Midterm Review

Question 1

The force exerted by circulating blood on the walls of blood vessels

Answer 1

Blood Pressure

Question 2

Blood pressure when the heart (ventricles) contract. The first # recorded

Answer 2

Systolic

Question 3

When the heart is in a period of relaxation and dilatation (expansion). Second # recorded

Answer 3

Diastolic Pressure

Question 4

Amount of blood ejected into the aorta

Answer 4

Stroke Volume

Question 5

Number of heart beats per minute (60-100)

Answer 5

Heart Rate

Question 6

Resistance factors in circulatory system that affect the ease of BF (tone in blood vessels and viscosity of blood)

Answer 6

Peripheral Resistance

Question 7

Pressure is difference between the systolic and diastolic pressures. Palpated as rhythmical throbbing over an artery, normally assessed at wrist or neck

Answer 7

Pulse

Question 8

Receptors within BV walls that sense pressure changes (Carotid Sinus)

Answer 8

Baroreceptor

Question 9

Monitor the concentration of O2, CO2 and H in the blood (Located in carotid sinus of heart) - Influence breathing rate

Answer 9

Chemoreceptor

Question 10

Elevation of blood pressure above normal for prolonged period

Answer 10

Hypertension

Question 11

Silent, long term condition that is not associated with underlying condition/disease, through associated with risk factors (silent killer)

Answer 11

Primary Hypertension

Question 12

Occurs secondary to another condition (kidney disease, vascular)

Answer 12

Secondary Hypertension

Question 13

Hearts inability to pump sufficient blood supply to the body’s needs

Answer 13

Congestive Heart Failure

Question 14

Decrease in systolic/diastolic BP below normal (95/60). There are many different reasons for hypotension but some of the more severe cases include myocardial infarction, shock, hemorrhage, allergy

Answer 14

Hypotension

Question 15

Excessive fall in BP on assuming an upright position. This is not a disease but manifestation of abnormal BP regulation due to variety of causes

Answer 15

Orthostatic Postural Hypotension

Question 16

Distended, dilated abnormally large, elongated bulging veins leading to venous insufficiency

Answer 16

Varicose Veins

Question 17

Inflammation of superficial or deep veins that leads to the formation of thrombus

Answer 17

Thrombophlebitis

Question 18

Increase blood flow (coagulation) - blood clotting, injury of the wall of the blood vessel

Answer 18

Venous stasis

Question 19

Hypotension Value

Answer 19

90 or loss / 60 or less

Question 20

Prehypertension Value?

Answer 20

130-139/85-89

Question 21

Stage 1 Hypertension (mild) Value

Answer 21

140-159/90-99

Question 22

Stage 2 Hypertension (moderate) Value?

Answer 22

160-179/100-109

Question 23

Stage 3 Hypertension (severe) Value?

Answer 23

180-209/110-119

Question 24

Stage 4 Hypertension (very severe) Value

Answer 24

210+/120+

Question 25

Risk factor of hypertension

Answer 25

1) 45 years of age and above
2) Family history
3) Smokers – double the risk
4) Diabetics
5) Darker races
6) Men > women until women hit menopause then it is equal
7) Pregnancy – affects 10%, referred to as “pre-eclampsia” or “eclampsia”, usually resolves after the birth
8) People with high stress levelshigh sodium intake high alcohol intake
9) People taking oral contraceptives
10) Obesity and/or physical inactivity

Question 26

What are different classifications of BP medication?

Answer 26

1) Diuretics
2) Angiotensin-Converting Enzyme Inhibitors
3) Beta-Blockers
4) Calcium Channel Blockers
5) Vasodilator Drugs

Question 27

The heart’s inability to pump sufficient blood to supply the body’s needs. May be secondary to heart disease, chronic high BP, valvular disease, viral infection, alcoholism and other conditions that stress the heart

Answer 27

Congestive Heart Failure (CHF)

Question 28

What are the risk factors of CHF?

Answer 28

1) Myocardial infarctions; Ischemic heart disease
2) Cardiomyopathy
3) Hypertension
4) Cigarette smoking; Obesity
5) Diabetes
6) Exacerbating factors

Question 29

What are the classes of CHF?

Answer 29

1) Class I: no limitation is experienced in activities; there are no symptoms from ordinary activities.
2) Class II: slight, mild limitation of activity; the patient is comfortable at rest or with mild exertion.
3) Class III: marked limitation of any activity; the patient is comfortable only at rest.
4) Class IV: any physical activity brings on discomfort and symptoms occur at rest.

Question 30

What is the difference between Left & Right Ventricular failure?

Answer 30

Left ventricular failure: Pulmonary congestion and edema. Dyspnea or Orthopnea

Right ventricular failure: Generalized edema distal to heart, including the lower limbs (beginning with the ankles, sacral area and posterior thighs), liver, peritoneal cavity (ascites) – chronic and pitted edema develop

Question 31

What are warning signs of cardiac distress?

Answer 31

1) Increased heart rate
2) Rapid pulse
3) Labored breathing
4) Sweating or clamminess of the skin
5) Extreme facial flushing (red or purple)
6) Tissue bogginess and edema post massage

Question 32

What are CIs for Hypertension & CHF?

Answer 32

1) Prolonged painful techniques avoided because they increase the sympathetic nervous system firing therefore increase blood pressure
2) Avoid vigorous stimulation techniques – cupping, hacking & pounding
3) Avoid prolonged rotation of the neck during neck treatments as it could occlude BF
4) Avoid simultaneous bilateral neck treatment (treat one side at a time)
5) Avoid using repetitive long broad techniques (ex. Effleurage)
6) Avoid repetitive full ROM, especially involving the limbs
7) Avoid full body MLD
8) Avoid prolonged elevation of arms or legs above the heart (careful of pillow use)
9) Be careful of prone position because heart is lower than body part being treated and has to work harder
10) Avoid full-body or extreme hydrotherapy applications
11) Avoid Hydrotherapy applications to the chest, back and neck
12) Some essential oils: Hypertensive oils – rosemary, sage, thyme, camphor & hyssop. Vasoconstricting oils – cypress, geranium & rosemary.

Question 33

What are treatment modifications for Hypertension & CHF?

Answer 33

• Always take blood pressure prior to treatment
• Positioning in prone should be limited (10min max)
• Avoid abdominal pillowing as compresses abdominal aorta
• Avoid stimulation, painful treatment of large limb
• Avoid deep massage or raising limb above heart
• 2 or more pillow under head and shoulders when client is supine or side lying
• Always check with client on their heart rate, blood pressure – look for dizziness, shallow breathing, sweating and skin color – be very observant and attentive. Explain to your client the importance of informing you of any changes in their condition during the treatment as well as between sessions

Question 34

What homecare is given for Hypertension & CHF?

Answer 34

1) Relaxation techniques (slow relaxed breathing, yoga, meditation)
2) Gentle modified exercising- walking, swimming. Stretch and strengthen regime
3) Improve diet, address other risk factors as necessary
4) Essential oils – Marjoram, Ylang ylang, Lavender, Lemon

Question 35

What are precautions if a client has Hypotension?

Answer 35

1) Be prepared to assist client off table to prevent injury
2) Encourage gradual movement to a standing position
3) Have a client sit at edge of table and move legs to normalize blood flow
4) Educate re: excessive use of diuretics
5) Educate re: excessive loss of fluids
6) Educate re: situations that encourage vasodilation

Question 36

What veins are primarily affected by varicose veins?

Answer 36

The great saphenous vein is most commonly affected.

Question 37

What are the types of varicose veins?

Answer 37

1) Primary: varicosities which originate in the superficial veins
2) Secondary: varicosities resulting from impaired flow in the deep venous channels

Question 38

What are the causes of varicose veins?

Answer 38

1) Increase in venous pressure
2) Impaired function of venous valves
3) Standing for prolonged periods
4) Secondary: Blocked blood flow from DVT
5) Vitamin C deficiency
6) Sitting with legs crossed

Question 39

What are CIs of varicose veins?

Answer 39

1) Deep, specific techniques over varicosities
2) Deep specific techniques on any local tissue that appears dystrophic
3) Do not massage directly over swollen, torturous or painful veins as you run the risk
4) Local massage to varicosities and after 24 hours after medical treatment of saline injections
5) Open wounds
6) Anticoagulant medication

Question 40

What are Sx Sx of varicose veins?

Answer 40

1) Enlarged and bulging veins
2) Bluish veins, that appear lumpy
3) Can become tortuous (knotted and twisted)
4) Become more prominent when standing
5) Can be asymptomatic or cause dull achy pain
6) Edema around ankles and lower legs
7) Itchiness on or around affected veins
8) Heavy, fatigued feeling of legs (may make walking difficult); Weakening of calf muscles
9) Nocturnal leg cramps in calf muscles
10) Skin over varicosities may appear shiny, bluish brown

Question 41

What is the treatment approach for varicose veins?

Answer 41

1) Elevate legs (prone supine)
2) Cool hydro
3) MLD
4) Redirect fluid to heart NOT feet
5) Decrease pain with relaxing GSM
6) Light pressure (shaving, vibrations)
7) Decrease fibrosis from edema/scare tissue adhesions through fascial and friction
8) Increase ROM

Question 42

What is homecare for varicose veins?

Answer 42

1) Check with MD for support stockings
2) Educate client on: Loose clothing, Avoid prolonged period of sitting/standing, heavy lifting
3) Not scratch skin over varicosities
4) Maintain good foot care
5) Cold foot bath
6) Self massage to legs
7) AF ROM
8) Elevate legs 3 times a day for 10 mins

Question 43

Do we treat Thrombophlebitis?

Answer 43

THIS IS NOT SOMETHING WE TREAT, RATHER A CONDITION WE MUST BE AWARE OF TO DETECT AND REFER OUT

Question 44

What is thrombophlebitis

Answer 44

Inflammation of a superficial or deep vein that leads to the formation of a thrombus (blood clot which is attached to the wall of a blood vessel)