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Summer NPTE Cradiopulm > cradioplum - 9 PT test and measures (my notes) > Flashcards

cradioplum - 9 PT test and measures (my notes) Flashcards

1
Q

angina pain scale

A

used to grade the severity of angina

1-4

1 least amount of pain

4 severe pain

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2
Q

what is the ankle brachial index (ABI)

A

compares systolic BP in the ankle and the arm

checking for peri artery disease

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3
Q

what is the procedure for ABI

A

systolic BP in measured in both bra hial arteries and tib post artery

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4
Q

how do we calculate ABI

A

divide the higher of the 2 BP in the ankle by the higher of the of the 2 BPs in the arm

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5
Q

how do we interpret ABI

A

> 1.4 indicates rigid art and a need for an ultrasound to check for PAD

1.0 - 1.4 normal no blockage

.8 - .99 mild block

.4 - .79 moderate block - claudication w/ exercise

<.4 severe block - claudication at rest

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6
Q

manuel arterial BP sounds

A

systolic - first sound you hear

diastolic - no more sounds

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7
Q

what is considered a normal BP

A

120/80

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8
Q

what is considered a elevated BP

A

120-129

<80

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9
Q

what is considered a stage 1 HTN

A

130 -39

80-89

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10
Q

what is considered a stage 2 HTN

A

> 140

> 90

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11
Q

what is considered a stage 3 HTN

A

> 180

> 120

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12
Q

when listening to heart sound the bell should be placed over what

A

bare skin

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13
Q

how should the pt breath what listening to heart sounds

A

quite breathing

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14
Q

S1

A

closing of the mitrial and tricupid valves

start of systole

lub

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15
Q

what is systole

A

contraction of the ventricles

causes injection of blood into the pulmonary and aortic branches

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16
Q

S2

A

dud

the aortic and pulmonary valves closing

the end of systole

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17
Q

what is diastole

A

when the heart relaxes and fills with blood

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18
Q

S3

A

lub dub dub

indication of cardiomyopathy or CHF

heard in artial contraction

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19
Q

is S3 heart sound normal in any population

A

yes children

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20
Q

what is cardiomyopathy

A

any disorder that effecting the heart

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21
Q

what is a S4 heart sound

A

la lub dub

indication of stiff or low complience contraction

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22
Q

what is a mumur

A

Turbulence of blood flow through the heart

often 2/2 distruption of blood flow past a stenotic or regurgitant valve

blowing

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23
Q

what is a Systolic murmur

A

Lub whoosh dub

o Aortic stenosis

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24
Q

what is a diastolic murmur

A

Lub dub whoosh

o Aortic or pulmonic regurgitation and mitral stenosis

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25
Q

where do we listen for S2 heart sounds

A

aortic valves: at the R 2nd intercostal interspace

pulmonary valve: at the L 2nd intercostal interspace

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26
Q

where do we listen for S1 heart sounds

A

tricusipd valve: lower L sternal border of 4th and 5th ICS

mitrial: apex of the heart, 5th ICS midcalvicular line

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27
Q

what is the procedure for listening to heart sounds

A

pt supine - HOB 30deg

pt breathing normally

place the diaphram of the scope at the 4 places -listening for S1 and S2 sounds

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28
Q

S1 and S2 pitch and duration

A

S1: lower pitch w/ longer duration

S2: higher pitch w/ shorter duration

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29
Q

where do we feel the apical pulse

A

the 5th ICS midclavicular line

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30
Q

why do we care about the apical pulse

A

it is an accuratee measure of HR

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31
Q

abdominal aortic aneurysm palpation - procedure

A

pt supine, examiner facing the pt head and shoulders

PT places both fingertips on both sides of the abd - just above the belly button and to the left

press firmly down and palpate

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32
Q

what is a normal finding w/ AAA testing

A

pulse width 1 inch or 2 fingertips

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33
Q

what is a abnormal finding w/ AAA testing

A

wide pulsation (>4cm) or lateral pulsations

width is the more important finding

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34
Q

AAA ausultation procedure

A

pt supine w/ knees bent

PT standing to side

scope is place above and left ot the belly button

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35
Q

what is an abnormal fincindg for AAA ausultation

A

burits or swooshing sound

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36
Q

what is bruits sound

A

a whooshing sound indicating a narrowed artery

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37
Q

what is pitt edema a sign of

A
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38
Q

what is the procedure when looking at pitting edema

A

hold down for 15-30 secs

release

grade edema on rate of return and depth

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39
Q

what kind of edema time is an indication for HF

A

> 40secs

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40
Q

what is the procedure for LE and and UE limb circumference measuring

A

LE: measure circumference at the knee or the tibial tuberosity, then repeat the measurement 10cm above and below

UE: measure at the styloid process, then repeat above and below

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41
Q

what is the capillary refill test used for

A

to test the distal blood flow

blockage in the peri arterial system

PAD or HF

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42
Q

what is the procedure for the capillary refill test

A

pt seated with hands at the level of the heart (upper) or in long sitting (lower)

depress the nail the nail for 5 secs - over the big toe or the distal finger

look for the time for it to refill

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43
Q

for the capillary refill test what is the timing

A

finger > 3 secs

toe > 5 secs

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44
Q

what is purpose of carotid artery ausculation

A

screen for possible carotid art blockage

progressive vascular disease, HTN, or cardiac disease along with symptoms of lightheadedness or dizziness may require screening for carotid artery blockage.

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45
Q

what is the procedure for carotid artery ausculation

A

pt seated or supine w/ head slightly turned away from the examiner

place stethoscope site at each site and perform the next steps at each

pt inhales and exhales and then hold breath for 15 secs

listen following exhalation

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46
Q

what are the four places that we look at for carotid artery ausculation

A

base of jaw

base of neck

subclavian artery

carotid birfurcation

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47
Q

what are wee looking for w/ carotid artery ausculation

A

carotid, systolic bruit > a blowing or swishing sound

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48
Q

what is the procedure for a tracheal shift test

A

the examiner palpates the position of the trachea with the PT index finger

49
Q

what is the purpose of the tracheal shift test

A

assess the presence for a tracheal shift

50
Q

tracheal shift - away from the primary abnormality

A

mass effect of a pleural effusion

collapsed lung

intrathoracic mass

51
Q

chest wall motion - purpose

A

looking for sym in the chest wall movement

52
Q

chest wall motion - procedure

A

place the thumbs in the following positions

  • anterior at the midsternum
  • anterior at the xiphoid process
  • posterior at the T8 level
53
Q

anterior at the midsternum is test what part of the lungs

A

the upper lobe

54
Q

anterior at the xiphoid process is tesing what part of the lungs

A

right middle lobe
left lingual

55
Q

posterior at the T8 level is testing what part of the lungs

A

lower lobe moton

56
Q

what is a normal finding for chest wall motion

A

3-5 cm expansion for midline

57
Q

Chest wall motion - COPD

A

reduction in movement bilaterally

58
Q

Chest wall motion - unilateral lung collapse

A

non sym movement

59
Q

Chest wall motion - unilateral delay

A

PNA

atelectasis

post op guarding

poor chest wall muscle function

60
Q

what is diaphragmatic motion test procedure

A

pt supine

PT places hands over the costal moargin and thumbs meeting at the xiphoid process

ask the pt to take a deep breath

the PT hand show move equally apart, with the diameter increasing by 2-3 inch

61
Q

what is the purpose of diaphragmatic motion testing

A

assesses the integrity of the diaphragm to engage in insipiration

62
Q

what does a postive diaphragmatic motion test look like

A

unequal or little movement

63
Q

what is the purpose of looking at lung sounds

A

this is the process of listening to air pass through the brochilio tree and the aveoli

used to confirm chart findings, percussion and ot tacile findings, and a reassessment tool

64
Q

in what part of the lung do lung sounds increase

A

in areas of increased density

65
Q

what is the procedure for lungs sounds

A

pt sitting

pt is ask to perform a deep breath through the mounth at each location

move from head to tail

first place scope a left of C7 (post) and manubrium (ant)

listen at one location and then move across the midline

66
Q

lung sound and the scapula

A

keep medial to the scapular border

67
Q

lung sounds - bronchial and trachea

A

loud tubular sounds over the trachea and the manubrium

equal inspiration and expiration phase

pause is heard between inspiration and expirations

68
Q

lung sounds - bronchovesicular

A

softer the bronchial

no pause between inspiration and expiration

69
Q

what is bronchovesicular

A

Anterior chest: Between the first and second intercostal spaces on the side of the chest next to the sternum

Posterior chest: Between the shoulder blades

70
Q

what is vesicular

A

sounds heard of the lung tissues

over most of both lungs.

People can hear them most easily below the second rib at the base of the lungs

71
Q

lung sounds - vesicular

A

soft rustling sound over more of the peri lung field

inspiration is longer the expiration

72
Q

Voice transmission test - purpose

A

used to see if there is a consolidation in the lungs

73
Q

Voice transmission test - procedure

A

place scope over area that is more likely impact then do >

  • epgophony: pt says E
  • bronchophony: pt says 99
  • whispered pectoriloquy: pt whispers
74
Q

Voice transmission test - what is a positive epgophony test

A

hear A

75
Q

Voice transmission test - what is a positive bronchophony test

A

when the sound is heard loud

76
Q

Voice transmission test - what is a positive whispered pectoriloquy test

A

whisper is heard loudly

77
Q

Voice transmission test - louder sounds

A

over areas of consolidation

78
Q

Voice transmission test - softer sounds

A

heard over areas of hyperinflamation, like COPD

79
Q

mediated percussion - purpose

A

eval chnages in lung density by the sound produced

80
Q

mediated percussion - procedure

A

middle finger is placed on intercostal space

other hand pull middle finger back to strike it on the chest wall

81
Q

mediated percussion - findings

A

resonant sounds

dull sound

tympanic sounds

82
Q

mediated percussion - resonant sound

A

heard over normal lung tissue

loud, low pitch, hollow sounds that is long in duration

83
Q

mediated percussion - dull sound

A

heard over dense tissue - such a consilation or tumor or mass

medium, high pitched, thud like sounds of medium duration

84
Q

mediated percussion - tympanic sound

A

heard over a hyperinflated lung region

very loud, high pitch or muscial pitch of medium duration

85
Q

tactile fremitus - purpose

A

palpable vibration of the chest wall transmitted from the phonating larynx and can be increased or decreased in specific locations based on tissue density in the region being palpated.

86
Q

tactile fremitus - procedure

A

place palms or ulnar border of hand surface between the scapula and the SP

pt is asked to say 99

PT looks for bilateral difference

move down and do this again

87
Q

tactile fremitus - positive finding

A

increased or decreased sound or fermitus in contralateral comparison

this warrents further investigation as the pt may have a consolidation or a poor ventilated area

88
Q

when is postural drainage indicated

A

therapeutic technique that uses gravity and airflow to help drain mucus from the lungs

89
Q

what is the procedure for postural drainage

A

start the treatment session by using auscultations to find the area of interest

use medical decices and med to decreased the thickness of the septum

put pt in postion

STOP to allow for cough

STOP after 3-5mins per lobe and ausulatate again

reapeat

90
Q

postural drainage upper lobes

A

elevate HOB, supine

91
Q

postural drainage mid lungs

A

supine 0-deg

92
Q

postural drainage left lung

A

lay on right side

opposite for right lung

93
Q

postural drainage inferior lobe

A

decrease HOB (EX: -30 deg)

94
Q

chest percussion: purpose

A

aimed at loosening retained secretions when the pt is in a postural drainage position

95
Q

chest vibration: when it used

A

used on exhalation

used in postural drainage position

used to clear secreations

96
Q

chest vibration: procedure

A

hand over hand and vibrate over area of interest

97
Q

teaching an effective cough

A

max inspiration w/ spinal extension and opening of the chest wall

max intrathoracic and intra-abdominal pressure w./ forward flexion while perfroming the cough
- pt may perform self abd thrust

orient pt to timing of these events

98
Q

huff and cough technique - purpose

A

helps to loosen secretions and may induce a cough

good for post surgical pts

99
Q

huff and cough technique - procedure

A
  • sit up straight with chin tilted and mouth open
  • take a slow deep breath to fill the lungs
  • hold breath for 1-3 secs
  • open mouth and force air out of your lungs w/ mouth open as if trying to fog up a mirror
  • repeat this two more times
  • follow with a strong cough
  • do this cycle 4 -5 times
100
Q

what is the active - what is the purpose

A

a series of manuvers performed by a pt used to emphasize independence in sercretion clearence

101
Q

what is the purpose fo PBL

A

decreasing a patient’s symptoms of dyspnea, generally slow respiratory rate and decrease airway collapse in patients, especially those with COPD.

102
Q

what are the indications for PBL

A

dyspnea

wheezing

slows the RR and may decrease airway collapse

103
Q

what showed the PBL ratio by

A

1:2 progressed to 1:6

104
Q

sniffing - indications

A

making sure the pt knows how it active the diaphragm

105
Q

sniffing - procedure

A

place fingers below the xiphoid

sniff several times

observe the abd and the lower costal expansion with each sniff

have the pt progress with prolonging the sniff

106
Q

diaphragmatic breathing - indication

A

hypoxemia

tachypnea

atelactsis

anxiety

other conditions w/ pulmonary weakness

107
Q

what is the purpose of diaphragmatic breathing

A

improve the diaphragms involvement with inhalation

decrease chest breathing and increase belly breathing

108
Q

diaphragmatic breathing - procedure

A

pt sitting or supine

place the dominent hand of the abd and other hand over the chest (mid sternal)

instruct the pt to take a deep breath through the nose - tell the to try to get the dominent hand to move

ND-hand: not moving

109
Q

diaphragmatic breathing - muscle energy/ quick stretch when is it used

A

used when the pt is having a hard time activating the D or coordinating the movement

110
Q

diaphragmatic breathing - muscle energy/ quick stretch procedure

A

prior to inspiration do a quick scoop up and under the thorax

instruct the pt to breath into your hand

111
Q

lower costal expansion - purpose

A

also used for diaphram movement

112
Q

lower costal expansion - procedure

A

belt or PT hand around the costal region

place hand over the pt anterior lateral rib cage

instruct pt to breath into hands

113
Q

segmental breathing - purpose

A

encourages expansion of a specfic part of the lungs that has been under ventilated

prevents lung shut down or collaspe

114
Q

segmental breathing - indications

A

assymetrical chest wall expansion with absence of breath sounds

localized consolidations

lung collapse

115
Q

segmental breathing - procedure

A

PT overlays hand over are of interest

instruct pt to breath deeply through nose trying to direct air to this particular area

PT allows expansion in that area

pt hold breath for 2-3 secs at the end of inspiration, then exhale

have pt do this one their own as HEP

116
Q

inspiration hold and stacked breathing - indications

A

poor ventilated areas

improve cough capabilities

hypoventilation, collasped lung, ineffective cough

117
Q

inspiration holds - procedure

A

prolonged holding of breath at max inspiration

breath held for 2-3 secs and then exhale

118
Q

Stacked breathing - procedure

A

series of deep breaths that build up on each other without expiration

each inspiration is held by a hold

Summer NPTE Cradiopulm (15 decks)

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