Study Flashcards
what is atherosclerosis
build up of fatty plaque deposits in the arteries
What happens if a plaque ruptures in a coronary artery
Causes a blood clot and blocks a coronary artery
What happens if plaque occlusion of an artery reaches 70%
insufficient blood will be delivered leading to heart failure
What BP is hypertension
140/90
how many women have hypertension
1 in 5
how many men have hypertension
1 in 4
Why does the CV system fatigue during hypertension
heart has to work harder due to enlarged walls, shrinking chambers, and peripheral resistance of the heart
What is peripheral vascular disease?
Atherosclerosis in the periphery
What causes ischemic pain
lack of O2
What happens if a plaque ruptures in a the periphery
stroke or myocardial infarction
Can exercise repair ischemic tissue
No
Can exercise remove atherosclerotic deposits
Not completely
When should you return to exercise after a CV event
ASAP (within 8-12 weeks)
What chamber of the heart can be impaired in patients with CHD
left ventricle
What is BP
Cardiac output * Total peripheral resistance
Cardiac output
HR * SV
Who should use the Bruce assessment protocol
young/healthy people as it is faster and more intense
Who should use the Naughton assessment protocol
Less functional people
Who should use the Balke-Ware assessment protocol
Less functional people
What are the Angina rating scale
- Mild, barely noticable
- Moderate, bothersome
- Moderately severe, very uncomfortable (consider terminating the test here)
- Most severe pain ever experienced (stop the test)
What are the Dyspnea rating scale
- Light, barely noticeable
- Moderate, bothersome
- Moderately severe, very uncomfortable (consider terminating the test here)
- Most severe or intense dyspnea ever experienced (stop the test)
What can cause a myocardial infarction
Usually a result of atherosclerotic plaque rupture (can be coronary artery or peripheral)
Does the heart stop beating during a myocardial infarction
Not always
Symptoms of myocardial infarction
angina
shortness of breath
anxiety
Treatment of myocardial infarction
O2 supplementation
Nitrogylcerin - vasodilator (causes arteries to dilate and pump more blood through)
Defibrillation - shock the SA node
What is Heart Failure
Inability for the heart to deliver blood to metabolising tissue
Does the heart stop beating during a heart failure
No
What is systolic heart failure
impaired ventricular contraction
What is diastolic heart failure
impaired ventricular filling
What is Valvular Regurgitation
Leaflets of valve don’t close properly allowing blood to seep back thru
Volume overload of ventricles occur if blood is pumped back into the aorta
Enlargement of the chamber
Can lead to heart failure
What is stenosis
Leaflets of valves fail to open properly
Higher resistance is encountered (higher blood pressure)
Hypertrophy of ventricular walls
Can lead to heart failure
Can Valvular Regurgitation and Stenosis lead to heart failure
Yes
What is the role of statins
inhibit liver cholesterol
What is the role of beta blockers
limit HR
What is the role of anti arrhythmic agents and anti thrombogenic agents
thinning the blood and maintaining sinus rhythm
What is the role of ACEI
vasodilator in the peripheral arteries
What is the role of anti anginal agents
vasodilation of the coronary arteries
What does ACEI stand for
Angiotensin converting enzyme inhibitors
How do diuretics work?
Reduces sodium reabsorption -> water to be pulled from the tissues to -> extracellular fluid is reduced -> BP lowers
How should aerobic training intensity be monitored in heart disease patients
RPE
HR at a % of the onset of complications rather than % of HRmax
What type of aerobic training should be prescribed for heart disease PT
Intermittent training with 3-5mins rest
What class of heart disease PT should avoid isometric exercises
II-IV
What type of resistance training should PT with MI undertake
High reps
What is the HRmax for PT with MI
HRrest + 20bpm
What are the exercise rec. for PT 1 month post MI
2-3 sessions/week
15-20mins
2.5-5km/h on treadmill
What are the exercise rec. for PT 2-6 months post MI
4-5 sessions/week
30-40mins
85% HRR
How many kJ should hypertension PT aim to expend
1000kJ/day
What are the aerobic exercise rec. for hypertension PT
30min sessions
4-7 week
<70% VO2max intensity
What are the resistance exercise rec. for hypertension PT
high rep range
circuit training
no valsalva manoeuvres
longer rest between sets
What are the aerobic exercise rec. for peripheral vascular disease PT
3 times/week
50-80% HRmax
minimum 15mins but building to >30mins
Typically walking
What is the main exercise goal for heart failure patients
Improve peripheral O2 kinetics
What are the aerobic exercise rec. for heart failure PT
40-85% peak VO2
30-60mins
3-5days/week
What are the resistance exercise rec. for heart failure PT
single joint exercises to place less strain on myocardium
Reduce blood lactate following training
What are the resistance exercise rec. for valvular disease PT
Exercise is not a form of treatment
How is asthma diagnosed
Peak flow rate. If there is a >20% improvement from initial peak flow rate after taking medication, then asthma can be diagnosed
What is peak flow rate
used to diagnose asthma. How quickly air can be expired
What can trigger asthma during exercise
cool dry air
What are the 2 types of COPD
Chronic bronchitis
Emphysema
What is chronic bronchitis
Increased number and size of mucal glands in the airway
What is emphysema
destruction of the bronchiole walls. Removes surface area for gas exchange, reducing O2 to be circulated around the body
What is the primary cause of COPD
cigarette smoke
What are the symptoms of COPD
Same as asthma
What are the symptoms of cystic fibrosis
Same as COPD and asthma
How is COPD diagnosed
FEV1:FVC ratio <70% = COPD. FEV1 is less than 80% of predicted value
What is ventolin
fast acting asthma reliever. Bronchodilator
What are Beta2-adrenoceptor agonists
salbutamol, levalbuterol
Why is aerosol intake medication more suitable than oral for asthma PT
No need for stomach digestion as it can head straight to the lungs
What is the best mode of exercise for asthma PT
swimming
What is extremely important for asthma PT
warm up
What is epinephrine
vasodilator for COPD
What is theophylline
sustained bronchodilator for COPD
What does a much-regulator do
breakdowns mucus
What should be monitored during exercise for COPD PT
O2 saturation
wrote learn normative values for cholesterol
…
What increases in the Bruce protocol?
speed and elevation
What increases in the Balke-Ware protocol
elevation in 1% intervals (starting at 2%)
What increases in the Naughton protocol
Elevation (speed only increases from stage 1 -> 2)
What is the P wave
polarisation of the atrioventricular node
What are the limitations of asthmatic PT performing physical assessmetns
none. They can perform any test as long as they have reliver medication on stadby
What is the QRS complex
depolarisation of the ventricles
What is the T wave
Depolarisation of the ventricles
Can COPD and late stage cystic fibrosis PT perform any exercise assessment
no
What is the normal FEV1:FVC ratio
70-80%
Why is swimming/cycling better for asthmatic PT
Lower respiratory demand due to effort intensity + muscle mass used = more O2 required
When should the session be terminated for an asthmatic PT
if medication does not reverse bronchoconstriction
What is the main goal for asthmatic PT
Improve aerobic capacity/ventilatory reserve
COPD exercise guidelines
Intensity - highest tolerable
Freq - regular
Duration - 20-40mins
Mode - whole body
What sort of exercise should COPD PT focus on
aerobic
Cystic Fibrosis exercise guidelines
Intensity - target HR is below the point of O2 desaturation. Resistance training should be using high rep ranges
Duration - standard 30min target
Mode - multiple
Freq - 3-5 days per week
What muscle is used for inspiration
Diaphragm
What are the rectus abdominus and intercostal muscles used for
contract and increase vol of lungs
What are the external intercostal muscles used for
force air out by restricting capacity of the lungs
