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PHTH 527 > Exercise for CV and Pulmonary Conditions > Flashcards

Exercise for CV and Pulmonary Conditions Flashcards

1
Q

Primary impairment is an imbalance between _______ oxygen supply and _______ oxygen demand.

A

myocardial

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2
Q

There is a decrease in supply to the heart due to narrowing of the lumen of the _____ ______.

A

coronary artery

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3
Q

______ _____ occurs when the blood supply to part of the heart is interrupted.

A

heart attach

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4
Q

Heart attacks most commonly occur de to occlusion of a coronary artery following the rupture of an ______ ______.

A

atherosclerotic plaque

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5
Q

_______ _______ = an unstable collected of lipids and WBC’s in the wall of an artery.

A

atherosclerotic plaque

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6
Q

What are 2 basic mechanisms of exercise intolerance in CAD?

A
  1. Impaired LV function

2. Myocardial ischemia (angina)

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7
Q

When VCO2 increases faster than VO2, what will change with RER?

A

Will go over 1

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8
Q

VO2 plateaus due to a ______ in SV with VCO2 continues to _______.

A

plateau; increase

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9
Q

RER is significantly higher in CAD due to impaired O2 _______ and increased metabolic _______.

A

delivery; acidosis

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10
Q

Ve/VCO2 ratio is normal at rest and during exercise in CAD (T/F).

A

TRUE

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11
Q

_________ compensation for metabolic acidosis during heavy exercise is normal and effective in CAD.

A

respiratory

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12
Q

Is a lower or higher Ve/VCO2 ratio more efficient?

A

lower

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13
Q

The _____ _____ is similar in health and CAD (indicating normal sub maximal O2 delivery and utilization).

A

anaerobic threshold

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14
Q

Above the _______ _____, VCO2 increases more steeply in CAD than in healthy subjects.

A

ischemic threshold

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15
Q

During the onset of myocardial ischemia in patients with CAD, what occurs with HR response?

A

curvilinear response rather than normal linear response

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16
Q

During the onset of myocardial ischemia in patients with CAD, what occurs to O2 pulse?

A

O2 pulse remains below predicted values

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17
Q

CAD patients are usually ventilatory limited (T/F).

A

FALSE

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18
Q

_________ _______ = process by which pt’s with cardiac disease, in partnership with a multidisciplinary team of health professionals, are encouraged and supported to achieve and maintain optimal physical and psychosocial health.

A

cardiac rehabilitation

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19
Q

What are 3 goals of cardiac rehabilitation (CR)?

A
  1. Limit adverse physiological and psychological effects of cardiac illness
  2. Decrease the risk of sudden death or reinfarction
  3. Control symptoms
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20
Q

What are 3 components of CR?

A
  1. lifestyle
  2. psychosocial care
  3. long-term management strategy
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21
Q

What are 5 examples of lifestyle factors that are addressed in CR?

A
  1. Pa and exercise
  2. Secondary prevention
  3. Education
  4. Diet and weight management
  5. Smoking cessation
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22
Q

Phase I of CR?

A

in patient period

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23
Q

Phase II of CR?

A
  • early post discharge

- up to 12 weeks of supervised exercise and/or education following discharge

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24
Q

Phase III of CR?

A
  • supervised out-pt program including structured exercise

- variable length program, intermittent of no ECG monitoring

25
Q

Phase IV of CR?

A
  • long-term maintenance of exercise and other lifestyle changes
  • no ECG monitoring and limited supervision
26
Q

One of the goals of CR is to have pt’s reach __-__ MET activity level by discharge.

A

3-4

27
Q

In CR, there should be a sow progression of activity intensity (increase by __ MET/day).

A

1

28
Q

For inpatient CR, progress when pt can exercise continuously for __-___ min.

A

10-15

29
Q

How many classes of activity classification are there for inpatient CR?

A

VI

30
Q

What are 3 goals of outpatient CR?

A
  1. Return pt to pre-morbid vocational and/or recreational activities
  2. Help pt establish and implement a safe and effective home exercise program and recreational lifestyle
  3. Provide pt and family education and therapies to maximize secondary prevention
31
Q

Beta blockers ____ HR response.

A

blunt

32
Q

If a PT is on beta blockers, what are two other methods to to measure level of work besides HR?

A
  1. %VO2

2. RPE

33
Q

_____-___ is very important in cardiac rehabilitation when exercising.

A

warm up

34
Q

Why is warm up important in cardiac rehabilitation?

A

Allows pt to exercise more intensely before feeling chest pain.

35
Q

Intensity for exercise in CR should be prescribed at a HR below the _______ threshold.

A

ischemic

36
Q

When resistance training in CR, what should the RPE be?

A

~11-13

37
Q

_____ is a beta blocker and it lowers HR and BP at rest and exercise.

A

metoprolol

38
Q

_______ controls atrial fibrillation and lowers HR at rest and exercise.

A

digoxin

39
Q

____ is a diuretic and has little effect on HR but increases urination frequency.

A

HCT

40
Q

_____ ______ _____ = Chronic airway obstruction due to inflammatory narrowing, smooth muscle hypertrophy and airway hyper secretion.

A

small airways disease (COPD)

41
Q

________ = loss of elastic lung recoil with attendant airway collapse during expiration; impaired pulmonary gas exchange and decrease in SA.

A

emphysema

42
Q

What are 3 causes of COPD?

A
  1. cigarette smoking
  2. exposure to indoor pollutants and biomass fuels
  3. smoke from cooking in poorly ventilated conditions
43
Q

Expiratory flow limitation will lead to an increase in ____ ______ , leading to lung hyperinflation.

A

air trapping

44
Q

_______ ________ = acute increase in end expiratory lung volume relative to rest.

A

dynamic hyperinflation

45
Q

Because pt’s with COPD breath very close to their TLC, _____ ______ ______ increase and tidal volume is unable to increase.

A

end expiratory volume

46
Q

________ increase the work of breathing.

A

hyperinflation

47
Q

The work and O2 cost of breathing at any given ventilation during exercise is considerably greater in COPD (T/F).

A

TRUE

48
Q

In COPD pt’s there is a ____ level of neural drive to increase TV.

A

high

49
Q

___________ dissociation refers to the connection, or lack thereof between the brain and respiratory system.

A

neuromechanical

50
Q

What are 5 examples of causes of exercise intolerance in COPD?

A
  1. Ventilatory limitations
  2. Exertional symptoms
  3. Metabolic and gas exchange abnormalities
  4. Cardiac impairment
  5. Peripheral muscle dysfunction
51
Q

What are 4 components of pulmonary rehabilitation (PR)?

A
  1. Exercise testing
  2. Education
  3. Psychosocial/behavioural interventions
  4. Outcome assessment
52
Q

PR (does/does not) change lung structure and function.

A

does NOT

53
Q

What 4 things does PR do?

A
  1. Reduce symptoms
  2. Improve exercise tolerance
  3. Increase functional ability
  4. Improve quality of life
54
Q

What 3 things PR improve?

A
  1. Muscle reconditioning
  2. Increased respiratory muscle strength
  3. Desensitization to dyspnea
55
Q

_______ ______ in COPD leads to functional changes in skeletal muscle function that can be partly or or completely reversed by exercise training,

A

activity avoidance

56
Q

Is interval or endurance training more effective for PR?

A

Similarly effective

57
Q

_______ muscle stimulation significantly improves muscle strength.

A

electrical

58
Q

There is a greater increase in exercise endurance in patients that got ______ _______ and O2 compared to other groups.

A

noninvasive ventilation

59
Q

Patients that improved exercise tolerance with ____ in pre-training tests had the greatest benefits during rehab exercise training.

A

O2

PHTH 527 (10 decks)

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