Listen to Your Heart
This phase of cardiac rehabilitation is the inpatient, acute phase beginning in the hospital 2–5 days after the event, focused on early mobilization, low-level activity, and patient education before discharge.
What is Phase I (acute/inpatient cardiac rehabilitation)?
Phase II is the medically supervised outpatient (subacute) phase, typically starting ~1 month post-event and considered the most important phase; Phase III is long-term self-maintenance/independent conditioning (Bryant et al., Journal of Medical Systems, 2022).
Name the two types of injury to the Brain in TBI.
What is DIA and Contusion?
Contusion (bruising) and DAI; Immediate disruption of the axons due to acceleration-deceleration and rotational forces that cause shearing upon impact. White matter punctate petechial hemorrhages characteristic of DAI
On the 6–20 Borg Rating of Perceived Exertion scale, this is the numeric range that corresponds to moderate-intensity aerobic exercise (40%–59% of heart rate reserve).
What is 12 to 13?
Per the 2024 AHA/AACVPR core components statement, vigorous intensity is 14–17 on the Borg 6–20 scale (60%–89% of heart rate reserve). Clinicians should avoid age-predicted max HR equations or "resting HR + 20–30" because of wide discrepancies from measured values (Brown et al., 2024).
Epidural hematoma is commonly associated with skull fracture. Which bone and what is the associated vasculature?
What is the Temporal bone crossing vascular territory of the middle meningeal artery/veins?
(middle meningeal vein, diploic veins, or venous sinus)
Along with decompensated heart failure, high-grade arrhythmias, and active thromboembolic disease, this unstable ischemic syndrome is an absolute contraindication to initiating exercise training in cardiac rehab.
What is refractory/unstable angina?
The 2024 ESC chronic coronary syndrome guideline lists refractory/unstable angina, high-grade arrhythmias, decompensated HF, severe aortic
dilatation, and active thromboembolic disease as cardiac contraindications; unstable conditions must be stabilized before starting (Vrints et al., ESC, 2024).
Central to post-stroke and TBI neurorehabilitation, these are the two primary mechanisms of neural plasticity.
What is neuronal regeneration/collateral sprouting and functional reorganization?
1. Neuronal regeneration/neuronal collateral sprouting - Intact axons establish new connections, weeks-months post injury
2. Functional reorganization/unmasking neural reorganization - Healthy structures not formerly used for a given purpose are reassigned to do functions formerly done by lesioned area
During monitored exercise, a systolic BP this high, or a diastolic BP above 110 mm Hg, is a sign to stop or not exceed exertion.
What is a systolic blood pressure greater than 240 mm Hg?
Other stop/limit criteria in the AHA/AACVPR table include onset of angina, a high heart rate at which ischemia or instability appears, a plateau or drop in SBP, ≥1 mm horizontal/downsloping ST depression, increasing ventricular ectopy, and high-grade AV block (Brown et al., 2024).
These parts of the brain are responsible for conciousness
What is RAS and the Cerebral Cortex?
Arousal (Wakefulness): Mediated by the Reticular Activating System (RAS). A diffuse network of brainstem neurons (midbrain, pons, upper medulla) that projects through thalamic and extrathalamic pathways to activate the forebrain. Injury to the RAS directly causes loss of wakefulness/coma.
Awareness (Content of Consciousness): Mediated by the Cerebral Cortex (functionally integrated with subcortical networks and thalamocortical loops). Awareness encompasses perception, cognition, emotion, and purposeful interaction with the environment.
Lacking autonomic innervation, a cardiac transplant recipient initially relies on this intrinsic mechanical principle
What is the Frank-Starling law (or mechanism)?
For 500 Bonus points:
Name 3 of the hemodynamic changes you see in a denervated heart.
In patients in a persistent vegetative state (Unresponsive Wakefulness Syndrome),what are the common anatomical findings?
What are bilateral thalamic lesions (or bilateral thalamic damage)?
Impairment of consciousness requires either bilateral cortical dysfunction, diffuse cortical damage, or a focal brainstem lesion disrupting the RAS. Unilateral cortical lesions generally do not cause coma unless they exert significant mass effect/herniation onto the brainstem.
Large observational data show a dose–response benefit of cardiac rehab, with this approximate percentage reduction in mortality for each individual rehab session attended.
What is 1% to 2% per session?
Contemporary CR is remarkably safe — roughly one cardiac arrest per 1.3 million patient-hours of exercise. Meta-analytic data cite a number-needed-to-treat of ~75 to prevent one MI at 12 months and ~12 to prevent one hospital readmission (Thomas, New England Journal of Medicine, 2024).
Requiring patients to manipulate colored plastic shapes based on increasingly complex auditory instructions, this classic receptive language tool boasts over 90% sensitivity in distinguishing individuals with aphasia from those without.
What is a Token Test?
Minimal Intellectual & Visual Demands: By using simple geometric tokens (varying only by shape, size, and color), the test isolates auditory comprehension without relying on broad world knowledge or complex visual context.
Graded Complexity: Instructions range from simple commands ("Touch a red circle") to complex syntactic structures ("Before touching the yellow square, pick up the small red circle"), making it effective for catching mild aphasic deficits that standard bedside screens might miss.