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2.3 > PTA 2.3 > Flashcards

PTA 2.3 Flashcards

1
Q

whats heart rate reserve + use for?

A

MHR - RHR = HRR
calculates target HR (THR), ideal range in which your heart should be beating for a given intensity

use karvonen formula to calcualte this
THR = (HRR x %intensity) + RHR

e.g. moderate intent: 40-59% of HRR
high intensity 60-89% of HRR

e.g. for me
MHR = 195
RHR = 50
HRR= 145
For
moderate : (145 x 0.59 ) + 50= 135.5 (using upper limit, 59% mod int)
vigorous: (145 x 0.89) + 50 = 179

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2
Q

modifiable risk factors heart diseases?

A
  • BP
  • Cholesterol
  • Smoking
  • Overweight
  • Diabetes
  • Physical activity
  • Stress
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3
Q

suggestions for heart failure therapy

A
  1. maintain condition
  2. lose weight, decrease cardiac output
  3. minimalize salt ingestion
  4. restrict fluids <2L a day
  5. stop smoking
  6. limit alcohol
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4
Q

what effect does losing weight have on cardiac output?

A

lower cardiac output

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5
Q

does salt increase or decrease cardicac load?

A

increase

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6
Q

when do you use ACE inhibitors and why

A

medications that help relax the veins and arteries to lower blood pressure.

use after loading, exercising to decrease BP, dilate arteries for easier transport of blood and less stress on the heart

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7
Q

signs of heart failure

A
  • shortness of breath
  • swelling feet and legs : disbalance in the body of fluids
  • chronic lack of energy
  • difficulty sleeping at night due to breathing problems
  • swollen or tender abdomen with loss of appetite
  • confusion, impaired memory
  • increased urination at night
  • cough with frequent sputum
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8
Q

red flags: heart failure

A

loss of weight >3 kg within a few days

cognitive problems

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9
Q

strength training protocol for cardiac patients?

A

3x a week, 3sets x 10-15 reps at 40-65% 1RM

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10
Q

woudl you use ACBt + IMT post- or preop?

A

preop

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11
Q

whats pericarditis?

A

inflammation of pericardium

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12
Q

whats endocarditis?

A

inflammation of inner wall of the heart

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13
Q

angina pectoralis?

A

chest pain or heart spasms

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14
Q

heart valve problems?

A

heart valve is narrowed or lacking

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15
Q

name modifiable factors for cardiac problems

A

smoking, alco, poor diet, high cholesterol high BP, increasing clotting of blood, overweight, diabetes, low PA

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16
Q

name non-modifiable factors for cardiac problems?

A

gender:M
age >60
hereditary
CVD at young age
history of CVD

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17
Q

what causes bronchitis / bronchi obstruction

A
  • hypersecretion of mucus
  • decreased airway diameter
  • collapse of airways
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18
Q

describe each term
1. bronchitis
2. asthamtic bronchitis
3. emphysema

A
  1. hypersecretion of mucus
  2. decreased airway diameter due to inflammation, swelling of airways
  3. collapse of airways eg due to change in intrapleural pressure
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19
Q

how is COPD recognized? whats the first symtom that gives it away?

A

increased inflammatory response to inhaled toxic particles and gasses

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20
Q

whats alfa1-antitrypsin deficiency?

A

a certain protein in blood that protects body usually against certain enzymes, the protein is missing so enzyme attacks lungs

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21
Q

prognostic factors for exacerbation (COPD, asthma)?

A
  • smoking
  • inactivity
  • airway responsiveness
  • comorbidities
  • body weight
  • dyspnea
  • functional exercise capacity - 6MWT
    lower FEV1
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22
Q

what is Cor pulmonale?

A

right sided heart failure, hypertrophy of right ventricle due to increased resistance in pulmonary arteries, more workload R ventricle has to do

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23
Q

systemic effects of COPD?

A
  • depression
  • metabolic diseases
  • bone diseases
  • CVD diseases
  • skeletal muscle weakness, loss of muscle mass
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24
Q

atopy: asthma, explain

A

predisposition to develop specific antibodies (IgE) against innocent triggers

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25
Q

differences between asthma and COPD: what happens to FEV1 after BD, the inhaler?

A

in asthma: 12% increase in FEV1
in COPD: no change

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26
Q

pattern of symptoms: asthma?

A
  • 1+ symptom (shortness of breath, cough)
  • Symptoms worse at night and early morning
  • Symptoms vary over time and in intensity
  • Triggered by viral infections (colds), exercise, allergens, exposure
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27
Q

asthma prognostic factors?

A

Smoking, inactivity, bodyweight (overweight), therapy adherence

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28
Q

symptoms of respiratory system problems

A
  • coughing
  • wheezing
  • dyspnoea
  • mucus
  • haemoptysis (cough up blood)
  • cyanosis - blue purple skin
  • headaches, drowsiness
  • decreased exercise capacity
  • chest pain
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29
Q

name 9 global targets for 2023 by WHO

A

10 % decrease in alcohol and physical inactivity
25% decrease in mortality and hypertension
30% decrease in salt intake and tobacco use
50% receiving drug therapy to prevent heart attacks
half the rise in obesity and diabetes
80% availability of affordable basic technologies and essential medicines

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30
Q

whats a risk factor

A

any characteristic or exposure of an individual that increases likelihood of developing a disease

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31
Q

consequences of high blood pressure?

A

plaque formation - causes blockage
endothelial damage
kidney failure
heart infarction

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32
Q

what leads to high levels of LDL?

A

saturated fatty acids

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33
Q

whats a normal cholesterol value?
whats a slightly increased cholesterol value?
severe increase?strong increase?

A

5.0mmol/liter
- 6.4
6.5-7.9
>=8mmol / l

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34
Q

effect of smoking on cholesterol?

A

reduces HDL cholesterol

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35
Q

BMI: overweight

A

25 - 29.9 kg /m2

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36
Q

ideal BMI?

A

18.5-24.9

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37
Q

ideal waist size per gender?
ideal body fat %?

A

M <102, <20%
F: <88cm, <30%

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38
Q

function of insulin?

A

stimulates absorption of glucose from the bloodstream; converts glucose into glycogen, lowers blood glucose

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39
Q

type 1 diabetes mellitus: describe

A

autoimmune disease, body unable to produce insulin

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40
Q

T2DM: describe

A

increase in blood sugar, body has become less sensitive to insulin - increases insulin resistance, decreases sensitivity

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41
Q

normal blood sugar values?

A

4 - 8mmol /l

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42
Q

most frequent side effects of hyperglycemia?

A

increases thirst, frequent urination

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43
Q

what is metabolic syndrome?

A

combo of high waist cirucmference; hypertension; insulin resistance, increased triglycerides in blood, lowered LDL

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44
Q

main reason for PAD?

A

atherosclerosis, build up of plaques, narrowing of arteries (large or medium large), not enough O2 to msucles

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45
Q

life expectancy with PAD?

A

<10 years because many get infarct or stroke after PAD diagnosis
many have cerebro or cardiovascular diseases

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46
Q

explain Fontain classification syte

A

sPAD classification based on claudication severity

1: asymptomatic
2a: mild claudication
2b: severe claudication
3: rest pain
4: ulceration, tissue loss, gangrene

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47
Q

whats ABPI

A

ankle brachial pressure index

dividing systolic BP in leg (dorsalis pedis or tibialis posterior) by systolic BP in a. brachialis (arm)

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48
Q

is BP usually higher in leg or arm?

A

leg, ankle

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49
Q

normal values for ABPI?

A

1 - 1.4

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50
Q

what value would you expect with PAD diagnosis in ABPI?

A

<0.9

severe PAD: 0.5

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51
Q

Supervised exercise programme for PAD: describe

A

2hrs per week for 3 months
encourage maximal pain during exercising (push through)

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52
Q

important to cheeck during screening`; sPAD

A

wounds
skin
colour temp
odema

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53
Q

explain graded treadmill test

A

speed: 3.2km. /h
start with 0 incline, increase by 2% every 2mins til 10incline.
go max til 30mins. assess functional and maximal walking distance

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54
Q

explain how ACSm grading scale is used during graded treadmill testing

A

grade1: light discomfort
grade 2: moderate pain
grade 3: intense pain, attention cant be diverted
grade 4: unbearable pain

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55
Q

QoL questionnaire for PAd patients?

A

EuroQoL 5D

56
Q

interventions in PAD?

A

walking through the pain - pain tolerance improvement

development of collaterals

aerobic metabolism

57
Q

minimze objective limitations: interventions

A

walk at grade 3-4 acsm
minimum 6months
3x a week
>30mins

58
Q

explain by weeks intense training: chronic care net

A

starting phase: 3x / week, for 4 weeks,

self training phase: 1-2/week for 8wks

maintenance phase 1-2x a month for 40 wks

59
Q

is it better for a sPAD patient to walk 1x1.5hr or 3x .0.5?

A

3x 0.5hr

60
Q

describe venous odema

A

faulty valves
inhibits return of deoxy blood back to heart

often in combi w lymphoedema

61
Q

describe lipoedema

A

fat swelling, irregular distirbution of fat

62
Q

what is lymphoedema

A

abnormal accumulation of tissue fluid, malfunction of lymph system

63
Q

hows manual lymphatic drainage useful?

A

massage technique, stimulates lymph system and allows for fluid to travel thru alternative routes

64
Q

when is lymphapress used

A

for long lasting oedema, stiff hardly movable edema

65
Q

which clinimetrics is used on identifying frailty?

A

TFI: tilburg frailty index

66
Q

geriatric giants

A

incontinence
falls
confusion
impaired homeostasis
iatrogenic disorders

67
Q

NNGB and fitnorm

A

NNGB: >=5 days a week of moderate intensity of >=30mins

Fitnorm at leat 3 days of 20mins heavy intensity

68
Q

whats poylpharmacy

A

use of more than 5 kind of meds

69
Q

DOS score

A

delirium observation screening

70
Q

describe angina pectoris scale class 1-4

A

class 1:angina only during HIIT
class 2: slight limitations, angina during vigorous activities
class 3: symptoms with everyday activities
class 4- inability to perform any activities angina also at rest

71
Q

what is angina?

A

chest pain (insufficient blood flow to the heart)

72
Q

cholesterol norm values

A

150 mg / dl
LDL: <150
HDL >45

73
Q

BP for a grade 3 hypertension

A

> =180 and >=110

74
Q

describe isolated systolic hypertension

A

S >=140
D: <90

75
Q

normal P top frequency

A

50 - 99 bpm

76
Q

sinus bradycardia:

A

slower hr
<50 pbm

77
Q

sinus tachycardia

A

P wave freq >100 bpm

78
Q

sinus arrhythmia

A

irregular occurence of identical P -tops

79
Q

atrial extra systole

A

P wave has a different form / peak in the grraph

80
Q

atrial flutter

A

no normal P waves
freq >300

81
Q

atrial fibrillation

A

irregular P waves

82
Q

ventricular extrasystole

A

QRS complex not normal
no P wave beforeQRS

83
Q

ventricular extrasystole

A

QRS complex not normal
no P wave beforeQRS

84
Q

ventricular tachycardia

A

no p wave
very fast WRS >140
abnormal qrs complex

85
Q

ventricualr fibrillation

A

chaotic graph, no normal waves just peaks

86
Q

increase in co2 leads to vaso ..

A

vasodilatation

87
Q

is bradycardia an example of PNS or SNS activity?

A

PNS (slower heartrate)

88
Q

which structure detects changes in blood pressure?

A

baroreceptors in wall of aorta and internal carotid artery

89
Q

if Co doesnt change but PR icnreases, what happens to BP?

A

increases

90
Q

CO = ..?

A

SV x HR

91
Q

BP = ..?

A

CO x PR

92
Q

name 3 diseases/ events atherosclerosis can lead to

A

myocardial infarction
PAD
angina pectoris (coronary heart disease)

93
Q

describe blood’s content (55 % … and 45%…)

A

55%- plasma so h2o, proteins, AA

45% - cells so leukocytes, erythrocytes, thrombocytes

94
Q

describe norma values for CPET (what youd expect)

A

BP <220/90
Vo2peak >=85%of pred vo2max
anaerobic threshold >40% of vo2max pred
HRpeak >90% pred
HRR <15
VEpeak <85% pred of MVV
ventil reserve >11l/min

95
Q

name criteria for a maximal test CPET

A

-Wmax achieved of pred.
-HRmax achieved of pred.
-VO2peak achieved of predicted
-VEpeak>=85% of predicted MVV
Borg >9
RER=1.15

96
Q

how do you calculate mvv (L/min) if you have FEV1?

A

MVV = 3.75 x FEV1

97
Q

at VT1 what happens to metabolism?

A

switches to partially anaerobic , production of lactic acid. slope becomes steeper.
increase in VCO2 >VO2

98
Q

if cardiac ceiling is reached, what do you expect regarding HRR?

A

no HRR left,

99
Q

explain treatment , aerobic training for a cardiac patient

A

divides into endurance and HIIT
use VO2max for intensity

endurance
first 2wks: 3x a week, 30mins, at 40-50% of VO2max
then 2 weeks: 3x a week of 30mins, at 50-80% of VO2max

HIIT
3x a week at 80-90% of VO2max

4x4mins w 3min active recovery breaks at 40-50% VO2max

100
Q

if someone is going into a CABG or valve replacement, explain the steps (KNGF guildeines) regarding rehav

A
  1. preop phase - screen for PPC complications - if risk high, do IMT, breathing, airway clearance -> then into surgery-> then rest-> mobilisation -> 3-4MET mod int activities
101
Q

explain preop (CABG) and postop techniques used in rehab

A

preop
- IMT
- Active CYCLC of Breathing Techniques

Postop
- ACBT
mobilise
inform and advise

102
Q

other ways of doing cardiac rehab than 30mins running (HIIT or endurance)? - starts 4 weeks after after registration

A

circuit training, 1hr, 2x a week

103
Q

clinimetrics for a cardiac patient

A

6mwt
PSC
steep ramp test - submax test
borg scale
1RM

104
Q

exercise restrictions after ICD implant?

A

6-8weeks cant do much

105
Q

strength training protocol for cardiac patients?

A

3x10 start w 30-40% of 1RM
build up to 80%

106
Q

name most important pulmonary diseases ?

A

COPD, asthma

107
Q

describe COPD and ASTHMA

A

COPD: treatable disease, with persistent respiratory symptoms and airflow limitations due to airway or alveolar abnormalities - usually caused by signif. exposure to noxious particles eg from smoking

108
Q

COPD and bronchi- whats the relation?

A

obstruction of bronchi (lower airways)

due to
- hypersecretion of mucus (bronchitis)
- decreased airway diameter due to eg inflammation (asthmatic bronchitis)
- collapse of airways - emphysema due to changes in intrapleural pressure (emphysema)

109
Q

pathophysiology of COPD

A

increased inflammatory response to inhaled noxious particles and gasses

110
Q

name 2 things that happen to lung parenchyma in COPD patients

A

loss of alveolar attachments and loss of elasticity

111
Q

GOLD stages describe what? and what type of patients is this system used for

A

for COPD patients
describes airways restrictions

stage 1 - FEV1 %pred >80
stage 2 - FEV1%pred 50-80
stage 3 30-50
stage <30

112
Q

in NL patients are most commonly GOLD stage _ ?

A

stage 2 so FEV1 50-80^%predicted

113
Q

whats an exacerbation

A

sudden worsening, beyond normal day to day variations

114
Q

whats airtrapping

A

extra air trapped in lungs, thorax stays in a position of inspiration-> functional weakening of the diaphragm

115
Q

whats atelectasis?

A

collapse of alveoli behind obstruction

116
Q

whats cor pulmonale

A

right sided heart failure.
enlargement of R ventricle due to high BP in lungs

117
Q

atopy

A

predisposition to develop specific antibodies (IgE) to innocent trigger

118
Q

is hayfever a specific or nonspecific reaction? how about cold, viral infections, smoke?

A

hayfever: specific

the rest: non specific, no interference of IgE

119
Q

what do u use to open airways in asthma patients and how does this work regarding FEV1?

A

bronchodilators
FEV1 increases

120
Q

in asthma is FEV1 lower or higher in mornings?

A

lower

121
Q

3 mechanisms to alleviate dyspnea

A
  1. decrease airway resistance
  2. strengthen respiratory muscles
  3. strengthen cardiorespiratory system
122
Q

how can you decrease airway resistance

A

Bronchodilators (opens airways) + rehab (endurance) -> best endurance capacity results

123
Q

whats hyperinflation

A

trapping of air inside the lungs

124
Q

describe Pursed Lip breathing: cons, pros, function

A
  • increases resistance when you breath out BUT generate pressure in airways so prevent collapse

improves physical capacity, moderate effect on dyspnea

125
Q

weak inspiratory muscles: what do you use to determine this?

A

MIP device : maximal inspiratory pressure
if its <70% of predicted then need IMT (need to train pressure inside airways)

tools: breath against resistance- trains inspiratory muscles:
powerbreath
threshold

126
Q

IMT: FITT?

A

F: 5x a week, 2x a day, minimum for 4 weeks
I: 30-50% PImax
T: deep fast inhalations, i:out 1:3
total ±5mins

127
Q

explain postural adjustments

A

bending forward a bit: to lengthen diaphragm; use accessory breathing muscles - if ure sitting means also lower load on legs so can be used in breathing

128
Q

Oxygen saturation and max exercise test

A

if theres >4% drop in SpOs - possible candidate for O2 supplementation

start exercising only if resting SpO2>=90%

if during exercising SpO2 <85% = refer to GP

SpO2 <90% after exercising: monitor

129
Q

hows mucus and mucus glands in COPD patients?

A

mucus: much thicker
mucus glands: hypertrphic

130
Q

how does physical exercise contribute to mucus transport?

A

increases airflow, ventilation
increases excursion of lung tissue
stimulates lung parenchyme and airways

131
Q

name 3 relaxation methods

A

1-5
jacobson: muscle tension relax
guided imagery- happy place

132
Q

3 types of skills associated with health literacy

A

functional
communicative - interactive
critical

133
Q

functional skills and red flags

A
  • understand wrriten, verbal info, own health, illness, can follow instructions

red flags
- doesnt want to fill out forms
-confuses dates, times of appointments
- never has questions about any info

134
Q

communicative HL and red flags

A
  • can describe own health; ask the right questions at the right time; uses professinoal as a support not know-it-all person

red flags
- patient looks confused or annoyed but doesnt have real questions
- patient doesnt chekc if he understands correctly

135
Q

critical HL

A

this is more assessing the right info, relevance and reliability of info and making informed choices regarding one’s health

red flags:
- patient is overconfident even tho theres evidence opposing it
- patient relies fully on your opinion and what you say as an expert
- patient doesnt follow treatment bc someone had a bad experience with it

2.3 (5 decks)

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