Chpt. 1: Cardiovascular Conditions and Rehabilitation Flashcards
What are 3 major arteries that supply the heart?
- Left Anterior Descending artery(LAD)
- Circumflex artery (irc)
- Right Coronary Artery (RCA)
What is the Vagus (10th cranial) nerve responsible regulating? (Cardiac Innervation)
- Heart rate
- Force of each contraction
- Cardiac output
What autonomic division is the Vagus nerve (10th cranial nerve) related to ?
PNS
What is the Sympathetic Innervation? (3)
- Increases heart rate
- Increases the force of contraction
- “Fight or flight response”
What is an average of BPM?
70 BPM
What is the Parasympathetic Innervation? (3)
- Decreases heart rate
- Reduces force of contraction
- Constricts the coronary arteries
describe heart rate
frequency of the cardiac cycle
What are the 4 vital signs?
- Blood pressure
- heart rate
- respiratory rate
- temperature
Factors affecting heart rate (8)
- Age
- Gender
- Environmental Temperature
- Infection
- Physical Activity
- Emotional Status
- Medications
- Cardiopulmonary Disease
Heart Rate Maximum Calculations
BPM-age= HRmax
(ex. 220 -18=)202
When is the best time to find out your resting heart rate?
Morning
_____ is used to determine one’s training target heart rate zone
Resting heart rate
What are Cardiac Arrythmias?
a group of conditions in which the muscle contraction of the heart is irregular or is faster or slower than normal
-some arrythmias are life threatening
What is Pulse described as?
rate, rhythm and volume
What are some terms used for Pulse? (4)
Strong and Regular
Weak and Regular
Irregular
Thready
What is a pacemaker?
What are they designed to correct?
Sophisticated electronic device that analyzes the function of the heart
-when needed it sends tiny precisely-timed electrical signal to the heart on demand
- bradycardia
- battery life about 8 years
____ is a small device that’s placed in the chest or abdomen and uses electrical pulses or shocks to help control life-threatening arrhythmias
ICD (Implantable Cardioverter Defibrillator)
What is the maximum output for the ICD?
830 volts in a tenth of a second
- to restore the heart rhythm back to normal
What are the ranges for blood pressure in an adult ?
- Systolic between 90 and 135mmHg
- Diastolic between 50 and 90mmHg
Systolic pressure goes up when?
1st pressure you hear
-stress, exercise
Diastolic pressure goes up why?
2nd sound to hear
diseases, conditions
Hypertension?
Hypotension?
Hypertension: too high readings of systolic/diastolic
Hypotension: too low
What is used to measure blood pressure?
Mercury manometer
with cuff
What are Diuretics?
“water pills” because they work in the kidney and flush excess water and sodium from the body
- helps CONTROL BLOOD PRESSURE
What are Beta-blockers ?
reduce nerve impulses to the heart and blood vessels
-(LOWERS BLOOD PRESSURE)
WHat are ACE inhibitors (ACE) ?
- inhibitors prevent the formation of a hormone called angiotensin II, which normally causes blood vessels to narrow. The ACE inhibitors cause the vessels to relax
- LOWERS BLOOD PRESSURE
What are Calcium channel blockers (CCBs) ?
keep calcium from entering the muscle cells of the heart and blood vessels. This causes the blood vessels to relax
- LOWERS BLOOD PRESSURE
What is a Pulse oximetry ?
attached to patients finger/ear lobe
non-invasive method of monitoring the percentage of haemoglobin (Hb) which is saturated with oxygen.
What are Some Cardiac Evaluation Tools? (6)
- History
- Heart rate, pulse and blood pressure
- Auscultation
- Laboratory tests i.e. Chest Xrays EKG, cholesterol, echocardiogram
- Cardiac Stress Testing: Maximal, Sub Maximal
- Fitness Testing
What is Auscultation?
heart reveals the normal audible (HEARING) cardiac cycle, which allows the clinician to assess heart rate, rhythm, and regularity
What is CAD: Coronary Artery Disease? (most common type of heart disease)
occlusion (closing of) of coronary artery leads to an inadequate oxygenation of an area of the heart and leads to a heart attack
-angina is a symptom (pain in chest)
What is angina?
(pain) usually a symptom of CAD; a symptom of an underlying heart problem
Stable angina:
KNOWN: can go away with medication
chest pain during activity or stress
Unstable angina
UNKNOWN: (more serious) warning sign of an impending heart attack
chest pain at rest
What is the most comomon congenital heart defect?
Ventriculoseptal defect (VSD) *hole in heart*
3 tyes of Valve disease?
- Incompetence: poorly functioning
- Stenosis: narrowing
- Valve disease: can affect either the Mitral or Aortic valves
What is Mitral Valve Prolapse ?
displacement of an abnormally thickened mitral valve leaflet into the left atrium during systole (contraction)
___ refers to an enlarged heart due to hypertrophy by overwork
Cardiomegaly
Cor Pulmonale?
enlargement of right side of heart is due to high blood pressure in the pulmonary blood vessels, usually caused by CHRONIC LUNG disease
Congestive Heart Failure (CHF)
symptoms?
heart can’t pump enough blood to the body’s other organs.
–most common signs: swollen legs/ ankles or difficulty breathing.
What is a Coronary Artery Bypass Surgery ?
a procedure to bypass a blocked section of a coronary artery and to deliver oxygen to the heart
Median Sternotomy?
incision into the sternum
**What are 6 Sternal Precautions (after incision) ?
Precautions: for 8 – 12 weeks.
- Avoid reaching behind you
- Avoid reaching out to your side: this does NOT include using grab bars in the bath tub.
- Avoid stretching your arms above your head.
- Avoid heavy lifting (anything over 5 lbs).
- Avoid pushing or pulling more than 5 lbs,.
- Remember, two hands are better than one.
What is the Bruce Protocol?
Sub maximal Cardiac Stress Test
At each “stage” of exercise, the pulse, blood pressure and ECG are recorded, along with any symptoms the patient may be experiencing
A drop of less than ____ beats per minute after maximal exercise has been correlated with a significant increase in mortality*. Healthy Rate Recovery? (HRR)
12
Normal range: 20 BPM
**Heart Rate Reserve (HRR) Calculations:
HRmax-HRest
(220-18) - (60)= 142
difference between a person’s resting heart rate and maximum heart rate
Astrand Cycle Ergometer’s Validity:
correlation to VO2max approximately _____
- 85-0.9 (very close)
- pedal cycle ergometer at a constant workload: HR measured every minute, and the steady state heart rate is then looked up on published tables to determine an estimation of VO2max.
VO2 max?
maximum amount of oxygen in milliliters, one can use in one minute per kilogram of body weight
How can you increase your VO2 max?
work out that raises your heart rate for at least 20 minutes 3/week to raise your HR between 65-85%
ex.- job 3/day
Several factors to be monitoring during CV exercise (5)
- Medical status of the patient
- Contraindications for exercise
- Orthopedic conditions
- Pulse rate
- Respiratory rate
What is Borg Perceived Exertion Scale?
how hard you feel like your body is working during physical acitivity
-a person’s exertion rating may provide a fairly good estimate of the actual heart rate during physical activity
-increase: HR, breathing, sweating, etc.
**What is Target Heart Rate?
How do you calculate it ?
desired range of heart rate reached during Aerobic exercise which enables one’s heart and lungs to receive the most benefit from a workout in a safe way
-calculate by using a range of 50%–85% intensity
**Calculations for Simple THR?
THR = HRmax × %Intensity
ex. 202 x .50= 101
What is the Karvone Method ( similar to simple THR calculations) ?
*its more accurate because it takes into account HRest (if its abnormally high or low)
THR = ((HRmax – HRrest) × %Intensity) + HRrest
When are “Fats mostly burnt? in which “Zone”?
Fitness Zone; 60-70 % max. HR
(DONT KNOW IF NEEDED) What are the 4 types of “Zones?
plus %
- Cardiovascular Training Zones
- Healthy Heart Zone (Warm up: 50-60%)
- Fitness Zone (Fat Burning: 60-70%)
- Aerobic Zone (Endurance Training: 70–80% )
- Anaerobic Zone (Performance Training:80–90% )
- Red Line (Maximum Effort 90-100%)
What is Mediastinum?
Space between the lungs which contains the heart, the aorta, and vena cava
What is Percardium?
visceral layer that encloses the heart
What is the Cardiac Stress Test used for?
to evaluate the heart and vascular system during Exercise or Load; used in diagnosis of Coronary Artery Disease (CAD)
What is the Submaximal Cardiac Stress Test?
patient exercises only until a predetermined level of exercise is attained (used in patients with KNOWN Coronary Artery Disease)
What are the advantages of Astrand Cycle Ergometer?
simple test, mostly accurate and appropriate for ECG monitoring during exercises
What are the Disadvantages of Astrand Cycle Ergometer?
may underestimate the fitness of those with a high maximum heart rate
-and overestimate fitness with advancing age (as max HR reduces with age)
WHat is the MET (metabolic equivalent) ?
the energy (oxygen) used by the body as you sit quietly, perhaps while talking on the phone or reading a book.
Medication that lowers blood pressure
A-B-C-D
Ace-inhibitor
Beta blockers
Calcium
Diaretics
