Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Special Pops > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

What is the genetic theory of aging?

A

Apoptosis

Limit to cell division

Cell damage from free radicals, poor nutrition, or hydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the nongenetic theory of aging?

A

Environmental factors damage DNA

Genetic mutation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are free radicals?

A

Comes from processed foods and other sources

Cause overall cell damage

Could cause cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How are free radicals combated?

A

Antioxidants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does acceleration of cell death lead to?

A

Parkinson’s and Alzheimer’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What happens to cartilage as you age?

A

Decreased hydration = increase fibrotic tissue = stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do you treat aging cartilage?

A

WB activities

Maintain strength of muscles around jt to decrease stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does muscle mass decrease?

A

Between ages 60-90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes change to occur in muscles?

A

Decreased activity level and disuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How much muscle is lost per year during aging?

A

1.5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What occurs physiologically to muscles as you age?

A

Decrease in motor units

Decrease speed of muscle, contraction, and movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to treat aging muscles?

A

Strength can still be increased and maintained

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What causes a decrease in skeletal mass?

A

Decrease levels of vitamin D3 = less calcium absorbed

Imbalance b/t ostoblast and osteoclast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How to treat loss of bone mass?

A

WB exercise

PRE to improve bone strength

Fall prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What occurs to fat composition as we age?

A

Increases at mid life and then decreases

Moves from under skin to hips in women and abs in thighs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What occurs in the neuro system as you age?

A

Atrophy of nerve cells in cerebral cortex (loss of mass)

Decrease cerebral blood flow and energy metabolism

Delayed nerve conduction

Neuronal loss and atrophy

More degeneration of motor function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What effects on movement does an aging neuro system?

A

Speed and coordination decrease

Slow recruitment of motor neurons = loss of strength

Reaction and movement time are increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How to treat aging neuro system?

A

Increase physical activity

Allow for increase reaction and movement time

Allow for memory limitation = one-step commands

Provide adequate explanation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What occurs to vision as you age?

A

Decline in acuity, presbyopia, increase sensitivity to light, loss of color discrimination, cataracts, glaucoma, senile MD, and diabetic retinopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How to treat vision aging?

A

Wear glasses

Work in appropriate light

Provide sensory cues

Safety education

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How to treat hearing loss?

A

Hearing aids

Minimize auditory distractions

Speak slow and clearly

Face patient

Use nonverbal communication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What occurs to the vestibular system as you age?

A

Degeneration of otoconia

Diminished vestibuloccular reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How to treat the vestibular system during aging?

A

More dependent on balance

Decreased ankle strategy and increased postural sway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What occurs to the somatosensory system when you age?

A

Decline in sensitivity to touch, temp, vibration, loss of joint receptor sensitivity, and pain threshold increases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How to treat an aging somatosensory system?

A

Allow extra time for response

Use touch communication

Give extra feedback through sensation

Teach compensatory strategies to prevent falls

AD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What happens to your cognitive abilities as you age?

A

Decline intellectual abilities

Perceptual speed decreases

Short term memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How to treat cognitive changes as you age?

A

Mass practice

Decrease pace

Memory tools

Increase physical activity

Provide written instruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What changes occur to the CV system with aging?

A

Slight increase in heart size

Heart will increase CO by increasing SV

Loss of pacemaker cells in SA

BV thicken

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are some precautions to starting exercise in those with an aging CV system?

A

Avoid quick changes in position

Avoid exercise after meal

MHR decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why does the heart increase as you age?

A

Heart works harder = muscles increase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Why should you avoid exercising after a meal?

A

Blood flow is going to GI system instead of the rest of the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What occurs to the pulmonary system as you age?

A

Chest wall thickens = increased kyphosis

Loss of elastic recoil

Less effective O2 uptake

Pulmonary BV thicken

Decrease lung capacity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How to treat a decreased pulmonary system function?

A

Increased vent cost of work at high intensity exercise

Impaired cough

Individualized exercise program essential

Aerobic training

Increase daily activity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What occurs to the integumentary system as you age?

A

Dermis thins

Decreased vascularity

Decreased sweating

Skin grows and heals more slowly

Decreased sensitivity to touch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What happens to the GI system as you age?

A

Decreased salivation, taste, and smell along with inadequate chewing

Reduced motility and control of lower esophageal sphincter and stomach

Reduced ability for absorption of nutrients in small intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is a negative effect of inadequate chewing?

A

Poor nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the recommended PT for someone with osteoporosis?

A

Promoting WB

  • Walking 30 min/day
  • Stair climbing
  • Weight belts

Postural training and balance

  • Postural re-ed
  • Stretching
  • Balance ex
  • Tai Chi
  • Gait training

Safety education/fall prevention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is Paget’s Disease?

A

Metabolic bone disease characterized by increased bone resorption and excessive, unorganized new bone formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What PT interventions are involved in Paget’s Disease?

A

Encourage regular CV and strengthening activity

Postural exercises

WB exercises

Coordination and balance work

AVOID high impact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Who is at high risk for fractures?

A

Elderly due to decreased bone density, age, co-morbid disease, dementia, and psychotropic meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Where are the most common areas for the elderly to fracture their bones?

A

Hip

Vertebral compressions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the risks of fractures in the elderly?

A

Heal slower

Complications such as ulcers, pneumonia, etc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is OA?

A

Non-inflammatory progressive degenerative process affecting the articular cartilage of the synovial jts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What are characteristics of OA?

A

Bony spurs

Capsular thickening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the tx for OA?

A

Reduce pain and maintain ROM

Balance training

Aerobic conditioning and wt reduction

Aquatic therapy

ADs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is RA?

A

CT disease that results in inflammation of synovial membrane, release of proteolytic enzymes, and jt damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Where are the inflammatory changes in RA?

A

Tendon sheaths

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

How do you treat RA?

A

Decrease pain

Increase/maintain ROM

Jt protection

Resistance exercise

Exercise

ADL

Gait

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is included in jt protection principles?

A

Respect fatigue

Conserve energy

Use good posture

Avoid increase in pain

Maintain jt alignment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What is the definition of delerium?

A

Fluctuating attention state causing temp confusion and loss of mental function, disorientation to place and time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the definition of dementia?

A

Loss of intellectual functions and memory causing dysfunction in daily living

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What problems are caused from immobility?

A 
Pressure sores
Contractures
Bone loss
Muscular atrophy
Deconditioning
CV issues
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What interventions occur in PT for someone who is immobile?

A

Work toward goals

Focus on optimum function and progression of ADLs

Prevent further complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What age increases fall risk?

A

65 and older

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

How to intervene falls and instability?

A

Determine fall risk

Eliminate fall risk

Increase functional mobility

Provide sensory compensation strategies

Balance and gait training

Functional training

Safety education

Environmental modification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What does nutritional deficiency do to the elderly?

A

Sensory impairments

Mobility

Fine motor skills

Memory and cognitive skills

Psychosocial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

How to advance dynamic balance activities in the elderly?

A

Controlled reaching in sitting and standing

Leaning in all directions while sitting and standing

Sitting postural control with external disturbances

WS activities in all directions

Stooping and bending

Reaching and lifting

Standing on high density foam

Walk in sturdy shoes

Walk barefoot

Vary amb surfaces

Ramps

Stairs

Directional changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is normal gait speed?

A

140-160 cm/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is aging gait speed?

A

118-125 cm/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is normal stride length?

A

150-160 cm/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is aging stride length?

A

126-140 cm/sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is normal stride width?

A

8-10 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is aging stride width?

A

Wider

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is normal gait swing-to-stance ratio?

A

40:60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is aging gait swing-to-stance ratio?

A

30:70

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is normal walking cycle duration?

A

1 sec free walking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is aging gait walking cycle duration?

A

1.25 sec free walking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is normal cadence?

A

110 steps/min free walking

132 steps/min fast walking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is aging cadence?

A

Decreases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is normal age foot clearance?

A

1-2 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is aging foot clearance?

A

Decrease or increase depending on pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is normal heel strike and push-off?

A

Present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is aging normal heel strike and push-off?

A

Frequently decreased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the definition of cadence?

A

Steps per min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the definition of gait speed?

A

Distance over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What are the types of dementia?

A

Alzheimer’s

Lewy Body dementia

Vascular dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is stage one Alzheimer’s disease?

A

No impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is stage two Alzheimer’s disease?

A

Very mild decline

Person may feel as though they have memory lapses, forgetting familiar words or the location of everyday objects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is stage three Alzheimer’s disease?

A

Mild cognitive decline

Friends, family, or co-workers begin to notice memory deficits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is stage four Alzheimer’s disease?

A

Mod cog decline (mild or early-stage)

Medical interview is conducted to make a clear diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What is stage 5 of Alzheimer’s disease?

A

Moderate severe

Gaps in memory are more noticeable

Begin to need help with day to day activities

Unable to recall personal info such as address, phone number, etc

Confused on the date

Need help choosing clothing

Still remember significant details about themselves and family

Do not need assist to toilet or eat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is stage 6 Alzheimer’s disease?

A

Severe cognitive decline

Memory continues to worsen and personality changes may take place

Need extensive help with ADLs

Can remember own name, but cannot remember personal hx, can distinguish between familiar or unfamiliar faces, forget caregiver/spouse’s name

Need help to dress or make mistakes trying

Changes in sleep patterns

Need help in toileting

Trouble controlling bowel and bladder

Major personality changes - may be suspicious, delusional, compulsive

Tend to wander or become lost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What is stage 7 of Alzheimer’s Disease?

A

Very severe cognitive decline (severe or late stage)

Final stage of disease

Individual loses ability to respond to environment or to carry on a convo. Eventually loses control of movement

May say words or phrases

Need help with personal care including eating and toileting

May lose ability to smile or sit up without support

Reflexes become abnormal, muscles grow rigid, and trouble swallowing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What are treatment options for someone with Alzheimer’s?

A

Meet where individual is at that day physically and cognitively

Dementia is more than forgetfulness - affects processing, sequencing, problem solving, critical thinking, and learning abilities

Need more time for tasks and demonstration.

Simple instruction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What are helpful tips when working with someone with Alzheimer’s disease?

A

Agree rather than argue

Divert rather than reason

Distract rather than shame

Reassure rather than lecture

Reinforce rather than force

Encourage rather than condescend

Reminisce instead of remember

Never say “I told you so”, instead repeat and regroup

Never say “You can’t”, instead say “let’s do this”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What are examples of environmental barriers?

A

Obstacles that impede the individual from functioning normal such as, safety hazards, access problems, home design difficulties, and workplace design difficulties

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Who regulates the requirements for public and commercial building accessibility guidelines?

A

ADA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

How do therapists evaluate the environment?

A

Accessibility, safety, function, and usability (circle and connect to one another)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What does it mean to have an accessible environment?

A

Assess identifiable barriers that could impact an individual

Make recommendations of realistic changes to make a space more accessible and accommodating to the patient’s need at home, work, or other buildings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What does it mean to have a usable environment?

A

Preparing the pt and their support system to their return home after a major injury.

Help to determine whether other services may be needed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

How do therapists benefit the function of an environment?

A

Determines need for AD, other adaptive equipment or assistive technology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What are the 5 main areas of the environment to assess?

A

Assistive or adaptive devices

Safety devices

Structural alterations

Modifications or altered location of environmental objects - IE. disabling stoves, placing locks on door handles, remove throw rugs, moving furniture

Task modification - IE. Visual/auditory/sensory cuing, work simplification, energy conservation, and joint preservation techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What are tips for accessibility at the route of entry to a home?

A

Most accessible - fewer stairs, closest to driveway, etc

Walkways should be smooth, well lit, and covered

Steps should be no greater than 7 inches high with a depth of 11 inches (non-slip surface)

Handrails should be the ht of min of 34 inches and max 38 inches

Ramp should have a min grade of 1 inch in height and 12 inches in depth. Minimum width should be 36 inches and non-slip surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What are tips of accessibility to an entrance for a w/c?

A

Large enough platform to allow the pt to enter and rest if need be

Door swinging out should be 5 feet x 5 feet

Door swinging in should be 3 feet deep x 5 feet wide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What are other tips for accessibility at an entrance?

A

Door locks should be accessible (look at height)

Door handle should be easy to turn

Adaptation to door to so pt can (I) open and close

Remote/automatic doors

Raised threshold should be removed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What should the doorway width be for someone who is in a w/c?

A

32-34 inches

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

How to make furniture arrangement to make space more accessible?

A

Move furniture to the walls

Place rubber suction cups under legs of sofas and chairs

Remove coffee tables, foot stools, and wires (prevent falls)

Clear passageway from one room to the next

Living room chairs should have double armrests, firm seating, and upright back (90-90-90)

Remove rocking chairs and other unstable furniture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What are common ideas of electrical controls for accessibility?

A

Wall switches and electrical outlets

Change overhead toggle switches to a rocker or sensor device

Use high wattage lightbulbs to last longer and be brighter

Use timers to turn on/off lights

Touch pad dimmer switches to activate the lamps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What are common ideas for accessible flooring?

A

Non-slip and level

  • Any coverings should be tacked down
  • Short-pile carpet

Refinish any unlevel flooring

Covered furniture or bright colored tape to ID uneven areas

Remove rugs

Matte finish to floors to reduce glare

Edge the room with tape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

What are tips for accessible doors?

A

Raised thresholds should be removed - if they cannot be removed then add wedges to improve transition

Widen doorways to at least 32 inches

Increase door clearance - IE. pocket doors, remove wood strips on doorframes, use offset hinges, or change door to a curtain

Door handle accessibility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Tips to make windows more accessible?

A

Use film on windows to reduce glare

Heavy drapes can be used to absorb background noise

Can install remote opening/closing systems for window coverings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What are some tips to make stairs more accessible?

A

Stairwells should have handrails

  • Make sure there is enough light
  • Handrail should extend 12 inches past the top and bottom of the stairs

Keep stairs free of obstacles
- Use bag to carry things up and down stairs

Use tape or lights to designate edge of stairs for those with vision impairments

Motorized stair lift

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What are some tips to make heating units more accessible?

A

Screen off or insulated pipes (help with those with sensation issues)

Adaptation for heating controls

Keep away combustible material

Make sure there are smoke detectors and CO detectors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What are some tips in the bedroom accessibility?

A

Stationary and positioned to allow a lot of room to move

Height of bed that can be raised or lowered

Mattress should be firm - can add wood board below the mattress

Make sure bedside table is near them

Lower closet bar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What are tips of accessibility for the bathroom?

A

Transferring into a chair with wheels once they get to the bathroom that fits and use LE to propel

Elevate toilet

Grab bars

  • Toilet - 36 inches from floor
  • Length of grab bars on side of wall 42-54 inches
  • Length of grab bars on the back wall 24-36 inches
  • Bath - 33-36 inches from the floor of tub

Tub transfer bench

Collapsible seat to attach to shower wall

Non-skid strips on the floor of the tub

Detachable showerhead

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What are tips of accessibility for the kitchen?

A

Height of counter should be less than 31 inches and depth of at least 24 inches

Make sure pt can reach faucet at the sink

Small carts with casters can help to move things around the kitchen

Check height of table

Make sure objects in cabinets are reachable

Use electric, not gas stoves

Dishwashers should be elevated by 6 inches from the floor and should be front loading

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What is cardiovascular disease?

A

CAD/CHD pathological process of atherosclerosis specifically of the coronary arteries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

What are sx/sx of CVD?

A

Vascular dysfunction

Arrhythmias

HTN

CAD leads to CVA and PVD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

What race is at more risk for heart disease?

A

African Americans
American Indians
Mexican Americans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What is the pericardium of the heart?

A

Sac surrounding the heart

Double walled

  • Outer layer is fibrous and dense (parietal)
  • Inner layer is thin (visercal)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What is the epicardium of the heart?

A

Inner layer of pericardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

What is the myocardium of the heart?

A

Muscle

Largest portion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

What is the endocardium of the heart?

A

Smooth lining of the inner surface and cavities of the heart

Continuous with the heart valves and endothelium of blood vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

What is between the two two layers of the pericardium?

A

Pericardial fluid - help layers to slide across one another

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

What is pericarditis?

A

Inflammation and/or infection of the pericardium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

What is cardiac tamponade?

A

Excessive fluid in pericardial space causing compression of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

What are cardiomyopathies?

A

Alterations of the muscular wall of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

What is the cycle of blood through the heart?

A

Enters through the SVC and IVC –> R atrium –> tricuspid valve –> R ventricle –> R AV valve –> Pulmonary Aa –> lungs –> Pulmonary veins (4) –> L atrium –> Mitral valve –> L ventricle –> L AV valve –> Aorta –> Body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

What is the definition of systole?

A

Ventricular contraction

Systole end volume is when there is about 50 mL of blood left in the ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

What is the definition of diastole?

A

Ventricular relaxation

Diastole end volume is when there is about 120 mL of blood left in the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

When does atrial contraction occur?

A

Last third of diastole and is complete with ventricular filling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

Where do the arteries of the heart arise from?

A

Aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

When does blood flow to the myocardium?

A

During diastole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

What does the right coronary artery supply?

A

R atrium. R ventricle, inferior wall of L ventricle, AV node, and bundle of His

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

What does the left coronary artery supply?

A

Most of the L ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

What does the left anterior descending artery supply?

A

L ventricle and interventricular septum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

What does the circumflex artery supply?

A

Lateral and inferior walls of the L ventricle and portions of L atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

Where does the coronary sinus receive blood?

A

Heart and empties into the R atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

Where is the SA node located in the heart?

A

Located in the junction of SVC and R atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

What is the function of the SA node?

A

Pacemaker of the heart

Innervation affects HR and strength of contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

Where is the AV node located?

A

Junction of R atrium and R ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

What does the AV node merge with?

A

Bundle of His

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

What is the process of conduction in the heart?

A

SA node –> spread to both atria (contract together) –> stim AV node –> transmit down bundle of His to Purkinje fibers –> impulse spread throughout ventricles (contract together)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

What does heart muscle fibers have more of?

A

Mitochondria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

What is the definition of stroke volume (SV)?

A

Amount of blood ejected w/ each contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

How much blood is ejected during SV?

A

~70 mL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

What is the definition of cardiac output (CO)?

A

Volume of blood discharged from the L/R ventricle per min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

How much blood is ejected from the ventricles in CO?

A

~4-6 L/min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

What is ejection fraction (EF)?

A

Percentage of blood emptied from ventricle during systole

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

What is a normal EF?

A

55-75%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

How to calculate CO?

A

HR x SV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

When does the size of arteries change size?

A

Triggered by sympathetic activity (vasoconstrict/vasodilate)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

What are capillaries?

A

Minute BV that connect end of arteries (arterioles) with the beginning of veins (venules)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

What is the function of capillaries?

A

Exchange of nutrients and fluids b/t blood and tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

Which vessel has a larger capacity than the other?

A

Veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

What do veins rely on to move blood?

A

Movement of surrounding muscles
Gravity
Respiration
Compliancy of R heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

When does venous reflux occur?

A

When vein valves do not function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

What occurs in the body during sympathetic stimulation (fight or flight)?

A

Increase HR and force of myocardial contraction and myocardial metabolism

Coronary artery vasodilation

Skin and peripheral vascularization = vasoconstricted

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

Where do the signals of fight or flight come from?

A

Medulla oblongata

Release of epi and NE

150
Q

What are beta-adrengeric agents?

A

Drugs to stimulate sympathetic activity by either acting as epi and NE or stimulate their release

151
Q

What are the functions of adrenergic drugs?

A 
Increase BP
Vasoconstrict
Open airways
Increase HR
Stop bleeding
152
Q

What conditions are adrenergic drugs given?

A

Cardiac arrest
Shock
Asthma attack
Allergic reaction

153
Q

What are some examples of adrenergic drugs?

A

Bronchodilators (Albuterol)
Vasopressors (Ephedrine, epinephrine, and dopamine)
Cardiac stimulants

154
Q

What are beta-adrenergic blocking agents?

A

Drugs that decrease sympathetic activity by binding to beta-adrenoreceptors to prevent epi and NE from binding

155
Q

What are beta-blockers used for?

A

Following MI - increase survival rates

156
Q

What are examples of beta-blockers drugs?

A

End in -olol

157
Q

How is the parasympathetic nervous system innervated?

A

Control of medulla oblongata by the vagus nerve (release of ACh)

158
Q

What are the effects of the PNS on the body?

A

Slow rate and force of myocardial contraction

Vasoconstriction

159
Q

What are baroreceptors?

A

Main mechanism controlling HR

160
Q

Where are baroreceptors located?

A

Aortic walls or aortic arch

Carotid sinus

161
Q

What is the circulatory reflex?

A

Respond to change in BP

Increase BP as a result of PNS and decrease rate and force of contraction

Decreased BP results in SNS stimulation = increase HR, BP and vasoconstrict peripheral BV

Increase atrial pressure causes reflex acceleration of HR

162
Q

What are chemoreceptors?

A

Sensitive to changes in blood chemicals such as oxygen, carbon dioxide, and lactic acid

163
Q

What change in blood chemicals cause the heart rate to increase?

A

Increase CO2
Decrease O2
Decrease pH

164
Q

Where are chemoreceptors located?

A

Carotid body

165
Q

How does temp affect HR?

A

Increase in temp = increase HR

Decrease in temp = decrease in HR

166
Q

What are potential effects of hyperkalemia?

A

Tachycardia

Potential cardiac arrest

167
Q

What are potential effects of hypokalemia?

A

Hypotension

Arrhythmias that may progress to V-fib

168
Q

What are potential effects of hypercalcemia?

A

HTN
Signs of heart block
Cardiac arrest

169
Q

What are potential effects of hypocalcemia?

A

Arrhythmias

Hypotension

170
Q

What are potential effects of hypernatremia?

A

HTN
Tachycardia
Pitting edema

171
Q

What are potential effects of hyponatremia?

A

Hypotension

Tachycardia

172
Q

What is the correlation between peripheral resistance and arterial blood vol/pressure?

A

Direct linear correlation

Increased peripheral resistance = increased arterial blood volume and pressure

Decreased peripheral resistance = decreased arterial blood volume and pressure

173
Q

What influences peripheral resistance?

A

Viscosity and diameter of BV/ arterial blood volume

174
Q

What happens to BP if the diameter of BV decreases?

A

BP increase

175
Q

What are risk factors of CV disease?

A 
Hypercholesterolemia
HTN
Smoking
Impaired fasting glucose
Obesity
Sedentary life
Family hx
PMH
Environment - fam support and education
Social habits - smoking and diet
Past and present level of activity
176
Q

What level of HDL should your blood be at to decrease risk of CV disease?

A

> 60 mg/dL

177
Q

What is the relationship between HR and external workload?

A

Direct linear correlation

178
Q

Where should you listen for heart sounds?

A

Aortic valve
Pulmonic valve
Tricuspid valve
Mitral valve

179
Q

What is the “lub” in lub/dub?

A

Closure of mitral and tricuspid valves

180
Q

What is the “dub” in lub/dub?

A

Closure of aortic and pulmonic valves

181
Q

What are some irregular sounds of the heart?

A

Murmur/bruit

182
Q

What is the P-wave?

A

Atrial depolarization

183
Q

What is the P-R interval?

A

Time required for impulse to travel through atria through the conduction system to Purkinje fibers

184
Q

What is the QRS wave?

A

Ventricular depolarization

185
Q

What is the ST segment?

A

Beginning of ventricular repolarization

186
Q

What is the T wave?

A

Ventricular repolarization

187
Q

What is the QT interval?

A

Time for electrical systole

188
Q

What are ventricular arrhythmias?

A

Ectopic (excitable group of cells) focus in the ventricles

189
Q

What are atrial arrhythmias?

A

Ectopic focus in the atria

190
Q

What are atrioventricular blocks?

A

Abnormal delays or failure to conduct through normal conducting system

191
Q

What are some causes of arrhythmias?

A 
Conditions of myocardium
Electrolyte imbalance
Acidosis or alkalosis
Hypoxemia
Hypotension
Emotional stress
Drugs
Alcohol
Caffeine
192
Q

What is an ectopic pacemaker or ectopic focus?

A

Group of excitable cells that cause premature heartbeats outside a normally functioning SA node

193
Q

What is ventricular fibrillation?

A

Pulseless, emergency situation

Perform CPR and defibrillation

Meds to treat

194
Q

What is premature ventricular contractions (PVC)?

A

Premature beat arising from the ventricle

Larger and quick QRS

195
Q

What is ventricular tachycardia?

A

Run of 3 or more PVCs occurring sequentially

HR = 150-200 bpm

196
Q

What is atrial fibrillation?

A

P-waves are abnormal or not identifiable

Tachycardia and atrial flutter

197
Q

What is the normal BP for 1-12 mon/old?

A

90/60 mmHg

198
Q

What is the normal BP for 1-5 y/o?

A

95/65 mmHg

199
Q

What is the normal BP for 6-13 y/o?

A

105/70 mmHg

200
Q

What is the normal BP for 14-19 y/o?

A

117/77 mmHg

201
Q

What is the normal BP for adults?

A

Less than 120/80 mmHg

202
Q

What is the ankle/brachial index used for?

A

Used for PAD

203
Q

How do you perform ABI?

A 
First take BP in both UE
Find pedal pulse
Use US over pulse - will hear swish until you find pulse
Pump up BP cuff until pulse disappears
Deflate until beat is heard again
204
Q

How do you calculate ABI?

A

Ankle systolic pressure divided by the highest UE systolic pressure

205
Q

What is normal ABI?

A

Greater than or equal to 1

206
Q

What is the value of minimal arterial disease ABI?

A

0.9-1.0

207
Q

What is the value of significant arterial disease ABI?

A

0.5-0.89

208
Q

What is the value of severe arterial disease ABI?

A

Less than 0.5

209
Q

What is the value of BP for pre-HTN?

A

120-139 mmHg/80-89 mmHg

210
Q

What is the value of BP for stage I HTN?

A

140-159 mmHg/90-99 mmHg

211
Q

What is normal to see in BP with exercise?

A

Systolic should increase by 10% increments of max HR, systolic increase 12-15 mmHg (less will occur in hypotensive situation), and won’t see much change in diastolic

212
Q

What is dyspnea?

A

SOB

213
Q

What does +1 mean on dyspnea scale?

A

Noticeable to pt but not observer

214
Q

What does +2 on dyspnea scale mean?

A

Some difficulty and noticeable to observer

215
Q

What does +3 mean on dyspnea scale?

A

Moderate difficulty, but can continue

216
Q

What does +4 mean on dyspnea scale?

A

Severe difficult and pt cannot continue

Does not necessarily mean pt cannot do therapy, it may just mean a particular exercise is too much

217
Q

What is the definition of hypoxemia?

A

Abnormally low oxygen in blood

218
Q

What is the definition of hypoxia?

A

Low oxygen levels in tissues

219
Q

When should you terminate exercise based on O2 sats?

A

Below 90% for those who are healthy

86% for those with chronic lung disease

220
Q

How to assess ischemic cardiac pain (angina or MI)?

A

Diffuse, retrosternal or tightness, achiness

Associated with dyspnea, sweating, indigestion, dizziness, syncope, and anxiety

221
Q

How to describe angina?

A

Sudden or gradual onset of chest pain

Occurs with rest or activity

Precipitated with physical/emotional stress or hot/cold temp

222
Q

How is angina treated?

A

Rest and nitroglycerin

223
Q

How do you describe MI pain?

A

Sudden onset

Last more than 30 min

Not relieved by meds

224
Q

Where is angina typically felt?

A

May present as heaviness in shoulder, jaw, arm, elbow, or back between scap

225
Q

What is diaphoresis?

A

Excess sweating with decrease CO

226
Q

What should be looked at prior to d/c?

A

Look for diaphoresis

Check arterial pulses

Observe skin color

Palpate skin temp

Observe skin changes

Observe pain, cramping, and fatigue during exercise and relieved by rest (associated with PVD)

Observe/measure edema

227
Q

What does rubor mean?

A

Dependent redness with PVD

228
Q

How to test for rubor?

A

Testing arterial insufficiency

Locate peripheral vein on foot and puffiness of vein

Raise leg to 45-degree angle and hold for 1-3 min

Lower LE and bring pt back up to dependent position

Vein should go back to normal puffiness w/in 15 sec and normal color in about 30 sec

229
Q

What is abnormal rubor?

A

Deep redness and takes longer to get back to normal

230
Q

What is the percussion test of the peripheral venous system used for?

A

Determines competence of greater saphenous vein

231
Q

How is the percussion test of the peripheral venous system done?

A

Stand and palpate one segment of vein while percussing about 20 cm above

232
Q

What represents an abnormal precussive test of peripheral venous system?

A

Pulse wave felt in the hand that is lower

233
Q

What is the Trendelenburg test for peripheral venous circulation used for?

A

Determine competence of communicating veins and saphenous system

Determines valvular incompetence in a pt with varicose veins

234
Q

How to perform a peripheral venous Trendelenberg test?

A

Supine with legs elevated about 60 degrees

Tourniquet on proximal thigh

Pt asked to stand

Note if vein fills back in a normal pattern within 30 sec

235
Q

What is a doppler US used for?

A

Listening for pulse sound of the peripheral venous system

236
Q

What is the definition of rubor of dependency?

A

Check color changes in the skin during elevation of foot followed by dependency

Pallor will develop in elevated position with insufficiency

237
Q

What is the definition of venous filling time?

A

Check time necessary to refill veins after emptying

238
Q

What is the procedure of venous filling time?

A

Pt supine - leg elevated about 60-degrees for 1 min, then back to dependent position

Note time for refill

239
Q

How to perform an examination for intermittent claudication?

A

Exercise induced pain or cramping in legs that is absent at rest

240
Q

Where is intermittent claudication most commonly felt?

A

Calf, buttock, hip, thigh, or foot

241
Q

What will a chest X-ray show?

A

Abnormal lung fields, cardiac shape and size, and aneurysm

242
Q

What will an ECG/EKG show?

A

Examine HR, rhythm, conduction delays, and coronary perfusion

243
Q

What will myocardial perfusion imaging show?

A

Diagnose and evaluate ischemic heart disease and MI

244
Q

What does an echocardiogram show?

A

US test to visual internal structures

245
Q

What does a cardiac cath show?

A

Used to diagnose and treat some heart conditions

246
Q

What is another name for cardiac cath?

A

Swan Ganz Cath

247
Q

What is an Exercise Tolerance Test?

A

Pt hooked up to EKG and monitored throughout workout

248
Q

What is Thromboangiitis?

A

AKA Buerger’s Disease

Occlusion of small arteries and veins

249
Q

What is diabetic angiopathy?

A

Elevation of blood glucose with associated atherosclerosis

250
Q

What is Raynaud’s disease?

A

Episodic spasms of small arteries

251
Q

What are varicose veins?

A

Distended, swollen superficial veins

252
Q

What are common rehab guidelines for arterial disease?

A

Risk factor modification

Avoid excessive strain and protect extremities from injury and extreme temps

Bed rest may be needed with gangrene, ulcerations, acute arterial disease

Exercise training for those with PVD

LE exercise

Medical treatment

253
Q

What should be considered with an exercise training program for PVD pts?

A

Use interval training

Walking program - 40-70% VO2 max for 3-7 days/wk

Exercise to point of pain

NMB might be necessary

Proper fitting shoes

254
Q

What are important LE exercises to perform in those with arterial disease?

A

Ankle pumps

Resistive calf exercises are most effective to increase blood flow

255
Q

What kind of meds might someone with arterial disease be on?

A

Meds to decrease blood viscosity and thrombus formation

Vasodilators

Calcium channel blockers

256
Q

What are common sx/sx of DVT?

A

Early stages are often asymptomatic

Dull ache, pain, tenderness in calf, edema, and fever

257
Q

What acute tx is done for someone with acute DVT?

A

Bed rest until signs of inflammation have subsided

Elevate extremity

Exercise contraindicated

Amb is permitted with stockings after tenderness and swelling resolve

258
Q

What are rehab guidelines for someone with venous insufficiency?

A

Varies by severity

Focus on “muscle pump”

  • Ankle pumps and foot circles
  • Periodic elevation
  • Use cycle ergometry
  • Early amb is IMPORTANT

Compression stockings

Manual lymphatic drainage

Exercise including ROM

Intermittent pneumatic compression

Skin care edu

259
Q

What is CAD?

A

Narrowing of coronary arteries due to atherosclerosis, which may lead to myocardial ischemia

260
Q

What are the risk factors for atherosclerosis?

A 
Age
Sex
Race
Fam hx of CAD
Smoking
High BP
High chol
Obesity
Sedentary lifestyle
Stress
261
Q

What are syndromes of CAD?

A

Angina
MI
CHF
Sudden death

262
Q

What are meds used to manage CAD?

A 
Nitroglycerin
Beta adrenergic/beta blockers
Ca Channel blockers
Antiarrhythmics
Antihypertensive
Digitalis
Diuretics
Aspirin
263
Q

What is the fxn of nitroglycerin?

A

Peripheral vasodilation

264
Q

What is the fxn of beta adrenergic, beta blockers?

A

Reduce HR and contractility

Reduce BP

265
Q

What is the fxn of Ca channel blockers?

A

Inhibit Ca flow

Reduce HR

Dilate coronary arteries

Reduce BP

266
Q

What is the fxn of antiarrhythmics?

A

Restore normal heart rhythm

267
Q

What is the fxn of digitalis?

A

Increase contractility and decrease HR

268
Q

What is the fxn of aspirin?

A

Decrease platelet aggregation

269
Q

What should the activity restriction include in someone who has had a recent acute MI or CHF?

A

Usually activity is performed within the first 24 hr or until pt is stable for 24 hours

270
Q

When is thrombolytic therapy used?

A

Acute MI to dissolve clot

271
Q

What is a Percutaneous Transluminal Coronary Angioplasty (PTCA)?

A

Surgical dilation of BV with balloon

272
Q

What are intravascular stents?

A

Wire mesh placed after an angioplasty to prevent BV from closing

273
Q

What is a Coronary Artery Bypass Graft (CABG)?

A

Surgical circumvention of an obstruction in a coronary artery using another BV (usually saphenous)

274
Q

What is transplantation?

A

Used in end stage only

Typical problems with rejection and immunosuppression

275
Q

What is the effect of prolonged HTN?

A

Decreased elasticity of arterioles = increased peripheral vascular resistance

276
Q

What are some symptoms that can be included in HTN?

A

Usually asymptomatic

Can include:

  • HA
  • Vertigo
  • Flushed face
  • Blurred vision
  • Increase nocturnal urination
  • Increase BP
277
Q

What are risk factors to HTN?

A 
Sedentary lifestyle
Smoking
Increased chol
Alcohol abuse
High Na
DM
278
Q

What are PT considerations with HTN?

A

Pt education

Aerobic conditioning

  • Emphasize LE
  • Monitor VS
  • Intensity 65-70% MHR
  • 3x/wk
  • Watch for med side effects
279
Q

What is CHF?

A

Inability of heart to effectively pump enough blood to supply the bodily needs

280
Q

Where is the main failure in CHF?

A

L ventricle - complication d/t HTN and ischemia

281
Q

What is the 1st phase of CHF?

A

L ventricle enlarges to hold more blood

Fibers become stretched so far they cannot pump

Blood accumulates in lungs (SOB)

282
Q

What is 2nd phase of CHF?

A

Sympathetic system stimulates increased pumping and increased HR

Hypertrophy of heart = increased demand of coronary arteries

283
Q

What is the 3rd phase of CHF?

A

Kidneys stim to retain fluid to increase blood volume = increase edema and place increased load on the heart

284
Q

What is the 4th phase of CHF?

A

Mild to severe fluid overload leads to heart failure

285
Q

What are sx/sx of CHF?

A

Dyspnea
Fatigue
Mm weakness

286
Q

What meds are used in CHF?

A

Decrease heart workload

Increase Mm contraction

Improve renal blood flow

ACE inhibitors

Vasodilators

Diuretics

Beta blockers

287
Q

What surgery may be performed on a pt with CHF?

A

CABG
Heart valve reconstruction
Cardiac transplant

288
Q

What are some PT indications with someone who has CHF?

A

Improve physiological response to exercise and improve physical abilities in every day activities

Exercise to increase peripheral endurance and respiratory mm training

Avoid exercise right after eating or meds

No resistnace training

Monitor RPE, BP, O2

289
Q

What is the target heart rate of someone with CHF?

A

Below 115 bpm

290
Q

What is the criteria to start exercise on someone who has CHF?

A

Medically stable

Exercise capacity > 3 METS

Exercise induced ischemia and arrhythmias are poor prognostic indicators

291
Q

What are some cardiac rehab indicators?

A 
Medically stable
Stable angina
CABG
PTCA
Compensated CHF
Cardiomyopathy
Heart transplant
Valve/pacemaker insertion
PAD
CAD
292
Q

What is compensated CHF?

A

Chronic form of CHF that is under control with meds

293
Q

What is the opposite of compensated CHF?

A

Decompensated

294
Q

What are normal responses to exercise?

A

Increase in VO2, CO, HR, Systolic BP, and RR

Diastolic should not inc/dec more than 10 mmHg

Decrease in total peripheral resistance

295
Q

What are contraindications to cardiac rehab?

A 
Unstable angina
Systolic > 200 mmHg or diastolic > 110 mmHg
Acute illness
Uncontrolled arrhythmias
Uncontrolled sinus tachycardia > 100 bpm
Uncompensated CHF
Recent embolism
Thrombophlebitis
Uncontrolled diabetes
296
Q

What is the definition of unstable angina?

A

Inability of heart to pump blood adequately to meet the demands of the body

297
Q

What is compensated heart failure?

A

Reduction of CO during initial stage of heart failure and triggers structural/functional changes in cardiac tissue

Often asymptomatic

298
Q

What is decompensated heart failure?

A

Adaptive changes fail to maintain desired CO

Become symptomatic

299
Q

When should someone be stopped during cardiac rehab?

A 
Persistent dyspnea
Dizziness/confusion
Onset of angina
Leg claudication
Excessive fatigue, pallor, or cold sweat
Ataxia
Bone/jt pain
Nausea/vomiting
Systolic BP does not rise or decrease
Systolic > 200 mmHg or diastolic > 110 mmHg
Significant change in ECG
300
Q

What is an Exercise Tolerance Test (ETT)?

A

Determines safe exercise levels w/o sx

Sets level to just below onset of sx

Use 12 lead EKG and face mask

301
Q

What is the goal of ETT?

A

Determine presence of ischemia

Determine functional aerobic capacity

302
Q

What does a positive ETT mean?

A

Point reached where O2 demands of myocardium exceeds supply

303
Q

What does a negative ETT mean?

A

O2 supply was adequate for myocardium needs

304
Q

What equipment is ETT tested on?

A

Treadmill or cycle ergometry

Step tests

305
Q

What are metabolic equivalents (METs)?

A

Measurement of estimated energy expenditure

O2 cost of the body to do activity

Measured in L/min or kcal or O2/kg/min

306
Q

What does 1 MET mean?

A

Basic O2 requirement at rest

307
Q

What does 5 METs mean?

A

5x the O2 requirement needed at rest

308
Q

What does VO2 mean?

A

O2 consumption of the body

309
Q

What does VO2 max mean?

A

Max O2 consumption

310
Q

How many METs are required to promote endurance?

A

3-4

311
Q

How many METs are mean to safely resume most daily activities?

A

5

312
Q

What are the exercise Rx variables?

A

Type (mode)
Intensity
Duration
Frequency

313
Q

How is intensity determined?

A

ETT within 40-85%

Use HR, RPE, and METs to determine

314
Q

Is HR the best determinant of intensity?

A

No

Beta/Ca blockers, pacemakers, and Valsalva can all affect HR

315
Q

What does an RPE of 10-11 mean?

A

Fairly light

Equate to 45-50% of HR range

316
Q

What does an RPE of 12-13 mean?

A

Somewhat hard

Equates to 60% of HR range

317
Q

What does an RPE of 16 mean?

A

Hard

Equates to 85% of HR range

318
Q

What should duration be in cardiac rehab?

A

5-10 min warm up and cool down

Condition for 15-60 min

Avg for mod intensity is about 20-30 min

319
Q

Which should be increased first duration or intensity?

A

Duration

320
Q

What determines frequency during cardiac activity?

A

Lower intensity and duration would equal a greater frequency

321
Q

When can an individual be progressed in cardiac rehab?

A

HR is lower than target

RPE is lower than previously

Sx of ischemia do not appear

Increase duration first, then intensity

Rate of progression can depend on age, health, functional capacity, goals, and preferences

322
Q

When should you reduce the level of activity/exercise in a cardiac rehab pt?

A

Acute illness

Acute injury

Increase edema, unstable angina

Change in meds

Environmental stressors

323
Q

What is phase 1 of cardiac rehab?

A

In patient - length of stay for uncomplicated MI

324
Q

What are the goals of phase 1 cardiac rehab?

A

Activity guidelines of 3-5 METs at D/C

Exercise guidelines

Pt and fam education

HEP

325
Q

What are the activity guidelines for phase 1 cardiac rehab?

A

Initiate independent ADLs early on

Counteract effects of bed rest

Reduce anxiety and depression

Provide medical surveillance

Provide stamina to go home

326
Q

What is involved with exercise guidelines post MI in phase 1 cardiac rehab?

A

First 24 hr - bedrest, bed mobs, ankle pumps, and breathing exercise

Once stable for 24 hr - sit EOB, sit OOB x 30 min several times per day, LE exercise

Gradual increase in am to 5 min a few times a day

ADLs - selected arm and leg exercise, progress amb to 10 min several times per day

Activity to go home - stairs

RPE in light range with HR increase of 10-20 bpm, constant monitoring of vitals and pt response

327
Q

What is involved in the exercise guidelines post-PTCA?

A

May amb comfortably after surgery

Avoid aerobic training for 2 weeks post-op

Exercise script based on post-op ETT results

328
Q

What is involved in the exercise guidelines post-CABG?

A

Sternal/intercostal incision precautions for 4-6 weeks

LE incision

Address soft tissue impairments

Address posture and scap retraction

UE ROM if cleared

Energy conservation

First 2 days hold pillow, hold pillow to sneeze or cough

Avoid reaching behind or lifting/pushing more than 10#

329
Q

When should post-MI increase amb?

A

Goal 20-30 min 1-2x/day at 4-6 weeks

330
Q

What occurs in phase 2 cardiac rehab?

A

Improve function

Progress toward full ADLs, hobbies, and work

Risk factor modification and lifestyle change

Encourage energy conservation

331
Q

What are the exercise guidelines for phase 2?

A

~36 visits

Duration - 30-60 min (5-10 min warmup)

Mode - walking and/or cycle/arm ergometer and strength training

Submax intensity

Strength training

  • Begin at 3 weeks of cardiac rehab, 5 weeks post MI, and 8 weeks post CABG
  • Begin with bands and light weights
  • Progress to mod loads
332
Q

What is phase 3 cardiac rehab?

A

Community exercise

333
Q

What are the goals of phase 3 cardiac rehab?

A

Improve functional capacity

Promote self-regulation of exercise program

Promote life-long commitment to risk-factor mod

334
Q

What are the exercise guidelines of phase 3 cardiac rehab?

A

Entry - 5 METs, stable angina, controlled arrhythmias during exercise

Progress to self-regulated exercise

335
Q

What is the criteria for exercise of CHF?

A

Medically stable
>3 METS

Exercise training

  • Prolonged warm up and cool down
  • Low intensity
  • Increased duration
  • Maintain HR below 115 bpm
  • Monitor RPE - fairly light
  • Avoid isos
  • May do light resistance
336
Q

What is a class I CHF?

A

Mild

No symptoms up to 6.5 METs

337
Q

What is class II CHF?

A

Mild

Dyspnea, fatigue, angina with activity at 5.6 METs

338
Q

What is class III CHF?

A

Moderate

Limited up to 3 METs by dyspnea, fatigue, angina

339
Q

What is class IV CHF?

A

Severe

Symptoms present even at rest

1.5 METs cause discomfort

340
Q

What is important to remember in someone with a pacemaker?

A

Should know the HR set limit

Use RPE

ST segment changes may be common

Avoid UE aerobic and strengthening exercise after implant

Contraindicated with electromagnetic signals

341
Q

How does poorly controlled blood glucose affect the body?

A 
CV disease
Renal disease
Neuropathy
PVD
Ulcers
Autonomic dysfunction
342
Q

How to test exercise limits with someone who has diabetes?

A

May need to use submax ETT

With PVD and peripheral neuropathy = may need to use UBE

343
Q

How to train someone with diabetes?

A

Exercise Rx

Monitor for hypoglycemia

Proper footwear

Jogging/jarring activities are contraindicated

344
Q

What is the intensity of exercise in someone with pulmonary disease?

A

60-95% of VO2 max when spaced and rest periods

Use warm up and cool downs

Emphasize controlled breathing

Use THR range and dyspnea scale

Use RPE

345
Q

How to determine duration of exercise with pulmonary disease?

A

Within THR at least 20-30 min (continuous or with rest)

Increase duration first during progression

Shorten breaks

346
Q

How to determine frequency of exercise with pulmonary disease?

A

3-5x/week if 20-30 min of exercise can be achieved

Increased frequency if duration is shorter or for pt with low functional abilities

347
Q

What PT interventions are used with someone who has pulmonary disease?

A 
Stretching
Posture
Strength Training
-Increase R with aerobic exercise
-Wt train
Progression
-Increase intensity once 20 min of continuous exercise is tolerated

Pt education

HEP

348
Q

Dementia vs AD

A

Dementia is a degenerative syndrome characterized by deficits of memory, language, and mood. AD is a form of dementia

AD is the earliest manifestation of loss of short-term memory

349
Q

What are other types of dementia?

A

Vascular dementia - more abrupt onset and is caused by physical insult of high BP, diabetes, and stroke

PD - dementia is present in late stages

350
Q

When do people typically start to develop AD?

A

~60 y/o

351
Q

What are common changes in advanced AD?

A 
Psychosis
Aggression
Profound personality change
Judgement loss 
Personal care neglect
Physical illness
352
Q

What neurotransmitter is affected in AD?

A

ACh

ACh loss = loss of memory

353
Q

What neurotransmitters affect changes in mood, behavior, and aggression in those with AD?

A

NE, GABA, and serotonin

354
Q

What medications can help slow the progression of AD?

A

ACh replacement (Aceytl cholinesterase inhibitors - Aricept, Exelon, Namenda)

Antidepressants and antianxiety meds

355
Q

What are PT implications of someone with AD?

A

Target and treat generalized weakness and abnormal movements

Fall prevention/balance

Treat underlying decreased proprioception

Change environment and decrease obstacles

Structed exercise program

Short and simple exercises

Use group therapy

356
Q

What is catatonic schizophrenia?

A

Motor disturbances with rigid posture

Pt remain aware during episodes

Episodes consist of uncontrolled movements

Med regulations

357
Q

What is paranoid schizophrenia?

A

Delusions of grandeur

Delusions of persecution

May believe that they possess power

358
Q

What is disorganized schizophrenia?

A

Usually progressive and irreversible

Inappropriate emotional response

Mumbled talking

359
Q

What medical treatments are there for schizophrenia

A

Meds to replace dopamine

Psychosocial tx in combination with

360
Q

What are PT indications with someone who has schizophrenia?

A

Try to keep the pt from social environment

Work in closed environment

361
Q

What are some PT implications for someone with depression?

A

Reassure and redirect the patients direction to positivity

Actively listen without judgement

Offer encouragement

PLISSIT
-Permission - acknowledge presence of depression and allow the person to feel what they are feeling

Limited info - acknowledge and validate how the person is feeling

Specific suggestions - have person seek out social contact everyday

Intensive Therapy - Get therapy from trained professional

362
Q

What is mania?

A

Constantly active

Impulsive

Unrealistic

Elation and self-confident

Disagreement with pt may result in aggression

Very few pt with mania are diagnosed

363
Q

When does bipolar manifest?

A

Late adolescence or early adulthood

364
Q

What are some common side effects of bipolar meds (IE. lithium)?

A

Hand tremors

Increased thirst

Increased urination

Vomit and diarrhea

Wt gain

Impaired memory

Poor concentration and drowsiness

Mm weakness

Decreased thyroid function

365
Q

What do meds for anxiety typically target?

A

Increase effects of GABA - there is potential for addiction

366
Q

What is borderline personality disorder?

A

Often occurs in women with abandonment issues

Unstable mood characterized by crisis and anger, alternating with depression

Vulnerable to brief psychotic episodes, substance abuse, and eating disorders

367
Q

What are PT implications for someone with personality disorder?

A

Focus on physical needs

Remind yourself that you are not there to satisfy all needs of the pt

Remain professional

Document troublesome exchanges

Do not try to be their friend

Do not take any client’s response personal

Do not allow emotions to take over documentation

368
Q

What are somatoform disorders?

A

Classified based on physical symptoms present in each disorder

Primarily in women

Complains of sx but now physiologic basis

Sx usually lead to meds and medical visits

Sx can alter pt life

Resemble hypochondrosis

369
Q

What is conversion disorder?

A

Physical complaints of neurological basis but no underlying cause

Paralysis most common finding

Other findings may include deafness/blindness

Freud believes this is a mental anxiety that is transformed into physical sx

Diagnosis can be made once testing is done to cross off negative physical ailments

370
Q

What are PT implications for someone with somatoform disorders?

A

Keep accurate records of findings

Assess regularly

Mention progress frequently

Focus on what you can change and avoid what you can’t

Praise strengths

Do not tell them it is in their head

Do not confront the obvious contraindications

371
Q

What is psychogenic amnesia?

A

Develop when a person unconsciously dissociates one part of mind from the rest

No physical cause

Forgets all aspects of the past

Special Pops (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions