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PTA 202 > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Where is the Base of the heart located?

A

It is the Top of the heart, located close to the 2nd Intercostal Space.

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2
Q

Where is the Apex of the heart located?

A

It is the bottom point of the heart, located in the 5th intercostal space.

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3
Q

What are the chambers of the heart?

A

-R&L Atrium
-R&L Ventricle

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4
Q

What is the Pericardium?

A

A fibrous sack which encloses the heart

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5
Q

What is the Myocardium?

A

It is the heart’s muslce tissue, which includes:
-Endocardium: Inner surface of mycardium
-Exocardium: External surface of myocardium

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6
Q

Name the stages of blood flow and circulation through the heart.

A

Vena Cava > R Atrium > Tricuspid Valve > R Ventricle > Pulmonary Valve > Pulmonary Arteries > Lungs > Pulmonary Veins > L Atrium > Mitral (Bicuspid) Valve > L Ventricle > Aortic Valve > Aorta > Coronary Arteries and Body

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7
Q

Name the Coronary Arteries, where they innervate, and if they split into smaller arteries.

A

Right Coronary Artery
-Innervates the R atrium/ventricle
Left Coronary Artery
-Innervates the L atrium/ventricle
-Splits into:
-Left Anterior Descending (LAD) (The Widow Maker)
-Left Circumflex

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8
Q

Which way does blood flow in Arteries?

A

Away from the heart.

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9
Q

Which way does blood flow in Veins?

A

To the heart

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10
Q

What are thee 3 unique properties of Myocardial Tissue?

A

-Automaticity: It contracts on its own
-Rhythmiticity: It contracts regularly
-Conductivity: It transmits electricity

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11
Q

Where is the SA Node located and what does it do?

A

-Located at the Superior Vena Cava and Right Atrium junction
-It is the pacemaker of the heart
-Parasympathetic input to SA node can decrease HR & sympathetic input can increase HR

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12
Q

What nerve innervates the SA and AV nodes?

A

Vagus

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13
Q

Where is the AV Node located and what does it do?

A

-Located in lower Right Atrium
-Backup system for SA node failure

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14
Q

What is normal sinus rhythm and Nodal AV Rhythm?

A

-Normal: 60-100 bpm
-Nodal AV: 40-60 bpm

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15
Q

What is the AV tissue called that merges to become right and left branches that relay impulse conduction?

A

The Bundle of His

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16
Q

What is the specialized tissue called that relays conduction impulse into the myocardium?

A

Purkinje Tissue

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17
Q

What is the normal conduction pathway of the heart?

A

-SA Node
-AV Node
-Bundle of his
-Branches
-Purkinje Fibers

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18
Q

What does the Sympathetic Nervous System do and which neurotransmitters are responsible for it?

A

-Increase HR & force of contraction, vasoconstriction of the peripheral arteries, and Vasodilation of the coronary arteries
-Norepinephrine & Epinephrine

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19
Q

What does the Parasympathetic (Vagal) Nervous System do and which neurotransmitters are responsible for it?

A

-Decrease HR & force of contraction and vasodilation of arteries.
-Acetylcholine

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20
Q

Which Cardiac Reflex senses increase pressure and stretch, therefore causing vagal stimulation?

A

Baroreflexes

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21
Q

Which Cardiac Reflex senses a stretch in the Right Atrial Wall, therefore activating the Sympathetic nervous system?

A

Bainbridge reflex

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22
Q

Which Cardiac Reflex senses elevated CO2 levels in the aorta and carotid arteries, therefore affecting the rate and depth of ventilation?

A

Chemo reflex

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23
Q

What might the Chemo reflex result in?

A

Sinus arrhythmia

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24
Q

What is Stroke Volume?

A

The amount of blood pumped per beat of the heart.
-Normal SV= 71 ml/beat (2.4 oz)

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25
What is Cardiac Output (CO)?
The amount of blood ejected from the heart per minute. -Normal CO= 4-6 liters/minute at rest -Can increase up to 25 l/min with exercise
26
What is Ejection Fraction?
-The ratio of blood volume ejected from the left ventricle per beat to the blood volume left in the left ventricle. -Normal EF= .6-.75 -<40%= high risk
27
T or F: The base of the heart is located at the 5th intercostal space.
F
28
T or F: The coronary arteries arise from the vena cava?
F
29
What are Systole and Diastole?
Systole occurs when the heart contracts to pump blood out, and diastole occurs when the heart relaxes after contraction.
30
Depression of the ST segment of an ECG is indicative of a...
CAD
31
Elevation of the ST segment of an ECG is indicative of an...
Acute MI
32
What is normal sinus rhythm, sinus bradycardia, and sinus tachycardia?
-Normal= 60-100 bpm -Bradycardia= <60 bpm -Tachycardia= >100 bpm
33
How do you calculate Max HR?
220-age
34
Does Max HR increase or decrease with age?
Decrease
35
Why should you initiate your Cardiac pt. TX with LE exercise instead of UE exercise?
UE exercise increases HR faster than LE exercise
36
What is the normal effect on BP during aerobic activity?
-Systolic BP increases 8-15 mmHg/MET -Diastolic can stay the same or increase to = 10mmHg
37
What is Normal BP?
<120 and <80
38
What is Elevated BP?
120-129 and <80
39
What is Hypertension stage I BP?
130-139 or 80-89
40
What is Hypertension stage II BP?
140 or higher or 90 or higher
41
What is Hypertension stage III BP?
Higher than 180 and/or Higher than 120
42
What is the result of low O2 supply?
Myocardial Ischemia & Infarction
43
What can Myocardial Ischemia or Infarction cause?
-Angina (chest pain, radiating down arm, pressure) -Coronary artery spasm -Coronary Atherosclerotic Disease (CAD) -Acute Coronary Syndrome (ACS) -Arteriosclerosis -Atherosclerosis -Thrombus -Embolus
44
What is Ventilation Vs. Perfusion?
-Ventilation refers to the amount of air flowing into and out of the lungs -Perfusion refers to the amount of blood flowing to the alveolar capillaries
45
What are the components of an ECG/EKG and what do they signify?
-P wave: Atrial Depolarization -QRS: Ventricular Depolarization -ST wave: Ventricles initiate repolarization -T wave: Ventricles Repolarization
46
What does CAD stand for?
Coronary Atherosclerotic Disease
47
What does CHF stand for?
Congestive Heart Failure
48
Which side of the heart has failed if the pt. has pulmonary congestion and edema?
The Left side
49
Which side of the heart has failed if the pt. has LE edema, Jugular distension, and systemic congestion?
The Right side
50
What does MI stand for?
Myocardial Infarction (Heart Attack)
51
What is Myocardial Ischemia and what does it lead to?
-Low oxygen supply to the myocardium -Leads to angina, radiating pain down arm, pressure, and eventually myocardial infarction
52
What causes Myocardial Ischemia and Myocardial Infarction?
-Coronary Artery Spasm -Coronary Atherosclerotic Disease (CAD) -Decreased elasticity -Acute Coronary Syndrome (ACS) -Arteriorsclerosis- elasticity issue -Artherosclerosis- plaque -Thrombus -Embolus- mobile clot
53
What is the pacemaker of the heart?
The SA node
54
Wich part of the ECG indicates ventricular depolarization?
QRS
55
Your patient tells you that he has an ejection fraction of .65 and a BP of 115/96. Which of these values is a concern?
Diastolic BP is too high
56
What is Atrial Fibrillation?
-Fluttering atrium -P wave flutters
57
What should the PT(A) be aware of when treating someone in A Fib?
Do not initiate exercise if resting HR is >115 bpm
58
Definition: An ectopic beat that originates in the atrium and yields an abnormal rhythm.
Premature Arterial Contraction (PAC)
59
What should the PT(A) be aware of when treating someone with Premature Atrial Contraction (PAC)
If the contractions run together to create a HR at 100-200 bpm, PT is contraindicated
60
What is Ventricular Tachycardia?
4 or more PVC's in a row
61
What should a PT(A) be aware of when treating someone with Ventricular Tachycardia?
-This is an emergency -PT in contraindicated -Initiate CPR
62
What is Ventricular Fibrillation?
No effective contraction of the ventricles at all
63
What should a PT(A) be aware of when treating someone with Ventricular Fibrillation?
-This is an emergency -Apply an AED
64
How long does a CABG pt. usually have sternal precautions?
6-8 wks
65
What are the sternal precautions for open heart surgery?
-No shoulder flexion >90 -No pushing up from chair -No reaching behind back -No lifting > 10lbs -If walker is indicated, a rolling walker is required so not to lift
66
What is a CABG?
Coronary Artery Bypass Graft
67
Describe the process of a CABG
-Chest is opened (median sternotomy) -The heart is stopped and pt. is put on bypass pumt -artery or vein is grafted to revascularize tissue
68
Definition: A catheter is guided from the femoral artery into the aorta and a contrast dye is injected into the coronary arteries to look for narrowing of the coronary arteries.
Angiography
69
What does PTCA stand for?
Percutaneous Transluminal Coronary Angioplasty
70
Describe the process of a PTCA
-The distal end of a catheter has a balloon that is inflated which causes pressure on the arterial wall and opens the artery -A stent is left in place to keep the vessel open
71
What is the difference between an Angioplasty and a PTCA
An PTCA is a type of angioplasty
72
What risk factors should the PT(A) be aware of when treating a cardiac pt.?
-Smoking -HTN -Cholesterol -Activity level -Sex -Age -Stress
73
What is the Karvonen Formula?
60%-80% (Max HR - Resting HR) + Resting HR
74
What level of the RPE scale would we like our Phase 1 cardiac patients to exercise at?
11-13
75
Normal Inspiration lasts...
1-2 seconds
76
The diaphragm contracts on...
Inhalation
77
How many Lobes and Segments does the Right lung have?
3 lobes and 10 segments
78
How many Lobes and Segments doe the Left Lung have?
2 lobes and 8 segments
79
Where does gas exchange occur in the pulmonary system?
At the Alveolar/Capillary membrane
80
How many liters of air a minute moves through the lungs
4
81
What does V/Q mean and what is the normal ratio
Ventilation (V) to Perfusion (Q) -The amount of air breathed (V) to the amount of blood pumped through the capillaries (Q) for gas exchange The normal V/Q ratio is 4/5 or .8
82
How many liters of blood moves through the capillaries at the lungs per minute?
5
83
Ventilation vs. Respiration
-Ventilation has to do with the amount of air moving in and out of the lungs -Respiration has to do with the amount of gas exchange in the blood at the lungs
84
What is the Fowlers Position and what is it good for?
-It is when the HOB is elevated slightly for the pt. -It relaxes the abs and decreases the weight on the chest to make it easier for the patient to breath
85
What is Tidal Volume and what is it's norm?
The amount of air breathed in and out while breathing normally -500 ml
86
What is Inspiratory Reserve Volume and what is its norm?
The extra amount of air that can be breathed in after normal inhalation -3000 ml
87
What is Expiratory Reserve Volume and what is its norm?
The extra amount of air that can be breathed out after normal expiration -1000 ml
88
What is Residual Volume and what is its norm?
The amount of air left in the lungs after forced exhalation -1500 ml
89
What is Total Lung Capacity and its norm?
The total amount of air that can fill the lungs -6000 ml (6 L)
90
What is Inspiratory Capacity?
Tidal Volume + Inspiratory Reserve Volume
91
What is Vital Capacity?
Tidal Volume + Inspiratory Reserve Volume + Expiratory Reserve Volume It's like the Total Lung Capacity, but minus the Residual Volume
92
What is Functional Residual Capacity?
Expiratory Reserve Capacity + Residual Capasity
93
What is Pulmonary Function Testing
Testing which aims to understand the amount of air the pt.s lungs are capable of breathing in and out.
94
What is the difference between obstructive and restrictive pulmonary disorders?
-Obstructive is when the pt. has difficulty exhaling -Restrictive is when the pt. has difficulty inhaling
95
What is Asthma?
Reaction to allergens or things such as smoke, fumes, or cold. -Bronchial constriction -Mucus production -Bronchial mucosa inflammation
96
What is Bronchiectasis?
Caused by infections such as TB, Whooping Cough, CF and immobile cilia -Thickening of the bronchial wall -Bronchial dilation -Bronchial artery enlargement
97
What is Chronic Bronchitis?
The presence of a cough and pulmonary secretions for at least 3 months, 2 years in a row -Inflammation and narrowing of the airway -Mucus gland hyperplasia -Decreased cilia activity -Leads to -hyperinflated alveoli -Bronchospasm -Secretion retention
98
What is Cystic Fibrosis?
Lethal genetic recessive trait that affects the exocrine glands -Thick, viscous secretions -1 in 3,700 births -Life expectancy is 37 yrs
99
What is Emphysema?
Progressive destruction of the alveolar walls and adjacent capillaries -Pulmonary tissue loses elasticity -Bullae formation -Hyperinflation of the lung
100
What is COPD?
Chronic Obstructive Pulmonary Disease -General term that refers to a number of pulmonary conditions
101
What are the physical characteristics of someone with COPD?
-Barrel Chest (enlarged thorax) -Dorsal kyphosis -Digital clubbing
102
What abnormal breathing sounds might you hear in a pt. with COPD?
Crackling or wheezing
103
What are the arteriole blood changes which occur in pt.s with COPD?
-Hypoxemia in the early stages -Hypercapnia in the later stages
104
What would a Pulmonary Function Test find in a pt. with COPD?
-Increased RV -Decreased FEV
105
What are medicinal ways to treat Pulmonary Dysfunction?
-Bronchodilators -Corticosteroids -Antitussives (block cough; robitussin) -Antibiotics -Supplemental oxygen
106
At what point should a pt. receive a nebulizer for Tx?
15-20 mins before
107
What is a Thoracotomy?
Opening of the chest wall for surgical access
108
What should the PTA do if a chest tube comes out?
-Stop PT immediately -Notify a nurse -Sit pt. upright -Monitor vitals
109
What is the normal ratio of inhalation to exhalation?
1:2
110
What is Dyspnea
Shortness Of Breath
111
What is Tachypnea?
>35 bpm
112
What is Bradypnea?
<10 bpm
113
What is Apnea?
Periods of no breathing lasting >15"
114
What is hyperventilation?
>16-20 bpm
115
What is Orthopnea
Shortness of breath in supine
116
What is Apneuis?
Prolonged inspiration/grunts on expiration
117
What is Cheyne-Stokes breathing?
variable, non rhythmic breathing pattern

PTA 202 (4 decks)

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