Cardiac Rehab Lecture 1

Question 1

What is Cardiopulmonary PT?

Answer 1

The purpose of CPPT is to prevent, mitigate, or reverse cardiopulmonary dysfunction, and hence, the impairment of or threat to oxygen transport

Question 2

What is oxygen transport?

Answer 2

OT refers to the delivery, uptake, and extraction of oxygen at the tissue level, thus it reflects the adequacy of the structure and function of the airways, lungs, pulmonary circulation, blood, heart, peripheral circulation, microcirculation, and tissue

Question 3

CPPT Interventions?

Answer 3

Include mobilization, exercise, body positioning, breathing control, coughing and airway clearance maneuvers, and manual techniques

Question 4

Layers of cardiac tissue

Answer 4

Endocardium: innermost part of heart
Myocardium: middle layer of heart
Epicardium: Outer layer of heart
Pericardium: Fibrous sac that surrounds heart. Creates the pericardial cavity around the heart

Question 5

Muscles of Inspiration

Answer 5

External Intercostals & Diaphragm

Secondary: SCM, Scalenes (ant, mid, post), pec major/minor, serratus ant, lat dorsi, serratus posterior anterior

Question 6

Muscles of Expiration

Answer 6

Internal Intercostals, intercostalis intimi, and subcostals.

Question 7

Acessory Muscles of Inspiration

Answer 7

Secondary: SCM, Scalenes (ant, mid, post), pec major/minor, serratus ant, lat dorsi, serratus posterior anterior

Question 8

Accessory Muscles of Expiration

Answer 8

Rectus abdominis, external oblique, internal oblique, and transversus abdominis.

Question 9

Pleura

Answer 9

Continuous membranous sacs, which cover each lung

Question 10

Parietal Pleura

Answer 10

outer portion of pleural sac

Question 11

Visceral Pleura

Answer 11

surface in contact with the lung tissue (parenchyma)

Question 12

Pleural Space

Answer 12

Potential space between parietal and visceral pleurae

Question 13

Primary Function of Lungs

Answer 13

Supply the body with O2 and remove CO2
In order for continuous gas exchange to take place there must be adequate ventilation, diffusion and profusion of the alveoli

Question 14

Ventilation

Answer 14

Process by which air moves into the lungs

Question 15

Normal Inspiration

Answer 15

Alveolar pressure less than or equal to atmospheric

Question 16

Normal Expiration

Answer 16

Alveolar pressure greater than or equal to atmospheric

Question 17

Compliance

Answer 17

Ease to which the lungs can be inflated during inspiration

Question 18

Surfactant

Answer 18

Complex lipoprotein which lines the alveoli, it increases compliance by lowering surface tension. A decrease in surfactant causes alveoli to collapse. 28 weeks for infant to produce

Question 19

Upper Airway

Answer 19

Nose, pharynx, larynx

Question 20

Lower Airway

Answer 20

Trachea, primary bronchi, and lungs

Question 21

Conductive Zone

Answer 21

Consists of the nose, pharnx, larynx, trachea, bronchi, and bronchioles. Forms continuous passageway for air

Question 22

Respiratory Zone

Answer 22

Found deep inside the lungs and is made up of bronchioles, alveolar ducts, and alveoli. Allow for diffusion/perfusion and exchange of gasses

Question 23

Diffusion

Answer 23

Oxygen movement across alveolar membrane into the pulmonary arterial circulation

Question 24

5 Factors of Diffusion

Answer 24

1. Area of alveolar capillary membrane
2. Diffusion capacity of the alveolar capillary membrane
3. pulmonary capillary blood volume
4. Ventilation rate (oxygen)
5. Perfusion rate (blood)

Question 25

Perfusion (Q)

Answer 25

Refers to the process of providing blood to an area via capillaries

Question 26

Voluntary Control of Breathing

Answer 26

Cerebral cortex, holding breath or hyperventilating will increase or decrease PaCO2

Question 27

Involuntary Control

Answer 27

(Pons, medulla, and reticular formation): Mediate the basic sequence of breathing so that it is even and rhythmical. Unconciously adapt to changes in activity level mainting optimal PaO2 and PaCO2 levels

Question 28

Neutral Control on Respiration

Answer 28

When respiration is controlled only from medulla: rate is slow and irregular, TV is low Pons: responsible for maintenance of a normal pattern of respiration

Question 29

Central Chemoreceptors

Answer 29

Located on the ventral lateral surface of the medulla. | Receptors respond to an increase in arterial PCO2 which increase rate and depth of ventilation

Question 30

Peripheral Chemoreceptors

Answer 30

Are located along carotid bodies and aortic bodies. Receptors respond to an increase in arterial PCO2 by increasing ventilation Primary function of peripheral is to respond to hypoxemia by increasing ventilation

Question 31

Joint and Muscle Receptors

Answer 31

Receptors located within these tissues respond to movement, increasing ventilation in anticipation of movement/activity *stroke may impact indirectly w/baroreceptors*

Question 32

Mechanoreceptors

Answer 32

Receptors in carotid and aortic sinuses experience corresponding pressure changes when there is change in the systemic blood pressure Increased BP: hypoventilation Decreased BP: hyperventilation