Northern Arizona University
Physical Therapy Program
P.T. 630 - Cardiopulmonary Therapeutics
Fall Semester, 2004


I. GENERAL INFORMATION

A. Instructor : David Arnall, P.T., Ph.D., FACSM, E.S.

B. Scheduled Class Times :

Lecture :

  • Wednesday : 08:00 AM - 11:00 A.M. in room 132
  • Friday : 9:10 AM - 12:00 PM in room 120 or 126 or 332-333
  • Labs :

  • As Announced
  • C. Virtual Chat Room :

    Chatroom Schedule For Fall, 2004 will be PRN for PT 630


    II. COURSE DESCRIPTION : Cardiopulmonary Therapeutics is designed to familiarize the student with the physical therapy rehabilitation tools that are used to assist healthy and unhealthy individuals towards optimal health. The course will draw the student's attention to the growing role that Physical Therapists have in developing adult fitness/wellness programs. Since the American public is aging, often reaching their eighth and ninth decades before death, there is a great need to understand exercise prescription for a variety of special populations which in a growing number of geographical regions will include a large healthy elderly population. In addition, the number of men and women with heart disease is growing. Americans are increasing their risk of cardiac disease because they are becoming increasingly less active and more overweight. The course material is designed to familiarize you with the philosophies and practices of Phase I - IV cardiac rehabilitation programs for this diseased segment of the population. Also, the student will be introduced to basic EKG interpretation, and the need to understand the importance of electrocardiographic monitoring. You will be required to recognize normal EKGs as well as abnormal dysrhythmias associated with cardiopulmonary disease such as : atrial flutter, atrial fibrillation, primary, secondary (Mobitz I and Mobitz II) and tertiary atrioventricular blocks, ventricular tachycardia, ventricular fibrillation, asystole, as well as right and left bundle branch blocks. It will be necessary for you to understand the principles of exercise prescription and be able to organize a meaningful exercise program for a variety of patient populations. Patient populations of interest to Physical Therapists include : patients with arthritis, ankylosing spondylitis, the healthy elderly, the very old & frail elderly, type I and type II diabetes mellitus, stroke, chronic obstructive pulmonary disease (asthma and emphysema), chronic fatigue syndrome, pregnancy, cystic fibrosis, hypertension, osteoporosis, obesity, exercise-induced asthma, peripheral vascular disease, organ transplantation, renal disease, hyperlipidemia and cancer.


    III. COURSE OBJECTIVES : Upon successful completion of the course, the student will be able to :

    1. Create a comprehensive medical history from the medical chart and from the patient, and family by interview techniques.
    2. Perform a basic cardiopulmonary physical evaluation of a patient using manual techniques and special tests such as administering an EKG and a pulmonary function test.
    3. Design an appropriate phase I cardiac rehabilitation treatment program for a patient who has had an uncomplicated myocardial infarction.
    4. Sight identify all major atrial and ventricular EKG dysrhythmias from videotape and EKG strip presentations and be able to formulate an emergency plan for patient rescue in dangerous and lethal dysrhythmias.
    5. Demonstrate the importance of patient and family education and its relationship to cardiac Phase I and II rehabilitation and explain how risk factor profiles can be modified.
    6. Design an appropriate Phase II and Phase III exercise program.
    7. Describe the key elements of an adult fitness assessment and be able to design a comprehensive exercise prescription for the average low risk healthy adult.
    8. Write an exercise prescription specifically addressing the intensity, frequency and duration of exercise for a variety of special populations who have special conditions or disease pathologies.
    9. Describe the Physical Therapist's role in the provision of preventative care through the development of an adult fitness program.
    10. Read the current journal literature and determine how the new findings might impact current practice.
    11. Demonstrate airway clearance techniques such as PD & P, assisted cough techniques, suctioning techniques, and the vibratory maneuver.
    12. Administer a pulmonary function test and interpret the results of that test.
    13. Perform a chest assessment on a patient using mediate percussion, auscultation, and other manual techniques to determine free motion of the thorax.
    14. Demonstrate the exercises used to strengthen respiratory musculature Ė pursed lip breathing, weighted chest and diaphragmatic exercise, and the use of an inspiratory breather trainer.
    15. Competantly auscultate the chest wall and identify all of the major lung sounds : crackles, rhonchi, wheezes, stridor, pleural friction rub, bronchophony, whispired pectoriloquy, egophony, vesicular breath sounds, bronchovesicular breath sounds and bronchial breath sounds.
    16. Demonstrate emergency rescue procedures for : airway obstruction and choking, bleeding, the unconscious patient, patients who are experiencing chest pain, shortness of breath, and myocardial infarction as demonstrated either by symptomatology or by abherrent rhythms on an EKG machine.
    17. Explain the use of a pulse oximeter and how pursed lip breathing and diaphragmatic breathing techniques may improve blood oxygen saturation.


    IV. TEXTBOOKS/SUPPLIES : THERE ARE THREE REQUIRED (MANDATORY) TEXTS FOR THIS COURSE.

    1. ECGs Interpretation Made Incredibly Easy, 2nd Edition, Springhouse Book Publishers, 2002 - ISBN # 1-58255-135-9.
    2. Guidelines For Exercise Testing and Prescription, 6th edition, The American College of Sports Medicine, Williams and Wilkins Publishers, 2000 - ISBN # 0-683-30355-4.
    3. Cardiopulmonary Physical Therapy, 2nd Edition, by Ellen Hillegass and Steve Sadowsky, Saunders Publishers, 2001 - ISBN # 0-7216-7288-4.

    STETHOSCOPES : You will be required to have your own stethoscope for this course as well as for your professional needs later on in practice. You will use it regularly for determining your patient's blood pressures, and for auscultating the patient's lungs. Flagstaff Uniform Shop has been very kind in offering a significantly reduced cost for a Sprague-Rappaport type stethoscope. If you will mention to the store owner that you are an NAU Physical Therapy student in Dr. Arnall's Cardiopulmonary Rehabilitation course, you will receive a significant discount. The Flagstaff Uniform Shop is located at 102 West Hunt Avenue in Flagstaff. Their telephone number is 774-0711. Please see the map for where the Flagstaff Uniform Shop is located.


    V. EVALUATION METHODS :

  • Unit I Activity Assignment - EKG Identification - 20 points
  • Unit II Activity Assignment - Patient Exercise Prescriptions - 20 points
  • Unit III Activity Assignment - Interpreting Pulmonary Function Tests - 20 points
  • Quizzes - 20 points x 3 Web Quizzes = 60 points
  • Pop Quizzes - 10 points x 4 = 40 points
  • In Class Midterm Exam = 100 points
  • In Class Final Exam - 100 points
  • Professionalism Grade - 36 points
  • Total Number Of Points = 396 points

    A Grade Of "A" =
    100 % - 90 % =
    396 - 356 points
    A Grade Of "B" =
    80 % - 89 % =
    355 - 317 points
    A Grade Of "C" =
    70 % - 79 % =
    316 - 277 points

    NOTE : Quizzes and all exams will be comprehensive. The grade for this course is calculated on a straight percentage of the accumulated points earned.

    NOTE : Ten percent (10%) of the final grade in this class is subjectively based on professional behavior. Professional behavior is construed to mean : coming to class on time, respectful attention, attending to the lecture and refraining from studying for other classes during class time, being prepared to have active intellectual exchange in the class on assignments or lecture, notifying the professor ahead of time of an absence, and helping others in the class to feel that the classroom is a productive learning environment. Having classmates provide you with lecture notes because you were absent is abusive - it basically says that your classmates are here to keep you afloat at their expense. This is unreasonable and is unfair to those who made the effort to be present for the classroom materials.

    Information About The Web-Based Quizzes

    Some quizzes will be located on your website. In order to access them, you will need to come to the course syllabus and "click" on the flashing Quiz Button seen below.

    After clicking on that link, you will be taken to the quiz directory. Choose the quiz that you will be taking, click the link and the quiz will appear on your screen. You will then take the quiz by entering your choices for the correct answers by using the left hand click button on your mouse.

    IMPORTANT : At the bottom of the quiz, you will need to type in your name, your email address (make sure the email address is correct) and the name of the class - PT 630 - Cardiopulmonary Therapeutics. Before submitting your quiz, print out a copy of your answers as a safety precaution!!!

    Then "click" on the box that says "Submit Answers" and you will be finished with the quiz. The JAN computer will instantly grade your quiz and send me and you a copy of the score directly to our E-mail In-boxes. Sometimes, it takes time for the score to find its way to your in-box - BE PATIENT ! It may take several minutes to an entire afternoon to reach you. Please do not send and re-send copies of your answers - it clutters my in-box and the University Computer folks get upset.

    When you have completed the quiz, the mainframe computer will kick you back to the main web site for Cardiopulmonary Therapeutics. In order to make a successful transition to the main web page, you will be asked to input the "User name" (pt630) and the "Password" (stethoscope).

    Before you take this quiz, this is a reminder to you that all quizzes are to be taken on your honor without help from anybody in or out of the class or in the community, over the phone, or from any place or site. This quiz, as is the case for all web-based quizzes, should be taken without the aid of your notes or any textual material. This quiz is on your honor - a precious commodity to be aggressively protected in this crazy world.
    Thank you.

    Quiz Button

    An Additional Note : Successful completion of the Fronske Clinic experience is tied to a passing grade in this class as well as the other Therapeutics courses in the Physical Therapy Program. The student is expected to participate in each assigned Wednesday afternoon clinic activity, and satisfactory performance including demonstration of essential professional behaviors and psychomotor skill competency, is required to successfully complete this class.


    VI. University And Physical Therapy Program Course Policies

    A. Student Testing And Evaluation By Program Instructors

    Instructors will determine the type of evaluation instrument(s) to be used. All student evaluation information shall be determined by the instructor and may be forwarded to the Department Chair on request. The instructor will, within the first week of class, inform the students which items will comprise their course grade and their relative weights; e.g., course paper, 20%; attendance, 5%; written examinations 70%, etc., via a course syllabus. It is the individual faculty memberís prerogative to determine the grading scales and passing standards for the course. The course syllabus will state the criteria to be used to determine an acceptable performance and the assignment of grades. Please recognize the trust and confidentiality the faculty place in the students regarding exams. The exams are your confidential record only and should always be interpreted as such. Final exams will be given during the Northern Arizona University finals week. The instructor will submit the final grade to the Department Chair after the grade has been determined.

    B. Student Participation in Program Activities

    Students are encouraged to participate in Program and Professional Association activities. The Program is a strong supporter of the American Physical Therapy Association. Students will be given the opportunity to join and participate in their Professional Association. The Program also encourages students to participate in Arizona Physical Therapy Association activities at both the district and statewide levels. Activities are encouraged especially during October which is Physical Therapy Month and the time of the Fall Arizona Physical Therapy Association State meeting. The class representatives for the first year students will be selected by the Department Chair for the first Fall semester, unless the class chooses to elect representatives. The first year class should elect two class representatives no later than two weeks after the spring semester begins. New representatives will be elected thereafter unless the class chooses to reelect the current representative(s). The class representatives will serve as liaison between their class, the faculty and staff.

    C. Class Attendance

    Class attendance policy shall be at the discretion of the instructor. Where class attendance is essential for demonstration by the student of the degree of mastery of course materials, such attendance may be appropriately weighted in determining the studentís final grade. The instructor shall inform the students by the end of the first or second class period of his/her policy regarding class attendance including the specific importance of class attendance in establishing the final grade. Students are not required to justify their absences, but should inform the instructor of their absence as a professional courtesy, and are responsible for all materials given, both in their attendance and absences. It is important to understand that it is not the responsibility nor the expected behavior of your classmates that they should rescue you by sharing their class notes with you. As Doctoral level learners, please be aware that your actions should not place any burden on your classmates. It is expected, therefore, that you will make appointments for doctors visits, and for other reasons during times when you are free and not in class. More than 2 unexcused abscences from this class will result in a failing grade.

    D. Professional Behavior

    Entrance into the program of study in physical therapy at Northern Arizona University signifies a commitment to a doctoring profession, which entails a consistent demonstration of specific knowledge, skills and attitudes. Professional behaviors are a defining element of a doctoring profession. Thus, integration of professional behaviors is a key aspect of the professional socialization process, which begins in the educational program. The following professional behavior (adopted from objectives 1-6, and 8 of the APTA Clinical Performance Instrument) are expected of all doctoral physical therapy learners :

    • Practice in a safe manner that minimizes risk to the patient, self, and others.
    • Present themselves in a professional manner.
    • Demonstrate professional behavior during interactions with others.
    • Adhere to ethical and legal practice standards.
    • Communicate in ways that are congruent with situational needs.
    • Adapt delivery of physical therapy care to reflect respect for and sensitivity to individual differences.

    E. Plagiarism

    Plagiarism or any other form of cheating will result in a failing grade of "F". Class activities in which students may work together will be specifically announced. All other assignments are assumed to be work that you will complete under your own efforts.

    F. Classroom Management

    Membership in the academic community places a special obligation on all members to preserve an atmosphere conducive to a safe and positive learning environment. Part of that obligation implies the responsibilities of each member of the NAU community to maintain an environment in which the behavior of any individual is not disruptive. It is the responsibility of each student to behave in a manner which does not interrupt or disrupt the delivery of education by faculty members or receipt of education by students, within or outside the classroom. The determination of whether such interruption or disruption has occurred has to be made by the faculty member at the time the behavior occurs. It becomes the responsibility of the individual faculty member to maintain and enforce the standards of behavior acceptable to preserving an atmosphere for teaching and learning in accordance with University regulations and the course syllabus. At a minimum, students will be warned if their behavior is evaluated by the faculty member as disruptive. Serious disruptions, as determined by the faculty member, may result in immediate removal of the student from the instructional environment. Significant and/or continued violations may result in an administrative withdrawal from the class. Additional responses by the faculty member to disruptive behavior may include a range of actions from discussing the disruptive behavior with the student to referral to the appropriate academic unit and/or the Office of Student Life for administrative review, with a view to implement corrective action up to and including suspension or expulsion.


    It is important to remember that this is an evolving syllabus - i.e. - "The best laid plans of men and mice often go astray" - i.e. - the way the class evolves may be different than the projected time table below.

    DATES TO REMEMBER

    Unit I - EKG Interpretation and Cardiac Medications

    • September 01, 2004 - Wednesday - 08:00 AM - 11:00 PM - Take The Pre-Test & Lecture
    • September 03, 2004 - Friday - 09:10 AM - 12:00 PM - Lecture - EKG
    • Reading assignments for week # 1 : Chapter 1 in ECG Interpretation Made Incredibly Easy; Chapter 1 in Cardiopulmonary Physical Therapy

    • ***September 07, 2004 - Tuesday - 08:00 AM - 4:30 PM - Lecture - EKG - THIS IS A CHANGE OF SCHEDULE !!!
    • Classes normally held on Wednesday and Friday are being held this week on Tuesday, instead.
    • Reading assignment for Week # 2 : Chapter 2 & 3 in ECG Interpretation Made Inredibly Easy; Chapter 9 in Cardiopulmonary Physical Therapy.

    • September 15, 2004 - Wednesday - 08:00 AM - 11:00 AM - Lecture - EKG
    • September 17, 2004 - Friday - 09:10 AM - 12:00 PM - Lecture and Blood Pressure Lab - EKG
    • Reading assignment for week # 3 : Chapters 4 & 5 in ECG Interpretation Made Incredibly Easy; Chapter 9 in Cardiopulmonary Physical Therapy.

    • September 22, 2004 - Wednesday - 08:00 AM - 11:00 AM - Lecture - EKG
    • September 24, 2004 - Friday - 09:10 AM - 12:00 PM - Lecture
    • Reading assignment for week # 4 : Chapters 6 & 7 in ECG Interpretation Made Incredibly Easy.

    • September 30, 2004 - Thursday - 1:00 PM - 5:00 PM - Lecture - EKG Web Quiz # 1
    • October 01, 2004 - Friday - 09:10 AM - 10:30 AM - Lab (A - L) - 12-Lead EKG Lab
    • October 01, 2004 - Friday - 10:30 AM - 12:00 PM - Lab (M - Z) - 12-Lead EKG Lab
    • Reading assignment for week # 5 : Chapter 8 & 11 in ECG Interpretation Made Incredibly Easy; Chapter 9 in Cardiopulmonary Physical Therapy.

    • October 06, 2004 - Wednesday - 08:00 AM - 11:00 AM - Lecture -EKG
    • October 08, 2004 - Friday - 09:10 AM - 12:00 AM - No Classes - AzPTA Meeting
    • Reading assignment for week # 6 : Chapter 1 & 2 in the ACSM Guidelines.

    • October 11, 2004 - Monday - 1:00 PM - 5:00 PM - Elderhostel - ALL STUDENTS ARE EXPECTED TO BE HERE FOR THE FESTIVITIES.
    • October 15, 2004 - Friday - 09:10 AM - 12:00 PM - Glucometer and Percent Body Fat Labs
    • Reading assignment for week # 7 : Chapter 3 & 4 in the ACSM Guidelines; Chapter 8 in Cardiopulmonary Physical Therapy.
    • October 15, 2004 - Friday - EKG Identification Unit Assignment Due

    Unit II - Cardiac Rehabilitation - Exercise Prescription For Special Populations

    • October 20, 2004 - Wednesday - 08:00 AM - 11:00 AM - Take The In-Class Midterm Exam
    • October 22, 2004 - Friday - No Class - Southwest Chapter of the American College of Sports Medicine Meetings in Las Vegas, NV.

    • October 27, 2004 - Wednesday - 08:00 AM - 11:00 AM - Phase I-IV Cardiac Rehab & Benefits of Exercise & Profiling Risk For Individuals Who Wish To Exercise
    • October 29, 2004 - Friday - 09:10 AM - 12:00 PM- Lab - Submaximal Exercise Testing (1/2 the class) - Rm 332.
    • Reading assignment for week # 9 : Chapters 6 & 7 in ACSM Guidelines

    • November 03, 2004 - Wednesday - 08:00 AM - 11:00 AM - Lecture - Exercise Prescription for Special Populations (Chapters 7, 8, 9, & 10 in ACSM Guidelines)
    • November 05, 2004 - Friday - 09:10 AM - 12:00 PM - Lab - Submaximal Exercise Testing (1/2 the class) - Rm 332. Web Quiz # 2
    • Reading assignment for week # 10 : Chapters 8 & 9 in ACSM Guidelines

    • November 10, 2004 - Wednesday - 08:00 AM - 11:00 AM - Lecture - Exercise Prescription For Special Populations
    • November 12, 2004 - Friday - 09:10 AM - 12:00 PM - Lecture - Chest Assessment
    • Reading assignment for week # 11 : Chapters 10 & 11 in ACSM Guidelines

    • November 17, 2004 - Wednesday - 08:00 AM - 11:00 AM - Lecture - Cardiac Pharmacology
    • November 19, 2004 - Friday - 09:10 - 12:00 PM - Maximal Exercise Stress Lab (1/2 the class) meet in Exercise Science Lab - Rm 332.
    • Reading assignment for week # 12 : Chapters 10 & 14 in Cardiopulmonary Physical Therapy.
    • November 19, 2004 - Friday - Patient Exercise Prescription Assignment Due


    Unit III - Pulmonary Rehabilitation - Auscultation - Pulmonary Function

    • November 24, 2004 - Wednesday - No Classes for Thanksgiving Holiday
    • November 26, 2004 - Friday - No Classes for Thanksgiving Holiday
    • Reading assignment for week # 13 : Chapter 15 & 17 in Cardiopulmonary Physical Therapy.

    • December 01, 2004 - Wednesday - 08:00 AM - 12:00 AM Lecture - Pulmonary Function Tests Interpretation, Pulmonary Function Lab & PD & P.
    • December 03, 2004 - Friday - 09:00 AM - 12:00 PM - Maximal Exercise Stress Lab (1/2 the class) - Room 332. Web Quiz # 3
    • Reading assignment for week # 14 : Chapters 16 & 19 in Cardiopulmonary Physical Therapy

    • December 08, 2004 - Wednesday - 08:00 AM - 11:00 AM - Lecture - Lung Sounds
    • December 10, 2004 - Friday - 09:00 AM - 12:00 PM - PD & P Lecture and Lab
    • - December 10, 2004 - Friday - Pulmonary Function Interpretation Assignment Due
    • December 13-16, 2004 - Finals Week


    E-Mail Dave Arnall with any questions you may have about the course material.


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    Last Updated On : 27 August, 2004