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TRI 4 - CP > Units 1-3 > Flashcards

Units 1-3 Flashcards

(60 cards)

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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
Describe the medical professional's goals when it comes to preventing HF
Prevent or delay with meds, diet, lifestyle changes and exercises
26
How does the PT help prevent HF
Educate the patient about exercise and report abnormal symptoms
27
What is mPAP
mean arterial pressure measure of pulmonary hypertension > 25 mmhg is abnormal > 20 is abnormal in patients with COPD
28
Describe some symptoms of left sided heartfailure
Dry cough Fatigue Pulmonary rales
29
Describe some symptoms of right sided heart failure
Dependent edema Jugular distension Increased right atrial pressure Peripheral effects
30
What is the affect of CHF on the muscles
decreased diameter of type 1 and 2 muscle fibers | Isometric strength is decreased (50%)
31
How do patients with CHF present when exercising
HR increases rapidly with submax load Blunted systolic BP Decreased O2 sat Elevated CO2 in blood
32
What are some signs of HF
Sudden weight gain pulmonary edema worsening dyspnea
33
Describe BNP
``` 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
Describe the stages of pulmonary edema
stage 1 - increased lymph flow, fluid in gravity dependent positions stage 2 - tachypnea, elevated PCWP stage 3 - flooding of alveoli, hypercapnia, hypoxemia
35
How do you dose a patient with CHF
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
Describe the 6 minute walk test
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
What is the "pace" of the SA, AV and Pukinje fibers
SA - 60-100 AV - 40-100 Pukinje 20-40
38
What are the methods to determine heart rate
1500/ # of small boxes | 300, 150, 100, 75, 60, 50
39
Describe depolarization as it relates to the ion channels
Opening of sodium and calcium channels
40
Describe redepolarization as it relates to the ion channels
Opening of potassium channels and closing of sodium channels
41
What is a plateau
When calcium channels are still open, after calcium channels close more potassium opens
42
What is the duration of the P wave, QRS and PR interval
P - 2 small boxes QRS - 2 small boxes PR - 5 small boxes
43
What is a long PR interval and what does it mean
Greater than .2 sec\ | Means there is a block
44
What does it mean when a QRS is greater than .1 seconds
Impulse if from the ventricles or abnormal ventricular conduction system
45
What does a deeply inverted q wave mean
MI and is getting worse will remain that way for months ST will return to normal
46
What does it mean when the ST segment elevates or depresses
Elevation - STEMI - MI, hypothermia | Depression - NON-STEMI / ischemia
47
What happens on the EKG in a STEMI and what is the pain like
``` ST elevation Q is 1/3 the size of the QRS T wave inversion will not be evident initially Severe pain More serious ```
48
What does T wave inversion indicate
Ischemia Injury Pulmonary embolism
49
Describe what is NON-STEMI is
Subendocardial block Not full thickness less severe chest pain when compared to a STEMI Can lead to fatal arrhythmias
50
How do you identify a NON-STEMI
ST depression greater than 1mm | T wave inversion will be variable
51
What on an EKG suggests ischemia
ST depression with biphasic negative-positive T wave
52
What indicates a pulmonary embolism
Troponin | Deep t wave inversion on leads 1-4
53
What can digitalis cause on an EKG
large QRS complex
54
What is the difference between atrial flutter and atrial fibrillation
Flutter - saw toothed | Fibrillation - coarse waves
55
Is it safe to exercise a patiet durring A FIB
Yes
56
Is it safe to exercise a patient durring V fib
No This is an emergency Ready the AED if necessary
57
What is considered V TAK
3 or more PVS's in a row
58
Describe a first degree AV block
Elongated PR interval
59
Describe second degree AV blocks
type 1 - Wenckebach - Progressive lengthening of PR then QRS drop type 2 - Mobitz - 2-4 P waves before a QRS
60
Describe a 3rd degree AV block
No relationship between P and QRS, they are firing independently of one another

TRI 4 - CP (4 decks)

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