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CardioPulmoaryPT1 > HTN: Exam 1 > Flashcards

HTN: Exam 1 Flashcards

1
Q

The “idea” BP

A

119/79

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2
Q

CPG NEW BP Guidelines

A

see pics

**CAN BE ONE OR THE OTHER

SBP OR DBP

doesn’t need to be both #s to be in that category!!!

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3
Q

NORMAL BP

A
  • SBP
    • ​<120
  • DBP
    • ​<80
  • Ideal== 119/79
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4
Q

ELEVATED BP

used to be “Pre-HTN”

A

SBP== 120-129

OR

DBP== <80

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5
Q

Hypertension

Stage 1

A

SBP== 130-139

OR

DBP== 80-89

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6
Q

HTN

Stage 2

A

SBP== >/= 140

OR

DBP== >/= 90

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7
Q

NOTE:

** indiv’s w/ SBP and DBP in 2 categories should be designated to _______

A

HIGHER BP category

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8
Q

BP======

controlled by what 2 mechs?

A

BP= CO(HR*SV) * TPR

controlled by:

1. ANS

2. Hormonal system (Renin-angio system)

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9
Q

Types of BP

Primary

essential or idiopathic

A

from Risk factors–90% of people

ex. sedentary, stress, genetics

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10
Q

Types of BP

Secondary

A

caused by SOMETHING ELSE IN SYSTEM

ex. kidney dis.,

hard to treat

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11
Q

Types of BP:

Labile

A

fluctuating BP

hormonal affects

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12
Q

Types of BP

Anxiety induced HTN

“white coat HTN

A

exactly what it sounds like

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13
Q

HTN:

The Sequela

explain

A
  • Initially
    • ​INC SNS stim from risk factors cause:
      • periph vasoconstrict
      • inc blood plasma vol
      • sustained + inotrope and/or + chronotropic effect
    • High Na+ diet==> inc plasma volume
    • lack of ex, inact, sedent,
      • decondition heart==> non-optimal SV w/ reflexive + chrono effect
    • obesity ==> inc press in abd area/LE/UE
      • inc’s TPR
    • sleep deprivation
      • activates SNS
          • chronotropic effect==INC HR/BP

**ALL of this produces overload in L. VENT, aorta, and periph arteries=====> EARLY HTN

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14
Q

Sustained HTN

DECd compliance/distensibility of aa’s:

elastic tissue of aa’s and arterioles are replaced by fibrous collagen tissue =====

A

no recoil

prolonged or irreversible HTN

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15
Q

sustained HTN

diminished SV is detected by KIDNEYS—->

activates RAS causing vasoconstriction and Na+/H2O retention=====

A

prolonged or irrev. HTN

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16
Q

Sustained HTN

DEC compliance of CA’s leads to DEC O2 supply to myocardium ======

A

prolonged or irrev. HTN

17
Q

sustained HTN

L. vent working against elevated HTN for prolonged pds will become HYPERTROPHIED or rigid or less kinetic

this cannot be reduced =====

A

prolonged or irrev. HTN

18
Q

Sx’s HTN

early Tx the better!!!!

A
  • asymptomatic
    • or just used to sx’s
  • HA
  • vertigo
  • flushed face
  • epistaxis
    • nausea, dry heave
  • blurred vision
  • nocturnal urinary freq
    • Nocturia
  • dyspnea
  • angina
19
Q

Basic med. tx HTN

Goal (3)

A
  • normalize BP BOTH @ rest and BP resp during exertion
  • PREVENT prolonged HTN patho
    • ​LVH, art stenosis, CVA
  • IMPROVE CA O2 supply

*LIFE-STYLE CHANGES!!!

20
Q

MED TX HTN

meds

A

beta blocks

alpha blocks

ACE inhibitors

Ca+ channel blocks

Diuretics

21
Q

HTN Tx

Category + Tx

A
  • Pre-HTN
    • ​lifestyle mod
  • stage 1 HTN
    • ​diuretics
    • maybe ACE inhibitors
  • Stage 2 HTN
    • ​combo of 2+ meds or cocktail
      • ​ALWAYS INCLUDES BETA BLOCKER
        • **blunted HR resp***
          • ​use borg!!!
22
Q

Systemic effects HTN

Brain

A

cerebral aneurysm

Hemorrhagic CVA

23
Q

Systemic effects HTN

Eyes

A

Retinopathy—-arterioloar damage

24
Q

Systemic effects HTN

A

Atherosclerosis

25
Q

Systemic effects HTN

Heart

A

CHF

atherosclerosis

angina

MI

26
Q

systemic effects HTN

Kidneys

A

Nephrosclerosis (hardened tubules)

CRF

27
Q

systemic effects HTN

BP

A

persistent elevation

28
Q

Prognosis of HTN

A

HTN===sig. risk factor for dev. of CAD, stroke, CHF and renal failure

precedes heart failure in 90% of all cases and INCing in all other assoc’d cond’s

29
Q

Exercise is like a DRUG for HTN

A

reduces systolic AND diastolic BP @ rest

DOSE dependent (more==better)

may be able to reverse early HTN

may be able to AVOID, DISCONT, DEC dosage of med mgmt in prolonged HTN

30
Q

High % of pts referred to PT will have ______

A

dx or undx’d HTN

  • Monitor during tx sessions:
    • ​any pt over 45
    • any pt w/ risk factors or Dx
      • ​CVA, DM, CAD, aortic aneurysm, PAD, obesity, CRF, alcoholism, chronic pain syndrome
31
Q

3 categories to follow when to take vitals

A
  • Healthy indiv’s
    • during eval
  • pts w/ risk factors
    • EVERY session pre/post aerobic
  • Pts w/ Dx HTN
    • keep cuff on
    • monitor constantly!!!
32
Q

Exercise Capacity is pts w/ prolonged HTN is REDUCED 15-30%

why?

A
  • Sub-opt SV
  • SV inc’s faster w/ ex
  • HIGHER RHR
  • LOWER peak HR
  • diminished CO

Prescribe accordingly!!!!

33
Q

Indiv’s medicated for HTN may have altered ___________ if taking Beta blocker

A

altered resp to EX

Do a warmup***

use RPE***

34
Q

ASCM Guidelines:

Ex testing is CONTRAINDICATED IF:

A

BP >200/110

35
Q

ASCM GUIDELINES:

Discontinue Ex testing if:

A

BP >220/110 in indivs w/ known CV dx

BP >250/115 in healthy indivs

Anytime there is a DROP in SBP

Anytime there is an ELEVATION or DROP in DBP >/= 10

36
Q

Pulm AA HTN== MAP > 25

3 types

A
  1. Idiopathic Pulm HTN
  2. Secondary Pulm HTN
  3. Chronic thromboembolic pulm HTN (CTEPH) —> dev clots over time==HTN

CardioPulmoaryPT1 (12 decks)

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