

Why do we auscultate the aortic area on the right side of the body and the pulmonic area on the left side of the body when those valves are switched inside the body

Answer 6

Because we are listening to the sounds of the heart after the valves close

Question 7

Will S1 or S2 be louder when listening to the mitral and tricuspid area

Answer 7

S1 or lub sound

Question 8

Will S1 or S2 be louder when listening to the aortic or pulmonic area

Answer 8

S2 or the dub sound

Question 9

Which valves close first in the heart

Answer 9

mitral and tricuspid

Question 10

When listening to the heart sounds, auscultate each site for at least ____ seconds

Answer 10

30

Question 11

If the sounds of the heart are abnormal, use the (diaphragm/bell) side to pick up (low/high) pitch sounds

Answer 11

bell; low

Question 12

If the sounds of the heart are abnormal, how you should you position your patient?

Answer 12

Lean them forward to allow the chest cavity to fall forward or lay the patient down in left recumbent position

Question 13

Why is it important to take BP in multiple positions

Answer 13

Quick movements can affect a patient’s BP and we want to check for orthostatic hypertension

Question 14

When taking BP, the cuff should encircle ___% percent of the patient’s arm

Answer 14

80

Question 15

What will happen to the BP reading if the BP cuff is too small?

Answer 15

The BP will be higher than normal

Question 16

What will happen to the BP reading if the BP cuff is too big?

Answer 16

The BP will be lower than normal

Question 17

When taking blood pressure, the patient’s arm should be held at ____ level. If it is too high, the BP reading will be too (high/low). If the level is too low, the BP reading will be too (high/low)

Answer 17

heart
low
high

Question 18

What are normal levels of BP

Answer 18

systolic: less than 120
diastolic: less than 80

Question 19

What are elevated levels of BP

Answer 19

SBP: 120-129
DBP: Less than 80

Question 20

What are stage 1 hypertension levels of BP

Answer 20

SBP: 130-139
DBP: 80-90

Question 21

What are stage 2 hypertension levels of BP

Answer 21

SBP: 140+
DBP: 90+

Question 22

What are the hypertension crisis levels of BP

Answer 22

SBP: 180+
DBP: 120+

Question 23

Weight reduction is a modification recommended to prevent hypertension. What should the BMI be and how much would it lower SBP?

Answer 23

BMI: 18.5-24.9

Lowers SBP 5-20

Question 24

Adopting the DASH eating plan is a modification recommended to prevent hypertension. What are the eating recommendations and how much would it drop SBP

Answer 24

Eat fruits, veggies, and lowfat dairy with reduced fats.

Lowers SBP 8-14

Question 25

Dietary sodium reduction is a modification recommended to prevent hypertension. What should the sodium levels be at and how much does it lower SBP

Answer 25

No more than 2.4g of sodium will reduce SBP 2-8

Question 26

Physical activity is a modification recommended to prevent hypertension. How much should someone exercise and how much would it reduce SBP

Answer 26

30 min a day for most days. Lowers SBP 4-9

Question 27

Moderation of alcohol is a modification recommended to prevent hypertension. What should the intake levels of alcohol be and how much would it lower SBP

Answer 27

Limit no more than 2 drinks a day for men and 1 drink a day in women. Lowers SBP 2-4

Question 28

What is an apical pulse and when should this pulse be taken?

Answer 28

It is when you auscultate the heart to get a pulse because the radial pulse very low or the patient has a condition that would make taking normal HR hard

Question 29

Where can the apical pulse be found

Answer 29

at the apex of the heart or the 5th intercostal and midclavicular line

Question 30

If you have to find an apical pulse on an individual without tremors, what could possibly be the cause of such a low heart rate

Answer 30

blood clots

Question 31

What is the normal respiratory rate for adults

Answer 31

12-20

Question 32

When listening to lungs sounds, the patient should be breathing out of their (nose/mouth) and the PT should be moving the stethoscope in a ______ pattern

Answer 32

mouth/ zig-zag

Question 33

A patient may have exercise induced hypoxemia if their O2 saturation decreases greater than __%

Answer 33

5

Question 34

A therapist should not continue with PT if a patient's O2 saturation at rest is below ___-___

Answer 34

88-90

Question 35

When is a pulmonary function test with spirometry recommended?

Answer 35

For all smokers over 45 years old that have SOB, chronic cough, wheezing, or excessive mucus

Question 36

The FEV1.0/FVC is diminished with (restrictive/obstructive) airway diseases

Answer 36

obstructive

Question 37

The FEV1.0/FVC is diminished with obstructive airway diseases. List some of the obstructive airway diseases

Answer 37

asthma, bronchitis, emphysema, COPD

Question 38

The FEV1.0/FVC is normal with (restrictive/obstructive) airway diseases.

Answer 38

restrictive

Question 39

The FEV1.0/FVC is normal with restrictive airway diseases. List some of the restrictive airway diseases

Answer 39

Kyphoscoliosis, neuromuscular disease, fibrosis, other lung diseases

Question 40

The term COPD can be used when chronic _____, _____, or both are present and spirometry documents an obstructive defect

Answer 40

bronchitis, emphysema

Question 41

(Emphysema/bronchitis) occurs when the walls of alveoli are damaged by inflammation and rupture from being overstretched

Answer 41

emphysema

Question 42

(Emphysema/bronchitis) occurs when the walls of the bronchial tubes thicken and become narrow, often inducing coughing spells

Answer 42

bronchitis

Question 43

What is the ratio of an individual with barrel chest due to emphysema?

Answer 43

1:1 | Normally it is 1:2

Question 44

When a patient is doing pursed lip breathing, they should breath in through the (mouth/nose) for ___ seconds and out through the (mouth/nose) for ___ seconds.

Answer 44

nose for 2 seconds | mouth for 4 seconds

Question 45

What is a normal vital capacity

Answer 45

3-5 L

Question 46

List some ROM exercises that can improve vital capacity

Answer 46

Rotation and extension of the thoracic spine UE progression with breathing Shoulder flexion and deep breathing

Question 47

What are the four breathing exercises for improving vital capacity

Answer 47

three quick sniffs triplicate breathing shoulder shrugs diaphragm strengthening in supine

Question 48

How can some cervical SCI patients breath on their own

Answer 48

The diaphragm has its own innervation

Question 49

Which nerve innervates the diaphragm

Answer 49

The phrenic nerve (C3, C4, C5)

Question 50

When we assess the lower extremity, what three things do we look at

Answer 50

skin, pulse, and edema

Question 51

How would you describe +1 pitting edema

Answer 51

barely detectable impression

Question 52

How would you describe +2 pitting edema

Answer 52

Slight indentation but goes away after 15 seconds to rebound

Question 53

How would you describe +3 pitting edema

Answer 53

Deeper indentation but goes away after 30 seconds

Question 54

How would you describe +4 pitting edema

Answer 54

Takes longer than 30 seconds for the edema to rebound

Question 55

What tool is used to test the sensation of skin, usually on the foot?

Answer 55

monofilament testing

Question 56

What are the three skin abnormalities discussed in the powerpoint

Answer 56

Tendon xanthoma Xanthelasma Skin cancer

Question 57

Monofilament testing is important to do with patients with ______.

Answer 57

diabetes

Question 58

Where is Xanthelasma usually located and what does it mean

Answer 58

Deposits show up in the corners of the eyes in people with high cholesterol

Question 59

After taking a patient's vitals, what resting HR readings would cause you to not go on with therapy

Answer 59

Below 50 or above 100

Question 60

After taking a patient's vitals, what resting BP readings would cause you to not go on with therapy

Answer 60

SBP: Greater than 200 or lower than 90 DBP: Greater than 110

Question 61

After taking a patient's vitals, what resting O2 saturation readings would cause you to not go on with therapy

Answer 61

Less than 90%

Question 62

After taking a patient's vitals, what resting blood sugar readings would cause you to not go on with therapy

Answer 62

less than 80 Greater than 250 with ketones Greater than 350 type 1 DM Greater than 450 type 2 DM

Question 63

Before exercise testing, participants should refrain from ingesting food, alcohol, or caffeine within ___ hours of testing

Answer 63

3

Question 64

If exercise testing is for diagnostic purposes, the patient should (continue/discontinue) their medications.

Answer 64

discontinue

Question 65

If exercise testing is for functional or Ex Rx purposes, the patient should (continue/discontinue) their medications.

Answer 65

continue