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Chapter 11. Cardiovascular Physical Therapy

In states with direct access, examination and intervention procedures are being performed by physical therapists in all phases of cardiopulmonary rehabilitation.

Given the importance of the cardiopulmonary system to overall health and function, the examination of this system should be an integral component of every patient profile. Thus, every physical therapist should have, at a minimum, the knowledge and skills to be competent in cardiopulmonary care.1

Anatomy and Physiology of Blood

Blood is a circulating tissue composed of several cells called corpuscles (Table 11-1), which constitute about 45% of whole blood. The other 55% is blood plasma, a yellowish fluid that is the blood's liquid medium. The functions of blood cells include:

  • To supply nutrients (eg, oxygen, glucose) and constitutional elements to tissues and to remove waste products (eg, carbon dioxide, lactic acid)—main function.
  • To enable cells (eg, leukocytes, abnormal tumor cells) and different substances (eg, amino acids, lipids, hormones) to be transported between tissues and organs.

Table 11-1. Blood Corpuscles
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Table 11-1. Blood Corpuscles

Red blood cells or erythrocytes (96%)

In mammals, these biconcave disk-shaped corpuscles lack a nucleus and organelles, so are not cells strictly speaking. They contain the blood's hemoglobin and distribute oxygen.

The red blood cells (together with endothelial vessel cells and some other cells) are also marked by proteins that define different blood types.

The combined surface area of all the erythrocytes in the human anatomy would be roughly 2000 times as great as the body's exterior surface.

The outstanding characteristic of erythrocytes is the presence of the iron-containing protein hemoglobin (see Transport of Oxygen).

The percentage of total blood volume which is erythrocytes is called the hematocrit. The normal hematocrit level is approximately 45% in men and 42% in women.

White blood cells or leukocytes (3.0%)

Formed in the bone marrow and are part of the immune system (refer to chapter 5).

Thrombocytes (also known as platelets) (1.0%)

Metabolically active cell fragments that lack a nuclei, which have specific roles in the coagulation (blood clotting or hemostasis) process. They originate from large cells (megakaryocyte) in bone marrow.

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Study Pearl
  • The term cardiac (Greek kardia (καρδτα) for "heart") means "related to the heart"; eg, cardiology, the study of diseases of the heart.
  • Medical terms related to blood often begin in hemo- or hemato- (haemo- and haemato-) from the Greek word "haima" for "blood"; eg, hematology: the science encompassing the medical study of the blood and blood-producing organs.
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Study Pearl

The normal pH of human arterial blood is approximately 7.40 (normal range is 7.35-7.45).

Blood that has a pH below 7.35 is acidic, while blood pH above 7.45 is alkaline.

Blood pH along with paCO2 and HCO3 readings ...

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