Pta Exam 7; Cardiovascular And Pulmonary System

Front 1

Lobes of the lungs

Back 1

Right-3

Left-2

Front 2

Coronary arteries

Back 2

Transport oxygen to the heart muscles.

Front 3

Endarterectomy

Back 3

Also known as Carotid Artery Surgery. Carotid endarterectomy is surgery that removes plaque buildup from inside a carotid artery in your neck. Overview. This surgery is done to restore normal blood flow to the brain to prevent a stroke if you already have symptoms of reduced blood flow.

Front 4

Hipertensión in Adults

Back 4

Normal: <120; <80

Elevated: 120-129; <80

Stage 1: 130-139; 80-89

Stage 2: at least 140; at least 90

Front 5

Ghj

Back 5

Fgh

Front 6

minute volume ventilation (VE - volume expired )

Back 6

VE=TV x respiratory rate

The volume of air expired in one minute

Front 7

Myocardium

Back 7

Contractile middle layer that forms the heart wall.

Front 8

Superior Vena Cava

Back 8

The vein that returns blood from the head , neck, and arms to the right atrium.

Front 9

How OXYGENATED blood returns to the LEFT ATTIUM

Back 9

Pulmonary VEINS

Front 10

Coronary Arteries

Back 10

The coronary arteries are a network of progressively smaller vessels that carry OXYGENATED blood to the MYOCARDIUM.

Front 11

Coronary veins

Back 11

1. Coronary sinus

2. Cardiac veins

3. Thebesian vein-drains into chambers of the heart, but primarily into the RA and RV.

Front 12

Cardiac plexus

Back 12

Vagus nerve

Sympathetic cardiac nerves

Front 13

Innervation of the heart

Back 13

Sympathetic: epinephrine and norepinephrine by SYMPATHETIC NERVES

Parasympathetic: acetylcholine by VAGUS NERVE

Front 14

Bainbridge reflex

Increase of HR

Back 14

Signals send by Vagus (afferent) to the Medulla about stretch of the walls of the RIGHT ATRIUM (increase in venous return), signals inhibit parasympathetic activity , resulting in an INCREASE in HR.

Front 15

Valsalva maneuver ( popping your ears in the swimming pool)

Back 15

Increased central venous pressure and decrease in venous return.

Decrease in cardiac output and blood pressure sensed by BARORESEPTORS which reflexively increase HR and myocardial contractility through sympathetic stimulation.

Front 16

Stroke volume

Back 16

Volume of blood ejected by left ventricle 60-80 ml

Front 17

Cardiac output

Back 17

4.5-5.0 L/min

Can increase to 25L/min during exercise.

Front 18

1.Anemia

2. Polycythemia

3. Thrombocytopenia

4. Thrombocythemia

Back 18

1. Low RBC

2. High RBS, stroke or heart attack

3. Low number of platelets, abnormal bleeding, bruising

4. High number of platelets, may result in stroke or heart attack, thrombosis.

Front 19

1.Leukopenia

2.Leukocytosis

Back 19

1. Low # of WBC, increases the risk of infection

2. High # of WBC, can indicate infection or LEUKEMIA

Front 20

Angle of Louis

Back 20

Articulation of manubrium and sternum

Front 21

Ribs which articúlate with one vertebra ?

Back 21

1,10,11, and 12

Front 22

1. Muscles of inspiration

2 Accessory muscles of inspiration

Back 22

1. Diaphragm and External Intercostals ( contraction of ext/int intercostals elevates the ribs)

2. Sternocleidomastoid, scalenes, pec. Major( sternocostal portion), and SERRARUS ANTERIOR

Front 23

Muscles of Exhalation

Back 23

Transverse abdominis

Rectas abdominis

Ext/int oblique

Front 24

Forced Vital Capacity (FVC)

Back 24

The volume of air expired during a forced maximal expiration after a forced maximal inspiration

Front 25

Forced expiratory volume

(FEV)

Back 25

The maximal volume of air exhaled in a specific period of time: usually the 1,2,3rd second of the Forced Vital Capacity FVC

Front 26

What finding positive exercise test for Angina indicates?

Back 26

Presence of ISCHEMIA

Front 27

1. Pneumothorax

2. Hemothorax

Back 27

1. Pleural space may contain air

2. Blood in the pleural space

Front 28

Marfan Syndrom

HEART problems

Back 28

An inherited disorder that affects connective tissue. Long arms, legs and fingers.

Marfan syndrome affects the HEART eyes, blood vessels, and bones.

Front 29

Aneurism, bulging in the vessel

Marfan syndrome

Back 29

Etiology: congenital, hypertension, connective tissues disease.

Signs and symptoms:

Abdominal - pulsation near navel

Cerebral: stiff neck, severe headache, seizure.

Aortic: usually asymptomatic, but may include abdominal and low back pain.

Treatment: meds for hypertension, synthetic fabric graft.

Front 30

Angina Pectoris: ( mostly coronary artery disease)

Stable - exercise

Unstable - spontaneous at rest

Prinzmetal (variant) - coronary artery spasm

Back 30

Ethnology: inadequate blood flow and oxigenación to the heart mostly due to Coronary artery disease

Signs and symptoms: pain behind the sternum, neck and back, how shoulders and arms, difficulty breathing, vomiting, sweating, anxiety and fear ( ANGINA EQUIVALENT )

Treatment: nitrates, betta blockers, calcium channel blockers, CORONARY ARTERI ANGIOPLASTY.

Front 31

Angina Equivalent

Anxiety of fear

Back 31

An anginal equivalent is a symptom such as shortness of breath (dyspnea), diaphoresis (sweating), extreme fatigue, or pain at a site other than the chest, occurring in a patient at high cardiac risk. Anginal equivalents are considered to be symptoms of myocardial ischemia.

Front 32

Atherosclerosis

(Intermittent claudification may result )

Back 32

Etiology: hypertension, smoking, high cholesterol, diabetes

Signs and symptoms:

If coronary artery affected: angina

If cerebral artery affected: numbness or weakness of UEs and LEs, difficulty speaking, drooping face muscles can result.

Treatment: antilipidemic, antiplatelet, antyhypertensive meds.

Angioplasty, bypass, endarterectomy.

Front 33

Chronic venous insufficiency

Back 33

Etiology: damaged valves, female gender, obesity, pregnancy, prolonged sitting or standing

Signs and symptoms: swelling, varicose veins, aching, itching, skin ulcer.

Treatment: compression stockings, elevation

Front 34

Cor Pulmanale

Pulmonary hypertension, right ventricle

Back 34

Etiology: pulmonary hypertension

Signs and symptoms: jugular vein distensión, swelling of the LEs, dizziness, syncope

Treatment: suplemental oxygen to maintain SaO2>90%; PaO2 >60mm Hg, diuretics, anticoagulants.

Front 35

Syncope

Back 35

Fainting, or a sudden temporary loss of consciousness.

Front 36

Coronary Artery Disease

Similar to atherosclerosis, can lead to Heart Attack.

Hashimoto’s ( hypothyroidism)

Back 36

Ethnology: narrowing or blockage of the coronary artery due to the atheromatous plagues.

Risk factors: high LDL cholesterol, low HDL cholesterol, type 2 diabetes.

Genetic factors: hypothyroidism ( Hashimoto’s ), hypertension.

Treatment: life style alterations, ( aspirin, Clopidogrel), ACE inhibitors, angiotensin 2 receptors blockers, and statins.

Front 37

Coronary Artery Disease

Back 37

Clopidogrel

Front 38

Deep Vein Thrombosis

Usually LE

Back 38

Etiology: Hormone replacement therapy, birth control, pregnancy, prolong sitting or bed rest.

Signs and symptoms: 50% a asymptomatic , when symptoms occur it’s swelling, pain, redness, warmth

Treatment: “Filter” in Vena Cava, compression stockings

Front 39

Heart Failure or Congestive HF

Heart can not maintain normal cardiac output, ventricles weakened and displayed to the point that heart cannot pump efficiently.

Back 39

Etiology: coronary artery disease, hipertensión, diabetes, myocardial infarction, abnormal heart valves, and cardiomyopathy.

Signs and symptoms: swelling in abdomen and legs, irregular heart beat with S3,S4 heart sounds, persistent cough or wheezing.

Treatment: repairing damaged heart valve or controlling an abnormal heart beat (pacemaker). Digitalis, anticoagulants, antihypertensives.

Front 40

Hypertension

Usually RENAL disease

Back 40

Etiology: usually renal disease

Sighs and symptoms: often asymptomatic until complications develop in the organs. An S4 heart sound is an early sign.

Treatment: Diuretics, beta blockers, calcium channel blockers, ACE inhibitors , angiotensin 2 receptor blocker, direct vasodilator.

Front 41

Myocardial Infarction MI

HEART ATTACK

Coronary Artery

Back 41

Etiology: ruptured atherosclerotic plaque or blood clot blocks the flow of blood through the coronary artery.

Signs and symptoms: pain in the arms, shoulder, neck or back, nausea, vomiting, sweating.

Treatment: anticoagulant, thrombolytic, antihypertensives.

Coronary angioplasty with staning, coronary artery bypass

Front 42

Hematocrit

Males

Females

Back 42

40-54

37-47

Front 43

Pharynx

Back 43

Respiratory and digestive system

Front 44

Expiration at rest

Back 44

Diaphragm and intercostals

Front 45

Total blood volume located in venous system.

Back 45

Two thirds

Front 46

In fetal heart circulation, which structure connects the two atria?

Back 46

Foramen ovale

Front 47

Medial side of LE drained by ?

Back 47

Great Saphenous vein

Front 48

Peripheral Arterial Disease

Stenotic, occlusive, and aneurysms diseases of the Aorta and peripheral arteries

Back 48

Etiology: Atherosclerotic or thromboembolic process. Intermittent claudication

Signs and symptoms: Fatigue, aching, numbness, or pain primarily in the BUTTOCKS, THIGH, CALF, or FOOT at rest or when walking. Wounds, hair loss, trophic changes, and hypertrophic nails.

Treatment: stop smoking, lipid lowering medication, control of diabetes and hypertension.

Front 49

Peripheral Arterial Disease

Back 49

Disabling intermittent claudication: angioplasty, stent.

Surgery: aortobifemoral

Aortofemoral

Iliofemoral

Aortoiliac bypasses

Front 50

Bronchodilators

Back 50

Beta-adregenic agonists

Methylxanthines

Anticolinergics

Front 51

Cold air

Back 51

Aggravates cough and promotes SOB

Front 52

COPD

Back 52

Emphysema and chronic bronchitis are two main conditions that make up COPD

Front 53

Protein Alpha-1-antitrypsin

Emphysema , COPD

Back 53

It protects elastic structures in the lungs. Low level of this protein can result in Emphysema

Front 54

Orthopnea

Back 54

Discomfort when breathing while lying down flat; common in people with some types of heart or lung conditions

Front 55

Barrel chest

Emphysema

Back 55

Barrel chest refers to an increase in the anterior posterior diameter of the chest wall resembling the shape of a barrel, most often associated with emphysema.

Front 56

Bullectomy surgery

Back 56

A bullectomy is a surgical procedure that involves removing bullae, which are enlarged, damaged air sacs in the lungs. A surgeon will remove one or more bullae through small incisions in the chest. Bullae can grow up to 20 centimeters across

Front 57

Significant increase in residual volume?

Back 57

COPD

Front 58

Bullous

Back 58

Bullous emphysema is characterized by damaged alveoli that distend to form exceptionally large air spaces, especially within the uppermost portions of the lungs

Front 59

Valvular Heart Disease

Regurgitation and Stenosis ( happens when leaflets thicken, stiffen or dude together and do not allow adequate blood flow)

Back 59

Ethnology: congenital defects, calcific degeneration, infective endocarditis, coronary artery disease, myocardial infarction, and RHEUMATIC FEVER

Signs and Symptoms: heart palpitation, SOB, chest pain, coughing, ankle swelling and fatigue.

Treatment: digitalis, diuretics, antiplatelet, and anticoagulant agents, betta blockers, calcium channel blockers.

Front 60

Asthma

Inflammation of the airways cause by hypersensitivity to various stimuli.

Back 60

Etiology: allergens such cockroaches, cold air, pollen, animal dander, cigaret smoke.

Signs and symptoms: Depending on airway restriction: mild - slight SOB, wheezing, chest tightness

Severe - dyspnea, flaring( бросающийся в глаза), DIMINISHED WHEEZING, cyanosis. Severa attack results in respiratory failure.

Treatment: Betta-adrigenic agonist, methylxanthines, and anticholirgenics.

Anti-inflammatory, bronchodilators, inhaled corticosteroids, cromolyn sodium, leukotriene modifiers.

Front 61

Bronchitis: Hypertrophy of the mucus secreting glands

Chronic: productive cough for 3 months out of 2 years.

Back 61

Etiology: acute-cold viruses, chronic-cigaret smoking

Signs and symptoms: production of thick sputum, increased use of the accessory muscles, increased pressure of pulmonary artery, dyspnea, wheezing, cyanosis. Cough is worse in the morning and damp weather

Treatment: breathing moist and warm air, antibiotics, anti-inflammatory, bronchodilators( airway clearance,breathing exercises, endurance and strength training).

Front 62

1.Emphysema

Back 62

Alveolar walls are gradually destroyed and alveoli are turned into large, irregular pockets with gaping holes in the walls. In addition, elastic fibers that hold open the bronchioles are destroyed, so that they COLLAPSE during EXHALATION, not letting air escape from the lungs.

Front 63

Emphysema 2

Back 63

Etiology: low level of protein ALPHA-1ANTITRYPSIN, it protects elastic structure of the lungs. Smoking is a LEADING cause of emphysema

Signs and symptoms: SOB, wheezing, chronic cough, BARREL CHEST, increase of accessory muscles, increased respiration rate, fatigue.

Treatment: suplemental oxygen, inhaled steroids, bronchodilators, Bullectomy, lung transplantation, ( airway clearance,breathing exercises)

Front 64

COPD - narrowing of the bronchial tree blocks airflow. Alveolar destruction and air trapping

Significant increase in Residual Volume ( RV 25%)

Increase in Total lung capacity.

Back 64

Etiology: low level of alpha-1-antitripsin, long-term smoking

Signs and symptoms: Excessive mucus production, chronic productive cough, wheezing, SOB, fatigue.

Treatment: supplemental oxygen, bronchodilators, inhaled steroids, lung volume reduction surgery, bullectomy, lung transplantation, airway clearence, breathing exercises.

Front 65

Cystic fibrosis

Exocrine glands disease ( affects lungs, pancreas, liver, intestines, sinuses, and sex organs.

Inherited!!!!!

Back 65

Etiology: mutation of chromosome 7. Body produces unusually thick, stocky mucus that leads to life-threatening lung infection. Abnormal digestion and absorptionof food.

Signs and symptoms: salty tasting skin cough, lung infections, SOB, wheezing, bulky stools.i

Treatment: pancreatic enzyme replacement, mucolytics,bronchodilators, airway clearance,assisted cough, breathing techniques.

Front 66

Pneumonia

Inflammation of the lungs, usually caused by bacterial, viral, fungal, or parasitic infection

Back 66

Etiology: Inflammation of the lungs, usually caused by bacterial, viral, fungal, or parasitic infection

Signs and symptoms: fever , cough, SOB, sweating, shaking chills, chest pain

Treatment: Antibiotic for bacterial and mycoplasma pneumonia, antiviral, antifungal, drinking a lot of fluids.

Front 67

Pulmonary Edema

Fluid collects in the alveoli within the lungs

Acute pulmonary edema is medical emergency

Back 67

Etiology: left ventricle is unable to pump blood adequately ( left-sides heart failure). As a result, pressure increases in the L atrium and then in the pulmonary veins and capillaries, causing fluid to be pushed into the alveoli.

Signs and symptoms: felling of suffocating or drowning, grasping of breath, anxiety, restlessness, coughing; frothy, blood-tinged sputum, chest pain, irregular pulse.

Treatment: supplemental oxygen and medications.

Front 68

Pulmonary Embolism

Arteries in the lungs become blocked

Back 68

Etiology: PE is caused by blood clots from the LEs

Signs and symptoms: sudden onset of shortness of breath and chest pain that becomes worse with deep breathing, eating, coughing, bending. Coughing up bloody sputum, LE swelling, irregular pulse

Treatment: anticoagulants and thrombolitic agents, filter into the inferior vena cava.

Front 69

Lingula

Left lung

Back 69

Tongue in the lung.

Front 70

Restrictive Lung Dysfunction

Decreased VITAL CAPACITY

Reduction of the lung expension (расширение)

Back 70

Etiology: atelectasis, pneumonia, pulmonary fibrosis,ABNORMAL PLEURA, neuralogic or neuromuscular disease, connective tissues disorders, pregnancy, obesity.

Signs and symptoms: Dyspnea on EXERTION, non- productive cough, increased respiratory rate, hypoxemia, decreased VITAL CAPACITY

Treatment: airway clearance, breathing exercises, respiratory mm training.

Front 71

Patient is 45, what is normal training rate? (60-90)

Back 71

220-45=175

175 x 0.60 = 105

175 x 0.90 = 157.5

Normal training rate between

105-157.5

Front 72

PaO2 vs SaO2’

Back 72

PaO2, in turn, determines the oxygen saturation of hemoglobin (along with other factors that affect the position of the O2-dissociation curve, discussed below).

The SaO2, plus the concentration of hemoglobin (15 gm/dl in this example), determine the total amount of oxygen in the blood or CaO2 (see equation for CaO2).

Front 73

1. Eucapnia

2. Hypercapnia

3. Hypocapnia

Back 73

1. Normal CO2

2. Elevated CO2

3. Low level CO2

Front 74

1. Hypxemia

2. Hypoxia

Back 74

1. Low level of oxygen in arterial blood

2. Low level of O2 in the tissue

Front 75

Total colesterol

Back 75

200-240 mg/dL

Front 76

LDL colesterol

Back 76

100 - 190 mg/ dL

Front 77

Ambulatory electrocardiography

Back 77

24-48 hours

Checking efficacy (эффективность) of medication, and pacemaker function.

Front 78

Hematocrit

Back 78

Low - anemia, blood loss

High - dehydration or polycythemia

Front 79

Angiography

Coronary arteries

Back 79

Radiologic examination, contrast medium.

Coronary angiograms are part of the group of procedures known as cardiac catherization.

Front 80

Cardiac catherization

Coronary arteries

Back 80

Thin catheter, legs or arms, contrast dye.

BP in the heart, oxygen in the blood.

Front 81

Computed tomography

X-ray machine that rotates around the pt.

Back 81

Organs and surrounding structures.

Front 82

Echocardiography

High frequency sound

Back 82

Provide information on the size and function of the ventricles, thickness of the septum, function of the walls, valves and chambers of the heart.

Used instead of Fluroscopy

Front 83

Invasive Hemodynamic Monitoring ( pressure, volume and temperature)

1. Swan-Ganz catheter

2. Thermodilution

3. Central venous pressure line

Back 83

1. Balloon catheter placed in PULMONARY ARTERY, obtaining Pulmonary artery wedge pressure, and LEFT!!!!!!! ATRIAL pressure.

2. Measures Cardiac Output

3. Pressure in the VENA CAVA and RIGHT ATRIUM

Front 84

MRI

3-D imagine

Back 84

Universal tool which has limited value for imaging the LUNGS.

Front 85

Myocardial Perfusion Imaging

Back 85

Aradionuclide agent is injected into the blood at rest and maximum level of exercise. Reveals areas that have reduced blood supply due to narrowing of one or more coronary arteries.

Front 86

Balloon angioplasty

Back 86

Stent ( small metal coil )