S1_L4: Vital Signs Flashcards
Vital signs are aka __, the indicators of the body’s physiological status
Cardinal signs
TRUE OR FALSE: Vital sign measurements yield the most useful information when performed and recorded at periodic intervals over time as opposed to a single measurement taken at a given point in time.
True
Normative temperature for adults in C
37º
Additional: In Fahrenheit, 98.6F plus/minus 1 degree
Normative pulse rate for adults
60-100 beats per minute
Normative respiratory rate for adults
12-20 cycles per minute
Normative blood pressure for adults
< 120/80 mmHg
Represents a balance between the heat produced or
acquired and the amount lost by the body.
Temperature
When body temperature decreases beyond normal
Hypothermia
When body temperature increases beyond normal
Hyperthermia (Hyperpyrexia)
TRUE OR FALSE: Humans are warm blooded animals
therefore our core temperature is not affected by changes in the temperature of the external environment.
True
Humans are homeothermic (warm-blooded)
TRUE OR FALSE: In cold blooded (poikilothermic) animals, their core temperature changes depending on the temperature of the external environment.
True
Conversion formula for F to C
C = [F - 32] x 5/9
Conversion formula for C to F
F = [9/5 x C] + 32
The system which monitors and acts to maintain
a relatively constant body temperature that is optimal for normal cellular and vital organ processes to function.
Thermoregulatory System
Determine the corresponding descriptions of the components of the thermoregulatory system
- Free nerve endings in skin
- Hypothalamus
- Provide feed forward responses to changes in core temperature to the regulating center
- Blood vessels, muscles, sweat glands, metabolic glands, hairs on the skin
- Coordinates heat loss and gains in the body by
influencing different effector organs to produce
heat dissipation or conservation mechanisms
A. Thermoreceptors
B.
Regulatory center
C. Effector organs
- A
- B
- A
- C
- B
Determine the corresponding descriptions of the mechanisms of heat transfer
- Loss of heat by movement of air or liquid
- This heat transfer happens in the body when
blood flow increases to release heat to the external environment - Provides the major mechanism of heat loss during heavy exercise because when the body produces sweat, the conversion of sweat droplets to vapor facilitates cooling of the body
- Heat transfer through solid liquid or gas that are in direct contact with each other
- Loss of heat by electromagnetic waves, objects are not in direct contact with each other
A. Radiation
B. Convection
C. Evaporation
D. Conduction
- B
- B
- C
- D
- A
Enumerate the 9 Factors Influencing Body Temperature
- Time of day
- Age
- Emotions / Stress
- Exercise
- Menstrual cycle
- Pregnancy
- External environment
- Measurement site
- Ingestion of warm or cold foods
Enumerate the 6 Factors Influencing Heart Rate
- Age
- Sex
- Emotions / Stress
- Exercise
- Medications
- Systemic or local heat
Enumerate the 8 Factors Influencing Blood Pressure
- Blood volume
- Arterial diameter and elasticity
- Cardiac output
- Age
- Exercise
- Valsalva maneuver
- Orthostatic hypotension
- Arm position
Enumerate the 7 Factors Influencing Respiration
- Age
- Body size and stature
- Exercise
- Body position
- Environment
- Emotions / Stress
- Pharmacological agents
Determine the corresponding descriptions of the adventitious sounds
- rattling or bubbling sound due to secretions
in the air passages - snoring sound due to partial obstruction of
the upper airway - high pitched crowing occurs with upper airway obstruction due to narrowing of glottis or trachea
- whistling sound due to air passing through
a narrowed airway more prominent in expiration - deep inspiration followed by prolonged
audible expiration; normal and it actually helps in expanding the alveoli
A. Wheeze
B. Stridor
C. Crackle / rales
D. Sigh
E. Stertor
- C
- E
- B
- A
- D
Determine the corresponding descriptions of the patterns of respiration
- Difficult or labored breathing with increased effort to breathe
- Abnormally fast rate and depth that can be due to anxiety, stress, or panic disorders
- Absence of respiration and is transient
- Normal breathing pattern
- Reduction in the rate and depth that may lead to increased levels of carbon dioxide in the blood
A. Eupnea
B. Hyperventilation
C. Hypoventilation
D. Dyspnea
E. Apnea
- D
- B
- E
- A
- C
Determine the corresponding descriptions of the patterns of respiration
- Period of apnea lasting for 10 - 60 secs followed by gradually increasing depth and frequency (period of hyperventilation)
- Dyspnea while lying down, commonly seen in pts with emphysema, asthma or pulmonary edema
- Regular but abnormally deep respiration with increased rate.
- Abnormally slow RR due to impairment of the respiratory center (≤ 10 cpm)
- Irregular respiration with variable depth
alternating with periods of apnea - Abnormally fast RR due to respiratory insufficiency and fever (> 24 cpm)
A. Orthopnea
B. Tachypnea
C. Bradypnea
D. Cheyne-Stokes
E. Biot’s
F. Kussmaul’s
- D
- A
- F
- C
- E
- B
Determine the corresponding descriptions of the phases of Korotkoff’s Sounds
- Crisp, more intense and louder due to flowing unobstructive blood
- Distinct with abrupt muffling with soft blowing quality; muffled sound and soft to the ears
- Last sound heard, diastolic pressure
- Clear, faint, rhythmic tapping sound which gradually increases, denotes systolic pressure
- Murmur or swishing sound as artery
widens
A. Phase I
B.
Phase II
C. Phase III
D. Phase IV
E. Phase V
- C
- D
- E
- A
- B
The temporary disappearance of sound normally heard over the brachial artery and may cover a
range of as much as 40mmHg.
Auscultatory gap
Most common measurement site for blood pressure
Brachial artery
Determine the corresponding placement of the BP cuff when using the ff measurement areas
- Above the wrist
- Above the knee
- Upper arm
- Above malleoli or at the midcalf
A. Brachial artery
B.
Radial artery
C. Popliteal artery
D. Dorsalis pedis artery, Posterior tibial artery
- B
- C
- A
- D
Determine the corresponding classification of the risk factors affecting BP
- Sedentary lifestyle
- High sodium intake, caffeine
- Age
- Response to stress, heavy alcohol consumption and tobacco use
- Sex
A. Modifiable risk factor
B. Non-modifiable risk factor
- A
- A
- B
- A
- B
Determine the corresponding classification of the risk factors affecting BP
- Drugs
- Obesity
- Race
- Pregnancy
- Hereditary
A. Modifiable risk factor
B. Non-modifiable risk factor
- A
- A
- B
- A
- B
Blood pressure measurement method where the a thin catheter is inserted into an artery
Direct method
Blood pressure measurement method where a stethoscope and sphygmomanometer are utilized. PTs and most of the health care professionals use this method.
Indirect method
-BP cuff, manometer, stethoscope
The period when blood initially flows through the artery and is the highest pressure in the system during ventricular contraction
Systolic pressure
Determine the corresponding descriptions of abnormal pulses
- Pulse with regular rhythm but with alternate weak and strong beats which is associated with left ventricular failure
- Increased pressure with rapid upstroke and downstroke and short peak
- Strong upstroke, downstroke and a second upstroke during systole which may be an indication of aortic insufficiency, regurgitation or stenosis
- Pulse with a marked decreased amplitude during inspiration due to constrictive pericarditis, advances lung disease, pericardial tamponade
- Irregular rhythm with premature beats alternate with sinus beats that may indicate heart failure or hypoxia
- Possible causes may include aortic regurgitation, patent ductus arteriosus, systemic arteriosclerosis
A. Corrigan’s (Water-Hammer) pulse
B. Pulsus alternans
C. Pulsus bigeminus
D. Pulsus bisferiens
E. Pulsus paradoxus
- B
- A
- D
- E
- C
- A
Determine the corresponding descriptions of pulse grading descriptions
- Barely perceptible, easily obliterated
- Very strong, hyperactive
- Easy to palpate
- No pulse even with max pressure
- Difficult to palpate
A. 0 (Absent)
B.
1+ (Thready)
C. 2+ (Weak)
D. 3+ (Normal)
E. 4+ (Bounding)
- B
- E
- D
- A
- C
Determine the corresponding descriptions of the parameters of respiration
- Regularity of inspiration and expiration
- Number of breaths per minute counted in 30
seconds x 2 if rhythm is regular - Amount of air exchanged with each breath
- heard in inspiration and is usually smooth and soft
A. Rate
B. Depth
C. Rhythm
D. Sound
- C
- A
- B
- D
Forced exhalation with a closed glottis, nose and
mouth. Increased intrathoracic pressure with
accompanying collapse of the chest wall veins, leading to a decreased venous return and decreased BP.
Valsalva maneuver
Additional: Once the person releases their breath, there is a sudden overshoot of the venous return to heart and a rise in BP will ensue.
Determine the corresponding reactions of the body to changes in body temperature
- Shivering reflex (in skeletal muscle) initiated by the posterior hypothalamus
- Cutis anserina / piloerection
- Heat loss via evaporation in sweat glands
- Secretion of norepinephrine, epinephrine,
and thyroxine - In vascular system, vasodilation of cutaneous blood vessels
A. Increased body temperature
B. Decreased body temperature
- B
- B (hair standing on end)
- A
- B
- A
Determine the corresponding descriptions of the phases of pyrexia
- Period of gradual or sudden rise until the max temp is reached with chills, shivering and paleness of skin
- Period during which the fever subsides where cutaneous vasodilation occurs and sweating
- Point of the highest elevation of fever with warm and flushed skin, no shivering
- Period prior to onset of fever with non-specific symptoms
A. Prodromal phase
B. Phase 1: Onset
C. Phase 2: Course
D. Phase 3: Defervescence
- B
- D
- C
- A
“Fever”, brought about by pyrogens from toxic bacteria or from degenerating body tissues. A sign that there is an underlying disease infection
going on inside the body.
Pyrexia
TRUE OR FALSE: Convulsions due to high fever is more common in children < 5 y/o due to their immature nervous system.
True
Below ___ºC, the thermoregulatory center becomes seriously impaired
34.4
Below ___ºC, the body has completely lost
thermoregulatory function
29.4
TRUE OR FALSE: In the body, the number of cold receptors is greater than warm receptors and cold receptors are more sensitive to changes in temperature.
True
This is because cooling the body poses more serious complications which may lead to death if not addressed immediately
Lowest temperature in the body occurs at what time (range)?
4-6 AM
Highest temperature in the body occurs at what time (range)?
4-8 PM
TRUE OR FALSE: Infants and young children have a higher temperature than normal due to the
immaturity of their regulatory centers resulting in temperature fluctuations
True
The body temperature ___ due to the release of
epinephrine and norepinephrine facilitated by
the sympathetic nervous system.
increases
These hormones increase metabolic rate thus increasing body temperature.
Women who are in the period of ovulation and
just before it, have a ___ temperature due to an
increased level of progesterone in the body
higher
Measurement site that generates the highest temperature than the rest of the measurement sites. It provides the closest measurement to the actual internal body temperature.
Rectal
Additional: Axillary measurement site generates a lower temperature due to the cooling effect of
the circulating air in the measurement site
The apical / central pulse is located in the ___
apex of the heart
This pulse is used for weak heartbeats that are imperceptible peripherally and other sites are inaccessible or difficult to locate or palpate. Also used to monitor the effects of cardiac medications designed to alter HR and rhythm.
Rapid or irregular heart rate perceived by a patient without actual palpation
Palpitations
Additional: In essence, palpitation is tachycardia but the former is reported by the patient while the
latter is obtained by the examiner
Premature, late, or missed pulse rhythm associated with conduction problems of the heart or an impulse originating from a different site
Arrhythmia / Dysrhythmia
Determine the corresponding descriptions of pulse parameters
- Pattern of pulsations and the intervals between
them - Amount of force created by the ejected blood
volume against the arterial wall during each
ventricular contraction - Number of pulsations or frequency per minute
A. Rate
B.
Rhythm
C. Quality
- B
- C
- A
TRUE OR FALSE: Fetuses and newborns have lower heart rates than adults.
False
Fetuses and newborns have smaller hearts thus
to compensate for the small size, their hearts
need to beat a lot faster to circulate the blood.
Fetus: 120-160 bpm
Newborn: 70-170 bpm
The linear relationship between heart rate and intensity of workload
Chronotropic competence
Suppose you have a 40 y/o patient who was referred to PT management for endurance training. Upon baseline assessment of vital signs, you obtained a BP of 110/70 mmHg, PR of 74bpm, and RR of 14 cpm. To train this patient in increasing his cardiovascular endurance, exercise intensity must be set at 60-70%. Compute for
the patient’s THR.
THR = 138 - 148 bpm
Beta-blockers ___ resting HR and HR response
to exercise
decrease
Refers to the difference between the rate of the apical and radial pulses. This is important especially when the patient has a heart problem or any CV disease to monitor any skip beats or disarrythmia
Pulse deficit
Determine the corresponding descriptions of the terms related to pulse monitoring
- decreased oxygen levels in the circulation
- complete lack of oxygen
- Measures arterial blood oxygenation updated with each pulse wave (SpO2)
- Examine pulses that are extremely weak or faint or that are obliterated by even slight pressure or when arterial flow is severely compromised
- decreased oxygen available to body tissues
A. Pulse Oximetry
B. Doppler Ultrasound
C. Hypoxia
D. Hypoxemia
E. Anoxia
- D
- E
- A
- B
- C
Increased levels of carbon dioxide or hydrogen ions in the blood
Acidosis
A protective stretch mechanism where the pulmonary stretch receptors of the lungs inhibit
further inspiration and increase duration of expiration. These signals will stop at the end of expiration to initiate another inspiration and this is more
significant in neonates than in adults.
Hering-Breuer Reflex
Medications (e.g. albuterol, bitolterol) that decrease airway
resistance and residual volume resulting to increase lung capacity and airflow
Bronchodilators
This adventitious sound is commonly heard in patietns with asthma exacerbation
Wheeze
This adventitious sound is commonly heard in patients with narrowing of the trachea or a lodged foreign object, like food
Stridor
This adventitious sound is common in patients with Congestive heart failure
Crackle / rales
This pattern of respiration is commonly seen in comatose patients and patients with disease of the basal ganglia
Cheyne-Stokes
This pattern of respiration is seen in patients with affectation of the pons or brain herniation
Biot’s
This pattern of respiration is often associated with metabolic acidosis or ketoacidosis seen in patients with diabetes
Kussmaul’s
Arrange the following in order from highest to lowest blood pressure
Choices: Capillaries, Veins, Arteries
- Arteries
- Capillaries
- Veins
A (1)__ pulse pressure indicates stiffened arteries due to normal decrease in elasticity as one ages or because of fat deposits, while a (2)__ pulse pressure indicates decreased cardiac output and may be
associated with heart failure
- large / high
- small / low
The impediment to blood flow inside the vessel that the heart must overcome
Peripheral resistance
TRUE OR FALSE: Larger blood volume and increased blood viscosity will result to an increase in BP.
True
Additional: The diameter and elasticity of the vessel wall have an inverse relationship with BP
TRUE OR FALSE: Blood pressure, especially Systolic BP, increases with an increase in exercise intensity. Diastolic BP does not increase that much because the blood vessel vasodilates to counteract the increase in cardiac output.
True
