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TRI 4 - CP > Units 1-3 > Flashcards

Units 1-3 Flashcards

1
Q

Describe pulmonary function

A

Transportation and distribution of essential nutrients

Removal of byproducts from cellular metabolism

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2
Q

What is the significance of the angle of louis

A

In palpation corresponds to second costal cartilage

Posteriorly corresponds to T4, T5 vertebrae

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3
Q

Describe normal fluid levels in the pericardial space and what is the name of the condition when this is elevated

A

10-20 ml

Pericardial effusion

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4
Q

During what phase does the heart receive blood

A

Diastole

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5
Q

What is the conduction system of the heart and their pace values

A

SA node - 60-100
AV node - 40-60
Bundle of his
Purkinje

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6
Q

What are the extrinsic and intrinsic regulatory factors on the heart

A

In - Sa and AV node
Ext - neural
- Symp - increase HR, vasodilates coronary arteries
- Para - slows HR, vasoconstricts coronary arteries

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7
Q

Describe the chronotropic effects on the heart

A

+ HR increases

- HR decreases

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8
Q

Describe the Inotropic effects on the heart

A

+ is increased contractility

- is decreased contractility

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9
Q

What is the equation for CO

A

CO = SV x HR

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10
Q

What is normal ejection fraction

A

60-70%

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11
Q

Describe rate pressure product

A

Index of myocardial O2 consumption

Reflects cardiac fitness

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12
Q

Describe the equation for RPP and interpretation of results

A 
RPP = (HR x systolic BP) / 1000
0-12 = normal
12-17= risk
17-21= danger
above 21 = very dangerous
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13
Q

Differentiate between coronary artery disease and coronary heart disease

A

Artery - problems with blood vessels and flow to the heart but no damage to heart muscles
Heart - damage to the heart muscles

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14
Q

What can coronary artery disease progress to

A

Coronary artery disease

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15
Q

Describe how the coronary arteries protect against occlusion

A

will vasodilate to help perfusion

If unsuccessful, will cause heart attack

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16
Q

What damages endothelium

A

LDLs
Smoking
HTN

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17
Q

What is the difference between atherosclerosis, arteriosclerosis and arteriolosclerosis

A

Athero - platelet aggregation
Arterio - hardening arteries
Arteriolo - hardening of arterioles seen in HTN and DM

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18
Q

Differentiate between STEMI and NON-stemi

A

STEMI - transmural infarction

Non-STEMI - nontransmural or subendocardial region infarction

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19
Q

What are the risk factors for something

A

Elevated homocysteine
Hematological factors
Inflammatory markers - elevated C reactive protein

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20
Q

What can HTN lead to in the heart

A

LV hypertrophy
Atherosclerosis
Systemic damage

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21
Q

What is stenosis and regurg

A

Stenosis - murmur when valve is open

Regurg - murmur when valve is closed

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22
Q

What cardiac diseases lead to HF

A

CAD
HTN
MI
Cardiomyopathies

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23
Q

Describe Cardiomyopathy

A

sudden death
1/4 of al sudden deaths are attributed to cardiomyopathies
1 in every 500 cases

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24
Q

How can renal insufficiency affect the heart

A

Overload the heart with fluid

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25
Q

Describe the medical professional’s goals when it comes to preventing HF

A

Prevent or delay with meds, diet, lifestyle changes and exercises

26
Q

How does the PT help prevent HF

A

Educate the patient about exercise and report abnormal symptoms

27
Q

What is mPAP

A

mean arterial pressure
measure of pulmonary hypertension
> 25 mmhg is abnormal
> 20 is abnormal in patients with COPD

28
Q

Describe some symptoms of left sided heartfailure

A

Dry cough
Fatigue
Pulmonary rales

29
Q

Describe some symptoms of right sided heart failure

A

Dependent edema
Jugular distension
Increased right atrial pressure
Peripheral effects

30
Q

What is the affect of CHF on the muscles

A

decreased diameter of type 1 and 2 muscle fibers

Isometric strength is decreased (50%)

31
Q

How do patients with CHF present when exercising

A

HR increases rapidly with submax load
Blunted systolic BP
Decreased O2 sat
Elevated CO2 in blood

32
Q

What are some signs of HF

A

Sudden weight gain
pulmonary edema
worsening dyspnea

33
Q

Describe BNP

A 
Brain natriuretic peptide
strong predictor of poor prognosis for heart failure
less than 100 is normal
100 - 400 are of concern 
above 400 indicate HF
34
Q

Describe the stages of pulmonary edema

A

stage 1 - increased lymph flow, fluid in gravity dependent positions
stage 2 - tachypnea, elevated PCWP
stage 3 - flooding of alveoli, hypercapnia, hypoxemia

35
Q

How do you dose a patient with CHF

A

5- 10 mins walking per day, progress to 30 mins
goal is 5-7 times per week
3-5 RPE / 10
65-85% of 1rm
Diaphragmatic breathing and pursed lip breathing 2 times per day

36
Q

Describe the 6 minute walk test

A

Poor prognosis if unable to ambulate 468 m or 1535 feet
If they cannot walk 300m it predicts mortality
Greater than 750 feet means shorter hospital stays

37
Q

What is the “pace” of the SA, AV and Pukinje fibers

A

SA - 60-100
AV - 40-100
Pukinje 20-40

38
Q

What are the methods to determine heart rate

A

1500/ # of small boxes

300, 150, 100, 75, 60, 50

39
Q

Describe depolarization as it relates to the ion channels

A

Opening of sodium and calcium channels

40
Q

Describe redepolarization as it relates to the ion channels

A

Opening of potassium channels and closing of sodium channels

41
Q

What is a plateau

A

When calcium channels are still open, after calcium channels close more potassium opens

42
Q

What is the duration of the P wave, QRS and PR interval

A

P - 2 small boxes
QRS - 2 small boxes
PR - 5 small boxes

43
Q

What is a long PR interval and what does it mean

A

Greater than .2 sec\

Means there is a block

44
Q

What does it mean when a QRS is greater than .1 seconds

A

Impulse if from the ventricles or abnormal ventricular conduction system

45
Q

What does a deeply inverted q wave mean

A

MI and is getting worse
will remain that way for months
ST will return to normal

46
Q

What does it mean when the ST segment elevates or depresses

A

Elevation - STEMI - MI, hypothermia

Depression - NON-STEMI / ischemia

47
Q

What happens on the EKG in a STEMI and what is the pain like

A 
ST elevation
Q is 1/3 the size of the QRS
T wave inversion will not be evident initially
Severe pain
More serious
48
Q

What does T wave inversion indicate

A

Ischemia
Injury
Pulmonary embolism

49
Q

Describe what is NON-STEMI is

A

Subendocardial block
Not full thickness
less severe chest pain when compared to a STEMI
Can lead to fatal arrhythmias

50
Q

How do you identify a NON-STEMI

A

ST depression greater than 1mm

T wave inversion will be variable

51
Q

What on an EKG suggests ischemia

A

ST depression with biphasic negative-positive T wave

52
Q

What indicates a pulmonary embolism

A

Troponin

Deep t wave inversion on leads 1-4

53
Q

What can digitalis cause on an EKG

A

large QRS complex

54
Q

What is the difference between atrial flutter and atrial fibrillation

A

Flutter - saw toothed

Fibrillation - coarse waves

55
Q

Is it safe to exercise a patiet durring A FIB

A

Yes

56
Q

Is it safe to exercise a patient durring V fib

A

No
This is an emergency
Ready the AED if necessary

57
Q

What is considered V TAK

A

3 or more PVS’s in a row

58
Q

Describe a first degree AV block

A

Elongated PR interval

59
Q

Describe second degree AV blocks

A

type 1 - Wenckebach - Progressive lengthening of PR then QRS drop
type 2 - Mobitz - 2-4 P waves before a QRS

60
Q

Describe a 3rd degree AV block

A

No relationship between P and QRS, they are firing independently of one another

TRI 4 - CP (4 decks)

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