THY 414 Exam 1 Flashcards
1
Q
What is intermittent claudication?
A
Lower extremity pain when blood supply is cut off
2
Q
What is a field test?
A
Conducted in more practical settings and can do larger groups at one time
3
Q
What is a lab test?
A
A more one on one based approach and very controlled
4
Q
What is a disease dependent risk?
A
the adverse effects of exercise that are consequence of disease
5
Q
An example of a disease dependent risk is ….
A
arthritic joints can become inflamed/diabetics can lose control of BS/skin irritation of prosthetics
6
Q
True or False:
You want to avoid or reduce activities that may cause these effects.
A
True
7
Q
What is an activity dependent risk?
A
the adverse effects that are consequences of accidents occurring during an activity
8
Q
An example of an activity dependent risk is …
A
exhaustion/falling/musculoskeletal injury
9
Q
What are the benefits of resistance training?
A
- better risk profiles
- lower risk of all-cause mortality and CVD events
- improvements in bone density
- lower risk in developing functional limitations
10
Q
True or False:
Resistance training is better than aerobic training.
A
True
11
Q
What are the benefits of aerobic training?
A
reduced chance of CVD, stroke, Type-2 diabetes, breast/colon cancer, depression, falls
12
Q
What does the P wave of an ECG represent?
A
atrial depolarization (contraction)
13
Q
What does the Q wave of an ECG represent?
A
initial depolarization of the ventricles
14
Q
What does the R wave of an ECG represent?
A
depolarization of main mass of ventricles
15
Q
What does the S wave of an ECG represent?
A
final depolarization
16
Q
What does the T wave of an ECG represent?
A
repolarization of the ventricles
17
Q
What is a relative contraindication?
A
When a particular treatment or procedure should be used with caution.
18
Q
When should you stop the test concerning BP levels?
A
SBP>250 OR DBP>110
19
Q
What are absolute contraindications?
A
That an event or substance could cause a life-threatening situation.
20
Q
What is optimal BP?
A
SBP<120 / DBP<80
21
Q
What is prehypertensive?
A
SBP 120-139 / DBP 80-89
22
Q
What is Stage 1 HTN
A
SBP 140-159 / DBP 90-99
23
Q
What is Stage 2 HTN?
A
SBP>160 / DBP>100
24
Q
What are the 3 categories of screening tests? What do they mean?
A
Identify: no exercise until conditions have been controlled
Recognize: person w/ clinically significant disease who should participate in a medically supervised ex. program
Detect: individuals at increased risk of disease who should undergo medical evals and ex. testing before joining an ex. program or increasing the FITT of current program
25
What are the health influencers?
Lifestyle behaviors, external factors, internal factors
26
How does blood flow through the heart?
RIGHT SIDE:
- deoxygenated blood comes into the right atrium from the superior and inferior vena cava
- goes through the tricuspid valve then into the right ventricle
- then goes into the pulmonary valve into the pulmonary artery then into the lungs
LEFT SIDE:
- oxygenated blood comes into the left atrium from pulmonary veins
- then goes through the bicuspid valve into the left ventricle
- then goes through the aortic valve into the aorta and gets pushed out to the rest of the body
27
What are the electrical components of the heart?
SA node, AV node, Bundle of His, Bundle Branches, and Purkinje Fibers
28
What does the SA Node do?
"the pacemaker" (P wave) makes atrials contract
29
What does Bachmann's Bundles do?
sends impulses from the SA node to the L&R atriums simultaneously
30
What does the AV Node do?
Acts as a gate that slows the electrical signal before it enters the ventricles, giving atria time to contract & fully empty (PR interval)
31
What does the Bundle of His do?
receives wave from AV node carrying depolarization to the apex of the ventricles
32
What do the Bundle Branches do?
Receives rapid conduction of impulses through the ventricles, reflected by QRS complex on the ECG
33
What do the Purkinje Fibers do?
innermost cells of the ventricles; carry depolarization throughout ventricles
34
The backup pacemaker of the heart is ____
the AV node
35
How is blood supplied to the heart?
1. blood comes in through the right atrium from the body
2. moves into the right ventricle and is pushed into the pulmonary arteries in the lungs
3. after picking up oxygen, the blood travels back to the heart through pulmonary veins into the left atrium to the left ventricle
4. finally goes out to the body's tissues through the aorta
36
What is autonomic tone?
the balance between the PNS and CNS
37
What do PAD and CAD stand for?
PAD: Peripheral Artery Disease
CAD: Coronary Artery Disease
38
What is the definition PAD?
occurs with plaque build up in major arteries that supply blood to legs, arms, and pelvis; can lead to pain, infection, inflammation; can occur in ANY artery
39
What is the definition CAD?
involves localized accumulation of lipid ad fibrous tissues within the coronary artery; progressively narrows and can lead to clots; may lead to MI or death
40
What is atherosclerosis?
disease where plaque builds up inside of arteries
41
Plaque is made up of _____
fats, cholesterol, calcium, etc
42
What can too much plaque build up lead to?
clots, MI, or death
43
What does PAC stand for and what does it look like on an ECG?
Premature Atrial Contraction -- early beat with P wave. (different spaces in-between beats)
44
What does PVC stand for and what does it look like on an ECG?
Premature Ventricle Contraction -- ventricles contract early so the P wave doesn't happen. (wide an bizarre QRS complex)
45
What does V-Tach stand for and what does it look like on an ECG?
Ventricular Tachycardia -- ectopic rhythm in the ventricles and discharges a rapid rate like 100bpm-250bpm (looks like monster teeth)
46
What does V-Fib stand for and what does it look like on an ECG?
Ventricular Fibrillation -- ectopic rhythm depicting multiple depolarization waves. MOST SERIOUS OF ALL ARRYTHMIAS; no pulse, no BP; shockable (looks like squiggly lines)
47
What does SVT stand for and what does it look like on an ECG?
Supraventricular tachycardia -- above the ventricles; 100bpm, since it happens before the SA and above AV, the P wave is nonexistent or buried in QRS (super super high QRS complex)
48
What does A-Fib stand for and what does it look like on an ECG?
Atrial Fibrillation -- depolarization waves occur so rapid that the atria no longer functions effectively, usually an irregular rhythm like 30bpm or 200bpm (squiggly squiggly POINT)
49
What does A-Flutter stand for and what does it look like on an ECG?
Atrial Flutter -- very rapid atrial waves (300bpm) producing a saw-toothed baseline. AV node can only beat to the 2nd, 3rd, or 4th wave it receives; flutter waves happen at the same time (saw teeth in between evenly spaced beats)
50
When can exercise testing begin after PTCA and what does it look like?
2-3 days after and can begin low-mod. Walking 2-3hrs after PTCA
51
When can exercise testing begin for CABG and what does it look like?
Long recovery post CABG; testing after 48-72hrs
52
What are the 4 components of a SOAP note?
Subjective, Objective, Assessment, Plan
53
Where is an MI located in the body, and what does it look like on an ECG?
Predominately affects the left ventricle but can extend to right ventricle or right atria (aka a heart attack); on ECG it has the ST wave super elevated.
54
True or False:
The patient should be standing when taking BP.
False
55
True or False:
You should discard the first reading of a BP test due to white coat syndrome.
True
56
What are long-term complications of HTN?
- left-ventricular hypertrophy
- acceleration of atherosclerosis
- renal disease
- stroke
- heart failure
57
What are the 5 most common medications for HTN?
1. Diuretics
2.ACE Inhibitors
3. Beta Blockers
4. Nitrates
5. Calcium-Channel Blockers
58
What do diuretics do?
decrease BP by decreasing blood volume
59
What do ACE Inhibitors do?
decrease BP by decreasing blood volume and decreasing peripheral vasoconstriction
60
What do Beta Blockers do?
prevents patients from working above their ischemic threshold; decrease submax and max HR & decrease myocardial oxygen demand (decrease HR and contractility)
61
What do Nitrates do?
increase oxygen supply by dilation of coronary arteries and decrease oxygen demand by dilation of peripheral arteries to decrease BP
62
What do Calcium-Channel Blockers do?
may decrease HR at rest and during exercise (be cautious of this); decrease myocardial demand
63
What are the 3 levels of risk stratification?
Low, moderate, and high
64
Definition of Low Risk Stratification:
asymptomatic men and women who have LESS THAN OR EQUAL TO 1 CVD risk factor
65
Definition of Moderate Risk Stratification:
asymptomatic men and women who have MORE THAN OR EQUAL TO 2 risk factors
66
Definition of High Risk Stratification:
individuals with 1 OR MORE signs and symptoms OR KNOWN cardiovascular, pulmonary, or metabolic disease
- CVD = cardiac, PAD, or cerebrovascular disease
- Pulmonary = COPD, asthma, interstitial lung disease, or cystic fibrosis
- Metabolic = Type 1 or 2 diabetes, thyroid disorders, and renal or liver failure
67
Risk factor level of LDLs is:
LDL > 130 mm Hg
68
Ideal level of HDLs is:
HDL < 40 mm Hg
69
Risk factor level of Cholesterol is:
Total Cholesterol > 200 mm/dL
70
What is the Dose Response Curve?
the range of optimal exercise doses for a given activity; don't do too much or too little
71
What are the three types of Lipoproteins?
LDL, HDL, and VLDL
72
What is LDL?
Low-Density Lipoprotein: "bad cholesterol"
- carries cholesterol though out the body, but high levels can lead to plaque build up
73
What is HDL?
High-Density Lipoprotein: "good cholesterol"
- the scavenger that picks up excess in the blood and brings it back to the liver to be broken down
74
What is VLDL
Very Low-Density Lipoprotein: "also bad...but"
- carries more fat (triglycerides)
75
What are the 5 Cholesterol medication
1. Statins
2. Bile Acid sequestrates
3. Cholesterol absorption inhibitors
4. Niacin
5. Fibrates
76
What do Statins do? Side effects?
most commonly used; works to lower total cholesterol and LDLs
Side effects:
- Myositis: inflammation of the muscles
- Elevated levels of CPK or creatine kinase
- Rhabdomyolysis: extreme muscle inflammation and damage
77
What do Bile Acid sequestrates do? Side effects?
appropriate for elevated cholesterol levels and NOT hypertriglyceridemia
78
What do Cholesterol absorption inhibitors do? Side effects?
typically approved as a second-line treatment AFTER statins to reduce blood cholesterol levels
79
What does Niacin do? Side effects?
increases HDL cholesterol and reduces triglycerides in the blood
80
What do Fibrates do? Side effects?
indicated for people with metabolic syndrome and are effective at reducing triglycerides while increasing HDL cholesterol
81
What are the two types of Ischemia?
Symptomatic and Silent
82
What is symptomatic ischemia?
most common symptom of ischemia is angina.
- discomfort in the chest (heavy, squeezing), last for 10-20 seconds, can last as long as 30 min
- ECG shows ST-segment depressions / T-wave flattening
83
What is silent ischemia?
no symptoms
- exactly like stable but you don't feel it
- must diagnose with stress test or continuous ECG
- common among diabetics with peripheral neuropathy (impaired pain sensation)
