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BCPR > Module 5: Cardiac/Pulmonary > Flashcards

Module 5: Cardiac/Pulmonary Flashcards

1
Q

How many main layers of the heart are there?

A

3

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2
Q

Name the 3 layers of the heart

A
  1. Epicardium
  2. Myocardium (middle)
  3. Endocardium (innermost)
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3
Q

How many chambers does the heart have?

A

4

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4
Q

Name the chambers of the heart

A

R atria, R ventricle
L atria, L ventricle

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5
Q

How many main valves are there to ensure blood flow of the heart?

A

4
- Aortic
- Pulmonary
- Tricuspid
- Mitral

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6
Q

What are the two phases of a cardiac cycle called?

A
  • Systole
  • Diastole
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7
Q

Describe systole?

A

Heart contracts and ejects blood forward through cardiovascular system

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8
Q

Describe diastole?

A

Heart relaxes and fills with blood

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9
Q

Do veins go towards or away from the heart?

A

Towards

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10
Q

Do arteries go towards or away from the heart?

A

Away

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11
Q

Describe blood flow through the heart

A
  1. Right atrium
  2. Right ventricle
    • Pulmonary valve + artery
    • Pulmonary artery takes blood to lungs where gas exchange occurs and returns to pulmonary veins
  3. Left atrium
  4. Left ventricle
    • Leaves left ventricle through aortic valve to circulatory system
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12
Q

MAP average

A

70-100

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13
Q

Ejection fraction measurement norms?

A

60-65%

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14
Q

Cardiac output norm?

A

5-6L/M

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15
Q

What does the upper airway include?

A
  • Nose & mouth
  • Pharynx
  • Larynx
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16
Q

What contains vocal cords necessary for voice production?

A

Larynx

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17
Q

What contains epiglottis that protects the lower airways during swallowing?

A

Pharynx

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18
Q

What does the lower airway include?

A
  • Trachea
  • Bronchi
  • Bronchioles
  • Alveolar sacs
  • Alveoli
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19
Q

These structures make up what?

  • Trachea
  • Bronchi
  • Bronchioles
  • Alveolar sacs
  • Alveoli
A

Lower airway

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20
Q

The structures make up what?

  • Nose & mouth
  • Pharynx
  • Larynx
A

Upper airway

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21
Q

Does the pulmonary artery carry deoxygenated blood to or from the heart to the lungs for gas exchange?

A

From the heart

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22
Q

Does the pulmonary vein carry oxygenated blood to or from the lungs to the heart to be circulated through the body.

A

From the lungs to the heart

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23
Q

What are the inspiratory muscles?

A
  • Diaphragm
  • External intercostal parasternal intercostal
  • Scalene
  • Sternocleidomastoid
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24
Q

Are the following inspiratory or expiratory muscles?
- Diaphragm
- External intercostal parasternal intercostal
- Scalene
- Sternocleidomastoid

A

Inspiratory

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25
Q

What are some accessory inspiratory muscles?

A
  • Scalenes
  • Sternocleidomastoid
  • Pectoralis
  • Serratus anterior
  • Latissiumus dorsi
  • Trapezius
  • Illiocostalis cervics
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26
Q

What are the body functions of the pulmonary system?

A
  1. Gas exchange
  2. Ventilation, breathing air in/out
  3. Balances acid base of the body
  4. Defense against harmful particles/substances inhaled into the body
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27
Q

What is a normal respiratory rate?

A

12 to 20 breaths per minute

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28
Q

What nerve innervates the diaphragm?

A

Phrenic nerve

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29
Q

What are some examples of MET level <1.5 activities?

A

Minimal

  • Resting
  • Sitting in a chair
  • Riding in a car
  • Watching TV
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30
Q

What are some examples of MET level 1.5 - 3 activities?

A

Light

  • Eating
  • Getting out of bed
  • Dressing and undressing
  • Walking at a slow pace
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31
Q

What are some examples of MET level 3-6 activities?

A

Moderate

  • Having a BM
  • Loading/unloading car
  • Gardening
  • General house hold tasks
  • Sex
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32
Q

What would examples of > 6 METs be?

A

Vigorous

  • Carrying groceries upstairs
  • Climbing stairs rapidly
  • Running
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33
Q

Is MET 3.0 - 6?

Minimal
Light
Moderate
Vigorous

A

Moderate

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34
Q

Is MET <1.5

Minimal
Light
Moderate
Vigorous

A

Minimal

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35
Q

Is MET 1.5-3

Minimal
Light
Moderate
Vigorous

A

Light

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36
Q

Is MET >6

Minimal
Light
Moderate
Vigorous

A

Vigorous

37
Q

What is a percutaneous coronary intervention (PCI)?

A
  • Minimally invasive procedure used to open up narrowed coronary arteries
38
Q

What is a Coronary Artery Bypass Graft (CABG)?

A
  • Surgical procedure used to treat an occluded coronary artery.
  • Bypass - the occlusion using a vessel taken from elsewher in the body
39
Q

How many classess of heart failure are there?

A

4
- 1-4
- A-D

1 - best, no limitations in physical activity
4 - unable to carry out physical activity without discomfort
A - No evidence of cardiovascular disease
D - Severe Cardiovascular disease, symptoms at rest

40
Q

What is left sided heart failure called?

A

Systolic heart failure

41
Q

What is right sided heart failure called?

A

Diastolic heart failure

42
Q

What is it called when there is a narrowing of the peripheral blood vessels, usually due to atherosclerosis. Commonly affects the legs.

A

Peripheral Vascular Disease

43
Q

What is orthopnea?

A

Sensation of breathlessness in the supine position, relieved by sitting or standing.

44
Q

What is dyspnea?

A

Sensation of breathlessness or shortness of breath.

45
Q

What is a cardiac angiogram?

A

A minimally invasive procedure that obtains clear pictures of the cardiac vasculature and blood filled chambers of the heart using a catheter.

46
Q

Medication: What are antihypertensives?

A

Goal is to lower the risk of cardiovascular disease and stroke.

47
Q

What are some functional implications of antihypertensives?

A
  • Can contribute to orthostatic hypertension
  • Beta blockers can cause bradycardia
  • Can contribute to fatigue from frequent urination or electrolyte abnormalities
48
Q

Medication: What are vasopressors?

A

A group of medications used to treat severe hypotension.

49
Q

What are some functional implications of vasopressors?

A
  • Patients requiring high doses may be medically unstable, make sure they are ready and cleared for therapy.
  • Patients that need stable doses of iontropic meds can be d/c home on continuous infusions.
  • Poor peripheral circulation - leading to peripheral ischemia and sometimes gangrene, requiring amputation
50
Q

How can you measure breathlessness?

A
  • Modified Borg Dyspnea Scale
  • Rate of Perceived Exertion
51
Q

What causes 90% of PE’s?

A

DVTs of the LE

52
Q

What are some common signs of PE’s?

A
  • Dyspnea at rest or w/ exertion
  • Pleuritic chest pain
  • Tachypnea
  • Cough
  • Orthopnea
  • Tachycardia
  • Wheezing
  • Syncope
  • Hemoptysis
53
Q

What are some good methods for prevention of PE’s?

A
  • Early mobilization on post surgical patients
  • Anticoagulation medication
  • Anti embolism stockings
  • LE SCDs
  • Placement of an inferior vena cava filter in patients with known LE clots
54
Q

What is Pulmonary Hypertension?

A

A rare, progressive disease causing elevated pressure and pulmonary vascular resistance in the pulmonary artery.

This can result in right sided heart failure.

55
Q

What are some symptoms of pulmonary hypertension?

A
  • Dyspnea at rest and with exertion
  • Chest pain
  • Cough
  • Fatigue
  • Syncope
  • Dizziness
  • Exercise intolerance
  • Pheripheral edema
  • Ascities
  • Heart murmur
  • Hemoptysis
  • Palpitations
  • Cyanosis
  • Elevated pulmonary artery pressure
56
Q

What are some OT considerations for pulmonary hypertension?

A
  • Overexertion can cause greater strain on cardiac function and should be avoided
  • Clinical monitoring should include BP assessment (drop in BP could mean heart failure)
  • Low intensity aerobic exercise and avoid strenuous activity
57
Q

What is the third leading cause of death in the US?

A

COPD

58
Q

What are some common signs/symptoms of COPD?

A
  • Chronic cough
  • Excess sputum production
  • Progressively worsening dyspnea on exertion
  • Fatigue and subsequent deconditioning d/t decline in activity
  • Hypoxia
  • Hypercapnia
  • Psychiatric disorders
59
Q

What are some OT considerations for patients with COPD?

A
  • 77% of patients with COPD have a comorbid cognitive impairment
  • Hypercapnia may cause symptoms of fatigue, lethargy and delayed reaction times.
  • Patient may prefer tripod posture.
  • UE strengthening and endurance training can improve muscle function and reduce oxygen demands, improving capacity for upper body ADL performance.
  • Activity prescriptions and home programs should emphasize routine intervals of activity to prevent patterns of inactivity and deconditioning.
  • Dyspnea may worsen after eating a large meal or during constipation. Smaller more frequent meals may improve nutritional intact.
  • Anxiety and depression are common
60
Q

What is interstitial lung disease?

A
  • Umbrella term for a group of chronic pulmonary conditions characterized by fibrotic scarring of the lung tissue. Progressive fibrosis damages alveoli and stiffens lung tissue, causing hypoxemia and reduced lung volumes and size.
61
Q

What are some OT considerations for working with patients with interstitial lung disease (SLD)?

A
  • They have significant activity induced hypoxia and require increased amounts of oxygen during activity
  • Rapid, shallow breathing often worsens during activity and may not respond to modified breathing techniques.
  • Integration of supplemental oxygen within daily activity routines is critical to support ongoing functional independence.
  • Early activity pacing and EC is critical.
62
Q

What is atelectasis?

A

Partial or complete collapse of the lung, caused by bronchial compression or obstruction.

63
Q

What is acute respiratory distress syndrome (ARDS)?

A
  • A clinical syndrome that can result from acute infections or exacerbations of chronic disease. It is marked by bilateral pulmonary infiltrates, pulmonary edema, and impaired gas exchange that can quickly lead to respiratory failure.
64
Q

What are some OT considerations for ARDS?

A
  • OT begins treatment in critical care once paralytic medications are no longer required and sedation can be lowered to allow for active participation.
  • Early mobilization and engagement are safe and feasible for patients receiving mechanical ventilation
  • Recovery is slow
65
Q

What are some neurological conditions with associated respiratory dysfunction?

A
  • Complete SCI (L C5 and above)
  • Stroke
  • TBI
  • Guillian Barre
  • ALS
  • Drug overdose
  • Myasthenia gravis
  • Tumor or injury involving the brain stem
  • Muscular dystrophies
66
Q

What term is used to describe the following:

This relies on the optimal performance of both the cardiovascular and pulmonary systems to appropriately sustain, increase, or decrease, the transport of blood and oxygen to all body organs during occupational engagement.

A

Functional endurance

67
Q

What is one of the most common client factors OT practicioners will address within the cardiopulmonary populations?

A

Functional endurance

68
Q

What are the 6 principles of Task Performance known to increase oxygen demand?

A
  1. Increased rate
  2. Increased resistance
  3. Increased use of large muscles
  4. Increased involvement of trunk musculature
  5. Raising ones arms
  6. Isometric work (straining)
69
Q

Do upper or lower extremity activities and exercises increase HR and BP faster?

A

Upper extremity

70
Q

What are some examples of inspiratory muscle training?

A

Using various commercially available incentive spirometry devices.

71
Q

What are some examples of expiratory muscle training?

A
  • Blowing bubbles
  • Windmills
  • Various commercially available spirometry devices.
72
Q

Research shows what percent of patients who survive an ICU admission for critical illness experience long term neuro cognitive impairment?

A

> 50%

73
Q

Describe the correct sequence of heart valves that blood flows through when returning to the heart via the superior and inferior vena cavas

A
  • Tricuspid valve
  • Pulmonary valve
  • Mitral valve
  • Aortic valve
74
Q

What lab values could put patient at risk for elevated bleeding?

A
  • Elevated INR
  • Elevated PT
  • Decreased platelet
75
Q

Does the SA or AV node control (slows) transmission of AP from the atria to the ventricles?

A

AV node

76
Q

What does MAP measure?

A

Average pressure throughout the cardiac cycle. It is used as a mesure of how well vital organs are perfusing.

77
Q

What is normal MAP ranges

A

70 - 100

78
Q

What is an ejection fracture?

A

Measurement of how much blood the left ventricle pumps per beat.

Sometimes used to classify type/severity of systolic heart failure.

Measured with ultrasound

79
Q

Normal ejection fracture ranges

A

60-65%

80
Q

The diaphragm serves as the bodies what?

A

Pressure regulator

81
Q

Describe pressure of chest/lungs during ispiration.

A
  • Diagram flattens, increasing intrathoracic volume
  • Decreasing intrathoracic pressure
82
Q

Read fact:

A

The diaphragm serves as the bodies pressure regulator and its contraction creates more space within the chest decreasing the intrathoracic pressure below that of the environment trigger movement of airflow into the lungs (inspiration). Diaphragm relaxation and recoil of the chest wells leads to passive decrease in volume of air within the chest, leads to increase in intrathoracic pressure compared to the environment causing the air to be pushed out.

83
Q

If patient is on anticoagulants and antiplatelets. What labs should you look at?

A
  • Hgb
  • Hct
  • PT
  • PTT
    -INR
84
Q

What is hemoglobin?

A

Protein in RBC that delievers oxygen.

85
Q

What is hematocrit?

A

Percentage of blood volume that is composed of RBCs

86
Q

What are platelets

A

Help form clots

87
Q

What is prothrombin time (PT) or partial thromboplastin time (PTT) or international normalized ration (INR)

A

Time it takes blood to clot.

88
Q

What are antihpertensives?

A

Lower risk of cardiovascular disease and stroke.

  • can contribute to orthostatic hypotension.
  • Beta blockers can cause bradycardia, fatigue, frequent urination or electrolyte abdormalities
89
Q

What do vasopressors do?

A

Treat hypotension

BCPR (19 decks)

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