Final Exam Flashcards
What is Cardiac Output?
The amount of blood that is pumped out of the heart in a minute
What is normal Cardiac Output?
4-6 L at rest
What is Stroke Volume?
The amount of blood pumped by the heart with each beat.
What is normal Stroke Volume?
2.4 oz (71 ml)of blood per beat
What is Ejection Fraction
It’s the ratio of the volume of blood ejected from the L ventricle per beat to the volume of blood in the L ventricle after filling
(diastole)
What is the normal Ejection Fraction
.6-.75
What does the P wave of an EKG represent?
Arterial Depolarization
What does the QRS portion of an EKG represent?
Ventricle Depolarization
What does the T wave of an EKG represent?
Ventricles Repolarization
What does the ST segment of an EKG represent?
Ventricles initiate repolarization
What is a dip in the ST segment of an EKG indicative of?
A CAD
What is a spike in the ST segment of an EKG indicative of?
An acute MI
What are the steps of Normal Conduction of the Heart?
- SA Node
- AV Node
- Bundle of His
- Branches
- Purkinje Fibers
What is the Karvonen’s Formula?
60%-80% x (HR max - HR rest) + HR rest = Target HR
How should you calculate a Max HR if no stress test has been performed?
220-age
What should the THR for a post MI patient be if no stress test was done?
Resting HR + 20 or <120 bpm
What should the THR for a post CABG patient be if no stress test was done?
Resting HR + 30
What should the normal response of HR and RR be if O2 drops?
They should increase
For every MET, how much should HR and BP rise?
8-12 bpm/mmHg
What are typical exercise METS for cardiac inpatient patients?
2-3
What is the goal RPE score for an inpatient cardiac patient being exercised?
11-13/20
What does a typical exercise prescription for a cardiac patient in acute rehab look like?
-10 min warm up at approximately 1.5 METS
-20-30 min aerobic exercise at THR (1.5-3 METS)
-5-10 min cool down till patient reaches resting HR
What is the Questionnaire used to determine if it is safe for a patient to begin an aggressive exercise regimen?
PAR-Q and You
What is the scoring for the Tinetti Assessment test like?
-16 possible points for Balance
-12 possible points for Gait
-28 total possible points
-The more points, the more functional the patient is
What is Pharmacokinetics?
What the drug does after it enters the body. How it is absorbed, distributed, metabolized and eliminated
What is Pharmacodynamics?
What the drug does to the body
What do Ace Inhibitors do?
Decrease BP via vasodilation
What are Antihyperlipidemic Agents used for?
For patients with Hight Cholesterol
What kind of drugs decrease HR, therefore necessitating the use of the RPE scale during exercise?
Beta Blockers
What do Diuretics do?
Decrease BP via excretion of sodium by peeing
What are the rules for taking Nitrate Agents (Nitro Glycerine)?
1 tablet every 5 minutes, but no more than 3 tablets
What are the steps in a Snap Shot Assessment of lines and tubes?
-Survey the Pt.
-Identify
-Where does it start?
-Where does it end?
-What does it do?
-How will it affect the Pt.s Tx
Which feeding tube provides short term nutrition through a venous catheter that is guided to the superior vena cava
-Bypasses the GI tract
-Pt. still feels hunger
-No restrictions for PT
Total Parenteral Nutrition (TPN)
Which feeding tube provides short term enteral nutrition (< 4wks)
-may also be used for suctioning the contents of the stomach
-common to go in the R nare
Nasogastric Tube (NG Tube)
Which feeding tube provides long term nutrition and is surgically implanted into the stomach wall?
Gastrostomy Tube (G-Tube) or Percutaneous Endoscopic G-Tube (PEG)
What implications should a PTA be aware of when treating a Pt. with a feeding tube?
-Avoid the supine position while the tube is running
-Ask the nurse if the tube can be disconnected prior to mobility
-Watch the location of the gait belt
Which Drain drains the contents of the abdominal or pleural space?
Jackson-Pratt Drain
How many liters of oxygen a minute does a nasal cannula deliver?
1-6 liters/minute
How many liters of oxygen a minute does a simple mask deliver?
5-10 liters/minute
Which mask is used for COPD patients, delivers greater % of O2, delivers 2-15 liters/minute of oxygen, and can also deliver aerosolized medications?
Venturi Mask
Which oxygen deliver variation is used for acutely ill pt.s, can deliver 15 Liters/minute of oxygen, and prevents rebreathing of expired air?
Non-rebreather mask
Which oxygen delivery variation is used for sleep apnea, ARDS, and COPD exacerbations?
CPAP and Bi-Pap
When are Standard Precautions used?
Always
What are the components of Standard Precautions?
-Wash hands before and after pt. care
-Establish a barrier to bloody, body fluids, secretions/excretions, non-intact skin, and mucous membrane
What are Protective Precautions used for?
A patient with impaired resistance to infection
What is the difference between Ventilation and Respiration?
-Ventilation: the movement of air in and out of the lungs
-Respiration: gas exchange of oxygen/carbon dioxide which occurs at the capillary membranes, alveoli, and body tissues
What are these names for?
-Tracheal
-Bronchial
-Bronchovesicular
-Vesicular
Normal Breathing Sounds
What are these names for?
-Crackling
-Wheezing
Adventitious Breath Sounds
Which position should you put a patient in for easier breathing?
Semi-Fowlers position: Supine with the head of the bed raised 30-45 degrees
Does the diaphragm contract on inhalation or expiration
Inhalation
Which muscles aid in Inhalation?
-Diaphragm
-Intercostals
-Sternocleidomastoid
-Traps
-Rhomboids
-Levator Scapulae
-Pecs
Which muscles aid in forced expiration?
The Abdominals
What is VC in terms of Pulmonary Rehab?
Vital Capacity: the amount of air a persons lungs can forcefully inhale and exhale
What is Tidal Volume?
The normal amount of air a person breaths (500ml)
What is IRV in terms of pulmonary rehab?
Inspiratory Reserve Volume: Max inspiration after resting inspiration? (3000 ml)
What is ERV in terms of pulmonary rehab?
Expiratory Reserve Volume: Max expiration after resting expiration (1000 ml)
What is RV in terms of pulmonary rehab?
Residual Volume: The amount of air left in the lungs after forced expiration. (1500 ml)
What is the difference between Obstructive and Restrictive Pulmonary Dysfunctions?
Obstructive: trouble exhaling
Restrictive: trouble inhaling
Types of Obstructive or Restrictive Diseases?
-Asthma
-Bronchitis
-Chronic Bronchitis
-Cystic Fibrosis
-Emphysema
-COPD
Obstructive
Types of Obstructive or Restrictive Diseases?
-Adult Respiratory Distress Syndrome (ARDS)
-Atelectasis
-Interstitial Pulmonary Fibrosis
-Lung Contusion
-Pneumonia
-Pulmonary Edema
-Pulmonary Embolism
Restrictive
What is the normal ration of inspiration to exhalation?
1:2
What are the different types of breathing techniques?
-Diaphragmatic Breathing
-Pursed Lip Breathing
-Segmental Breathing
When does Spinal Shock take place and how long does it last?
Can occur 20-60 minutes after injury and can last 24 hours to weeks
What are the Key Muscles to test post SCI?
C5=Elbow Flexors
C6=Wrist Extensors
C7=Elbow Extensors
C8=Finger Flexors
T1=Finger Abductors
L2=Hip Flexors
L3=Knee Extensors
L4=Ankle Dorsiflexors
L5=Big Toe Extensors
S1=Ankle Plantar Flexors
What is Central Cord Syndrome?
It is an Incomplete Lesion to the spinal cord where UEs are affected >LEs and ambulation is possible for many patients
Which typed of Incomplete SCI is a hemisection of the spinal cord caused by a gunshot or stab wound and affects the opposite side of the body
Brown-Sequard Syndrome
Which type of Incomplete SCI occurs from a flexion injury to the C-spine and results in loss of things like P!, motor control, and temp sensation below injury; but keeps things like proprioception, vibration sense, and deep pressure sense?
Anterior Cord Syndrome
What is the type of Incomplete SCI which results in the sparing of centrally locate sacral tracts?
Sacral Sparing
What is the scale used to determine the severity of a SCI by assigning it a grade?
The ASIA scale
What are the grades of the ASIA scale and which is the best?
A-E
E is the best
Which key anatomic structures need to be protected to preserve the function of an SCI patient?
Preserve finger flexion and low back extension
How is extension of the flaccid legs achieved for a SCI patient?
The use of a KAFO and resting on the Y-ligament
What type of ulcers are found on the lateral ankle, dorsum of foot, or toes; round in shape with smoothed, defined edges; deep; and causes P! with elevation?
Arterial
Which type of ulcer is found on the medial malleolus, has irregular shaggy edges, is shallow, and causes P! in the dependent position?
Venous
What is normal capillary refilling time?
2 seconds
What is the most important part of a prosthetic and why?
The socket, because if it’s not comfortable, the patient won’t wear it
What are the most common socket designs for prosthetics?
-liner pin and lock
-suction/vacuum
Which type of transtibial socket design loads pressure tolerant areas and relieves pressure intolerant areas?
Patella Tendon Bearing (PTB) Socket
Which Transtibial Socket design creates a uniform shape for the limb to share the load equally and has less pointed pressure, therefore less perceived pressure?
Total Surface Bearing (TSB) Socket
Which type of Transfemoral Socket Design is square shaped and maintains the ischium on top of the seat?
Quadrilateral Socket
Which type of transfemoral socket design is oval shaped and contains the ischium within the socket design?
Ischial Containment Socket
Which transfemoral socket design is the most common?
The ischial containment socket
What are the Medicare K levels and which is most functional?
K0-K4
K4 is the most functional
