Lecture 3: OAT Cardiopulmonary Patient Flashcards
At which cobb angles does exercise capacity become effected; at what angles is their respiratory and cardiovascular compromise?
- 5-15° = mild = exercise capacity decreased
- >50° = respiratory compromised
- >75° = CV compromised
Length of stride (gait) in pt with severe HF is reduced and how does this affect oxygen consumption/cost?
Oxygen cost associated with short-stepping gait pattern = high
Where does lymph from the visceral pleura of the lungs drain into?
DEEP pulmonary plexus
Majority of lymphatic drainage from the heart and lungs is carried back through which lymph channel?
Right lymphatic duct
The thoracic duct is functionally under the control of which part of the ANS; how does hyperractivity effect lymph flow?*******
Sympathetic control –> hypersympathetic tone–> ↓lymph flow
Postganglionic fibers (T1-T5) form the sympathetic cardiac nerves, which converge at the what?
Cardiac plexu
The deep cardiac plexus splits into the right and left halfs, what does each innervate?
- Right half –> SA node + right and left coronary plexus
- Left half –> AV node
Cholinergic and adrenergic fibers passing through the cardiac plexus are most strongly concentrated where?
SA and AV nodes
Sympathetic hyperactivity of the right half of heart affects SA node and increases risk for what?
What about parasympathetic (right vagal) hyperactivity on the right?
- Sympathetic at SA node –> ↑ risk of SVT
- Right vagal at SA node –> sinus BRADYarrhythmias
Sympathetic hyperactivity of the left half of heart affects AV node and increases risk for what?
What about parasympathetic (left vagal) hyperactivity at AV node?
- Sympathetic at AV node –> ↑ risk of ectopic foci and Vfib
- Left vagal at AV node –> AV blocks
Smooth muscle tone of the airways is predominantly under control by which branch of the ANS?
Parasympathetic
Irritation of the pulmonary branches of the vagus nerve produce what strong relex on the heart; example of what type of reflex?
Strong inhibitory reflexes on the heart = viscero-visceral reflex
Where is anterior chapman’s point for myocardium and bronchus?
2nd ICS along SB
Where is anterior chapman’s point for upper and lower lung?
- Upper = 3rd ICS along SB
- Lower = 4th ICS along SB
Where is posterior chapman’s point for the myocardium?
Intertransverse spaces between T2-3
Where is posterior chapman’s point for the bronchus?
Lateral to T2 SP
Where is posterior chapman’s point for the upper lung?
Intertransverse space between T2-3 AND T3-T4
Where is posterior chapman’s point for the lower lung?
Intertransverse space between T4-5
Which OMT technique can be used to ↓ SVR associated with HTN?
Paraspinal inhibition
What is a caution that should be taken when using OMT in pt with CHF?
To NOT overwhelm the circulatory system and exacerbate sx’s
Which OMT technique can be used in CHF under the respiratory-circulatory model to improve breathing?
Rib raising
Which 2 OMT techniques under the metabolic-energetic-immune model can help restore electrolyte levels in CHF?
Lymphatic pumps and effleruage
Which 2 techniques would fit under the respiratory-circulatory model for tx of arrhythmias?
- Valsalva maneuver
- Carotis sinus massage
What are the 3 main goal of OMT for pneumonia?
- ↓ congestion
- ↓ sympathetic hyperactivity to pulmonary parenchyma of lung
- ↓ mechanical impediments to thoracic cage respiratory motion
Which 3 OMT techniques can be utilized for the neurological model of tx pneumonia?
- Paraspinal inhibition T1-T7
- CV4
- Tx OA/AA to normalize PNS
Which OMT technique is contraindicated in COPD?
Thoracic vacuum
If OMT causes ↑ sympathetic tone in a cardiopulmonary pt this could lead to what complication?
Constriction of lymph vessels and systemic blood vessels
