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PTA 202 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Where is the Base of the heart located?

A

It is the Top of the heart, located close to the 2nd Intercostal Space.

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2
Q

Where is the Apex of the heart located?

A

It is the bottom point of the heart, located in the 5th intercostal space.

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3
Q

What are the chambers of the heart?

A

-R&L Atrium
-R&L Ventricle

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4
Q

What is the Pericardium?

A

A fibrous sack which encloses the heart

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5
Q

What is the Myocardium?

A

It is the heart’s muslce tissue, which includes:
-Endocardium: Inner surface of mycardium
-Exocardium: External surface of myocardium

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6
Q

Name the stages of blood flow and circulation through the heart.

A

Vena Cava > R Atrium > Tricuspid Valve > R Ventricle > Pulmonary Valve > Pulmonary Arteries > Lungs > Pulmonary Veins > L Atrium > Mitral (Bicuspid) Valve > L Ventricle > Aortic Valve > Aorta > Coronary Arteries and Body

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7
Q

Name the Coronary Arteries, where they innervate, and if they split into smaller arteries.

A

Right Coronary Artery
-Innervates the R atrium/ventricle
Left Coronary Artery
-Innervates the L atrium/ventricle
-Splits into:
-Left Anterior Descending (LAD) (The Widow Maker)
-Left Circumflex

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8
Q

Which way does blood flow in Arteries?

A

Away from the heart.

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9
Q

Which way does blood flow in Veins?

A

To the heart

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10
Q

What are thee 3 unique properties of Myocardial Tissue?

A

-Automaticity: It contracts on its own
-Rhythmiticity: It contracts regularly
-Conductivity: It transmits electricity

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11
Q

Where is the SA Node located and what does it do?

A

-Located at the Superior Vena Cava and Right Atrium junction
-It is the pacemaker of the heart
-Parasympathetic input to SA node can decrease HR & sympathetic input can increase HR

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12
Q

What nerve innervates the SA and AV nodes?

A

Vagus

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13
Q

Where is the AV Node located and what does it do?

A

-Located in lower Right Atrium
-Backup system for SA node failure

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14
Q

What is normal sinus rhythm and Nodal AV Rhythm?

A

-Normal: 60-100 bpm
-Nodal AV: 40-60 bpm

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15
Q

What is the AV tissue called that merges to become right and left branches that relay impulse conduction?

A

The Bundle of His

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16
Q

What is the specialized tissue called that relays conduction impulse into the myocardium?

A

Purkinje Tissue

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17
Q

What is the normal conduction pathway of the heart?

A

-SA Node
-AV Node
-Bundle of his
-Branches
-Purkinje Fibers

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18
Q

What does the Sympathetic Nervous System do and which neurotransmitters are responsible for it?

A

-Increase HR & force of contraction, vasoconstriction of the peripheral arteries, and Vasodilation of the coronary arteries
-Norepinephrine & Epinephrine

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19
Q

What does the Parasympathetic (Vagal) Nervous System do and which neurotransmitters are responsible for it?

A

-Decrease HR & force of contraction and vasodilation of arteries.
-Acetylcholine

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20
Q

Which Cardiac Reflex senses increase pressure and stretch, therefore causing vagal stimulation?

A

Baroreflexes

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21
Q

Which Cardiac Reflex senses a stretch in the Right Atrial Wall, therefore activating the Sympathetic nervous system?

A

Bainbridge reflex

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22
Q

Which Cardiac Reflex senses elevated CO2 levels in the aorta and carotid arteries, therefore affecting the rate and depth of ventilation?

A

Chemo reflex

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23
Q

What might the Chemo reflex result in?

A

Sinus arrhythmia

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24
Q

What is Stroke Volume?

A

The amount of blood pumped per beat of the heart.
-Normal SV= 71 ml/beat (2.4 oz)

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25
Q

What is Cardiac Output (CO)?

A

The amount of blood ejected from the heart per minute.
-Normal CO= 4-6 liters/minute at rest
-Can increase up to 25 l/min with exercise

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26
Q

What is Ejection Fraction?

A

-The ratio of blood volume ejected from the left ventricle per beat to the blood volume left in the left ventricle.
-Normal EF= .6-.75
-<40%= high risk

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27
Q

T or F: The base of the heart is located at the 5th intercostal space.

A

F

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28
Q

T or F: The coronary arteries arise from the vena cava?

A

F

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29
Q

What are Systole and Diastole?

A

Systole occurs when the heart contracts to pump blood out, and diastole occurs when the heart relaxes after contraction.

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30
Q

Depression of the ST segment of an ECG is indicative of a…

A

CAD

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31
Q

Elevation of the ST segment of an ECG is indicative of an…

A

Acute MI

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32
Q

What is normal sinus rhythm, sinus bradycardia, and sinus tachycardia?

A

-Normal= 60-100 bpm
-Bradycardia= <60 bpm
-Tachycardia= >100 bpm

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33
Q

How do you calculate Max HR?

A

220-age

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34
Q

Does Max HR increase or decrease with age?

A

Decrease

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35
Q

Why should you initiate your Cardiac pt. TX with LE exercise instead of UE exercise?

A

UE exercise increases HR faster than LE exercise

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36
Q

What is the normal effect on BP during aerobic activity?

A

-Systolic BP increases 8-15 mmHg/MET
-Diastolic can stay the same or increase to = 10mmHg

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37
Q

What is Normal BP?

A

<120 and <80

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38
Q

What is Elevated BP?

A

120-129 and <80

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39
Q

What is Hypertension stage I BP?

A

130-139 or 80-89

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40
Q

What is Hypertension stage II BP?

A

140 or higher or 90 or higher

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41
Q

What is Hypertension stage III BP?

A

Higher than 180 and/or Higher than 120

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42
Q

What is the result of low O2 supply?

A

Myocardial Ischemia & Infarction

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43
Q

What can Myocardial Ischemia or Infarction cause?

A

-Angina (chest pain, radiating down arm, pressure)
-Coronary artery spasm
-Coronary Atherosclerotic Disease (CAD)
-Acute Coronary Syndrome (ACS)
-Arteriosclerosis
-Atherosclerosis
-Thrombus
-Embolus

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44
Q

What is Ventilation Vs. Perfusion?

A

-Ventilation refers to the amount of air flowing into and out of the lungs
-Perfusion refers to the amount of blood flowing to the alveolar capillaries

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45
Q

What are the components of an ECG/EKG and what do they signify?

A

-P wave: Atrial Depolarization
-QRS: Ventricular Depolarization
-ST wave: Ventricles initiate repolarization
-T wave: Ventricles Repolarization

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46
Q

What does CAD stand for?

A

Coronary Atherosclerotic Disease

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47
Q

What does CHF stand for?

A

Congestive Heart Failure

48
Q

Which side of the heart has failed if the pt. has pulmonary congestion and edema?

A

The Left side

49
Q

Which side of the heart has failed if the pt. has LE edema, Jugular distension, and systemic congestion?

A

The Right side

50
Q

What does MI stand for?

A

Myocardial Infarction (Heart Attack)

51
Q

What is Myocardial Ischemia and what does it lead to?

A

-Low oxygen supply to the myocardium
-Leads to angina, radiating pain down arm, pressure, and eventually myocardial infarction

52
Q

What causes Myocardial Ischemia and Myocardial Infarction?

A

-Coronary Artery Spasm
-Coronary Atherosclerotic Disease (CAD)
-Decreased elasticity
-Acute Coronary Syndrome (ACS)
-Arteriorsclerosis- elasticity issue
-Artherosclerosis- plaque
-Thrombus
-Embolus- mobile clot

53
Q

What is the pacemaker of the heart?

A

The SA node

54
Q

Wich part of the ECG indicates ventricular depolarization?

A

QRS

55
Q

Your patient tells you that he has an ejection fraction of .65 and a BP of 115/96. Which of these values is a concern?

A

Diastolic BP is too high

56
Q

What is Atrial Fibrillation?

A

-Fluttering atrium
-P wave flutters

57
Q

What should the PT(A) be aware of when treating someone in A Fib?

A

Do not initiate exercise if resting HR is >115 bpm

58
Q

Definition: An ectopic beat that originates in the atrium and yields an abnormal rhythm.

A

Premature Arterial Contraction (PAC)

59
Q

What should the PT(A) be aware of when treating someone with Premature Atrial Contraction (PAC)

A

If the contractions run together to create a HR at 100-200 bpm, PT is contraindicated

60
Q

What is Ventricular Tachycardia?

A

4 or more PVC’s in a row

61
Q

What should a PT(A) be aware of when treating someone with Ventricular Tachycardia?

A

-This is an emergency
-PT in contraindicated
-Initiate CPR

62
Q

What is Ventricular Fibrillation?

A

No effective contraction of the ventricles at all

63
Q

What should a PT(A) be aware of when treating someone with Ventricular Fibrillation?

A

-This is an emergency
-Apply an AED

64
Q

How long does a CABG pt. usually have sternal precautions?

A

6-8 wks

65
Q

What are the sternal precautions for open heart surgery?

A

-No shoulder flexion >90
-No pushing up from chair
-No reaching behind back
-No lifting > 10lbs
-If walker is indicated, a rolling walker is required so not to lift

66
Q

What is a CABG?

A

Coronary Artery Bypass Graft

67
Q

Describe the process of a CABG

A

-Chest is opened (median sternotomy)
-The heart is stopped and pt. is put on bypass pumt
-artery or vein is grafted to revascularize tissue

68
Q

Definition: A catheter is guided from the femoral artery into the aorta and a contrast dye is injected into the coronary arteries to look for narrowing of the coronary arteries.

A

Angiography

69
Q

What does PTCA stand for?

A

Percutaneous Transluminal Coronary Angioplasty

70
Q

Describe the process of a PTCA

A

-The distal end of a catheter has a balloon that is inflated which causes pressure on the arterial wall and opens the artery
-A stent is left in place to keep the vessel open

71
Q

What is the difference between an Angioplasty and a PTCA

A

An PTCA is a type of angioplasty

72
Q

What risk factors should the PT(A) be aware of when treating a cardiac pt.?

A

-Smoking
-HTN
-Cholesterol
-Activity level
-Sex
-Age
-Stress

73
Q

What is the Karvonen Formula?

A

60%-80% (Max HR - Resting HR) + Resting HR

74
Q

What level of the RPE scale would we like our Phase 1 cardiac patients to exercise at?

A

11-13

75
Q

Normal Inspiration lasts…

A

1-2 seconds

76
Q

The diaphragm contracts on…

A

Inhalation

77
Q

How many Lobes and Segments does the Right lung have?

A

3 lobes and 10 segments

78
Q

How many Lobes and Segments doe the Left Lung have?

A

2 lobes and 8 segments

79
Q

Where does gas exchange occur in the pulmonary system?

A

At the Alveolar/Capillary membrane

80
Q

How many liters of air a minute moves through the lungs

A

4

81
Q

What does V/Q mean and what is the normal ratio

A

Ventilation (V) to Perfusion (Q)
-The amount of air breathed (V) to the amount of blood pumped through the capillaries (Q) for gas exchange

The normal V/Q ratio is 4/5 or .8

82
Q

How many liters of blood moves through the capillaries at the lungs per minute?

A

5

83
Q

Ventilation vs. Respiration

A

-Ventilation has to do with the amount of air moving in and out of the lungs
-Respiration has to do with the amount of gas exchange in the blood at the lungs

84
Q

What is the Fowlers Position and what is it good for?

A

-It is when the HOB is elevated slightly for the pt.
-It relaxes the abs and decreases the weight on the chest to make it easier for the patient to breath

85
Q

What is Tidal Volume and what is it’s norm?

A

The amount of air breathed in and out while breathing normally
-500 ml

86
Q

What is Inspiratory Reserve Volume and what is its norm?

A

The extra amount of air that can be breathed in after normal inhalation
-3000 ml

87
Q

What is Expiratory Reserve Volume and what is its norm?

A

The extra amount of air that can be breathed out after normal expiration
-1000 ml

88
Q

What is Residual Volume and what is its norm?

A

The amount of air left in the lungs after forced exhalation
-1500 ml

89
Q

What is Total Lung Capacity and its norm?

A

The total amount of air that can fill the lungs
-6000 ml (6 L)

90
Q

What is Inspiratory Capacity?

A

Tidal Volume + Inspiratory Reserve Volume

91
Q

What is Vital Capacity?

A

Tidal Volume + Inspiratory Reserve Volume + Expiratory Reserve Volume

It’s like the Total Lung Capacity, but minus the Residual Volume

92
Q

What is Functional Residual Capacity?

A

Expiratory Reserve Capacity + Residual Capasity

93
Q

What is Pulmonary Function Testing

A

Testing which aims to understand the amount of air the pt.s lungs are capable of breathing in and out.

94
Q

What is the difference between obstructive and restrictive pulmonary disorders?

A

-Obstructive is when the pt. has difficulty exhaling
-Restrictive is when the pt. has difficulty inhaling

95
Q

What is Asthma?

A

Reaction to allergens or things such as smoke, fumes, or cold.
-Bronchial constriction
-Mucus production
-Bronchial mucosa inflammation

96
Q

What is Bronchiectasis?

A

Caused by infections such as TB, Whooping Cough, CF and immobile cilia
-Thickening of the bronchial wall
-Bronchial dilation
-Bronchial artery enlargement

97
Q

What is Chronic Bronchitis?

A

The presence of a cough and pulmonary secretions for at least 3 months, 2 years in a row
-Inflammation and narrowing of the airway
-Mucus gland hyperplasia
-Decreased cilia activity
-Leads to
-hyperinflated alveoli
-Bronchospasm
-Secretion retention

98
Q

What is Cystic Fibrosis?

A

Lethal genetic recessive trait that affects the exocrine glands
-Thick, viscous secretions
-1 in 3,700 births
-Life expectancy is 37 yrs

99
Q

What is Emphysema?

A

Progressive destruction of the alveolar walls and adjacent capillaries
-Pulmonary tissue loses elasticity
-Bullae formation
-Hyperinflation of the lung

100
Q

What is COPD?

A

Chronic Obstructive Pulmonary Disease
-General term that refers to a number of pulmonary conditions

101
Q

What are the physical characteristics of someone with COPD?

A

-Barrel Chest (enlarged thorax)
-Dorsal kyphosis
-Digital clubbing

102
Q

What abnormal breathing sounds might you hear in a pt. with COPD?

A

Crackling or wheezing

103
Q

What are the arteriole blood changes which occur in pt.s with COPD?

A

-Hypoxemia in the early stages
-Hypercapnia in the later stages

104
Q

What would a Pulmonary Function Test find in a pt. with COPD?

A

-Increased RV
-Decreased FEV

105
Q

What are medicinal ways to treat Pulmonary Dysfunction?

A

-Bronchodilators
-Corticosteroids
-Antitussives (block cough; robitussin)
-Antibiotics
-Supplemental oxygen

106
Q

At what point should a pt. receive a nebulizer for Tx?

A

15-20 mins before

107
Q

What is a Thoracotomy?

A

Opening of the chest wall for surgical access

108
Q

What should the PTA do if a chest tube comes out?

A

-Stop PT immediately
-Notify a nurse
-Sit pt. upright
-Monitor vitals

109
Q

What is the normal ratio of inhalation to exhalation?

A

1:2

110
Q

What is Dyspnea

A

Shortness Of Breath

111
Q

What is Tachypnea?

A

> 35 bpm

112
Q

What is Bradypnea?

A

<10 bpm

113
Q

What is Apnea?

A

Periods of no breathing lasting >15”

114
Q

What is hyperventilation?

A

> 16-20 bpm

115
Q

What is Orthopnea

A

Shortness of breath in supine

116
Q

What is Apneuis?

A

Prolonged inspiration/grunts on expiration

117
Q

What is Cheyne-Stokes breathing?

A

variable, non rhythmic breathing pattern

PTA 202 (4 decks)

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