PHYSICAL THERAPY IN CARDIOVASCULAR AND PULMONARY CONDITIONS

Cardiovascular disease (CVD)

What remains the number one cause of death for men and women in the United States?

24%

What percentage of all U.S. deaths does CVD currently represent?

Reducing CVD risk factors like hypertension, high cholesterol, and smoking.

What is emphasized by the Million Hearts campaign?

48% of all CVD deaths

What proportion of CVD deaths are caused by coronary heart disease (CHD)?

Approximately 600,000 people

How many people did CVD kill in the U.S. in 2010?

Non-Hispanic Black individuals

Which racial group had the highest prevalence of chronic bronchitis in 2011?

Women

Which gender has had more COPD deaths in the past 11 years?

Emphysema and chronic bronchitis

What are the two main conditions included under COPD?

Chronic Obstructive Pulmonary Disease

What does COPD stand for?

left of center in the chest cavity (mediastinum)

Where is the heart located in the chest cavity?

pericardial sac 

What is the fibrous tissue that surrounds the heart called?

myocardium

What type of tissue makes up the major portion of the heart?

4

How many chambers does the heart have?

It is cross-striated muscle tissue with fibers arranged in multiple directions

Describe the structure of the myocardium

The right atrium

Which chamber receives venous blood from the body?

superior and inferior venae cava

through which vessels does the right atrium receive blood?

tricuspid valve

What valve allows blood to pass from the right atrium to the right ventricle?

left atrium

Which chamber receives oxygenated blood from the lungs?

 pulmonary veins

through which vessels does oxygenated blood enter the left atrium?

bicuspid (mitral) valve.

What valve allows blood to pass from the left atrium to the left ventricle?

atrial systole

The contraction of the atria that pushes blood into the ventricle

The ventricles contract, increasing pressure and closing the tricuspid and bicuspid valves to prevent backflow into the atria

What happens during ventricular systole?

The pulmonic (semilunar) valve

Which valve opens for blood to leave the right ventricle?

To the lungs for reoxygenation.

Where does the blood go after leaving the right ventricle?

The aortic valve

Which valve opens for blood to leave the left ventricle?

Into the aorta and through the systemic circulation to the body

Where does oxygenated blood go after leaving the left ventricle?

The left ventricle

Which ventricle has the thickest muscular wall?

To transport oxygen, nutrients, and hormones through the blood and remove waste products

What is the main function of the cardiovascular system?

 To ensure one-way flow of blood and prevent regurgitation.

What is the role of heart valves during contraction?

→ Body → Right Atrium → Right Ventricle → Lungs → Left Atrium → Left Ventricle → Body

flow of blood in order:

To conduct electrical impulses that cause the heart muscle to contract in a synchronized pattern.

What is the function of the myocardium’s special conduction tissue?

Blood moves efficiently through the heart chambers and blood vessels

What happens when the myocardium depolarizes and repolarizes in a synchronized way?

Nodal and Purkinje fibers

What are the specialized tissues that conduct electrical impulses in the heart called?

The pacemaker of the heart

What is the sinoatrial (SA) node often called?

 It initiates the electrical impulse that triggers the heartbeat (sinus rhythm)

What does the SA node do?

atrioventricular (AV) node

receives the signal from the atria and transmits it to the ventricles.

The bundle of His

What structure carries the impulse from the AV node to the ventricles?

The Purkinje fibers

What fibers spread the impulse throughout the ventricular muscle tissue?

The depolarization signal must travel through the entire conduction system of the heart

What must happen for every heartbeat or contraction to occur?

The SA node and AV node

Which parts of the conduction system receive autonomic nerve fibers?

The sympathetic and parasympathetic systems

Which two branches of the autonomic nervous system influence the heart?

Neurotransmitters

What do the sympathetic and parasympathetic nerves release to affect heart function?

They alter heart rate and the strength of myocardial contractions

How do autonomic neurotransmitters influence the heart?

It allows the heart to respond to changing demands, such as during exercise or stress

Why is autonomic control of heart rate and contractility important?

The normal heartbeat initiated by the sinoatrial (SA) node

What does “sinus rhythm” mean?
.

The AV node or other parts of the : conduction system may act as secondary pacemakers.

What happens if the SA node fails to function properly?

The delayed transmission of the impulse through the AV node

What ensures the ventricles contract after the atria?

To maintain a coordinated, rhythmic heartbeat that efficiently pumps blood throughout the body

What is the ultimate purpose of the heart’s conduction system?

From the right and left coronary arteries.

From where does the myocardium receive its blood supply?

 They arise from the ascending aorta.

Where do the right and left coronary arteries originate?

It is the major artery leaving the left ventricle that carries oxygenated blood to the body

What is the function of the ascending aorta?

The right side of the heart

What does the right coronary artery generally supply?

The left side of the heart

What does the left coronary artery generally supply?

Myocardial infarction (MI)

What is the medical term for a blockage that stops oxygen supply to the heart?

heart attack

What is another common name for myocardial infarction (MI)?

The cells are permanently damaged or die

What happens to heart cells when oxygen supply is cut off due to a blockage?

Because the heart muscle (myocardium) needs a continuous oxygen and nutrient supply to contract effectively.

Why is coronary circulation vital for heart function?

Arteries, capillaries, and veins

What are the three main types of blood vessels in peripheral circulation?

Cardiovascular and pulmonary dysfunction

What can disorders in peripheral blood vessels lead to?

The aorta

Which blood vessel has the largest diameter in the body?

Elastic fibers and smooth muscle

What two structures make up the walls of arteries and arterioles?

The vessel diameter decreases, increasing resistance to blood flow

What happens when the smooth muscle in the arterial wall contracts?

Resistance vessels

What are arterioles often referred to as?

Arteriosclerosis

What disease is known as the “hardening of the arteries”?

They become thick and stiff, losing elasticity

What happens to arterial walls in arteriosclerosis?

It increases resistance and restricts blood flow to tissues and organs

How does arteriosclerosis affect blood flow?

 Capillaries

What are the smallest blood vessels in the peripheral circulation?

Arteries and veins

What do capillaries connect?

Only one cell thick

How thick are capillary walls?

To allow efficient exchange of gases and nutrients

Why are capillary walls only one cell thick?

Veins

What type of blood vessels return blood to the heart?

Veins have less elastic fiber and smooth muscle

How do the walls of veins differ from those of arteries?

tas a blood reservoir

What special role can larger veins play in the circulatory system?

Capacitance vessels

hat are large veins often called due to their ability to store blood?

respiration

The process of exchanging oxygen (O₂) and carbon dioxide (CO₂) between the air we breathe and the blood cells in the lungs.

ventilation

The process of exchanging air between the atmosphere and the lungs through inspiration (inhalation) and expiration (exhalation)

The lungs, chest, and respiratory muscles

What structures affect the mechanics of breathing?

diaphragm

What is the primary muscle responsible for inspiration?

The thoracic cavity expands, increasing space inside the chest

What happens when the diaphragm contracts?

It causes air pressure inside the lungs to drop

What effect does thoracic cavity expansion have on lung pressure?

expiration

The process of air leaving the lungs — the reverse of inspiration.

It relaxes, causing the thoracic cavity to decrease in size and push air out.

What happens to the diaphragm during expiration?

Inspiration (air in) and expiration (air out).

hat are the two main phases of ventilation?

Tubes that transport air into and out of the lungs

What are the conducting airways?

 Nose, pharynx, and larynx

components of the upper conducting airway.

Cleans, humidifies air, and directs it to the trachea

What are the main functions of the upper conducting airway?

 At the beginning of the trachea

Where does the upper airway terminate?

Trachea, bronchi, bronchioles, terminal bronchioles

components of the lower conducting airway.

Terminal bronchioles

What is the endpoint of the conducting airway system?

In the alveoli

Where does gas exchange take place?

Capillaries

What surrounds the alveoli?

Left atrium

Which chamber of the heart receives oxygenated blood from the lungs?

Exchange oxygen and carbon dioxide between air and blood

What is the function of alveoli?

Because of the branching structure of the bronchial airways

Why are the lungs divided into lobes?

pleura?

A double-layered membrane covering the lungs and chest wall

Inner layer: covers lungs; Outer layer: lines chest wall

What are the layers of the pleura?

Facilitates ventilation and maintains lung structure

What is the main function of the pleura?

ischemic condition and cardiac muscle dysfunction.

what are the two major categories of disease processes that influence the myocardium

ischemia

Insufficient blood flow causing inadequate oxygen delivery to tissues.

coronary heart disease (CHD)

Arteriosclerosis affecting the coronary arteries