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PTA Cardio/Pulm Test

PT testing for cardio-pulmonary conditions

Angina Pain Scale 1 - mild, barely noticeable 2- Moderate. bothersome 3- Moderately severe, very uncomfortable 4 - Most severe pain ever
Ankle-Brachial Index (ABI) - description AKA ankle-arm index; compares systolic BP of ankle and arm to check for peripheral artery disease; divide higher of ankle measurements by higher of arm measurements
ABI - Scale 1.3+ - calls for further testing, rigid arteries 1-1.3 normal 0.8-0.99 - mild blockage, begining PAD 0.4-0.79 - moderate blockage, claudication with exercise <0.4 - Severe; claudication at rest
Arterial BP - procedure -Use a pneumatic cuff and a sphygmomanometer -Use appropriate size cuff, when in doubt go bigger -Using brachial artery to measure BP -Deflate about 2-3mm Hg/sec -Listen for Korotkoff sounds
Arterial BP - Korotkoff Sounds Phase I - first sound, systolic BP # Phase II - softer and longer Phase III - crisper and louder Phase IV - muffled and softer Phase V - sounds disappear, Diastolic BP # at last audible sound
Auscultation of Heart Sounds - Description -Listening to intensity and quality of heart sounds through chest -Press bell of stethoscope against bare skin with enough pressure to create a seal
Auscultation of Heart Sounds - Locations Aortic area - 2nd intercostal space, R sternal border Pulmonic Area - 2nd intercostal space L sternal border Mitral Area - 5th intercostal space, medial to L mid-clavicular line Tricuspid Area - 4th intercostal space, L sternal border
Auscultation of Heart Sound - 1st and 2nd Heart Sounds S1 - lub - closure of mitral/tricuspid (atrioventricular) valves, ventricular systole S2 - dub - closure of aortic/pulmonic (semilunar) valves, ventricular diastole
Auscultation of Heart Sounds - 3rd and 4th Heart Sounds S3 - Vibrations of distended ventricles, filling/diastole; children = normal, "physiologic 3rd HS"; adults = heart failure," ventricular gallop" S4 - Vibration of ventricular wall during atrial contraction; "atrial gallop"; sign of HTN, stenosis, MI
Heart Murmurs Vibrations longer than heart sounds; disruption in blood flow due to stenosis or regurgitate valve; soft, blowing or swishing sound
Auscultation of Lung Sounds - Procedure -Make firm contact of stethoscope bell to bare skin -Start at apices and work downward symmetrically -Pt breaths in and out through mouth a little deeper than normal -Listen to at least 1 cycle of in/exhale at each pulmonary segment
Auscultation of Lung Sounds - Listening to Sounds - Compare intensity, pitch and quality from 1 side to the other - Identify breath sounds as vesicular (thorax), broncho-vesicular, bronchial (trachea) or absent -Note adventitious (extra) sounds
Auscultation of Lung Sounds - Normal Sounds - Tracheal/Bronchial: loud, tubular; inhale shorter than exhale, has a pause between NOTE: distal bronchial sounds = abnormal; compression of lungs -Vesicular: high pitched, breezy; usually distal; inhale longer than exhale, with no pause
Auscultation of Lung Sounds - Abnormal Sounds Heard outside of normal location or phase of respiration
Crackle/Rales - Abnormal Lung Sound Discontinuous, high pitched popping; more often with inhalation; Associated with restricted or COPD
Pleural Friction Rub - Abnormal Lung Sound Dry, crackling; during inspiration and expiration
Rhonchi - Abnormal Lung Sound Continuous low pitched sounds; snoring or gurgling quality; during inspiration and expiration
Stridor - Abnormal Lung Sound Continuous, high pitched, wheeze; inspiration or expiration
Wheeze - Abnormal Lung Sound Continuous, musical or whistling sound, variety of pitches; inspiration and expiration; very variable
BMI Weight divided by height; 18.5-24.9 - normal
Capillary Refill Time Time capillary bed refills after occlusion; indicator of perfusion in extremities; firm pressure to nail or skin until blanches, release, observe time of refill -Normal - full color in <2 sec - Abnormal - >2 sec; blood flow is compromised
Dyspnea Scales Uncomfortable awareness of breathing resulting from decreased O2, hypoventilation, hyperventilation, anxiety; many scales -Borg: 0 - no breathlessness to 10 - maximal
ECG Waves - P Wave Atrial Depolarization; first small bump
ECG Waves - PR Interval Time for atrial depolarization, conduction from SA to AV node; from beginning of first bump to beginning of first dip
Created by: ashleighobrien