Additional Information
Book Details
Abstract
Improve your understanding of the cardiopulmonary system with Essentials of Cardiopulmonary Physical Therapy, 4th Edition. Based on best practices prescribed in The Guide to Physical Therapist Practice, this new edition provides comprehensive coverage of anatomy, physiology, and cardiopulmonary assessment, along with expanded chapters on the growing topics of early mobilization of the ICU patient and acute care management. Using a practical approach, expert author Ellen Hillegass also discusses pathophysiology, pharmacology, and interventions in the outpatient setting.
- Evidence-based content reflects the latest research in the field and incorporates the use of ICF.
- Material uses best practices defined by the American Physical Therapy Association.
- Clinical tips give you real-world hints and suggestions from practicing clinicians.
- NEW! Expanded chapters cover early mobilization of the ICU patient and acute care management.
- NEW! Updated references emphasize evidence-based information from the text.
- NEW! Full-color printing enhances text.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| ESSENTIALS OF CARDIOPULMONARY PHYSICAL THERAPY | i | ||
| Copyright | ii | ||
| Dedication | iii | ||
| Contributors | iv | ||
| Preface | vi | ||
| Acknowledgments | vii | ||
| Contents | viii | ||
| 01 - Anatomy and Physiology | 1 | ||
| 1 - Anatomy of the cardiovascular and pulmonary systems | 1 | ||
| Thorax | 1 | ||
| Sternum | 1 | ||
| Ribs | 2 | ||
| The Respiratory System | 3 | ||
| Muscles of Ventilation | 3 | ||
| Diaphragm | 3 | ||
| External Intercostal Muscles | 5 | ||
| Accessory Muscles | 5 | ||
| Sternocleidomastoid Muscle | 5 | ||
| Scalene Muscle | 5 | ||
| Upper Trapezius | 6 | ||
| Pectoralis Major and Minor | 6 | ||
| Serratus Anterior and Rhomboids | 6 | ||
| Latissimus Dorsi | 7 | ||
| Serratus Posterior Superior | 7 | ||
| Thoracic Erector Spinae Muscles | 7 | ||
| Muscles of Expiration | 7 | ||
| Abdominal Muscles | 7 | ||
| Internal Intercostal Muscles | 7 | ||
| Pulmonary Ventilation | 7 | ||
| Pleurae | 7 | ||
| Lungs | 8 | ||
| Hila and Roots | 9 | ||
| Lobes, Fissures, and Segments | 9 | ||
| Upper Respiratory Tract | 11 | ||
| Nose | 11 | ||
| Pharynx | 12 | ||
| Nasopharynx | 12 | ||
| Oropharynx | 12 | ||
| Laryngopharynx | 12 | ||
| Larynx | 12 | ||
| Lower Respiratory Tract | 12 | ||
| Tracheobronchial tree or conducting airways | 13 | ||
| Trachea | 13 | ||
| Mainstem and lobar bronchi | 13 | ||
| Segmental and subsegmental bronchi | 13 | ||
| Terminal respiratory (acinar) units | 14 | ||
| Innervation of the Lungs | 15 | ||
| The Cardiovascular System | 15 | ||
| Mediastinum | 15 | ||
| Heart | 15 | ||
| Tissue Layers | 16 | ||
| Pericardium | 16 | ||
| Myocardium | 16 | ||
| Endocardium | 16 | ||
| Chambers of the Heart | 16 | ||
| Right Atrium | 17 | ||
| Right Ventricle | 17 | ||
| Left Atrium | 17 | ||
| Left Ventricle | 18 | ||
| Heart Valves | 18 | ||
| Conduction System | 18 | ||
| Innervation | 19 | ||
| Cardiac and Pulmonary Vessels | 19 | ||
| Aorta | 19 | ||
| Right Coronary Artery | 19 | ||
| Left Coronary Artery | 20 | ||
| Pulmonary Artery | 20 | ||
| Pulmonary Veins | 21 | ||
| Vena Cava and Cardiac Veins | 21 | ||
| Systemic Circulation | 21 | ||
| Arteries | 21 | ||
| Endothelium | 22 | ||
| Veins | 22 | ||
| Summary | 22 | ||
| 2 - Physiology of the cardiovascular and pulmonary systems | 23 | ||
| The Pulmonary System | 23 | ||
| Ventilation | 23 | ||
| Additional Lung Volumes | 23 | ||
| Control of Ventilation | 24 | ||
| Afferent Connections to the Brainstem | 24 | ||
| Hypothalamic and Limbic Influence | 24 | ||
| Chemoreceptors | 24 | ||
| Lung Receptors | 26 | ||
| Joint and Muscle Receptors | 26 | ||
| Mechanics of Breathing | 26 | ||
| Intrapulmonary and Atmospheric Pressures | 26 | ||
| Intrapleural and Transmural Pressures | 27 | ||
| Physical Properties of Lungs | 27 | ||
| Compliance | 27 | ||
| Elasticity | 28 | ||
| Surface tension | 28 | ||
| Resistance to airflow | 29 | ||
| Respiration | 30 | ||
| Partial Pressures of Gases | 30 | ||
| Diffusion | 30 | ||
| Perfusion | 30 | ||
| Ventilation and Perfusion Matching | 31 | ||
| Transport of Oxygen and Carbon Dioxide | 32 | ||
| Transport of Oxygen | 32 | ||
| Hemoglobin | 32 | ||
| Oxyhemoglobin Dissociation Curve | 32 | ||
| Carbon Dioxide Transport | 33 | ||
| Dissolved carbon dioxide | 33 | ||
| Carbaminohemoglobin | 33 | ||
| Bicarbonate ions and the chloride and reverse chloride shifts | 33 | ||
| Acid–Base Balance | 33 | ||
| The Cardiovascular System | 34 | ||
| The Cardiac Cycle | 34 | ||
| Physiology of Cardiac Output | 36 | ||
| Cardiac Output = Heart Rate × Stroke Volume | 36 | ||
| Regulation of Heart Rate | 36 | ||
| Regulation of Stroke Volume | 37 | ||
| Preload | 37 | ||
| Contractility | 38 | ||
| Afterload | 38 | ||
| Ejection Fraction | 38 | ||
| Venous Return | 39 | ||
| Coronary Blood Flow | 39 | ||
| Blood Flow to Muscles During Exercise | 39 | ||
| Aging and Cardiovascular Physiology | 40 | ||
| Summary | 40 | ||
| 02 - Pathophysiology | 42 | ||
| 3 - Ischemic cardiovascular conditions and other vascular pathologies | 42 | ||
| Anatomy of the Coronary Arteries | 43 | ||
| Outer Layer | 43 | ||
| Middle Layer | 43 | ||
| Inner Layer | 43 | ||
| Myocardial Perfusion | 43 | ||
| Major Determinants of Myocardial Blood Flow | 44 | ||
| Atherosclerosis | 44 | ||
| Pathophysiology | 45 | ||
| Atherosis | 45 | ||
| Sclerosis | 46 | ||
| Vasospasm | 46 | ||
| Risk Factors | 46 | ||
| Seven Health Metrics for Ideal Cardiovascular Health | 47 | ||
| Cigarette Smoking | 47 | ||
| Physical Activity | 47 | ||
| Body Weight | 47 | ||
| Diet | 47 | ||
| Blood Pressure | 48 | ||
| Cholesterol | 48 | ||
| Fasting Blood Glucose | 48 | ||
| Other Risk Factors | 48 | ||
| Family History | 48 | ||
| Age | 49 | ||
| Gender | 49 | ||
| Stress | 49 | ||
| Emerging Risk Factors | 49 | ||
| Clinical Course | 50 | ||
| Sudden Cardiac Death | 50 | ||
| Angina | 50 | ||
| Chronic Stable Angina | 50 | ||
| Acute Coronary Syndrome | 50 | ||
| Factors That Contribute to Unstable Angina | 51 | ||
| Other Acute Coronary Syndrome: STEMI and Non-STEMI | 53 | ||
| Medical Management of Acute Coronary Syndrome | 54 | ||
| Complications with STEMI and Non-STEMI | 56 | ||
| Ventricular Remodeling | 57 | ||
| Prognosis | 57 | ||
| Natural History of Coronary Disease | 57 | ||
| Hypertension | 58 | ||
| Hypertensive Heart Disease | 59 | ||
| Treatment of Hypertension | 60 | ||
| Hypertension and Exercise | 60 | ||
| Implications for Physical Therapy Intervention | 61 | ||
| Cerebrovascular Disease | 62 | ||
| Treatment for Stroke Prevention: Primary and Secondary Prevention | 62 | ||
| Implications for Physical Therapy Intervention | 63 | ||
| Peripheral Arterial Disease | 63 | ||
| Exercise and Peripheral Arterial Disease | 63 | ||
| Implications for Physical Therapy Intervention | 64 | ||
| Other Vascular Disorders | 65 | ||
| Venous Disease | 65 | ||
| Venous Insufficiency | 65 | ||
| Venous Thromboembolic Disease | 66 | ||
| Implications for Physical Therapy | 66 | ||
| Renal Artery Disease | 67 | ||
| Aortic Aneurysm | 67 | ||
| Implications for Physical Therapy | 68 | ||
| Summary | 68 | ||
| 4 - Cardiac muscle dysfunction and failure | 78 | ||
| Causes and Types of Cardiac Muscle Dysfunction | 79 | ||
| Hypertension | 79 | ||
| Coronary Artery Disease (Myocardial Infarction/Ischemia) | 79 | ||
| Cardiac Arrhythmias | 80 | ||
| Renal Insufficiency | 80 | ||
| Cardiomyopathy | 80 | ||
| Dilated Cardiomyopathies | 80 | ||
| Hypertrophic Cardiomyopathy | 82 | ||
| Restrictive Cardiomyopathy | 82 | ||
| Heart Valve Abnormalities and Congenital/Acquired Heart Disease | 82 | ||
| Pericardial Effusion or Myocarditis | 83 | ||
| Pulmonary Embolism | 83 | ||
| Pulmonary Hypertension | 83 | ||
| Spinal Cord Injury | 84 | ||
| Age-Related Changes | 84 | ||
| Congenital and Acquired Heart Disease | 85 | ||
| Age-Associated Changes in Cardiac Performance | 85 | ||
| Cardiac Muscle | 86 | ||
| Pathophysiology | 86 | ||
| Congestive Heart Failure Descriptions | 87 | ||
| Specific Pathophysiologic Conditions Associated with Congestive Heart Failure | 88 | ||
| Cardiovascular Function | 88 | ||
| Biochemical Markers: Natriuretic Peptides Released by Cardiac Muscle | 90 | ||
| Renal Function | 91 | ||
| Pulmonary Function | 92 | ||
| Neurohumoral Effects | 93 | ||
| Normal Cardiac Neurohumoral Function | 93 | ||
| α-Adrenergic Receptors | 94 | ||
| β-Adrenergic Receptors | 94 | ||
| Guanine Nucleotide–Binding Regulatory Proteins | 94 | ||
| Catalytic Unit of Adenylate Cyclase | 94 | ||
| Neurohumoral Alterations in the Failing Human Heart | 94 | ||
| Abnormalities in Sympathetic Neural Function | 94 | ||
| Hepatic Function | 94 | ||
| Hematologic Function | 95 | ||
| Skeletal Muscle Function | 95 | ||
| Pancreatic Function | 96 | ||
| Nutritional and Biochemical Aspects | 96 | ||
| Clinical Manifestations of Congestive Heart Failure | 97 | ||
| Symptoms of Congestive Heart Failure | 97 | ||
| Dyspnea | 97 | ||
| Paroxysmal Nocturnal Dyspnea | 97 | ||
| Orthopnea | 97 | ||
| Signs Associated with Congestive Heart Failure | 97 | ||
| Breathing Patterns | 97 | ||
| Rales (Crackles) | 98 | ||
| Heart Sounds | 98 | ||
| Peripheral Edema | 99 | ||
| Jugular Venous Distention | 99 | ||
| Pulsus Alternans | 100 | ||
| Changes in the Extremities | 100 | ||
| Weight Gain | 100 | ||
| Sinus Tachycardia | 100 | ||
| Decreased Exercise Tolerance | 100 | ||
| Quality of Life in Congestive Heart Failure | 102 | ||
| Cognition | 103 | ||
| Radiologic Findings in Congestive Heart Failure | 104 | ||
| Laboratory Findings in Congestive Heart Failure | 104 | ||
| Echocardiography | 104 | ||
| Medical Management | 104 | ||
| Dietary Changes and Nutritional Supplementation | 104 | ||
| Pharmacologic Treatment | 104 | ||
| Diuretics | 105 | ||
| Aldosterone Antagonists | 106 | ||
| Digoxin (Lanoxin) and Other Positive Inotropic Agents | 106 | ||
| Dopamine | 107 | ||
| Dobutamine | 107 | ||
| Amrinone/Milrinone | 107 | ||
| Vasodilators and Venodilators | 107 | ||
| Angiotensin-Converting Enzyme Inhibitors and α-Receptor Blockers | 107 | ||
| α-Adrenergic Antagonists and Partial Agonists | 107 | ||
| Anticoagulation | 108 | ||
| Mechanical Management | 108 | ||
| Implantable Cardiac Defibrillator Implantation | 108 | ||
| Cardiac Resynchronization Therapy | 108 | ||
| Special Measures | 108 | ||
| Dialysis and Ultrafiltration | 108 | ||
| Assisted Circulation | 109 | ||
| Ventricular Assist Devices | 109 | ||
| Surgical Management | 109 | ||
| Abandoned Procedures | 110 | ||
| Cardiac Transplantation | 110 | ||
| Prognosis | 110 | ||
| Physical Therapy Assessment | 111 | ||
| Physical Therapy Interventions | 112 | ||
| Exercise Training | 112 | ||
| Guidelines for Exercise Training | 112 | ||
| Exercise Training and Quality of Life | 114 | ||
| Exercise Training During Continuous Intravenous Dobutamine Infusion | 114 | ||
| Exercise Training with Ventricular Assist Devices | 114 | ||
| Exercise Training During Continuous Positive Airway Pressure Ventilation | 115 | ||
| Ventilation | 115 | ||
| Breathing Exercises | 115 | ||
| Expiratory Muscle Training | 115 | ||
| Inspiratory Muscle Training | 115 | ||
| Instruction in Energy Conservation | 116 | ||
| Self-Management Techniques | 116 | ||
| Summary | 117 | ||
| 5 - Restrictive lung dysfunction | 125 | ||
| Etiology | 126 | ||
| Pathogenesis | 126 | ||
| Compliance | 126 | ||
| Lung Volumes | 126 | ||
| Work of Breathing | 128 | ||
| Clinical Manifestation | 129 | ||
| Signs | 129 | ||
| Symptoms | 129 | ||
| Treatment | 129 | ||
| Maturational Causes of Restrictive Lung Dysfunction | 129 | ||
| Abnormalities in Fetal Lung Development | 129 | ||
| 03 - Diagnostic Tests and Procedures | 266 | ||
| 8 - Cardiovascular diagnostic tests and procedures | 266 | ||
| Diagnostic Test Interpretation and Probability of Disease | 267 | ||
| Sensitivity/Specificity of Testing | 267 | ||
| Clinical Laboratory Studies | 267 | ||
| Serum Enzymes and Cardiac Biomarkers | 267 | ||
| Blood Lipids | 270 | ||
| Other Potential Clinical Laboratory Risk Factors for CAD | 271 | ||
| Complete Blood Cell Count | 272 | ||
| Coagulation Profiles | 272 | ||
| Electrolytes | 273 | ||
| Blood Urea Nitrogen and Creatinine and B-type Natriuretic Peptide | 273 | ||
| Serum Glucose | 274 | ||
| Other Laboratory Values | 274 | ||
| Other Noninvasive Diagnostic Tests | 274 | ||
| Holter Monitoring | 274 | ||
| Echocardiography | 275 | ||
| Contrast Echocardiography | 276 | ||
| Other Imaging Modalities | 277 | ||
| Positron Emission Tomography | 277 | ||
| Computed Tomography | 277 | ||
| Single-Photon Emission Computed Tomography | 277 | ||
| Electron Beam Computed Tomography | 278 | ||
| Multigated Acquisition Imaging | 278 | ||
| Magnetic Resonance Imaging | 278 | ||
| Magnetic Resonance Angiogram | 278 | ||
| Exercise Testing | 279 | ||
| Maximal versus Submaximal Stress Testing | 279 | ||
| Low-Level Exercise Testing | 280 | ||
| Safety in Exercise Testing | 281 | ||
| Contraindications to Testing | 282 | ||
| Exercise Testing Equipment | 282 | ||
| Protocols for Exercise Testing | 283 | ||
| Terminating the Testing Session | 284 | ||
| Interpretation of Results | 284 | ||
| Prognostic Value of Maximal Exercise Testing | 284 | ||
| Heart Rate Recovery | 285 | ||
| Exercise Testing with Ventilatory Gas Analysis | 286 | ||
| Exercise Testing with Imaging Modalities | 286 | ||
| Radioactive Nuclide Perfusion Imaging | 287 | ||
| Thallium-201 Perfusion Imaging | 287 | ||
| Sestamibi | 287 | ||
| Pharmacologic Stress Testing | 288 | ||
| Adenosine or Dipyridamole–Walk Protocol | 288 | ||
| Ergonovine Stimulation | 289 | ||
| Heart Rate Variability | 289 | ||
| Cardiac Catheterization: Coronary Angiography and Ventriculography | 289 | ||
| Indications for Cardiac Catheterization | 290 | ||
| Procedure for Cardiac Catheterization | 291 | ||
| Interpreting the Test Results | 291 | ||
| Digital Subtraction Angiography | 291 | ||
| Intravascular Ultrasonography | 292 | ||
| Diagnostic Tests for Women | 293 | ||
| Endocardial Biopsy | 294 | ||
| Vascular Diagnostic Testing for Aortic, Peripheral, and Carotid Disease | 294 | ||
| Aortic Disease and Dysfunction and Diagnosis | 294 | ||
| Peripheral Arterial Disease and Dysfunction and Diagnosis | 295 | ||
| Ankle–Brachial Index | 295 | ||
| Segmental Limb Pressures | 295 | ||
| Pulse Volume Recordings | 295 | ||
| Arterial Duplex Ultrasonography | 295 | ||
| Exercise Studies | 295 | ||
| Other Clinical Tests | 295 | ||
| Rubor Dependency Test | 295 | ||
| Venous Filling Time Test | 296 | ||
| Peripheral Venous Disease and Diagnosis | 297 | ||
| Trendelenburg Test | 297 | ||
| Carotid Artery Disease and Diagnosis | 298 | ||
| Summary | 299 | ||
| 9 - Electrocardiography | 305 | ||
| Basic Electrophysiologic Principles | 305 | ||
| The Autonomic Nervous System | 307 | ||
| Sympathetic Division | 307 | ||
| Parasympathetic Division | 307 | ||
| The Conduction System | 307 | ||
| The Electrocardiogram Recording | 308 | ||
| Heart Rate | 309 | ||
| Six-Second Tracing | 310 | ||
| R Wave Measurement | 310 | ||
| Counting Boxes | 310 | ||
| Heart Rhythm: Assessment of Single-Lead Electrocardiogram | 310 | ||
| Assessment Approach | 312 | ||
| Normal Waveforms | 312 | ||
| The Physiology Underlying the Normal Waveforms | 313 | ||
| Basic Interpretation of Heart Rhythm | 314 | ||
| Normal Sinus Rhythm | 314 | ||
| Sinus Bradycardia | 314 | ||
| Signs, Symptoms, and Causes | 315 | ||
| Treatment | 315 | ||
| Sinus Tachycardia | 315 | ||
| 04 - Surgical Interventions, Monitoring, and Support | 364 | ||
| 11 - Cardiovascular and thoracic interventions | 364 | ||
| Cardiovascular and Thoracic Surgical Procedures | 364 | ||
| Cardiothoracic Surgical Approaches | 364 | ||
| Posterolateral Thoracotomy | 364 | ||
| Anterolateral Thoracotomy | 365 | ||
| Lateral Thoracotomy | 365 | ||
| Axillary Thoracotomy | 365 | ||
| Median Sternotomy | 365 | ||
| Thoracic Surgical Complications | 365 | ||
| Pain | 366 | ||
| Minimally Invasive Approaches | 367 | ||
| Cardiothoracic Surgical Interventions | 368 | ||
| Percutaneous Revascularization Procedures | 368 | ||
| Coronary Artery Bypass Graft | 369 | ||
| Advances in Cardiac Surgery | 371 | ||
| Robotics | 372 | ||
| Valvular Repair and Replacement | 372 | ||
| Advances in Valve Surgery | 374 | ||
| Gene Therapy for the Stimulation of Angiogenesis | 375 | ||
| Radiation | 375 | ||
| Chest Tube Placement | 375 | ||
| Thoracic Organ Transplantation | 377 | ||
| Abdominal Aortic Aneurysmectomy | 377 | ||
| Indications for Surgery | 377 | ||
| Peripheral Vascular Interventions | 378 | ||
| Peripheral Vascular Surgery | 378 | ||
| Pacemaker Implantation | 379 | ||
| Implantable Cardioverter Defibrillator | 381 | ||
| Summary | 382 | ||
| 12 - Thoracic organ transplantation: heart and lung | 386 | ||
| History | 386 | ||
| Evaluation | 388 | ||
| Candidacy | 388 | ||
| Contraindications to Transplantation | 389 | ||
| Medical Aspects of Evaluation | 389 | ||
| Physical Therapy Examination | 393 | ||
| Preoperative Rehabilitation | 393 | ||
| Alternative Therapies to Transplantation | 395 | ||
| Alternatives to Lung Transplantation | 397 | ||
| Alternatives to Heart Transplantation | 399 | ||
| Donor Selection and Matching Criteria | 399 | ||
| Surgical Techniques | 399 | ||
| Cardiac Transplantation | 399 | ||
| Lung Transplantation | 401 | ||
| Medications | 402 | ||
| Postoperative Treatment | 403 | ||
| Response to Activity | 403 | ||
| Changes in Cardiovascular Status | 403 | ||
| Changes in Pulmonary Status | 403 | ||
| The Acute Postoperative Inpatient Phase | 403 | ||
| Heart Transplantation | 406 | ||
| Lung Transplantation | 409 | ||
| The Postoperative Outpatient Phase | 410 | ||
| Future Trends in Transplantation Care161 | 412 | ||
| Summary | 415 | ||
| 13 - Monitoring and life support | 419 | ||
| Monitoring Equipment | 419 | ||
| Noninvasive Monitoring Equipment | 419 | ||
| Electrocardiogram | 419 | ||
| Pulse Oximetry | 420 | ||
| Blood Pressure Monitoring | 420 | ||
| Respiratory Rate | 422 | ||
| Level of Consciousness | 422 | ||
| Invasive Monitoring | 423 | ||
| Arterial Line | 423 | ||
| Central Line | 424 | ||
| Pulmonary Artery Catheter (Swan–Ganz Catheter) | 425 | ||
| Left Atrial Pressure and Pulmonary Capillary Wedge Pressure | 425 | ||
| Cardiac Output | 425 | ||
| Mixed Venous Oxygen Saturation | 426 | ||
| Temperature Monitoring | 427 | ||
| Intracranial Pressure Monitoring | 427 | ||
| Life Support Equipment | 429 | ||
| Noninvasive Positive-Pressure Ventilation | 429 | ||
| Manual Resuscitators | 430 | ||
| Oxygen Delivery Devices | 430 | ||
| Nasal Cannula | 430 | ||
| Simple Mask | 431 | ||
| Aerosol Mask | 431 | ||
| Venturi Mask | 431 | ||
| Nonrebreather Masks | 432 | ||
| Pediatric Delivery Devices | 432 | ||
| Invasive Ventilatory Devices | 433 | ||
| Airway Adjuncts | 433 | ||
| Mechanical Ventilation | 435 | ||
| Other Modes (Nontraditional) of Mechanical Ventilation | 435 | ||
| Portable Ventilators | 437 | ||
| Innovative Ventilation System | 437 | ||
| Chest Tubes | 437 | ||
| Invasive Cardiac Devices | 438 | ||
| Pacemakers | 438 | ||
| Automatic implantable cardiac defibrillator | 438 | ||
| Intraaortic balloon pump | 438 | ||
| Ventricular assist devices | 440 | ||
| Extracorporeal Membranous Oxygenation | 441 | ||
| Hemodialysis | 442 | ||
| Summary | 443 | ||
| 05 - Pharmacology | 445 | ||
| 14 - Cardiovascular medications | 445 | ||
| Pharmacokinetics | 446 | ||
| Bioavailability | 446 | ||
| Distribution | 447 | ||
| Clearance | 447 | ||
| Half-Life | 447 | ||
| Dosage | 448 | ||
| Pharmacodynamics | 448 | ||
| Autonomic Nervous System and Its Receptors | 448 | ||
| Autonomic Drugs | 449 | ||
| Kidney Regulation | 449 | ||
| Vascular Smooth Muscle | 449 | ||
| General Considerations of Pharmacologic Management | 449 | ||
| Ischemic Heart Disease | 450 | ||
| Antiischemic Drugs | 450 | ||
| Physiology | 450 | ||
| Pathophysiology | 450 | ||
| Pharmacologic Intervention | 452 | ||
| Drugs that Decrease Myocardial Oxygen Demand | 452 | ||
| β-Blockers | 452 | ||
| Side effects of β-blockers | 453 | ||
| Calcium-Channel Blockers | 453 | ||
| Nitrates | 453 | ||
| Drugs That Increase Myocardial Oxygen Supply | 455 | ||
| Thrombolytic Agents | 455 | ||
| Antiplatelet Agents | 456 | ||
| Anticoagulants | 456 | ||
| Calcium-Channel Blockers | 456 | ||
| Heart Failure | 457 | ||
| Physiology | 458 | ||
| Pathophysiology | 458 | ||
| Pharmacologic Intervention | 458 | ||
| Diuretics | 458 | ||
| Beta-Blockers | 459 | ||
| Drugs Affecting the Renin–Angiotensin–Aldosterone System | 461 | ||
| Angiotensin-converting enzyme inhibitors | 461 | ||
| Angiotensin-receptor blockers | 462 | ||
| Aldosterone antagonist | 462 | ||
| Positive inotropes | 462 | ||
| Cardiac glycosides | 462 | ||
| Sympathomimetics | 462 | ||
| Bipyridines/phosphodiesterase inhibitors | 463 | ||
| Vasodilators | 463 | ||
| Alpha-adrenergic antagonists | 463 | ||
| Venodilators | 463 | ||
| Arteriodilators | 463 | ||
| Combined arteriolar and venous dilators | 463 | ||
| Human-BNP | 463 | ||
| Morphine | 463 | ||
| Signs and Symptoms of Impending Heart Failure | 463 | ||
| Dysrhythmias | 464 | ||
| Physiology | 464 | ||
| Pathophysiology | 465 | ||
| Pharmacologic Intervention | 466 | ||
| Membrane stabilizers | 466 | ||
| Class 1 drugs (membrane stabilizers) | 466 | ||
| Class 2 drugs | 466 | ||
| Class 3 drugs | 467 | ||
| Class 4 drugs | 467 | ||
| Digitalis | 468 | ||
| Miscellaneous drugs | 468 | ||
| Hypertension | 468 | ||
| Physiology | 469 | ||
| Pathophysiology | 469 | ||
| Pharmacologic Intervention | 469 | ||
| Diuretics | 469 | ||
| Drugs Acting on the Sympathetic Nervous System | 470 | ||
| Drugs Acting on Other Sites | 470 | ||
| Vasodilators | 471 | ||
| Drugs Acting on the Renin–Angiotensin System | 472 | ||
| Centrally Acting Drugs | 472 | ||
| Lipid Disorders | 472 | ||
| Drugs for Lipid Disorders | 474 | ||
| Side Effects | 475 | ||
| Cardiac Drugs Used in Critical Care | 475 | ||
| Oxygen | 475 | ||
| Drugs that Affect the Autonomic Nervous System | 475 | ||
| Non–Autonomic Nervous System Vasodilator and Inotropic Agents | 476 | ||
| Antiarrhythmic Agents | 477 | ||
| Other Pharmacologic Agents Used in Critical Care | 478 | ||
| Cardiac Pharmacology in the Geriatric Population | 478 | ||
| Alteration in Pharmacokinetics | 479 | ||
| Therapeutic Indications | 479 | ||
| Cardiac Pharmacology in the Neonate and Pediatric Populations | 480 | ||
| Alteration in Drug Elimination | 480 | ||
| Therapeutic Indications | 480 | ||
| Pharmacologic Management of Diabetes | 481 | ||
| Heart Transplantation | 483 | ||
| Immune Mechanism | 484 | ||
| Pharmacologic Intervention | 484 | ||
| Corticosteroids | 484 | ||
| Calcineurin Inhibitors | 484 | ||
| Antiproliferative Agents | 484 | ||
| Antilymphocyte Antibodies | 485 | ||
| Maintenance Therapy | 485 | ||
| Vascular Pharmacology | 485 | ||
| Arterial Disease | 485 | ||
| Atherosclerosis | 485 | ||
| Pulmonary Hypertension | 486 | ||
| Vascular Disease | 486 | ||
| Veno-Thromboembolism | 486 | ||
| Summary | 486 | ||
| 15 - Pulmonary medications | 489 | ||
| Physiology | 489 | ||
| Bronchomotor Tone | 489 | ||
| Rationale for Bronchodilators | 490 | ||
| Bronchodilators | 492 | ||
| Sympathomimetic Agents or Adrenergic Agonists | 492 | ||
| Sympatholytic Agents or Adrenergic Antagonists | 495 | ||
| Parasympatholytic Agents or Muscarinic Antagonists | 495 | ||
| Methylxanthines | 496 | ||
| Corticosteroids | 496 | ||
| Mast Cell Stabilizers (Cromones) | 496 | ||
| Leukotriene Inhibitors | 496 | ||
| Anti-IgE Monoclonal Antibodies | 497 | ||
| New Drug Development | 497 | ||
| New Antifibrotic Medications (for the Treatment of Idiopathic Pulmonary Fibrosis) | 497 | ||
| Pulmonary Arterial Hypertension Medications | 497 | ||
| Ancillary Pulmonary Medications | 497 | ||
| Decongestants | 497 | ||
| Antihistamines | 497 | ||
| Antitussives | 498 | ||
| Mucoactive Agents | 499 | ||
| Respiratory Stimulants and Depressants | 499 | ||
| Neuromuscular Blocking Drugs | 499 | ||
| Antimicrobial Agents | 500 | ||
| Other Agents | 502 | ||
| Summary | 503 | ||
| 06 - Cardiopulmonary Assessment and Intervention | 506 | ||
| 16 - Examination and assessment procedures | 506 | ||
| Elements of Patient Management | 506 | ||
| Patient History | 507 | ||
| Medical Chart Review | 507 | ||
| Diagnosis and Date of Event | 507 | ||
| Symptoms | 508 | ||
| Other Medical Problems and Past Medical History | 509 | ||
| Medications | 509 | ||
| Risk Factors for Heart Disease | 509 | ||
| Wells Prediction Tool for Deep Vein Thrombosis | 509 | ||
| Relevant Social History | 509 | ||
| Clinical Laboratory Data | 510 | ||
| Radiologic Studies | 510 | ||
| Oxygen Therapy and Other Respiratory Treatment | 510 | ||
| Surgical Procedures | 511 | ||
| Other Therapeutic Regimens | 511 | ||
| Electrocardiogram and Serial Monitoring | 511 | ||
| Pulmonary Function Tests | 511 | ||
| Arterial Blood Gases | 511 | ||
| Cardiac Catheterization Data | 511 | ||
| Vital Signs | 512 | ||
| Hospital Course | 512 | ||
| Nutritional Intake | 512 | ||
| Occupational History | 512 | ||
| Home Environment and Family Situation | 512 | ||
| Interview with the Patient and the Family | 512 | ||
| Systems Review | 513 | ||
| Physical Examination | 513 | ||
| Inspection | 513 | ||
| General Appearance | 513 | ||
| Facial Characteristics | 514 | ||
| Evaluation of the Neck | 515 | ||
| Evaluation of the Chest: Resting and Dynamic | 516 | ||
| Phonation, Cough, and Cough Production | 518 | ||
| Appearance of Extremities | 518 | ||
| Auscultation of the Lungs | 519 | ||
| Lung Sound Definitions | 520 | ||
| Adventitious Lung Sounds | 521 | ||
| Wheezes | 521 | ||
| Crackles | 521 | ||
| Pleural rub | 522 | ||
| Auscultation of the Heart | 522 | ||
| Abnormal Heart Sounds | 523 | ||
| Third Heart Sound | 523 | ||
| Fourth Heart Sound | 524 | ||
| Murmurs | 524 | ||
| Systolic and diastolic murmurs | 524 | ||
| Pericardial Friction Rub | 524 | ||
| Palpation | 524 | ||
| The Mediastinum (Tracheal Position) | 524 | ||
| Chest Motion | 525 | ||
| Evaluation of Fremitus | 525 | ||
| Evaluation of Muscle Activity of Chest Wall and Diaphragm | 525 | ||
| Chest Wall Pain or Discomfort | 526 | ||
| Evaluation of Circulation | 526 | ||
| Mediate Percussion | 528 | ||
| Activity Evaluation | 529 | ||
| Heart Rate Measurement | 530 | ||
| Heart Rhythm | 531 | ||
| Blood Pressure Measurement | 531 | ||
| Evaluation of Oxygen Saturation | 532 | ||
| Normal Responses | 532 | ||
| Abnormal Responses | 534 | ||
| Abnormal Systolic Responses | 534 | ||
| Clinical Implications | 534 | ||
| Abnormal Diastolic Responses | 534 | ||
| Other Symptoms of Cardiovascular Inadequacy | 535 | ||
| Angina | 535 | ||
| Variant angina | 535 | ||
| Preinfarction angina | 536 | ||
| Pericarditis | 536 | ||
| Mitral Valve Dysfunction | 536 | ||
| Bronchospasm | 536 | ||
| Esophageal Spasm | 536 | ||
| Shortness of Breath | 536 | ||
| Palpitations | 536 | ||
| Dizziness | 536 | ||
| Fatigue | 536 | ||
| Evaluation | 537 | ||
| Summary | 537 | ||
| 17 - Interventions for acute cardiopulmonary conditions | 539 | ||
| Airway Clearance Techniques | 540 | ||
| Postural Drainage | 541 | ||
| Percussion | 543 | ||
| Vibration | 544 | ||
| Cough Techniques and Assists | 544 | ||
| Active Cycle of Breathing | 545 | ||
| Mechanical Aids for Coughing | 546 | ||
| Manual Hyperinflation and Airway Suctioning | 546 | ||
| Breathing Strategies, Positioning, and Facilitation | 547 | ||
| Therapeutic Positioning Techniques and Ventilatory Movement Strategies | 547 | ||
| Positioning for Dyspnea Relief | 549 | ||
| Breathing Exercises | 549 | ||
| Pursed-Lip Breathing | 549 | ||
| Paced Breathing | 550 | ||
| Inspiratory Hold Technique | 550 | ||
| Stacked Breathing | 550 | ||
| Diaphragmatic Controlled Breathing | 550 | ||
| Lateral Costal Breathing | 551 | ||
| Upper Chest Inhibiting Technique | 551 | ||
| Thoracic Mobilization Techniques | 552 | ||
| Counterrotation | 552 | ||
| Butterfly | 552 | ||
| Inspiratory Muscle Training | 552 | ||
| Special Considerations for Mechanically Ventilated Patients | 554 | ||
| Weaning Criteria | 554 | ||
| Methods of Weaning | 555 | ||
| Assessing Consciousness and Delirium in the Intensive Care Unit | 555 | ||
| Intervention Considerations | 555 | ||
| Exercise | 557 | ||
| Components of Exercise: Intensity, Duration, Frequency, and Modes | 558 | ||
| Intensity | 558 | ||
| Duration | 559 | ||
| Frequency | 559 | ||
| Modes of Exercise | 559 | ||
| Functional Mobility Training | 559 | ||
| Bed Mobility | 559 | ||
| Transfers and Ambulation | 560 | ||
| Injury Prevention and Equipment Provision | 560 | ||
| Patient Education | 561 | ||
| Discharge Planning | 562 | ||
| Pediatric Considerations | 562 | ||
| Summary | 565 | ||
| 18 - Interventions and prevention measures for individuals with cardiovascular disease, or risk of disease | 568 | ||
| Primary Prevention | 569 | ||
| Rehabilitation of Patients with Documented Cardiovascular Disease | 570 | ||
| Patient Populations | 570 | ||
| Rehabilitation Programs | 570 | ||
| The Beginning in Acute Care | 571 | ||
| Management and Evaluation of Patients during the Acute Phase | 572 | ||
| Initial Assessment/Examination | 572 | ||
| Activity Program Guidelines | 573 | ||
| Indications for an Unmodified Program | 573 | ||
| Indications for a Modified Program | 573 | ||
| Indications for Withholding a Program | 573 | ||
| General Precautions | 573 | ||
| Relative Contraindications to Continuing Exercise | 574 | ||
| Other Components of the Acute Phase | 574 | ||
| Diet and Nutrition | 574 | ||
| Psychological and Behavioral Rehabilitation | 575 | ||
| Outcome Measures | 575 | ||
| Discharge Planning | 575 | ||
| Postacute Phase Rehabilitation | 576 | ||
| Candidacy | 576 | ||
| Home-Based Cardiac Rehabilitation | 576 | ||
| Rehabilitation/Secondary Prevention in the Outpatient Setting | 577 | ||
| The Rehabilitation Team | 577 | ||
| Program Components | 577 | ||
| Efficacy of Cardiac Rehabilitation | 577 | ||
| Initial Assessment | 578 | ||
| General Management Strategies | 579 | ||
| Interventions | 580 | ||
| Therapeutic Exercise | 580 | ||
| Exercise Training and Effects of Training | 581 | ||
| Components of the Exercise Prescription for Aerobic Training | 581 | ||
| Intensity | 581 | ||
| Establishing a training heart rate by rating of perceived exertion | 582 | ||
| Establishing training heart rates using signs and symptoms | 583 | ||
| Mode | 583 | ||
| Continuous aerobic training | 583 | ||
| Higher intensity or aerobic interval training | 583 | ||
| Four- versus two-extremity exercise | 584 | ||
| Frequency and duration of exercise | 584 | ||
| Resistance exercise training | 585 | ||
| Circuit Training | 586 | ||
| Flexibility Programs | 586 | ||
| Program Progression | 586 | ||
| Other Considerations in Planning Exercise Programs | 587 | ||
| Altitude | 587 | ||
| Cold | 587 | ||
| Heat and humidity | 587 | ||
| Secondary Prevention: Management of Risk Factors | 588 | ||
| Early Intervention | 588 | ||
| The Outpatient Setting | 588 | ||
| Diet and Nutrition | 588 | ||
| Weight Loss | 589 | ||
| Psychosocial Recovery | 589 | ||
| Compliance | 591 | ||
| Outcome Measurement | 592 | ||
| Follow-up Assessment | 592 | ||
| Criteria for Discharge | 592 | ||
| Special Patient Populations | 593 | ||
| Patients with Peripheral Arterial Disease | 593 | ||
| Patients with Heart Failure | 594 | ||
| Patients with Chronic Obstructive Pulmonary Disease | 594 | ||
| Patients with Diabetes Mellitus | 595 | ||
| Patients Who Have Had a Cerebrovascular Accident | 595 | ||
| Patients with Renal Disease | 596 | ||
| Heart Disease and Women | 596 | ||
| Pediatric Programs | 596 | ||
| The Elderly Coronary Patient | 597 | ||
| Administrative Considerations | 597 | ||
| Safety in the Outpatient Cardiac Rehabilitation Setting | 597 | ||
| Facility Concerns | 597 | ||
| Records and Documentation | 598 | ||
| Medical and Legal Considerations | 599 | ||
| Charges to Patients and Third-Party Carriers | 599 | ||
| Summary | 601 | ||
| 19 - Pulmonary rehabilitation | 605 | ||
| Choosing Goals and Outcomes in Pulmonary Rehabilitation | 606 | ||
| Structure of the Pulmonary Rehabilitation Program | 606 | ||
| The Pulmonary Rehabilitation Team | 606 | ||
| The Patient and Family | 607 | ||
| The Medical Director | 607 | ||
| The Program Director | 607 | ||
| Other Team Members | 607 | ||
| Program Components | 607 | ||
| Patient Assessment and Goal Setting | 607 | ||
| Exercise and Functional Training | 608 | ||
| Self-Management Education | 608 | ||
| Nutritional Assessment and Intervention | 608 | ||
| Psychosocial Evaluation and Plan of Care | 609 | ||
| Patient Candidacy | 609 | ||
| Physical Therapy Management | 609 | ||
| Patient Evaluation Procedures | 610 | ||
| Chart Review | 610 | ||
| Patient Interview | 610 | ||
| Patient Examination | 610 | ||
| Treatment Intervention | 611 | ||
| Airway Clearance | 611 | ||
| Functional Training | 612 | ||
| Energy Conservation | 612 | ||
| Relief of Dyspnea | 612 | ||
| Breathing Retraining | 612 | ||
| Oxygen Evaluation and Use | 613 | ||
| Physical Conditioning | 615 | ||
| Endurance Training | 616 | ||
| Frequency and Duration of Exercise | 616 | ||
| Modes of Exercise | 616 | ||
| Intensity of Exercise | 616 | ||
| Upper and Lower Extremity Training | 617 | ||
| Strength Training | 617 | ||
| Flexibility | 618 | ||
| Respiratory Muscle Exercise | 618 | ||
| Exercise Considerations for Different Stages of Lung Diseases | 619 | ||
| Patients with Mild Lung Disease | 619 | ||
| Patients with Moderate Lung Disease | 619 | ||
| Patients with Severe Lung Disease | 620 | ||
| Summary | 621 | ||
| 20 - Pediatric cardiopulmonary physical therapy | 626 | ||
| Respiratory System Development | 626 | ||
| Cardiac Development | 627 | ||
| Congenital Heart Defects | 629 | ||
| Acyanotic Lesions | 629 | ||
| Atrial Septal Defects | 629 | ||
| Patent Ductus Arteriosus | 629 | ||
| Ventricular Septal Defect | 630 | ||
| Atrioventricular Septal Defects | 630 | ||
| Coarctation of Aorta | 631 | ||
| Cyanotic Lesions | 631 | ||
| Tetralogy of Fallot | 631 | ||
| Hypoplastic Left-Heart Syndrome | 631 | ||
| Transposition of the Great Arteries | 631 | ||
| Tricuspid Atresia | 631 | ||
| Pulmonary Atresia | 631 | ||
| Truncus Arteriosus | 632 | ||
| Total Anomalous Pulmonary Venous Return | 632 | ||
| Respiratory Conditions of Infancy | 632 | ||
| Prematurity (Born Before 37 Weeks’ Gestation) | 632 | ||
| Persistent Pulmonary Hypertension | 632 | ||
| Respiratory Distress Syndrome | 633 | ||
| Sudden Infant Death Syndrome | 633 | ||
| Meconium Aspiration Syndrome | 633 | ||
| Bronchopulmonary Dysplasia | 634 | ||
| Cystic Fibrosis | 634 | ||
| Primary Ciliary Dyskinesia | 635 | ||
| Pediatric Conditions with Secondary Cardiopulmonary Issues | 635 | ||
| Down Syndrome | 635 | ||
| DiGeorge Syndrome | 635 | ||
| VATER Association | 635 | ||
| Marfan Syndrome | 635 | ||
| Williams Syndrome | 635 | ||
| Arthrogryposis Multiplex Congenita | 636 | ||
| Fetal Alcohol Syndrome | 636 | ||
| Pediatric Conditions with Decreased Activity Levels and/or Altered Posture | 636 | ||
| Cerebral Palsy | 636 | ||
| Spina Bifida | 638 | ||
| Duchenne Muscular Dystrophy | 638 | ||
| Spinal Muscular Atrophy | 638 | ||
| Physical Therapy Examination | 638 | ||
| Physical Therapy Evaluation, Diagnosis, and Prognosis | 642 | ||
| Physical Therapy Intervention | 642 | ||
| Rib Cage Mobility | 642 | ||
| Flexibility | 642 | ||
| Strength | 643 | ||
| Posture | 643 | ||
| Breathing Pattern | 644 | ||
| Airway Clearance Techniques | 644 | ||
| High-Frequency Chest Wall Oscillation | 644 | ||
| Positive Expiratory Pressure | 644 | ||
| Blow Toys | 645 | ||
| Huffing | 645 | ||
| Assisted Cough | 645 | ||
| Choosing the Most Appropriate Airway Clearance Technique | 645 | ||
| Functional Mobility | 645 | ||
| Cardiovascular/Endurance Training | 646 | ||
| Treatment in the Early Intervention Setting | 647 | ||
| Summary | 648 | ||
| 21 - The lymphatic system | 650 | ||
| Anatomy and Physiology | 651 | ||
| Pathophysiology | 655 | ||
| Excess Weight Is Risk Factor for Lymphedema | 656 | ||
| The Role of the Lymphatic System in the Cardiovascular System and in Cardiovascular Disease | 656 | ||
| Medical Management | 657 | ||
| Diagnosis | 658 | ||
| Treatment | 659 | ||
| Medications | 660 | ||
| Surgery | 661 | ||
| Intermittent Pneumatic Compression | 662 | ||
| Thermal Therapy | 662 | ||
| Conservative Methods | 663 | ||
| Components of Complete Decongestive Therapy | 663 | ||
| Manual Lymph Drainage | 663 | ||
| Compression | 664 | ||
| Exercise | 667 | ||
| Meticulous Skin Care | 668 | ||
| Lipedema | 668 | ||
| Clinical Manifestations and Differential Diagnosis | 668 | ||
| Combination Forms of Lipedema and Lymphedema | 669 | ||
| Treatment of Lipedema | 669 | ||
| Conservative Methods | 669 | ||
| Surgical Methods | 669 | ||
| Lipedema Education of the Public, Patients, and Health Care Providers | 670 | ||
| Summary | 670 | ||
| 22 - Outcome measures: A guide for the evidence-based practice of cardiopulmonary physical therapy | 674 | ||
| Outcomes Defined | 675 | ||
| Psychometric Properties | 676 | ||
| Intended Population | 676 | ||
| Validity | 676 | ||
| Reliability | 677 | ||
| Responsiveness/Sensitivity to Change | 677 | ||
| Minimal Detectable Change | 677 | ||
| Minimally Clinically Important Difference (MCID) | 677 | ||
| Importance of Measuring Outcomes | 677 | ||
| Selection of Data to Measure | 678 | ||
| Biologic/Physiologic Variables | 680 | ||
| Vital Signs | 680 | ||
| Ankle–Brachial Index | 680 | ||
| Pulmonary Function Tests | 683 | ||
| Graded Exercise Stress Test | 683 | ||
| Functional Performance | 683 | ||
| Seated Step and Chair Rise Tests | 687 | ||
| The 2-Minute Step Test | 688 | ||
| The 6-Minute Walk Test | 688 | ||
| The Modified Shuttle Test | 689 | ||
| Functional Performance Measures | 690 | ||
| The Timed Up and Go Test Measures | 690 | ||
| Gait Speed | 690 | ||
| Perme Intensive Care Unit Mobility Score | 691 | ||
| Index | 703 | ||
| Numbers | 703 | ||
| A | 703 | ||
| B | 705 | ||
| C | 705 | ||
| D | 711 | ||
| E | 711 | ||
| F | 713 | ||
| G | 713 | ||
| H | 713 | ||
| I | 714 | ||
| J | 715 | ||
| K | 715 | ||
| L | 715 | ||
| M | 716 | ||
| N | 717 | ||
| O | 717 | ||
| P | 718 | ||
| Q | 721 | ||
| R | 721 | ||
| S | 722 | ||
| T | 723 | ||
| U | 724 | ||
| V | 724 | ||
| W | 725 | ||
| X | 725 | ||
| Z | 725 |