DPT 611 Cardiovascular Rehabilitation Quiz

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Questions and Answers

What is a significant risk factor that can lead to heart disease and stroke?

High fresh fruit consumption

Frequent exercise

Increased vitamin D levels

Low physical activity (correct)

Which factor is NOT a consideration when assessing the risk of heart disease?

Gender

Hair color (correct)

Diabetes

Age

What does a high level of low-density lipoprotein (LDL) contribute to?

Decreased risk of heart disease

Increased risk of heart disease (correct)

Improved cardiovascular health

Lower cholesterol levels

At what HDL level is there an increased risk for MEN?

Below 40 mg/dL Signup and view all the answers

What happens to the risk of heart disease for women after age 50?

It increases due to decreased estrogen Signup and view all the answers

Which layer of the heart is responsible for muscle contraction?

Myocardium Signup and view all the answers

What is the function of myocardial cells that exhibit automaticity?

To contract without any stimuli Signup and view all the answers

Where is the apex of the heart located?

Around the 5th intercostal space Signup and view all the answers

Which risk factor is NOT typically associated with cardiovascular disease?

Excessive hydration Signup and view all the answers

What does the term 'rhythmicity' refer to in the context of myocardial cells?

Ability to beat in a regular pattern Signup and view all the answers

In which part of the heart is the base located?

Superior portion, tilted posteriorly Signup and view all the answers

What is the primary focus of the course DPT 611 Cardiovascular Rehabilitation?

Cardiovascular anatomy and rehabilitation principles Signup and view all the answers

What is the main purpose of categorizing risk factors for cardiovascular disease?

To determine treatment protocols Signup and view all the answers

What is the formula used to calculate cardiac output (CO)?

CO = SV x HR Signup and view all the answers

What is considered a normal range for ejection fraction (EF)?

50-75% Signup and view all the answers

What does preload refer to in cardiac physiology?

The volume of blood returning to the heart Signup and view all the answers

How does peripheral circulation resistance affect myocardial oxygen demand?

It increases myocardial oxygen demand Signup and view all the answers

What does the A-vO2 difference indicate?

How much oxygen is being used by the system Signup and view all the answers

Which of the following conditions has a doubled risk for individuals with diabetes?

Coronary artery disease Signup and view all the answers

What is a common consequence of cardiovascular autonomic neuropathy in diabetic patients?

Orthostasis Signup and view all the answers

What lifestyle factor can increase cardiovascular risk in women over 35 with diabetes?

Birth control pills Signup and view all the answers

Which of the following is NOT typically higher in individuals with diabetes?

Body mass index Signup and view all the answers

What is a potential effect of stress on individuals with diabetes?

Increased myocardial oxygen demand Signup and view all the answers

What is the primary function of the media layer in arteries?

To regulate blood pressure and oxygen delivery Signup and view all the answers

What distinguishes large arteries like the aorta from smaller arterioles and capillaries?

Large arteries possess more elastic properties Signup and view all the answers

Which of the following statements about veins is true?

Veins contain valves to ensure one-way flow of blood Signup and view all the answers

During ventricular systole, what is the status of the AV and semilunar valves?

AV valves are closed and semilunar valves are open Signup and view all the answers

What role do lymphatics play in the cardiovascular system?

Help maintain fluid balance and transport excess fluid to the heart Signup and view all the answers

What is the primary role of the vagus nerve in the autonomic regulation of the heart?

Decrease heart rate Signup and view all the answers

Which artery does the left main coronary artery split into?

Left anterior descending and left circumflex arteries Signup and view all the answers

Which receptors bind epinephrine and norepinephrine to influence heart rate and contractility?

Beta1 receptors Signup and view all the answers

During which phase of the cardiac cycle does the myocardium receive blood due to arterial compression?

Ventricular diastole Signup and view all the answers

What primarily determines coronary artery perfusion?

Diastolic blood pressure Signup and view all the answers

In a typical right dominant coronary circulation, which nodes does the right coronary artery feed?

Both sinoatrial and atrioventricular nodes Signup and view all the answers

What is the role of the sympathetic trunk in relation to the heart?

Increases heart rate and contractility Signup and view all the answers

Which walls of the left ventricle are primarily fed by the left anterior descending artery?

Anterior wall only Signup and view all the answers

Study Notes

Course Information

Course name: DPT 611 Cardiovascular Rehabilitation
Course instructor: Lora Packel PT, PhD
Course semester: Spring 2025
FNIBBLE assignment due by the end of week 3

Cardiovascular Risk Factors, CV Anatomy & Physiology

Learning Objectives for the module:
- State the normal anatomy and physiology of the cardiovascular and lymphatic systems related to cardiovascular disease.
- State risk factors for cardiovascular disease.
- Interpret and categorize risk factors.
- State fundamental principles in exercise physiology related to the cardiovascular system.
- Define the movement system and use it to direct examinations of a mock patient with cardiovascular disease.

Cardiovascular Anatomy

Draw the heart (including valves) and the branches of the aorta with a classmate.
Do not draw coronary arteries yet.

Heart - Gross Anatomy

The base of the heart is the top portion tilted backward.
The apex of the heart is the bottom portion in the vicinity of the 5th intercostal space.
The heart is positioned two-thirds to the left of the breastbone (sternum).
Three layers: Epicardium (outermost layer), Myocardium (middle, muscular layer responsible for contraction), and Endocardium (innermost layer)
Myocardial cell characteristics:
- Automaticity: Ability to contract without a stimulus.
- Rhythmicity: Ability to beat in a patterned manner.
- Conductivity: Ability to transmit nerve impulses.

Aorta Branches

Various arteries branch off the aorta, including the right and left common carotids, right and left subclavians, brachiocephalic, and coronary arteries (right and left).
Other branches include the celiac trunk, superior mesenteric, renal, inferior mesenteric, and common iliac arteries.

Blood Flow and the Cardiac Cycle

Pair with a classmate to discuss and draw the path of blood through the heart.
Be prepared to report your findings.
Do not look ahead to the next slides.

Heart Diagram

Diagram showing blood flow through the heart, including the superior and inferior vena cava, right and left atria, right and left ventricles, pulmonary artery, pulmonary veins, aorta, and various heart valves (pulmonary, mitral, tricuspid, and aortic valves).
Diagram provides a clear visual representation of blood flow direction.

Coronary Circulation

Aortic sinuses of Valsalva give rise to the right and left coronary arteries.
Arteries are epicardial (on the heart surface) and have endocardial branches that nourish the myocardium.
Left main coronary artery branches into the left anterior descending (LAD) artery (feeds anterior left ventricle wall) and the left circumflex (LCX) artery (feeds left atrium, lateral, and posterior wall of the left ventricle).

Coronary Arteries

The right coronary artery (RCA) supplies blood to the right side of the heart, and in most people, it also supplies the sinoatrial (SA) and atrioventricular (AV) nodes.
Arteries are compressed during systole; therefore the myocardium is perfused during diastole.
Diastolic blood pressure determines coronary artery perfusion.
Because of the high extraction/delivery rate of oxygen in the coronaries, the heart rate increases if it needs more oxygen.

Peripheral Arteries, Arterioles, Capillaries, Venules, Veins, and Lymphatics

Arterial structure has three layers: intima (innermost), media (middle with contractile tissue for blood pressure regulation and oxygen delivery), and adventitia (outermost).
Large arteries (e.g., aorta) have more elastic properties than smaller arterioles and capillaries which have more muscular properties.

Venules and Veins

Veins carry deoxygenated blood back to the heart.
Veins have valves to ensure one-way blood flow.
Lymphatic vessels, with valves, carry excess fluid and proteins back to the heart.

Fundamentals of Cardiovascular Physiology

Concepts of neural and hormonal input, electrical system, mechanical system, pumping ability, relaxation ability, valve function, coronary artery function, lungs (gas exchange), hemoglobin function, peripheral artery function, and myoglobin function.

Cardiac Cycle

Review of systole (contraction) and diastole (relaxation) phases of the cardiac cycle.
Evaluation of AV valve and semilunar valve positions during ventricular systole.

Fundamentals of Cardiac Physiology

Defining cardiac output (CO): The volume of blood pumped by the heart per minute.
Defining stroke volume (SV): The amount of blood pumped per heartbeat.
Defining ejection fraction (EF): The percentage of blood ejected from the left ventricle during each heartbeat.
Preload and afterload are factors influencing cardiac performance.

Frank-Starling Principle

Explanation of the relationship between preload and cardiac performance.
A graphical representation showing that a greater ventricular end-diastolic volume increases stroke volume.

Peripheral Circulation

Resistance in peripheral circulation impacts the heart's workload.
Skeletal muscle function impacts blood flow during rest and activity.
During activity, metabolism increases, triggering oxygen release from hemoglobin to myoglobin for muscle function.
A-vO2 difference reveals oxygen use by the body.

Risk Factors for Heart Disease

Review of risk factors for heart disease from exercise physiology.
Normative values and recommended levels for assessment.
Major risk factor categories: Hypertension (know the stages), High Cholesterol (total, HDL, LDL, triglycerides), Diabetes, Obesity and overweight (criteria review), Smoking.
Additional risk factors outlined: Physical inactivity, Male gender (risk difference after 65), Hereditary and race (family history, ethnicity-specific risk factors), Age (older age increases risk), Stress, and Birth Control pills.

Diabetes and Heart Disease

Full pathophysiology covered in separate medical management courses.
Two main diabetes types: Type I (autoimmune) and Type II (acquired), both characterized by insulin resistance or absence.
Insulin delivers glucose to cells for metabolism; without insulin, glucose builds up in the blood leading to potential circulatory and bodily system damage.
Diabetes increases the risk (2x) for CAD, CVD, heart failure.
Diabetes manifests in Macrovascular Changes, including hastened development of coronary artery disease, more widespread CAD in multiple vessels, and autonomic neuropathy (damage to nerves regulating heart and blood vessels).

Contributing Risk Factors

Various factors can contribute to cardiovascular risk. Stress raises blood pressure and myocardial oxygen demand while increasing adrenaline. Birth control pills and alcohol can also influence cardiovascular health.

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Description

Test your knowledge on key concepts related to cardiovascular rehabilitation with the DPT 611 course. This quiz covers risk factors, heart anatomy, and physiological functions that contribute to heart health. Assess your understanding of important terms and their implications in heart disease prevention.