Term
anatomy of CV system:
2 types of cells?
nodes?
coronary arteries? |
|
Definition
electrical and contractile cells;
sinoatrial and atrioventricular node;
right and left coronary artery, left circumflex, left anterior descending |
|
|
Term
|
Definition
HR x SV = CO
CO x TPR = SBP |
|
|
Term
|
Definition
| amount of blood ejected from left ventricle in 1 beat |
|
|
Term
| what is SV dependent upon? |
|
Definition
| muscle pump, venous return (note: vein competency and dependent positioning), heart contractility |
|
|
Term
what about stroke volume and dependent positioning?
how can blood pool less? |
|
Definition
the more body parts that are vertical, the more blood is pooled at the feet;
with movement, exercise, and activity |
|
|
Term
|
Definition
| volume of blood ejected out of the left ventricle per minute |
|
|
Term
| ejection fraction? what's normal? |
|
Definition
percentage of volume of blood ejected relative to volume of blood received;
60-70% |
|
|
Term
| what is TPR or systemic vascular resistance affected by? |
|
Definition
| vasodilation and vasocontriction |
|
|
Term
|
Definition
| represents the force exerted by blood against the arterial walls during a cardiac cycle |
|
|
Term
|
Definition
| decreases HR, contractility, BP; coronary artery vasoconstriction; peripheral vasodilation; vagus nerve |
|
|
Term
| CV Sympathetic stimulation |
|
Definition
| increases HR, contractility, BP; coronary artery vasodilation; peripheral vasoconstriction; T1-T4 segments |
|
|
Term
|
Definition
| SA node, atrial muscle, internodal fibers, AV node, AV bundle, right and left bundle branches, purkinje fibers, ventricular muscle |
|
|
Term
|
Definition
| record of electrical voltage in heart |
|
|
Term
|
Definition
| movement, higher level cognitive function, language |
|
|
Term
|
Definition
| visuospatial awareness, sensation, spoken and/or written language, |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| breathing, digestion, heart rate, blood pressure, arousal (being awake and alert), swallowing |
|
|
Term
normal resting HR?
what should HR be in order to exercise patient safely? |
|
Definition
60-100 bpm;
safe exercise <100 bpm |
|
|
Term
| heart rate max in younger individuals? |
|
Definition
|
|
Term
| target heart rate (Karvonen Method) |
|
Definition
| (HR max-HR rest) x (50-80%) + HR at rest |
|
|
Term
tachycardia?
bradycardia?
flat response?
hypoadaptive response? |
|
Definition
resting HR > 100 bpm
resting HR < 60 bpm
does not increase with exercise
HR decreases with exercise |
|
|
Term
| when should you measure heart rate? |
|
Definition
with every new patient/examination;
when new activities are added to the exercise program;
when there are abnormal signs and symptoms |
|
|
Term
systolic BP?
diastolic BP? |
|
Definition
force generated by left ventricle (contraction);
force the blood in the vascular system exerts on the arterial walls (relaxation) |
|
|
Term
normal resting SBP and DBP?
what happens with activity? |
|
Definition
SBP=90-120 mmHg
DBP=40-90 mmHg
note: with activity, SBP increases with no change or slight decrease in DBP |
|
|
Term
normal BP?
prehypertension?
high BP (hypertension) stage 1?
high BP stage 2?
hypertensive crisis? |
|
Definition
<120, <80;
120-139, 80-89;
140-159, 90-99;
160 or higher, 100 or higher;
higher than 180, higher than 110 (emergency care!) |
|
|
Term
| at what BP should treatment be held and what should be done? |
|
Definition
SBP>180, DBP>100;
notify MD's and RN's of any abnormalities |
|
|
Term
normal respiratory rate?
tachypnea?
bradypnea? |
|
Definition
12-20 breaths/min;
rapid, shallow breathing, RR>24;
slow breathing, RR<10 |
|
|
Term
normal O2 saturation?
abnormal?
special notes? |
|
Definition
SpO2>94% (normal)
SpO2<94% (abnormal)
note: do not begin or increase activity if baseline SpO2<90% and stop any activity that causes a decrease in SpO2<90% |
|
|
Term
| SaO2 and PaO2 relationship |
|
Definition
high affinity for O2=decreased temp, decreased CO2, increased pH (basic)
low affinity for O2=increased temp, increased CO2, decreased pH (acidic) |
|
|
Term
| indications for physiological monitoring |
|
Definition
| baseline measure, assessment and documentation of physical stress imposed by an activity, assessment of intensity and progression of an endurance program, identify risk of a strenuous activity, when signs and symptoms indicate to |
|
|
Term
|
Definition
sign=objective data (observable findings of a disease)
symptom=subjective data (reported indications of disease perceived by the patient); note: symptoms are more significant when associated with a clinical sign |
|
|
Term
symptoms of dyspnea?
signs? |
|
Definition
shortness of breath;
tachypnea (elevated RR), cyanosis (bluish tinge), increased use of accessory breathing muscles, loss of balance, disorientation, decreased O2 saturation, dyspnea scale |
|
|
Term
|
Definition
| poor O2/CO2 exchange, severe deconditioning, normal with extreme exertion, pulmonary embolism (PE), anxiety-dyspnea relationship (cycle of decreased activity leads to increased anxiety about becoming SOB which leads to increased SOB which leads to decreased activity |
|
|
Term
|
Definition
| stop/rest, relaxation techniques, tailor program to level of tolerance, breathing retraining (pursed lip breathing, diaphragmatic breathing, GOAL: to decrease demand for O2, make breathing easier) |
|
|
Term
|
Definition
chest pain;
substernal chest pain, chest pressure tightness, heaviness, back, neck pain/pressure, jaw pain, UE pain L>R |
|
|
Term
|
Definition
| SOB, reproducible pain at same rate pressure product (HR x SBP), abnormal heart sounds, crackles/rales, EKG abnormal rhythms (often seen with ST-segment depression) |
|
|
Term
|
Definition
myocardial requirements exceed oxygen supply (myocardial ischemia), myocardial infarction
note: ischemia=inadequate blood supply; infarction=obstruction of blood supply (typ. by thrombus or embolus) causing local death of the tissue |
|
|
Term
| stable angina vs unstable angina |
|
Definition
stable: resolved with nitroglycerine (NTG) and rest
unstable: unrelieved by NTG (vasodilator) |
|
|
Term
| angina differential diagnosis |
|
Definition
pleural-pain increases with deep breathing;
musculoskeletal-sharp, knife-like, reproducible with UE movement or with palpation of chest musculature;
cardiac |
|
|
Term
|
Definition
| stop/rest, take vital signs, notify MD and RN, NTG/O2 will need MD prescription, 12 Lead EKG |
|
|
Term
| symptoms of lightheadedness |
|
Definition
| pass out, mental/visual blurring, dizzy |
|
|
Term
|
Definition
| increased HR, low BP, loss of balance (LOB), syncope (fainting), arrhythmias seen on EKG |
|
|
Term
| causes of lightheadedness |
|
Definition
| carotid stenosis (narrowing), hypoglycemia, arrhythmias, orthostatic hypotension (decrease in BP with position changes in conjunction with increase in HR; sig drop is 20 mmHg) note: don't stand because all body will be in dependent position; when blood pool SV decreases so HR must increase to compensate. Symptoms stabilize quicker if pump ankle/leg for increased venous return |
|
|
Term
| treatment of lightheadedness |
|
Definition
| monitor vital signs with positional changes, if orthostatic hypotension ask MD if TED hose, ace wraps, or abdominal binder can be used, lie patient back down if sitting, sit patient down if standing or have them march in place |
|
|
Term
vertigo symptoms?
signs?
causes? |
|
Definition
dizzy, room is spinning;
loss of balance (LOB), nystagmus (rapid phase beating);
CNS pathology, vestibular pathology |
|
|
Term
|
Definition
| vestibular rehab-repositioning procedures (if a peripheral problem), habituation exercises, functional training |
|
|
Term
| intermittent claudication |
|
Definition
symptom-cramping in calves with exercise, resolved with rest
sign-faint pulses in LE's, bluish feet/toes, rubor of dependency
cause-artherosclerosis (hardening of arteries)
treatment-continue program to patient tolerance to increase efficency of blood distrib to muscles, improve O2 extraction to trained muscles |
|
|
Term
|
Definition
swelling, heaviness;
increased girth, inflammatory signs (redness, warmth, tender to touch, pain) |
|
|
Term
|
Definition
lymphedema, congestive heart failure (CHF), acute injury, dependent positioning, deep vein thrombosis (DVT) clot in leg
note: positive Homan's sign=passive dorsiflexion of ankle or squeezing of calf causes sharp pain in sensate patient |
|
|
Term
|
Definition
| RICE, compression (clear of DVT), massage (clear of CHF and DVT), ace bandages (clear of DVT), HOLD TREATMENT IF DVT IS SUSPECTED! will become pulmonary embolus |
|
|
Term
| fatigue signs and symptoms |
|
Definition
general appearance/affect, SOB, abnormal vital signs;
"i'm tired" |
|
|
Term
|
Definition
| anemia, depression, decreased nutrition, deconditioning, decreased motivation, sleep deprivation |
|
|
Term
|
Definition
| rest, tailor treatment session to decrease workload, hold treatment if Hgb <8 |
|
|
Term
| diaphoresis symptom, sign, causes |
|
Definition
i'm sweaty;
cold, clammy;
autonomic dysrefelxia, orthostatic hypotension, hypoglycemia |
|
|
Term
|
Definition
| stop/rest, place patient in supine if don't suspect autonomic dysreflexia (autonomic overstimulation), monitor vital signs, notify MD/RN |
|
|
Term
|
Definition
| bluish discoloration of lips and nail beds of fingers and toes; causes=inadequate blood O2 levels, decreased hemoglobin levels |
|
|
Term
| factors that may affect the physiological systems |
|
Definition
| prolonged bedrest, deconditioning, aging, positioning, muscle weakness/paralysis, dehydration, previous activity levels, intensity of activity, psychological influences |
|
|
Term
| relationship between function and pathology |
|
Definition
PT's are movement specialists, if understand pathology, PT is a better clinician and prognosticator of functional recovery
note: prognosis=likely course of a disease |
|
|
Term
| causes of orthostatic hypotension |
|
Definition
| dehydration, deconditioning, paralysis (venous return is dependent on muscle contraction) |
|
|
Term
| causes of orthostatic hypotension |
|
Definition
| dehydration, deconditioning, paralysis (venous return is dependent on muscle contraction) |
|
|
Term
|
Definition
| lead to formation of blood clots, increased risk of pulmonary infection, hypovolemia, muscle atrophy, susceptibility to orthostatic hypotension |
|
|
Term
|
Definition
coronary artery disease- progressive disorder including arteriosclerosis, thrombus and spasm of arteries;
monitor: BP, pulse, signs/symptoms |
|
|
Term
|
Definition
myocardial infarction-development of ischemia and necrosis of myocardial tissue, resulting from decrease in myocardial O2 without adequate supply;
monitor: BP, HR, signs, symptoms of angina, O2 saturation, EKG |
|
|
Term
| inferior MI vs lateral MI vs anterior MI |
|
Definition
right coronary artery (inferior)
left circumflex (lateral)
left anterior descending (anterior) |
|
|
Term
|
Definition
| coronary artery bypass graft-surgery creates new routes around narrowed and blocked arteries allowing sufficient blood flow to deliver O2 and nutrients to cardiac tissue; note: great saphenous vein in leg and internal mammary artery of heart; monitor symptoms for angina, BP, SpO2, HR, RR, incision, sternal precautions |
|
|
Term
|
Definition
| congestive heart failure-failure of pumping system, VS to monitor: HR, BP, O2 saturation, watch esp. for an increase in HR with a decrease in BP (20 mmHg drop in SBP is significant) comparing activity to BP to resting BP |
|
|
Term
|
Definition
| pulmonary edema, SOB with increasing activity, orthopnea (SOB-difficulty with laying flat), decreased O2 saturation, weight gain |
|
|
Term
|
Definition
| SOB, bilateral LE edema, frequent urination at night, jugular venous distention, palpitations, arrythmias, fatigue, weakness, fainting, decreased O2 saturation |
|
|
Term
|
Definition
| batteries send electrical impulses to heart for proper pumping. Most are demand pacemakers: sensing device; turns signal off when heartbeat is above certain level, turn signal on when heartbeat too slow; monitor: HR, BP responses |
|
|
Term
|
Definition
aortic VR and mitral VR
monitor: BP, RR, SpO2, HR |
|
|
Term
|
Definition
peripheral vascular disease-impaired circulation, which can affect the arterial, venous, or lymphatic circulatory system;
monitor for signs/symptoms of intermittent claudication, cyanosis, feelings of cold, numbness, signs of DVT, edema, presence of absence of pulses;
DVT-caused by blood stasis, hypercoaguable states or endothelial injury |
|
|
Term
|
Definition
inflammation of the lungs at the level of the lobe or in the terminal bronchioles and alveoli;
monitor: RR, SpO2, HR, tachypnea |
|
|
Term
|
Definition
| chronic obstructive pulmonary disease-obstruction of outflow of air |
|
|
Term
|
Definition
reversible obstructive lung disease caused by increased reaction of the airways to various stimuli;
monitor: RR, SpO2, HR |
|
|
Term
|
Definition
permanent overdistention of the air spaces and loss of normal elastic tension in lung tissue; resulting in "dead space" which are areas in the lung that do not participate in gas exchange;
monitor: SpO2, dyspnea on exertion, RR, cyanosis |
|
|
Term
|
Definition
inflammation of the trachea and bronchi; can be acute or chronic, resulting in hypertrophy of mucus-producing cells and obstruction of airways;
monitor: RR, SpO2, cyanosis, decreased exercise tolerance |
|
|
Term
|
Definition
lethal genetic disease involving production of thick secretions from exocrine glands, causing both severe lung disease and pancreatic insufficiency;
monitor: RR, SpO2, for cyanosis and digital clubbing, exertional dyspnea, sustained chronic cough with mucous production |
|
|
Term
|
Definition
relates to lung volumes that are reduced due to decreased compliance in the lung parenchyma and/or chest wall;
includes: pulmonary fibrosis, asbestosis;
monitor: RR, SpO2, dry, non-productive coughs (except for asbestosis) and HR |
|
|
Term
|
Definition
involves pulmonary vascular obstruction by a displaced thrombus (blood clot), air bubble, fat globule, or vegetations on heart valves;
may be seen in highly deconditioned individuals who have been on bedrest;
monitor: SOB, tachypnea, tachycardia, and chest pain |
|
|
Term
|
Definition
cerebrovascular accident-neurological sequelae due to hemorrhage (bleeding) or ischemia (lack of blood flow) to the brain, causing irreversible damage;
may be present with cognitive changes, communication deficits, swallowing difficulties, weakness on one side of the bodyj,j changes in sensation, and balance deficits;
monitor BP, c/o headache, HR, vision changes, tremors, weakness, seizures |
|
|
Term
|
Definition
transient ischemic attack-occurs when blood supply to part of the brain has been temporarily disrupted;
monitor: BP, c/o headache, HR, vision changes, tremors, weakness, seizures |
|
|
Term
|
Definition
| monitor BP, HR, c/o lightheadedness, SpO2, signs of DVT or PE, sensory or motor changes; watch for orthostatic hypotension with paralysis |
|
|
Term
| SCI and autonomic dysreflexia |
|
Definition
caused by a noxious stimuli-may appear in those with thoracic SCI (esp. T5 and above). Condition where severe vasoconstriction occurs in the periphery, contributing to an elevated BP and a decrease in HR --> life threatening! (treatment: need to remediate noxious stimuli)
note: keep patients up! if lay down...BP will go up |
|
|
Term
| peripheral nerve injuries (monitor?) |
|
Definition
| monitor for sensation and motor (strength, coord.) changes |
|
|
Term
|
Definition
| burns, pressure ulcers, diabetic wounds |
|
|
Term
|
Definition
| diabetes, hyperthyroidism, hypothyrodism |
|
|
Term
|
Definition
chronic disorder caused by deficient insulin or defective insulin action in the body;
safe blood glucose levels are generally 100-250 mg/dl;
affects circulation, sensation, motor function |
|
|
Term
|
Definition
glucose levels > 400 mg/dl;
if blood glucose is >250 mg/dl, postpone PT session until blood glucose is under better control |
|
|
Term
|
Definition
blood glucose <70 mg/dl; if blood glucose is <100mg/dl a 10-15 carb snack should be given, with glucose (such as 1/2 cup of fruit juice or sugared cola or 2 packs of sugar) retested in 15 min to ensure approp. level
note: with exercise, blood sugar levels will go down. Best to exercise within 1 to 2 hours after meals |
|
|
Term
|
Definition
| monitor for confusion, lethargy, changes in mental function, sensation and circulation deficits; use glucometer (one touch machine) |
|
|
Term
|
Definition
disorders in which the thyroid gland secretes excess amounts of thyroid hormone;
monitor: HR (for tachycardia), increased sweating, heat intolerance, fatigue tremor, nervousness, dyspnea, weight loss |
|
|
Term
|
Definition
insufficient thyroid hormone causing generalized depression of body metabolism;
monitor for HR (for bradycardia), dyspnea |
|
|
Term
|
Definition
| urinary tract infections, incontinence, renal failure |
|
|
Term
|
Definition
| abdominal pain, diarrhea, constipation, peptic ulcers, inflammatory bowel disease, GI bleeding |
|
|
Term
| common orthopedic diagnoses |
|
Definition
| total knee replacement (arthroplasty), total hip replacement (arthroplasty), ORIF (open reduction internal fixation) of the femur, ORIF of the fibular/tibula, laminectomy, back fusion, cervical fusion, ACL reconstruction, rib fracture, pelvic fracture, multiple trauma |
|
|
