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Cardiovascular + Pulmonary Systems > Physical Therapy Tests And Measures > Flashcards

Physical Therapy Tests And Measures Flashcards

1
Q

Describe the Ankle-Brachial Index (ABI)

A
  • known as the ankle arm index

- Compares the SYSTOLIC BP at the ankle and arm to check for PERIPHERAL ARTERY DISEASE (PAD)

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2
Q

What arteries are used to measure the ankle brachial index (ABI)?

A
  • Brachial arteries

- tibialis posterior arteries

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3
Q

How is the ABI calculated?

A

Divide the higher of the two BP measurements in the ankles by the higher of the two systolic BP measurements in the arm.

[Ankle Systolic/ Arm Systolic]

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4
Q

What is the normal ABI?

A

1.0-1.3 = Normal, no blockage

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5
Q

What is an abnormal ABI?

A

> /= 1.30

Indicates rigid arteries and the need for an ultrasound test to check for PAD

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6
Q

What is number is considered a mild blockage?

A

0.8-0.99

Mild blockage; beginnings of PAD

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7
Q

What number indicates a moderate blockage?

A

0.4-0.79

Moderate blockage; may be associated with intermittent claudication during exercises

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8
Q

What number indicates a Severe blockage?

A

<0.4

Severe blockage; suggesting severe PAD; may have claudication present at rest

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9
Q

When taking BP what percentage of the bladder inside the cuff should encircle an adults arm? And child’s arm (<13yo)?

A

Adults-80%

Child-100%

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10
Q

What happens to the BP reading if the cuff is too small?

A

False high readings will occur

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11
Q

At what interval should you deflate the BP cuff?

A

No more than 2-3mmHg/sec

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12
Q

Describe Phase 1 of the Korotkoff sounds

A

1st appearance of clear tapping sounds corresponding to the appearance of a palpable pulse

This phase corresponds with systolic blood pressure (SBP)

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13
Q

Describe Phase II of the Korotkoff sounds

A

Sounds become softer and longer

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14
Q

Describe phase III of the Korotkoff sounds?

A

Sound becomes crisper and louder

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15
Q

Describe Phase IV of the Korotkoff sounds?

A

Sounds become muffled and softer

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16
Q

Describe Phase V of the Korotkoff sounds.

A

Sounds disappear completely

The diastolic pressure (DBP) is the pressure at the last audible sound

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17
Q

How is BP classified in children ages 3-17 years old?

A

Classified by SBP and DBP percentiles for age, sex and height

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18
Q

What is normal BP for children (3-17yo)?

A

SBP and DBP <90th percentile

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19
Q

What is Prehypertensive for children (3-17)?

A

SBP or DBP >/= 90th percentile to < 95th percentile

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20
Q

What is Stage 1 hypertension for children (3-17 yo)?

A

SBP and/or DBP >/= 95th percentile to =99th percentile plus 5 mmHg

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21
Q

What is Stage II hypertension in children (3-17 yo)?

A

SBP and/or DBP > 99th percentile plus 5 mmHg

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22
Q

In adults what is considered normal BP?

A

<120 mmHg SBP;and <80 mmHg DBP

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23
Q

In adults what is considered prehypertension?

A

120-139 mmHg SBP or 80-89 mmHg DBP

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24
Q

In adults what is considered Stage 1 Hypertension?

A

140-159 mmHg SBP and 90-99 mmHg DBP

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25
Q

In adults what is considered stage 2 hypertension?

A

> /= 160 mmHg SBP; and >/= 100 mmHg

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26
Q

When is BP considered a medical emergency?

A

> /= 210 mmHg; and >/= 110 mmHg

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27
Q

What are the designated auscultatory areas of heart sounds?

A
  1. Aortic area- 2nd intercostal space a the right sternal border
  2. Pulmonic area-2nd intercostal space @ left sternal border
  3. Mitral area- 5th intercostal space; medial to the left midclavicular line
  4. Tricuspid area- 4th intercostal space at the left sternal border
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28
Q

Describe the first S1 (lub)?

A
  • 1st heart sound
  • closure of the mitral and tricuspid (AV) valves at the onset of ventricular SYSTOLE
  • High frequency sound w/ lower pitch and longer duration than S2 (dub)
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29
Q

Describe S2 (dub)

A
  • 2nd heart sound
  • closure of the aortic and pulmonic (semilunar) valves at the onset of ventricular diastole
  • High frequency sound with HIGHER pitch and SHORTER duration than S1 (lub)
30
Q

Describe S3.

A
  • 3rd heart sound
  • vibration of the distending ventricle walls due to passive flow of blood form the atria during the rapid filling phase of diastole
  • normal in healthy young children; termed “physiologic” 3rd heart sound
  • Abnormal in adults may be associated with heart failure; often called “ventricular gallop
31
Q

Describe S4

A
  • 4th heart sound
  • pathological vibration of the ventricular wall with the ventricular filling and atrial contraction
  • may be associated with hypertension, stenosis, hypertensive heart disease or MI; often called “atrial gallop”
32
Q

Describe normal tracheal and bronchial breath sounds

A
  • loud, tubular sounds normally heard over trachea

- inspiratory phase is SHORTER than the expiratory phase and there is a slight pause b/t them

33
Q

Where is it abnormal to hear bronchial sounds?

A

Over the distal airways

Represent consolidation or compression of lung tissue that facilitates transmission of sound

34
Q

Describe normal vesicular breath sounds.

A
  • high pitched, breezy sounds normally heard over the distal airways in healthy lung tissue
  • inspiratory phase is LONGER than expiratory phase and there is no pause b/t them
35
Q

Describe crackles (rales) sounds.

A
  • abnormal, discontinuous, high pitched POPPING sound heard more often during INSPIRATION
  • May be associated with restrictive or obstructive respiratory disorders
36
Q

Describe wet crackles

A

Represents the movement of fluid or secretions during inspiration

37
Q

Describe dry crackles

A

Occur from the sudden opening of closed airways

38
Q

What do crackles that occur during the latter half of inspiration typically represent?

A
  1. Atelectasis
  2. Fibrosis
  3. Pulmonary edema
  4. Pleural effusion
39
Q

What do crackles due to movement of secretions sound like?

A

Usually low-pitched and can be heard during inspiration/expiration like the sound of hairs being rubbed together b/t the thumb and forefinger

40
Q

What may pulmonary edema produce in regards to lung sounds?

A

May produce fine crackles as air bubbles through fluid in the distal airways

41
Q

Where are crackles typically heard?

A

Bases of the lungs with interstitial lung disease, atelectasis, pneumonia, bronchietasis, and pulmonary edema

42
Q

Describe Rhonchi

A

-Continuous low-pitched sounds described as having a “snoring or “gurgling” quality that may be heard during booth inspiration and expiration

43
Q

What are Rhonchi caucused by?

A

Caused by air passing through an airway which is obstructed by inflammatory secretions or liquid, bronchial spasm or neoplasms in the smaller (sibilant rhonchi) or larger (sonorous Rhonchi) airways

44
Q

Describe a strider (lung sound).

A

Continuous high-pitched wheeze with inspiration or expiration

Indicates UPPER airways obstruction

45
Q

Describe a wheeze (lung sound)

A
  • continuous “musical” or whistling sound composed of a variety of pitches
  • heard both during inspiration and expiration, but variable from minute to minute and area to area
46
Q

What causes wheezing?

A

Arises from turbulent airflow and the vibrations of the walls of small airways due to narrowing by bronchospasm, edema, collapse, secretions, neoplasm or foreign body

47
Q

Describe bronchial breath sounds

A

Abnormal breath sounds when heard in locations (distal airways) where vesicular sounds are normally present

Pneumonia may produce these sounds

48
Q

What does a decreased or diminished sound indicate?

A

A less audible sound may indicate severe congestion, emphysema, or hypoventilation

49
Q

What do absent breath sounds indicate?

A

Absent lung sounds may indicate pneumothorax or lung collapse

50
Q

In Normal lungs what do voice sounds present as?

A
  • Transmission of spoken sounds is usually muffled

- Whispered words are faint and the syllables are not distinct except over the main bronchi

51
Q

What does increase in loudness and distinctness in voice sounds indicate?

A

Indicates consolidation, atelectasis or fibrosis, all of which improve transmission of vibrations through lung tissue

52
Q

T of F: whispered and spoken voice sounds are somewhat more valuable than breath sounds in detecting pulmonary consolidation, infarction, and atelectasis

A

True

53
Q

Describe bronchophony.

A

Increased vocal resonance with greater clarity and loudness of spoken words

(E.g.- “99”)

54
Q

Describe Egophony.

A

A form of bronchophony in which the spoken long “E” sound changes to a long, nasal-sound “A”

55
Q

Describe Whispered pectoriloquy

A

Recognition of whispered words, “1,2,3”

56
Q

What is the equation for BMI?

A

BMI = weight [kg] / height [m2]

OR

BMI = weight (lb)/ height (in2) x 703

57
Q

BMI of <18.5 is classified as?

A

Underweight

58
Q

BMI of 18.5-24.9 is classified as what?

A

Normal

59
Q

BMI of 25-29.9 is classified as what?

A

Overweight

60
Q

BMI of 30-34.9 is classified as?

A

Obesity (class 1)

61
Q

BMI of 35.0-39.9 is classified as?

A

Obesity (class 2)

62
Q

BMI of >/= 40.0 is classified as what?

A

Extreme obesity

63
Q

What population is the BMI appropriate to use for?

A

General population

Overestimates body fat for athletes; underestimates body fat for elders

64
Q

BMI classifications do not apply to what population?

A

Children and adolescents. Instead the following is used:

BMI b/t 85-95th percentile for age and sex is considered at risk for becoming overweight

BMI >/= the 95th percentile is considered overweight or obese

65
Q

What is normal capillary refill time? Abnormal?

A

Normal: Full color returns < 2 seconds

Abnormal: Refill time is >2 seconds; BF is compromised (arterial occlusion, hypovolemic shock; hypothermia)

66
Q

For claudication symptoms; if pt has pain in the buttock, hip or thigh what arteries may be obstructed?

A

Aorta and iliac (always the most proximal stenosis)

67
Q

For claudication symptoms; pt with pain in the calf occurs with stenosis of what arteries?

A

Femoral and popliteal arteries

68
Q

For claudication symptoms; Pain in the ankle or foot occurs with disease in what arteries?

A

Tibial or peroneal arteries

69
Q

What is the procedure for the claudication test?

A

Patient walks on a flat track at maximum speed or on a treadmill a 2.0 mph at a constant grade b/t 0-12%

Score: initial claudication distance (ICD): pain-free walking distance AND
Absolute claudication distance: maximum distance walked when test is terminated due to pain AND speed of walking

70
Q

List the anatomic locations when applying ECG electrodes to the limb.

A
  1. Right arm (RA)- infraclavicular fossa medial to R deltoid muscle
  2. Left arm (LA)- infraclavicular fossa medial to L deltoid muscle
  3. Left leg (LL)- Left side of abdomen below the rib cage
  4. Right Leg (RL)- Right side of abdomen below the rib cage (GROUND ELECTRODE)
71
Q

List the anatomic locations of the chest electrodes for percordial leads

A

V1: 4th Intercostal space at R sternal border
V2: 4th intercostal space at L sternal border
V3: Midway b/t V2 and V4
V4: 5th intercostal space at left midclavicular line
V5: Left anterior axillary line at V4 level
V6: Left midaxillary line at V4 and V5 Levels

Cardiovascular + Pulmonary Systems (14 decks)

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