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Cardio ROUND 2 > CP 2 > Flashcards

CP 2 Flashcards

1
Q

What branch of the left coronary artery supplies the L arterium, L ventricle (anterior, lateral, posterior, and some inferior)

A

Circumflex artery

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2
Q

Cardiac conduction system

A

Sa node to av node to bundle of his to purkinje fibers

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3
Q

Forced expiration against a closed glottis produces increased intrathoracic pressure, increased central venous pressure, and decreased venous return know as ?

A

Valsalva maneuver - the resultant decrease in CO and blood pressure is sensed by baroreceptors, which reflexively increase HR and myocardial contractility through sympathetic stim.

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4
Q

Once the glottis opens following a valsalva maneuver what happens

A

Venous return increases and so does the blood pressure, causing the baroreceptors to reflexively decrease the HR through the parasympathetic efferent pathway

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5
Q

Contraction of the external and internal interconstals muscles does what

A

Elevates the ribs during INSPIRATION

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6
Q

Four muscles of expiration

A

Rectus abdominis, external oblique, internal oblique, and transverse abdominis

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7
Q

Carina is at the level of

A

T4 and sternal angle

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8
Q

What sympathetically innervates the smooth muscles or the bronchi and pulmonary blood vessels

A

Post ganglionic sympathetic fibers. Parasympathetic is via vagus nerve

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9
Q

What structure increases ventilation by responding to increases in partial pressure of CO2 and hydrogen ion

A

Central chemoreceptors in the medulla

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10
Q

What structures respond to hypoxia by increasing ventilation

A

Peripheral chemoreceptors in carotid bodies

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11
Q

Pain at the navel, abdominal and/or LBP

A

Abdominal Aneurysm

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12
Q

Sudden severe headache, vomiting, stiff neck, seizure

A

Cerebral aneurysm

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13
Q

A congenital heart disease where the foramen ovale fails to shut leaving a hole between the R and L atria allowing blood to bypass the lungs

A

Atrial septal defect

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14
Q

A congenital heart disease in which the ductus arteriosus, which normally shunts blood from the pulmonary artery directly to the aorta in utero does not close after birth

A

Patent ductus arteriosus causes back flow of from aorta to the PA then to lungs. If left untreated will cause lung damage, heart failure and pulmonary hypertension

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15
Q

A congenital heart defect where there’s a hole in the septum separating the right and left ventricles.

A

Ventricular septal defect VSD- can cause r sided heart failure, cyanosis, rapid HR

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16
Q

Tetralogy of fallot four defects

A

Ventricular septal defect, pulmonary stenosis, right ventricular hyper trophy, aorta overriding the ventricular septal defect

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17
Q

Antihistamine action and side effect

A

Blocks the effects of histamine resulting in a decrease in nasal congestion, mucosal irritation and symptoms of common cold or allergy … May side effect is postural hypotension !!!

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18
Q

Anti inflammatory agents corticosteroid inhaler implication for PT

A

Instruct pt to rinse mouth with water after use to avoid irritation of local mucosa and advise them that these should not substitute Bronchodilators during acute asthma attack

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19
Q

What is heart sound is heard at the onset of diastole

A

S2

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20
Q

What is heard when vibrations of longer duration than the heart sound occur due to disruption of blood flow past a stenotic or regurgitating valve

A

Murmur

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21
Q

Lung sound auscultation with bell or diaphragm

A

Diaphragm- start at the apices and work downward, pt breathe in through mouth a little deeper than usual

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22
Q

Sudden opening and closing of airways

A

Dry crackles

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23
Q

Sound heard due to movement of fluid or secretions during inspiration

A

Wet crackles

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24
Q

Child and adolescent BMI in the 95th percentile or great is considered

A

Overweight or obese

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25
Q

For circumferential measurements how many sites per extremity are recommended

A

7

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26
Q

Procedure for claudication test

A

Pt walks on a flat track at max speed or on a treadmill at 2.0 mph at a constant grade between 0-12 %

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27
Q

Initial claudication distance

A

Pain free walking

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28
Q

Absolute claudication distance

A

Max distance walked when test had to be terminated due to pain

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29
Q

One small box amount of time?

A

.04 secs

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30
Q

One large box is

A

.2 secs- 1 second -5 large boxes

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31
Q

How many boxes in a 6 sec strip

A

30

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32
Q

Memorization method procedure

A

Find a qrs complex where the R hits directly on a dark line. The following dark line is 300, next dark line is 150-100-75-60-50

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33
Q

Rapid arterial depolarization from one foci

A

A flutter. Many p waves

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34
Q

Quivering of atrial with absent p wave

A

A fib

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35
Q

Controlled a fib

A

hr

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36
Q

Uncontrolled a fib

A

Hr >100

Monitor vital closely

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37
Q

Prolonged pr interval (longer than 3-5 cubes)

A

1st degree heart block - asymptomatic (no impact on co)

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38
Q

Progressive prolongation of PR interval until one impulse doesn’t get through

A

Second degree heart block - asymptomatic and rarely progresses to other blocks BENIGN

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39
Q

Blocked conduction of one impulse to ventricles, making qrs miss a beat

A

Second degree heart block type II- drop in CO and Can progress to Complete Heart Block

40
Q

No impulses from above the ventricle are conducted through AV node. No communication between atria and ventricles, so no relationship between p wave and qrs

A

Third degree heart block- medical emergency

41
Q

PVC are more dangerous when

A

Couplets, multifocal, > 6/minute, triplets – May progress to V tach or V fib

42
Q

3 or more PVC in a row

A

Vtach - Cardiac output greatly affected ***Emergency

43
Q

Quivering ventricles causing no CO

A

V fib

44
Q

Non q wave mi

A

Sub endocardial more likely to reinfarct

45
Q

Earliest sign of acute transmural infraction

A

ST elevation

46
Q

A sign of subendocardial ischemia

A

ST segment depression

47
Q

A characteristic marker of infraction signifying a loss of positive electrical voltages due to necrosis

A

Q wave

48
Q

6 absolute indications for terminating an exercise test

A

10 mmhg drop or greater in SBP with other evidence if ischemia, moderately severe angina (3/4), increasing nervous system symptoms( ataxia, dizziness), signs of poor perfusion ( cyanosis, pallor), sustained vtach, 1.0 mm ST elevation

49
Q

Relative indications for terminating an exercise test

A

Drop Sbp >10 mm hg from baseline without other evidence of ischemia, >2 mm ST segment depression, arrhythmias (multi focal PVCs, supra ventricular tachycardia, heart block or Brady arrhythmias), fatigue claudication, inc chest pain, hypertensive response ( Sbp >250 mm hg, dbp > 115 mm hg)

50
Q

Radial pulse location

A

Lateral to the flexor Capri radialis tendon

51
Q

Femoral pulse point

A

One third of the distance from the pubis to the asis

52
Q

Dorsalis pedis pulse point

A

Near the center of the long axis of the foot, between the first and second metatarsals

53
Q

Inferred from spirometry when FVC is reduced and fev1/FVC is normal or >80%

A

Restrictive impairment

54
Q

Percent of arterial oxygen saturation (spo2) of hemoglobin is measure via

A

Pulse oximetry

55
Q

RPP (25.5 x 10^3) is useful for guiding exercise prescription because

A

Keeping the intensity below the RPP will reduce the risk of developing ischemia/angina

56
Q

Irregular breathing c periods of apnea due to damage to the medulla or inc intrathoracic cranial pressure

A

Biots pattern

57
Q

Deep and fast breathing often associated c metabolic acidosis

A

Kussmaul’s breathing pattern

58
Q

Chronic adaptations to aerobic exercise for BP and blood lactate

A

Slight increase at max exercise and slight decrease at submax exercise

59
Q

Active cycle breathing procedure

A

Breath control ie diaphragmatic breathing - thoracic expansion ie 3-4 slow, deep inhalations to inspiratory reserve with passive exhalation combined with chest percussion, vibration, or shaking- forced expriratory technique ie 2-3 huff cough combined c brisk adduction of the upper arms

60
Q

Autogenic drainage procedure

A

Unsticking phase- slow, low breathing c breath hold for collateral ventilation, the exhale into expiratory ERV—- collection phase- breathe at tidal volume, interspersed breath holds —– evacuation phase- deeper inspiration from low-to- mod inspiration reserve volume, c breath holding followed by a huff

61
Q

Acapella and flutter are handheld devices that combine positive expiratory pressure and high frequency vibration to mob mucus in the airway. What is the procedure?

A

Inhale slowly 75% of full breath — hold for 2-3 secs—exhale through device for 3-4 secs— repeat 10-20 breaths— remove device and perform 2-3 coughs or huff coughs

62
Q

Percussion for how long in postural drainage position?

A

2-3 min

63
Q

Vibrations take place c tightened hand one on top of the other, during?

A

Exhalation

64
Q

Cough or huff cough should take place after ____ vibrations

A

2-3

65
Q

Procedure for Threshold IMTs

A

Measure the pt’s max inspiratory pressure MIP with a manometer – begin training at 30-40% of pt’s MIP, the pt breathes against the resistance at TV for 5-15 mins, 2-3 x per day— progress in small increments until the training load reaches 40-60% of MIP

66
Q

PFLEX IMT procedure

A

Begin at 30-40% level of MIP for 10-15 min daily, gradually inc to 20-30 min, once pt can do 30 min at one setting inc the resistance

67
Q

Which breathing exercise is indicated for a pt with dyspnea at rest or activity, or inefficient breathing pattern during activity

A

Pacing

68
Q

Expected outcomes of pacing

A

Ability to time easy component of task with inhalation and the more strenuous component with exhalation

69
Q

Technique to reduce RR and prevent airway collapse

A

Pursed lip breathing

70
Q

Respiratory technique during which PT applies a firm pressure at the end of exhalation on the pt’s chest wall overlying the area to be expanded. Then the pt inhales deeply and slowly expanding the rib cage under PTs hand

A

Segmental breathing / thoracic expansion

71
Q

Respiratory exercise used for atelectasis, restricted lung disease associated c SCI, or dec intrathoracic lung volume

A

Sustained max inhalation c incentive spirometry vs IMTrainers are just for poor inspiratory muscle strength

72
Q

Sustained max inhalation c incentive spirometry procedure

A

Hold in a vertical position- have pt exhale completely, then breath in slowly and deeply through the mouth raising the ball of the spirometer– encourage pt to move diaphragm not upper chest while inspiring — hold breath for at least 3 sec— do 5-10 breathes per hour when awake

73
Q

Phase I cardiac rehab active exercises progress from sitting to standing, ambulation, stairs. What is the appropriate MET range?

A

1-4 METS

74
Q

Phase I cardiac rehab intensity prescription (RPE, and HR )

A
75
Q

Phase I cardiac rehab active exercise direction

A

Intermittent bouts of 3-5 min, progressing to 10-15 mins of continuous activity .. Multiple time per day

76
Q

How many sessions of medical and ECG monitoring are required for a pt with low risk and known stable CAD

A

6-12 sessions

12 or more sessions for pt with mod - high risk

77
Q

Terminate exercise in phase II (OP) cardiac rehab if

A

SBP plateaus or falls c inc work or >250 mmhg, DBP 115 or greater, ST segment depression >1 mm, 2nd or 3rd degree heart block, ventricular dysrhythmias, angina or other symptoms of cardio insufficiency

78
Q

Exercise target HR should be ____ or less BPM below the known ischemic or anginal threshold

A

10

79
Q

A rating of 1 on the angina scale during inpatient and outpatient cardiac rehab

A

Recommended end point to cease activity - have the pt rest, if the angina doesn’t terminate with rest or by 3 sublingual nitroglycerin tablets transport individual to ER

80
Q

RPE of 12-16 represent _____% of max capacity

A

40-85%

81
Q

Appropriate RPE upper limit in the initial phases of OP cardiac rehab

A

11-13

82
Q

Bathing or cooking MET

A

2-3

83
Q

Walking at home MET

A

2

84
Q

Playing a musical instrument MET

A

2-2.5

85
Q

Carrying or stacking wood MET

A

5.5

86
Q

Walking 3 MPH MET

A

3-4

87
Q

Walking 4 MPH MET

A

4.5-7.0

88
Q

Bicycling MET flat 10-12 Mph MET

A

6.0

3-6 mod

89
Q

Jogging MEt

A

8

90
Q

Running 7 MPH MET

A

11.5

More than 6 METS is vigorous

91
Q

Compression depth for adults?

A

At least 2 inches- allow complete recoil of chest

92
Q

Compression depth for children and infants ?

A

At least 1/3 AP depth

93
Q

Compression to ventilation ratio CPR

A

30:2

Or compressions only when the provider is untrained

94
Q

When to attach and use AED

A

As soon as possible c minimal interruption in the compressions

95
Q

Respiratory acidosis the pH will be dec, the PaCO2 will be inc, how about the HCO3?

A

Inc… HCO3 and PaCO2 always same direction

96
Q

Original RPE rating that represents 70% of max HR

A

14/20

97
Q

What artery supplies the interventricular septum

A

Left anterior descending

Cardio ROUND 2 (1 decks)

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