Pt 533 Cardiopulmonary Pt And Exercise Science Exam 1

Front 1

What is the fibrous protective sac that encloses the heart?

Back 1

Pericardium

Front 2

What is the smooth epithelial tissue that lines the inner surface of the myocardium and allows blood to pass through chambers without damage to RBC?

Back 2

Endocardium

Front 3

What are the 4 chambers of the heart?

Back 3

Left and right atrium
Left and right ventricle

Front 4

What receives blood from the systemic circulation, blood arrives through inferior and superior vena cava?

Back 4

Right Atrium

Front 5

What receives blood from the right atrium through the tricuspid valve, pumps blood through semi-lunar valve into lungs?

Back 5

Right Ventricle

Front 6

What receives blood from left atrium through bicuspid (mitral) valve, pushes blood to body through aortic valve?

Back 6

Left Ventricle

Front 7

How many major arteries supply blood to the heart?

Back 7

2

Front 8

What supplies blood to the right atrium, right ventricle, inferior wall of the left ventricle, AV node, bundle of His, and SA node?

Back 8

Right Coronary Artery

Front 9

What branches into the circumflex artery and left anterior descending artery and also supplies blood to the left ventricle, interventricular septum, and right ventricle?

Back 9

Left Coronary Artery

Front 10

At what phase does circulation to the heart occur?

Back 10

Diastole

Front 11

The heart is well suited for aerobic ______.

Back 11

Exercise

Front 12

What is the principle source of energy production to the heart?

Back 12

Oxidation of free fatty acids

Front 13

At rest, the heart extracts approximately _____ % of O2 delivered by arteries.

Back 13

70%

Front 14

During increased work, increased demand for O2 is met by increasing blood flow due to _________ of coronary vessels.

Back 14

dilation

Front 15

What are the 2 additional types of cardiac muscle tissue?

Back 15

Nodal
Purkinje

Front 16

What is the pacemaker?

Back 16

SA node

Front 17

When is the SA node under parasympathetic control?

Back 17

Rest

Front 18

The AV node receives impulses from the SA node and conducts it to ______.

Back 18

Bundle of His

Front 19

What can act as the pacemaker if the SA node fails?

Back 19

AV node

Front 20

What are specialized conducting tissue to both ventricles?

Back 20

Purkinje Tissue

Front 21

Where does electrical impulses that cause the heart to beat originate?

Back 21

SA node

Front 22

Impulse spreads quickly through both atria which _________ simultaneously.

Back 22

contract

Front 23

What is the order in which an electrical impulse travels through the conducting tissue of the heart?

Back 23

SA node
AV node
Bundle of His
Purkinje Fibers

Front 24

After the electrical impulse travels down the Purkinje Fibers, it cause simultaneous __________ contraction.

Back 24

ventricular

Front 25

What is the innervation to the heart?

Back 25

Vagus Nerve (Cranial Nerve X)

Front 26

The parasympathetic nerves stimulate the release of which chemical?

Back 26

ACH

Front 27

ACH causes the HR to ______ and the force of contraction to _______.

Back 27

Decrease
Increase

Front 28

ACH causes the coronary arteries to ______.

Back 28

Dilate

Front 29

At rest, the heart is under continous ________ control.

Back 29

parasympathetic

Front 30

The sympathetic nerves stimulate the release of which chemical?

Back 30

NE

Front 31

NE causes the HR to ______ and the force of contraction to _______.

Back 31

increase
increase

Front 32

Where are pressure receptors located in the CP system?

Back 32

Aorta
Carotid Sinus

Front 33

Which receptors are sensitive to change in levels of O2, CO2 and lactic acid?

Back 33

Chemoreceptors

Front 34

Where do chemoreceptors detects change?

Back 34

Blood

Front 35

What 2 chemicals (compounds) cause an increased HR?

Back 35

CO2
Lactic Acid

Front 36

A decreased body temperature cause a __________ HR.

Back 36

decreased

Front 37

What condition is associated with increased levels of potassium?

Back 37

Hyperkalemia

Front 38

Hyperkalemia ________ HR and _______ force of contraction

Back 38

decrease
decrease

Front 39

What is a state of increased calcium?

Back 39

Hypercalcemia

Front 40

Hypercalcemia _______ HR and ______ force of contration

Back 40

increases
increases

Front 41

Systolic BP > _____ is abnormal.

Back 41

140

Front 42

Diastolic > ______ is abnormal.

Back 42

100

Front 43

What 3 items cause BP to vary?

Back 43

Age
Emotional States
Exercise

Front 44

What is the amount of blood ejected from the heart each minute?

Back 44

Cardiac Output

Front 45

What is the about of blood ejected per beat?

Back 45

Stroke Volume

Front 46

Finish the equation:

CO = ___ x ___

Back 46

CO = HR x SV

Front 47

The force of contraction of which chamber of the heart affects stroke volume?

Back 47

Left Ventricle

Front 48

What regulates stroke volume?

Back 48

Ratio of sympathetic to parasympathetic impulses to the heart.

Front 49

What is the main control of HR?

Back 49

Baroreceptors

Front 50

_______ pressure causes decreased HR.

Back 50

Increased

Front 51

Grief causes a(n) __________ HR.

Back 51

increased

Front 52

What adaptations normally occur after a single bout of exercise?

Back 52

1. Cardiac
2. Coronary Circulation
3. Systemic Circulation
4. Blood Pressure
5. Blood Fluid
6. Metabolic

Front 53

What is termed when the HR increases before exercise begins?

Back 53

Anticipatory Rise

Front 54

During exercise, HR is proportional to _____ of activity.

Back 54

intensity

Front 55

What are responses to exercise by the heart?

Back 55

Increases HR
Increase force of contraction

Front 56

Maximal HR decreases inversely with ____.

Back 56

age

Front 57

HR and SV increase while individual is exercising at ___ to ___% of maximum capacity.

Back 57

40-60%

Front 58

At higher levels, increased cardiac output accomplished by increasing ___ only.

Back 58

HR

Front 59

What would happen to cardiac patient at higher intensities?

Back 59

They won't be able to keep up, err on the side of lower intensity.

Front 60

What percent of O2 is extracted from coronary blood circulation at rest?

Back 60

70%

Front 61

Increased O2 to cardiac muscle during exercise is accomplished by increasing rate at which blood flows through ________ arteries.

Back 61

coronary

Front 62

How do you increase coronary artery flow?

Back 62

1. Increase coronary output
2. Dilation of coronary arteries
3. Increase aortic blood pressure

Front 63

Which muscles need increased O2 during exercise?

Back 63

Active muscles

Front 64

What happens to systemic circulation during exercise?

Back 64

Blood flow is shunted away from inactive tissues
Shunted to actively exercising muscles
Increased blood flow to lungs to pick more O2 for tissue delivery
Increased blood flow to skin to dissipate heat.

Front 65

What are blood pressure adjustments during aerobic exercise?

Back 65

Blood vessels dilate
Dilation results in decreased BP
Cardiac output increases negating drop in BP

Front 66

In normal people, how does systolic BP change relative to the intensity of the activity?

Back 66

Increases in proportion to instensity

Front 67

In normal people, how does diastolic BP change relative to the intensity of the activity?

Back 67

Remains relatively unchanged

Front 68

what happens if you stop exercising suddenly?

Back 68

Rapid decrease of systolic BP

Front 69

In order to avoid a rapid decrease of systolic BP, what should be done?

Back 69

Include a cool down phase

Front 70

What types of exercise cause a greater increase in BP?

Back 70

Upper body

Front 71

Cooling only occurs by ____________.

Back 71

Perspiration

Front 72

What affects does dehydration have on blood volume?

Back 72

Decrease blood volume
Blood becomes thicker causing increased resistance to flow and increasing BP

Front 73

What are metabolic adaptations to aerobic exercise?

Back 73

Tissues need more O2
Results in increased CO and blood flow to working muscles
O2 utilization at cellular level depends on # mitochondria and other factors

Front 74

How do cardiac muscle fibers adapt to aerobic exercise?

Back 74

They become larger and stronger

Front 75

Cardiac muscle fibers don't improve on its ability to utilize O2 as occurs in _____ muscle.

Back 75

skeletal

Front 76

How does hypertrophy of cardiac muscle fibers affect SV?

Back 76

Results in larger SV

Front 77

At any given workload, how does the heart adapt?

Back 77

The heart doesn't have to beat as often to supply adequate amount of blood.

Front 78

In relation to agina, how does the heart adapt?

Back 78

Rraises the amount of work you can do before angina occurs

Front 79

Endurance training results in quicker ________ from all levels of work.

Back 79

recovery

Front 80

Increased coronary blood flow results from which 3 things?

Back 80

1. Increased HR
2. Increased SV
3. Vasodilation

Front 81

Because of exercise training what allows for increased perfusion of blood into coronary arteries?

Back 81

Bradycardia
Increased SV

Front 82

What are changes in systemic circulation because of aerobic training?

Back 82

1. Increased # capillaries to skeletal muscle
2. Increased # mitochondria & enzymes important for energy production due to increased O2 utilization.

Front 83

In submaximal work, what is more important than blood flow?

Back 83

O2 utilization

Front 84

In relation to systemic circulation, what two things are important at maximal work?

Back 84

O2 utilization
Blood flow

Front 85

How are BP medications related to exercise?

Back 85

Some patients on medication are able to decrease or discontinue BP medication

Front 86

What are reasons for how BP changes during exercise?

Back 86

Reasons are unknown as to BP changes during exercise

Front 87

What are blood and fluid responses to aerobic training?

Back 87

1. Increased total blood volume by increasing plasma
2. Patients more easily adjusts to environment of high temperature and humidity
3. Increase RBC numbers slightly

Front 88

What is the max amount of O2 utilized at work?

Back 88

VO2 max

Front 89

During aerobic training, and increased VO2 max secondary to improved C.O. and O2 utilized at ___________ level.

Back 89

cellular

Front 90

How does body composition change due to exercise?

Back 90

Decreased % body fat & increase lean body mass.

Front 91

What provides the best results for cardiac patients to lose % body fat?

Back 91

Aerobic exercises
Restricted calories

Front 92

How does aerobic training affect blood lipids?

Back 92

1. Decreases total blood cholesterol
2. Decreases trigliceride levels (animal & veg fats)
3. Increase high density lipoprotein (HDL)

Front 93

Personality types may act to predispose individuals to ___________.

Back 93

Coronary Heart Disease

Front 94

What factors are associated with type A personalities?

Back 94

-increased levels of catecholamines (epi & nor)

- increased heart rate

- increased blood pressure

Front 95

Anxiety and depression _______ affect CV condition.

Back 95

adversely

Front 96

How does aerobic training affect stress?

Back 96

It can help disseminate tension and assist in providing sense of well being.

Front 97

What results when O2 demand by heart is greater than O2 supply?

Back 97

Ischemia

Front 98

What is caused by atherosclerosis or coronary artery spasms and results in angina?

Back 98

Ischemia

Front 99

Aerobic training can ________ ischemic threshold & result in greater workloads before angina is manifest.

Back 99

raise

Front 100

What 5 things according to a Farmingham study could exacerbate the onset of CHD?

Back 100

1. Elevated BP
2. Blood Fats
3. Blood Sugar
4. Cigarette Smoking
5. Lack of appropirate exercise

Front 101

What is the single most prevalent cause of death in the U.S.?

Back 101

Cardiac Heart Disease

Front 102

What setting is phase I of cardiac rehabilitation?

Back 102

Inpatient

Front 103

Patients with uncomplicated MI, coronary artery bypass grafts, pulmonary disease or PVD will begin programs ________ during hospital stay.

Back 103

early

Front 104

What setting is phase II of cardiac rehabilitation?

Back 104

Outpatient

Front 105

If a cardiac patient enters phase II rehab, what 3 things must be present in the outpatient setting?

Back 105

1. Continuous ECG Monitoring
2. Emergency Equipment
3. Medically Supervised Exercise

Front 106

Which types of conditions should be trained in a medically supervised setting?

Back 106

1. Low maximal functional capacity
2. Severely depressed left ventricular function
3. Complex ventricular arrhythmia
4. Exercise induced hyptension
5. Exertional angina
6. Inability to self-monitor H.R.

Front 107

Generally, cardiac rehabilitation exercise is conducted how often?

Back 107

3 times per week for 12 weeks

Front 108

What is the purpose of performing a re-evaluation including a stress test?

Back 108

Helps to prescribe HEP

Front 109

What is phase III of cardiac rehab?

Back 109

Community/Home Program

Front 110

When does phase III of cardiac rehab begin?

Back 110

When it is determined that medical supervision in no longer necessary?

Front 111

What 4 things determine is a patient can progress to a community/home program?

Back 111

1. Patient's functional capacity
2. Patient's ability to self-monitor exercise
3. Absence of contra-indications
4. Psychological/emotional status of patient

Front 112

What did a study by Pierce reveal about aerobic training with respect to pulmonary rehabilitation?

Back 112

1. Decreased exercise HR
2. Decreased exercise RR
3. Decreased exercise minute ventilation
4. Decreased exercise O2 consumption and CO2 production

Front 113

What functional activity can increase significantly with pulmonary rehabilitation exercise?

Back 113

Walking

Front 114

What are 4 goals of acute pulmonary care?

Back 114

1. Improve ventilation
2. Improve gas exchange
3. Promote secretion clearance
4. Maintain functional capacity

Front 115

During acute pulmonary care, activity should be of an intensity such that heart rate does not rise more than ___ to ___ beats above the resting heart rate.

Back 115

20-30

Front 116

During acute pulmonary care, activity should not induce breathing more that ___________.

Back 116

Mildly short of breath

Front 117

What is the minimum O2 sat during pulmonary rehab?

Back 117

88%

Front 118

What are discharge criteria for pulmonary patients?

Back 118

1. Demonstrate increases in functional capacity
2. Able to exercise safely without supervision
3. MET educational goals

Front 119

What are benefits of pulmonary rehabilitation?

Back 119

Increased exercise tolerance
Increased ability for self care
Decreased sensation of dyspnea
Improved quality of life
Decreased utilization of health care
Decreased anxiety and depression
Increased survival

Front 120

Knowledge of respiratory physiology is important for proper ________ and _______ of pulmonary disease.

Back 120

Diagnosis and Treament

Front 121

What is the main function of the respiratory system?

Back 121

Exchange of gases to maintain pH, arterial O2, and CO2

Front 122

What shape are lungs?

Back 122

Cone Shaped

Front 123

What covers each lung?

Back 123

Visceral Pleura

Front 124

Which lung is larger?

Back 124

Right

Front 125

Which lung has 3 lobes?

Back 125

Right

Front 126

What are the 3 lobes of the right lung?

Back 126

Upper
Middle
Lower

Front 127

What are lobes of the lungs subdivided into?

Back 127

Bronchopulmonary segments

Front 128

What type of innervation goes to the lungs?

Back 128

Sympathetic
Parasympathetic

Front 129

What does sympathetic stimulation of the lung cause?

Back 129

Bronchodilation
Vasoconstriction

Front 130

What does parasympathetic stimulation of the lung cause?

Back 130

Bronchoconstriction
Vasodilation

Front 131

As inspired air flows through the nose to the alveoli the forward velocity is _______ which allows for diffusion through the alveoli into the pulmonary _______ .

Back 131

slowed
capillaries

Front 132

What does the nose function to do?

Back 132

Filter air
Humidify and cool/warm air

Front 133

What is the function of the larynx?

Back 133

It only serves as a conduit for air to travel by.

Front 134

What is the function of the pharynx?

Back 134

Allows passage of food

Front 135

What acts as a valve preventing food from entering the trachea?

Back 135

Epiglottis

Front 136

What is lined with ciliated epithelium and carries debris toward the pharynx?

Back 136

Trachea

Front 137

How many cartilaginous rings line the trachea?

Back 137

16-20

Front 138

Which structure is mostly cephalic cartilage?

Back 138

Cricoid

Front 139

Which main bronchus branches at more of an acute angle and is longer?

Back 139

Left

Front 140

Which main bronchus is more in line with the trachea and predisposes it to aspiration of material?

Back 140

Right

Front 141

What are small envanginations of the respiratory bronchioles, alveolar ducts, and alveolar sacs?

Back 141

Alveoli

Front 142

What are the thin walls of the alveoli suited for?

Back 142

Gas exchange

Front 143

Which type of cells are large flat cells that comprise most of the internal alveolar surface?

Back 143

Type 1 Cells

Front 144

Which type of cells are ovoid, less numerous and produce surfactant?

Back 144

Type 2 Cells

Front 145

What is the process of inspiration and expiration?

Back 145

Ventilation

Front 146

What is the purpose of ventilation?

Back 146

To maintain optimal levels of O2 and CO2

Front 147

What is an increase in alveolar ventilation that decreases below normal levels below normal limits that is also know as hypocapnia?

Back 147

Hyperventilation

Front 148

What is an increase in CO2 levels caused by decrease in alveolar ventilation that is also know as hypercapnia?

Back 148

Hypoventilation

Front 149

What increases oxygen tension?

Back 149

Hyperventilation

Front 150

What is the volume of inspired or expired air during each cycle?

Back 150

Tidal Volume

Front 151

What is the max volume inspired from peak of tidal volume?

Back 151

Inspiratory Reserve Volume

Front 152

What is the max volume expired from a normal tidal expiration?

Back 152

Expiratory Reserve Volume

Front 153

What is the volume remaining after greatest expiration?

Back 153

Residual Volume

Front 154

What is the amount of gas in the respiratory system after a max inspiration?

Back 154

Total Lung Capacity

Front 155

What is the max volume of gas that can be expelled from the lungs after mas inspiration?

Back 155

Vital Capacity

Front 156

What is the max volume of gas that can be inspired from the resting and expiration level?

Back 156

Inspiratory Capacity

Front 157

What is the volume of gas in the lungs when the respiratory system is at rest, the volume in the lung at the end of a normal expiration?

Back 157

Function Residual Capacity

Front 158

What 2 factors does the functional residual capacity depend on?

Back 158

Inward elastic recoil of the lung tending to collapse the lung
Outward elastic recoil of the chest wall tending to expand the lung

Front 159

What refers to the volume within the respiratory system that does not participate in gas exchange?

Back 159

Dead Space

Front 160

Anatomic dead space = volume of gas contained in the _________ airways.

Back 160

conducting

Front 161

Alveolar dead space = volume of gas _________ in ventilation (poorly perfused alveoli).

Back 161

wasted

Front 162

What is the total volume of air not involved in gas exchange?

Back 162

Physiologic Dead Space

Front 163

In normal people, physiologic dead space = _________

Back 163

anatomic dead space

Front 164

In diseased people, physiolgic dead space = ___________

Back 164

anatomic dead space + alveolar dead space

Front 165

Inspired air is not _________ distributed throughout the lungs.

Back 165

uniformly

Front 166

Lungs are different in size with allows for ________ distribution.

Back 166

unequal

Front 167

In sitting or standing, apical ventilation ________ basilar ventilation.

Back 167

exceeds

Front 168

In which position is the posterior portion of the lung better ventilated than the anterior portion?

Back 168

Supine

Front 169

When do all areas tend to be well ventilated?

Back 169

During heavy breathing

Front 170

What causes hypotension with some areas not be well ventilated?

Back 170

During shallow breating

Front 171

What factors may cause limited ventilation?

Back 171

Respiratory muscle weakness
Regional airway obstruction
Abnormal lung or chest wall compliance
Disease