Biomechanics exam 3

cardiopulmonary dysfunction

pathology of cardiac disease

ischemic heart disease - becoming narrow

heart temporarily being deprived of O2

most common cause = cardiopulmonary artery disease (CAD)

dvelops w/o symptoms over time

mmight have agina

arthereosclerosis

plaque accumulation on internal walls of arteries

agina

chest pain due to reduced blood flow to the heart

w/ eating, exercising, exertion, exposure to cold

varies - squeezing, tightness, fullness, pressure, sharp pain

pain may radiate to arm, back, neck, jaw

usually no heart damage

warning sign

myocardial infarction

blockage of one or more coronary arteries

heart muscles deprived of blood begin to die

if substantial selection of the heart is damaged - it will stop pumping (cardiac arrest)

fist 6wks post MI

activity restrictions - balance rest / activity to prevent re-injury

no excersion

after 6wks MI

scar tissue reformed, risk of reinjury decreases

scarred heart tissue does not contract

hearts efficiency is compromised

graded exercise program can be presribed (radiac rehab)

CAD can lead to cognitive heart failure

assessing cardiovascular disability

OT intervention for stages 3 and 4

preventative programs for stages 1 and 2

stages 3 and 4

stages where OT is most beneficial to providing tx and interventions

stages 1 and 2

stages where OTs can provide pretentitive programs

valvular disease

atrial fibrillation - irregular, ineffective heart beats

increased risk of stroke

non modifiable cardiac risk factors

heredity

male gender

age

modifiable cardiac changes

high blood pressure

cigarette smoking

cholesterol levels

inactive lifestyles

contributing cardiac risk factors

diabetes

stress

obesity

bidirectional link b/w depressed and CAD - contributes to each other

surgical procedures to correct CAD

precutaneous transluminal coronary angioplasty (PTCA)

coronary artery bypass grafting (CABG)

cardiac ablation

percutaneous transluminal coronary angioplasty (PTCA)

balloon angioplasty

catheter is inserted though femoral artery and guided through coronary arteries

balloon inflated at leision site to push plaque against arterial wall

circulation imporves after balloon is deflated and removed

cardiac risk factors

non-modifiable

modifiable

cotributing factors

surgical procedures cardiopulmonary

PTCA

CABG

sternotomy

cardiac ablation

PTCA

balloon angioplasty

mainly implant a stent, wire mesh tube

CABG

coronary artery bypass grafting

diseased section of coronary artery is bypassed w/ healthy blood vessels from other parts of body

sternotomy

surgeon cracks the sternum and spreads ribs to assess the heart

cardiac ambulation

procedure that destroys small areas of heart that are emitting dangerous signals causing abnormal contractions

heart transplant

when pumping ability is too compromised

cardiac medications

side effects may vary

consider impact on rehab and occupations

shaving on blood thinners

diruretics and increased urination

psychosocial considerations

depression

anger

anxiety disorders

social isolation

cardiac rehab phase 1

inpatients cardiac rehabilitation

monitored low-level physical activity

paarticipation in self care

reinforcement of cardiac and post surgical precautions

establishment of guidelines for approprite activity lvls at discharge

education on signs and symptoms of cardiac

cardiac rehab phase 2

outpatient

usually from d/c from inpatient

exercise inensity is advanced

may be delivered in persons hime initially to build tolderance in clinic

instruction in sustainable program for optimal physical conditioning

cardiac rehab phase 3

communit based exercise program

individualized recommendations for maintenance

prevent trauma to new graft sites, incisions and sternum

sternal precautions

generally 8wks post surgery

do not push. / pull arms when getting into the bed or chair

do not bring elbows above shoulders

avoid twisting and deep bending

hig a pillow when couging or sneezing

dont drive until cleared by surgen

report clicking or popping noises to your surgeon

controversial

monitoring response to activity

heart rate

blood presure

rate pressure product (RPP)

HR x SBP

RPP should rise at peak activity and return to baseline in recover

other cardiopulmonary assessments

aterial blood gases (ABG)

arterial pressure line

oximeter - 92-100%

chronic lung disease

people wiht this will benefot from learning better ways to breathe and to conserve thier energy

CODP

empysema

chronic bronchitis

air sacs are damages, lose elasticity, become clogged w/ mucus

breating takes more effort - pariticipation can decrese

damage is irreversable

pulmonary risk factors

cigarette smoking

enviromental irritants (air pollution, chemical exposure, dust)

medical mx cardiopulmonary

CODP is chronic, progressive disease

medications

O2 therapy

medical ventilation prescribes for acurate exacerbation of disease caused by pnemonia, influenza or CHF

pulmonary rehabilitaion

multidiciplinary, comprehensive

psychological, emotional, physical and emotional

S and S respiratory distress

difficulty breathing

extreme fatigue

nonproductive cough

confucion

impaired judgement

cyanosis

goals of pulmonary rehab

stabilze or reverse. the disease porcess

return patient’s function and participation in activity / occupation to the highets capacity

dyspnea control postures

in seated, individual leans forward at the waist while supporting upper body by leaning upper body by leaning forward on table or thighs

in standing - releif obtained by leaning forward and porpping oneself on a counter

pursed lip breathing

prevent tightness in airway by providing resistance

1. relax neck and shoulder muscels

2. inhale slowly through nose for count or two

3. purse lips like to whistle

4. exhale slowly of count of four through pursed lips like trying to make a candle flicker w/o blowing it out