Chapter 3b Flashcards
What are the four components of body composition
Weight
BMI
Waist Girth
% Body Fat
Where would you put the stethoscope to hear the aortic valve
The second rib interspace on the right side of the patient’s sternum
Where would you put the stethoscope to hear the pulmonic valve
The second rib interspace on the left side of the patient’s sternum
Where would you put the stethoscope to hear the tricuspid valve
The fourth rib interspace on the left side of the patient’s sternum
Where would you put the stethoscope to hear the mitral valve
The fifth rib interspace in the midclavicular line
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
Because we are listening to the sounds of the heart after the valves close
Will S1 or S2 be louder when listening to the mitral and tricuspid area
S1 or lub sound
Will S1 or S2 be louder when listening to the aortic or pulmonic area
S2 or the dub sound
Which valves close first in the heart
mitral and tricuspid
When listening to the heart sounds, auscultate each site for at least ____ seconds
30
If the sounds of the heart are abnormal, use the (diaphragm/bell) side to pick up (low/high) pitch sounds
bell; low
If the sounds of the heart are abnormal, how you should you position your patient?
Lean them forward to allow the chest cavity to fall forward or lay the patient down in left recumbent position
Why is it important to take BP in multiple positions
Quick movements can affect a patient’s BP and we want to check for orthostatic hypertension
When taking BP, the cuff should encircle ___% percent of the patient’s arm
80
What will happen to the BP reading if the BP cuff is too small?
The BP will be higher than normal
What will happen to the BP reading if the BP cuff is too big?
The BP will be lower than normal
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)
heart
low
high
What are normal levels of BP
systolic: less than 120
diastolic: less than 80
What are elevated levels of BP
SBP: 120-129
DBP: Less than 80
What are stage 1 hypertension levels of BP
SBP: 130-139
DBP: 80-90
What are stage 2 hypertension levels of BP
SBP: 140+
DBP: 90+
What are the hypertension crisis levels of BP
SBP: 180+
DBP: 120+
Weight reduction is a modification recommended to prevent hypertension. What should the BMI be and how much would it lower SBP?
BMI: 18.5-24.9
Lowers SBP 5-20
Adopting the DASH eating plan is a modification recommended to prevent hypertension. What are the eating recommendations and how much would it drop SBP
Eat fruits, veggies, and lowfat dairy with reduced fats.
Lowers SBP 8-14
Dietary sodium reduction is a modification recommended to prevent hypertension. What should the sodium levels be at and how much does it lower SBP
No more than 2.4g of sodium will reduce SBP 2-8
Physical activity is a modification recommended to prevent hypertension. How much should someone exercise and how much would it reduce SBP
30 min a day for most days. Lowers SBP 4-9
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
Limit no more than 2 drinks a day for men and 1 drink a day in women. Lowers SBP 2-4
What is an apical pulse and when should this pulse be taken?
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
Where can the apical pulse be found
at the apex of the heart or the 5th intercostal and midclavicular line
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
blood clots
What is the normal respiratory rate for adults
12-20
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
mouth/ zig-zag
A patient may have exercise induced hypoxemia if their O2 saturation decreases greater than __%
5
A therapist should not continue with PT if a patient’s O2 saturation at rest is below ___-___
88-90
When is a pulmonary function test with spirometry recommended?
For all smokers over 45 years old that have SOB, chronic cough, wheezing, or excessive mucus
The FEV1.0/FVC is diminished with (restrictive/obstructive) airway diseases
obstructive
The FEV1.0/FVC is diminished with obstructive airway diseases. List some of the obstructive airway diseases
asthma, bronchitis, emphysema, COPD
The FEV1.0/FVC is normal with (restrictive/obstructive) airway diseases.
restrictive
The FEV1.0/FVC is normal with restrictive airway diseases. List some of the restrictive airway diseases
Kyphoscoliosis, neuromuscular disease, fibrosis, other lung diseases
The term COPD can be used when chronic _____, _____, or both are present and spirometry documents an obstructive defect
bronchitis, emphysema
(Emphysema/bronchitis) occurs when the walls of alveoli are damaged by inflammation and rupture from being overstretched
emphysema
(Emphysema/bronchitis) occurs when the walls of the bronchial tubes thicken and become narrow, often inducing coughing spells
bronchitis
What is the ratio of an individual with barrel chest due to emphysema?
1:1
Normally it is 1:2
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.
nose for 2 seconds
mouth for 4 seconds
What is a normal vital capacity
3-5 L
List some ROM exercises that can improve vital capacity
Rotation and extension of the thoracic spine
UE progression with breathing
Shoulder flexion and deep breathing
What are the four breathing exercises for improving vital capacity
three quick sniffs
triplicate breathing
shoulder shrugs
diaphragm strengthening in supine
How can some cervical SCI patients breath on their own
The diaphragm has its own innervation
Which nerve innervates the diaphragm
The phrenic nerve (C3, C4, C5)
When we assess the lower extremity, what three things do we look at
skin, pulse, and edema
How would you describe +1 pitting edema
barely detectable impression
How would you describe +2 pitting edema
Slight indentation but goes away after 15 seconds to rebound
How would you describe +3 pitting edema
Deeper indentation but goes away after 30 seconds
How would you describe +4 pitting edema
Takes longer than 30 seconds for the edema to rebound
What tool is used to test the sensation of skin, usually on the foot?
monofilament testing
What are the three skin abnormalities discussed in the powerpoint
Tendon xanthoma
Xanthelasma
Skin cancer
Monofilament testing is important to do with patients with ______.
diabetes
Where is Xanthelasma usually located and what does it mean
Deposits show up in the corners of the eyes in people with high cholesterol
After taking a patient’s vitals, what resting HR readings would cause you to not go on with therapy
Below 50 or above 100
After taking a patient’s vitals, what resting BP readings would cause you to not go on with therapy
SBP: Greater than 200 or lower than 90
DBP: Greater than 110
After taking a patient’s vitals, what resting O2 saturation readings would cause you to not go on with therapy
Less than 90%
After taking a patient’s vitals, what resting blood sugar readings would cause you to not go on with therapy
less than 80
Greater than 250 with ketones
Greater than 350 type 1 DM
Greater than 450 type 2 DM
Before exercise testing, participants should refrain from ingesting food, alcohol, or caffeine within ___ hours of testing
3
If exercise testing is for diagnostic purposes, the patient should (continue/discontinue) their medications.
discontinue
If exercise testing is for functional or Ex Rx purposes, the patient should (continue/discontinue) their medications.
continue
