Sarah's grandmother is coming in for a massage with you. Sarah feels her grandmother, a widow for the past 25 years, needs some nurturing touch to help her with her general aches and pains from arthritis. Her grandmother is hunched over with arthritis in her LB and hips.  Grandma also has hypertension for the past 20 years and is managed by medication.  Grandma has constant cold hands and feet, and her deceased husband was a habitual smoker. Worried about the status of her heart health, you ask if she has shortness of breath, to which she responds only when climbing up a large staircase.

What severity of CCHF would you classify Grandma? a) mild b)moderate c)severe d)none

A grandmother,  widow for the past 25 years, needs some nurturing touch to help with her general aches and pains from arthritis. She is hunched over with arthritis in her LB and hips.  She also has hypertension for the past 20 years, managed by medication.  She has constant cold hands and feet, and her husband was a habitual smoker. Worried about her heart health, you ask if she has shortness of breath. She responds only when climbing up a large staircase.
What is the most important treatment modification for Grandma?

a) avoid heat application

b)avoid prone

c) avoid petrissage techniques

d) avoid any cold or cool application

A grandmother,  widow for the past 25 years, needs some nurturing touch to help with her general aches and pains from arthritis. She is hunched over with arthritis in her LB and hips.  She also has hypertension for the past 20 years, managed by medication.  She has constant cold hands and feet, and her husband was a habitual smoker. You ask if she has shortness of breath. She responds only when climbing up a large staircase.
What are the tx goals for Grandma?

a) abdominal massage for her hypertension and low back pain

b) FBM in prone & supine to ↓ her SympNS and lower her BP

c) a HNS mx as a FBM would be too much, in supine with a pillow under her knees

d) steam cabinet to ↓ her blood volume = ↓ BP and be relaxing as well

e) full body relaxation, with modified techniques in sideline and supine and pillow under the head (in both positions)

A grandmother,  widow for the past 25 years, needs some nurturing touch to help with her general aches and pains from arthritis. She is hunched over with arthritis in her LB and hips.  She also has hypertension for the past 20 years, managed by medication.  She has constant cold hands and feet, and her husband was a habitual smoker. You ask if she has shortness of breath. She responds only when climbing up a large staircase.
If the damage to Grandma's heart was from smoking (if she smoked herself) and leads to CCHF, what s/s would you expect to see first?

a) improved memory

b) pulmonary edema

c) systemic peripheral edema

d) tissue dystrophy

Please indicate if the stressor below is either

a) intrinsic

b) extrinsic

Stressor: hyperthyroidism

Please indicate if the stressor below is either

a) intrinsic

b) extrinsic

Stressor: obesity

Please indicate if the stressor below is either

a) intrinsic

b) extrinsic

Stressor: hypertension

Please indicate if the stressor below is either

a) intrinsic

b) extrinsic

Stressor: mitral valve prolapsed

Please indicate if the stressor below is either

a) intrinsic

b) extrinsic

Stressor: anemia

Please indicate if the stressor below is either

a) intrinsic

b) extrinsic

Stressor: emphysema

Please indicate if the stressor below is either

a) intrinsic

b) extrinsic

Stressor: myocardial infarction

Please indicate if the stressor below is either

a) intrinsic

b) extrinsic

Stressor: smoking

Normal, homeostatic factors that PREVENT edema from accumulating in the interstitial spaces are:

a) Colloid osmotic pressures of the interstitium

b) heart and liver dysfunction

c) colloid osmotic pressures of the blood

d) venous insufficiency

To prevent decubitus (bedsores), a therapist should:

a) slowly move the client by gently sliding them to an upright position or better position for venous drainage

b) give the client a cold wash near the affected area to improve circulation

c) elevate the client's legs

d) all of the above

e) none of the above

e) none of the above

a→sliding not recommended = LIFTING

b→cold wash = no moist

A saccular type of aneurysm is best described as:

a) an abnormal dilation of the medial layers of the blood vessel

b) a bulge in a blood vessel caused by leaking of blood from the intimal to the medial layers

c) caused by a specific, localized weak spot in the blood vessel

d) an abnormal, full circumferential bulge in a blood vessel, usually at areas of bifurcations

The element in the blood that has the greatest effect on colloid osmotic pressure is:

a) erythrocytes

b) leukocytes

c) albumin

d) fibrinogen

Which of the following statements best illustrates the Frank-Starling Law of the heart?

a) the SV of the heart increases in a response to an increase in the volume of blood filling the heart

b) the more stretch placed on cardiac muscle, the stronger the contraction

c) the more blood presented to the heart, the harder/stronger it contracts

d) all of the statements above describe the Frank-Starling Law of the heart equally well

Which of the following structures is most likely to be damaged by a dissecting aneurysm?

a) aorta

b) capillaries

c) small to medium blood vessels of the cerebrum and cerebellum

d) the coronary arteries

e) none of the above

If a thrombus develops on the mitral valve and becomes an embolus, where would the embolitic infarct/occlusive infarct MOST likely occur?

a) arterioles of the lungs

b) arterioles of the peripheral circulation (ie: legs)

c) venules of the peripheral circulation

d) venules of the lungs

b) arterioles of the peripheral circulation (ie: legs)

*Mitral valve = Left atrium and Left ventricle

The presence of an aneurysm over a long period of time can cause

a) compression on nearby structures, such as alternative blood supply, nerves

b) faulty impairment if the aneurysm is located in the brain

c) degeneration of bone or other structures

d) all of the above

e) none of the above

The myocardium is perfused by the coronary arteries during:

a) diastole

b) systole

c) in conjunction with the filling of the coronary sinus

d) filling of the aortic sinus

a) diastole

From the lower legs, where does the deoxygenated blood return?

a) right ventricle /superior vena cava

b) left atrium/inferior vena cava

c) right atrium/inferior vena cava

d) left ventricle/inferior vena cava

True or false?

Arteries typically have larger tunica media layers than veins

True or False?

Increased thickness (hypertrophy) of the left ventricular myocardium enhances the Frank-Starling law of the heart, by creating a further stretch on the myocardial fibers

True or false?

Laminar (smooth flow) of blood is vital to prevent thrombosis development

What word matches this definition best?

a) infarction

b) perfusion

c) thrombus

d) hyperemia

e) ischemia

Definition: Mass of static blood

What word matches this definition best?

a) infarction

b) perfusion

c) thrombus

d) hyperemia

e) ischemia

Definition: Delivery of arterial blood relative to metabolic need

What word matches this definition best?

a) infarction

b) perfusion

c) thrombus

d) hyperemia

e) ischemia

Definition: Inadequate amount of blood for metabolic purposes

What word matches this definition best?

a) infarction

b) perfusion

c) thrombus

d) hyperemia

e) ischemia

Definition: cell necrosis or tissue death due to blood supply loss

What produces amino acids, assisting in maintaining colloid osmotic pressures in the blood?

a) kidneys

b) intestines

c) liver

d) lymphatics

c) liver

* amino acids = protein synthesis*

* kidneys = electrolytes balance*

True or false?

The lymphatics are completely responsible for fluid balance in the cardiovascular system.

What word defines fluid accumulation in the peritoneal cavity?

a) ascites

b) anasarca

c) hydrothorax

d) hydroperitonealism

Infarctions can be described as:

a) hemorrhagic

b) occlusive

c) ischemic

d) A and B

e) all of the above

Severe pain with active dorsiflexion at the ankle could indicate:

a) thrombosis

b) thrombophlebitis

c) deep vein thrombosis

d) partial to complete occlusion of the vein

e) all of the above

Severe pain with active dorsiflexion at the ankle could indicate thrombosis, thrombophlebitis,

deep vein thrombosis or partial to complete occlusion of the vein = all of the above

During long term stress, the heart may adapt with:

1. Increase in heart rate

2. increase in chamber dilation

3. myocardial hypertrophy