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KIN 335 > Chapter 24 - Physical Activity at Medium and High Altitude > Flashcards

Chapter 24 - Physical Activity at Medium and High Altitude Flashcards

1
Q

What are the effects of being at near sea-level altitude?

A

No Effects On:
- Well-being
- Performance

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2
Q

What is considered near sea-level altitude?

A
  • Below 500m
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3
Q

What is considered low altitude?

A
  • 500-2000m
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4
Q

What are the effects of low altitude/

A
  • No effect on well-being
  • Performance may be diminished
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5
Q

At what level of low altitude might athletes performance be diminished?

A
  • above 1500m
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6
Q

How might performance decrements seen in low-altitude be overcome?

A
  • Acclimatization
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7
Q

What level is moderate altitude?

A
  • 2000m-3000m
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8
Q

What effects are seen at moderate altitudes?

A
  • Well-being effects on unacclimated individuals
  • Decreased maximal aerobic capacity and performance
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9
Q

Can optimal performance at moderate altitude be restored?

A
  • may or may not be restored with acclimatization
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10
Q

What level is considered high altitude?

A
  • 3000-5500m
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11
Q

What are the effects of high altitude?

A
  • Adverse health effects in most individuals
  • Significant performance decrements even with full acclimatization
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12
Q

What does the physiologic challenges at high altitude come from?

A
  • decreased ambient partial pressure of oxygen (Po2)
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13
Q

What does the oxygen transport cascade refer to?

A
  • Progressive changes in the environment’s O2 pressure and body areas
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14
Q

What does the oxygen transport cascade represent?

A
  • Oxygen cascade at different elevations
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15
Q

What must air that we inspire be?

A
  • Warmed and humidified
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16
Q

What is the partial pressure of water at body temperature?

A
  • 47mmHg
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17
Q

What does alveolar Po2 determine by?

A
  • The removal of O2 into the pulmonary capillary blood and the addition of O2 from ventilation
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18
Q

What is the slight decrease in Po2 between alveolar air and arterial blood?

A
  • 5mmHg
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19
Q

What is the Po2 of 40mmHg in mixed-venous blood due to?

A
  • Tissue oxygen use
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20
Q

What are some possible well-being effects at 1500m?

A
  • Lightheadedness
  • Headaches
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21
Q

What are some possible well-being effects at 3000m?

A
  • Insomnia
  • Nausea
  • Vomitting
  • Pulmonary Discomfort
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22
Q

What are some possible well-being effects at 4000m?

A
  • Dyspnea
  • Anorexia
  • GI disturbances
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23
Q

What are some possible well-being effects at 6000m?

A
  • Lethargy
  • General Weakness
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24
Q

What are some possible well-being effects at 8000m?

A
  • Impending collapse
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25
Q

How much does air temperature decrease with ascent?

A
  • About 1C per 150m
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26
Q

What is the average temperature near the summit of Mount Everest?

A

-40C

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27
Q

What poses a serious risk of cold-related disorders at altitude?

A
  • Low temperature
  • Low ambient water vapor pressure
  • High winds
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28
Q

How does the extremely low partial pressure of water at high altitude lead to dehydration?

A
  • Evaporation of moisture from skin surface due to the large gradient between skin and air
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29
Q

At what point would there be a significant change in hemoglobin percent saturation with O2?

A
  • approx 3000m
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30
Q

What happens to hemoglobin oxygenation when you transition from moderate to higher altitudes?

A
  • Dramatic decrease
  • Negative affect on mild-intensity aerobic exercise
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31
Q

Define Acclimatization

A
  • Refers to adaptations produced by changes in the natural environment, whether through a change in season or place of residence.
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32
Q

Define Acclimation

A
  • Adaptations produced in a controlled laboratory environment
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33
Q

What does altitude acclimatization describe?

A
  • adaptive responses in physiology and metabolism that improve tolerance to altitude hypoxia
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34
Q

What is the response to immediate exposure of elevations >2300m?

A
  • Rapid physiologic adjustments to compensate for thinner air and the accompanying reduction in alveolar PO2
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35
Q

What are some important immediate adjustments made in response to elevations above 2300m?

A

Increase
- respiratory drive to produce hyperventilation
- Blood flow during rest and submaximal exercise

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36
Q

What does hyperventilation from reduced arterial Po2 reflect?

A
  • Significant immediate response to native low-landers to altitude exposure
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37
Q

What does a hyperventilation response to high altitudes do?

A
  • Hypoxic drive increases
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38
Q

When does an increase in hypoxic drive increase? How long does it remain elevated?

A

When
- First few weeks
How Long
- A year or longer during prolonged exposure

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39
Q

What happens to resting blood pressure in early stages of altitude adaptation?

A
  • Increases
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40
Q

What happens to submaximal exercise heart rate and cardiac output in altitude?

A
  • Rises to 50% above sea level values
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41
Q

What happens to stroke volume at submaximal exercise in altitude?

A
  • Remains unchanged
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42
Q

What compensates for arterial desaturation at altitude?

A
  • Increased submaximal exercise blood flow
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43
Q

What happens to the sympathoadrenal activity during rest and exercise with altitude?

A
  • Progressively increases over time
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44
Q

What coincides with increased blood pressure and heart rate at altitude?

A

A steady rise in:
- Plasma levels
- Excretion rates of epinephrine

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45
Q

What does an increased sympathoadrenal activity in altitude contribute to?

A

Regulation of:
- Blood pressure
- Vascular resistance
- Substrate mixture during short- and long-term hypobaric exposure

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46
Q

Sketch the Catecholamine Response of Altitude?

A
  • Check Notes
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47
Q

Sketch the Comparison of O2 Cost and Relative Strenuousness of submaximal exercise at sea level and altitude

A
  • Check Notes
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48
Q

Sketch the comparison of cardiorespiratory and metabolic responses during exercise at Sea Level and Altitude

A
  • Check Notes
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49
Q

What allows body water to evaporate as inspired air becomes warmed and moistened in respiratory passages?

A
  • Ambient air in mountainous regions remains cool and dry
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50
Q

What leads to moderate dehydration and accompanying dryness of lips, mouth, and throat at high altitudes?

A
  • Fluid loss
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51
Q

When does fluid loss become pronounced at high altitudes? Why?

A

When
- physically active people
Why
- large daily total sweat loss
- Exercise pulmonary ventilation

52
Q

Sketch the response to altitude of sensory functions

A
  • Check Notes
53
Q

What are the immediate pulmonary acid-base responses to altitude?

A
  • Hyperventilation
  • Bodily Fluids become more alkaline due to reduction in carbon dioxide with hyperventilation
54
Q

What are the longer-term pulmonary acid-base responses to altitude?

A
  • Hyperventilation
  • Excretion of base (HCO3-) via the kidneys and concomitant reduction in alkaline reserve
55
Q

What are the immediate cardiovascular responses to altitude?

A

Increase
- submax HR
- submax Cardiac Output
Same or Slight Decrease
- Max Cardiac Output
- Stroke Volume

56
Q

What are the longer-term cardiovascular responses to altitude?

A
  • Submax HR elevated
  • Submax Cardiac Output below sea-level
  • Stroke Volume Decreases
  • Max Cardiac Output decreases
57
Q

What are the longer-term hematological responses to altitude?

A

Decreased
- Plasma Volume
Increased
- Hematocrit
- Hemoglobin Concentration
- Total # Red blood cells

58
Q

What are the longer-term local responses to altitude?

A

Increased
- capillarization of skeletal muscle
- Red blood cell 2,3-DPG
- Mitochondria Density
- Aerobic Enzymes in Muscles
- Loss of body weight/lean body mass

59
Q

how does the effect of hyperventilation at altitude to increase alveolar PO2 relate to the bodies CO2 level?

A
  • Opposite Effect
60
Q

What does carbon dioxide loss from fluids in the body create?

A
  • Physiologic disequilibrium
61
Q

How does the body manage the disequilibrium created by the carbon dioxide loss from fluids at altitude?

A
  • Produces CO2 via the action of carbonic anhydrase
62
Q

What does the high level of carbonic anhydrase activity do?

A
  • decreases H+ in the blood
  • Makes body fluids more alkaline
63
Q

How does the body control ventilatory-induced alkalosis?

A

Very Slowly
- kidneys excrete base (HCO3-) through the renal tubules

64
Q

What does the control of ventilatory-induced alkalosis by the kidneys through the renal tubules do?

A

Restores normal pH

65
Q

What happens when the pH is restored by the kidneys following ventilatory-induced alkalosis?

A
  • Increases the respiratory center’s responsiveness to enable an even greater hyperventilation response
66
Q

What does establishing acid-base equilibrium with acclimatization occur at the expense of?

A
  • Loss in absolute alkaline reserves
67
Q

What happens to blood lactate concentrations during submaximal exercise on immediate ascent to altitude compared to sea-level values?

A
  • Increased
68
Q

What is an explanation for the increases in blood lactate accumulation during submax exercise during immediate ascent to altitude?

A
  • Increased reliance on anaerobic metabolism
69
Q

What happens following several weeks of altitude exposure at the same submaximal and maximal intensity exercises?

A
  • Large muscle groups produce lower blood lactate levels
70
Q

What does lower blood lactate levels at the same submax or max intensity following several weeks of altitude exposure occur despite of?

A
  • Lack of increase in VO2max or regional blood flow in active tissues
71
Q

Where does research point to involving the lactate paradox?

A
  • Reduced output of epinephrine (during exercise)
  • Its controversial
72
Q

What does epinephrine do for glucose?

A
  • Mobilizes hormone
73
Q

What reduces the capacity for lactate formation?

A
  • Reduced glucose mobilization
74
Q

What might reduced lactate formation during maximal exercise at high altitudes partly reflect?

A
  • Reduced CNS drive
75
Q

What does a reduced CNS drive do?

A
  • Reduces capacity for all-out effort
76
Q

What is the most important longer-term adjustment to altitude exposure?

A
  • Increase in blood’s oxygen-carrying capacity
77
Q

What two factors account for the adaptation of increased blood oxygen-carrying capacity?

A
  • Initial decrease in plasma volume
  • Increase in erythrocytes and hemoglobin synthesis
78
Q

What happens to the body fluid in the first several days of altitude exposure?

A
  • Shifts from the intravascular space to the interstitial and intracellular space
79
Q

What does the decrease in plasma volume that occurs within several hours of altitude exposure do?

A
  • Increases red blood cell concentration
80
Q

What happens after a week at 2300m regarding plasma volume?

A
  • Declines about 8%
81
Q

What happens after a week at 2300m regarding red blood cell concentration and hemoglobin?

A

Red Blood Cell Concentration
- Increases 4%
Hemoglobin
- Increases 10%

82
Q

What does the rapid plasma volume reduction do compared to the arrival at altitude values?

A
  • increases the oxygen content of arterial blood
83
Q

Define Diuresis

A
  • Increased urine output that accompanies the fluid shift from plasma during acclimatization
84
Q

What does diuresis do?

A
  • Maintains balance in the fluid compartments despite a lower total body water content
85
Q

What does a reduced arterial Po2 at altitude stimulate?

A
  • Increase in total number of red blood cells, or polycythemia
86
Q

What initiates red blood cell formation?

A
  • Erythropoietin
87
Q

How quickly does the initiation of red blood cell formation from erythropoietin occur?

A
  • within 15 hours after altitude ascent
88
Q

Where does erythrocyte get produced?

A
  • The marrow of the long bones
89
Q

What happens to erythrocyte production during prolonged altitude stay?

A
  • Remains elevated
90
Q

What is seen in some healthy high-altitude natives?

A
  • High red blood cell count compared to native lowlanders
91
Q

What does the blood of a typical miner in the Andes contain?

A
  • 38% more erythrocytes than lowlanders
92
Q

What happens to well-acclimatized mountaineers’ blood carry?

A
  • More oxygen per deciliter than lowland residents
93
Q

What is the result of increased hemoglobin concentration?

A
  • Even with reduced hemoglobin oxygen saturation at altitude, the quantity of oxygen in arterial blood may approach or even equal sea-level values
94
Q

What can chronic hypoxia do?

A
  • Initiate remodeling of capillary diameter and length
95
Q

How does chronic hypoxia’s initiation of remodeling of capillary diameter and length?

A
  • formation of new capillaries
96
Q

What does the formation of new capillaries due to chronic hypoxia do?

A
  • Increase oxygen conductance to neural tissues
97
Q

What do human residents of sea level also increase during an altitude stay?

A
  • Increase tissue capillarization
98
Q

What reduces the oxygen diffusion distance between blood and tissues? What does it do?

A

What
- Prolific Microcirculation
Do
- Optimizes tissue oxygenation at altitude when arterial PO2 decreases

99
Q

What do muscle biopsy specimens from humans living at altitude indicate?

A
  • Myoglobin increases up to 16% after acclimatization
100
Q

What does additional myoglobin do?

A
  • augments oxygen “storage” in specific fibers
  • Facilitates intracellular oxygen release and delivery at a low-tissue PO2
101
Q

What does the increased concentration of red blood cell 2,3-Diphosphoglycerate (2,3-DPG) facilitate?

A
  • Oxygen release from hemoglobin in long-term altitude exposure
102
Q

Sketch the Oxygen-Hemoglobin Dissociation Curve

A
  • Check Notes
103
Q

What does prolonged high-altitude exposure do to lean body mass and body fat?

A
  • Reduction
104
Q

What does daily caloric intake from depressed appetite decrease by during the exposure period?

A
  • 43%
105
Q

By how much did reduced energy intake reduce body mass? What is this predominantly from?

A

How much
- 7.4kg
from
- muscle component of fat-free body mass

106
Q

What does time required for acclimatization depend on?

A
  • Elevation
107
Q

Does acclimatization to one altitude ensure acclimatization to higher elevations?

A
  • Only partial adjustments
108
Q

How long does it take to adapt to altitude up to 2300m?

A
  • approx 2 weeks
109
Q

What is the acclimatization rate after the initial 2 weeks for 2300m?

A
  • 610m every week
110
Q

When do small declines in VO2max become noticeable?

A
  • 589m
111
Q

What is the rate of decrease in VO2max due to arterial desaturation?

A
  • 7-9% per 1000m
  • Altitudes up to 6300m
112
Q

When does the rate of VO2max decrease drastically?

A
  • above 6300m
113
Q

What does VO2max average at 7000m?

A
  • one half that at sea level
114
Q

Why might there be small improvements in endurance during acclimatization, despite lack of concomitant increases in VO2max?

A
  • Increase in minute ventilation
  • Increase arterial oxygen saturation/cellular aerobic functions
  • Blunted blood lactate responses
115
Q

What happens to VO2max after several months of acclimatization despite relatively rapid increases in hemoglobin concentration?

A
  • Remains below sea-level values
116
Q

What offsets the hematologic benefits of acclimatization?

A
  • Lower max HR
  • Decreased Stroke Volume
117
Q

What increases submaximal cardiac output at altitude?

A
  • immediate response to physical activity
118
Q

What happens to increases in submax cardiac output as acclimatization progresses?

A
  • Diminishes
  • Does not improve with prolonged exposure
119
Q

What happens to progressive decreases in stroke volume during altitude?

A
  • Stays reduced
120
Q

What happens with lower cardiac output at high altitudes?

A
  • Submax oxygen consumption remains stable through expanded a-vO2diff
121
Q

When does maximum cardiac output decrease? what happens after?

A
  • after 1 week above 3048m
  • Remains lower throughout stay
122
Q

What is the reduced blood flow in high altitude a combined effect of?

A
  • Decreased plasma volume (reduced stroke volume)
  • Increase in parasympathetic tone
123
Q

What is the increase in parasympathetic tone at high altitude induced by?

A
  • prolonged altitude exposure reduces maximum heart rate
124
Q

When doesnt sea-level exercise performance improve after living at altitude?

A
  • When VO2max serves as improvement criterion
125
Q

What effects of high altitude acclimatization do not enhance sea-level performance?

A
  • Residual muscle mass loss
  • Reduced max HR and SV
  • Reduced Max Q
126
Q

Why do increases in the blood’s oxygen-carrying capacity not necessarily increase sea-level performance?

A
  • Reductions in Maximum Cardiac Output

KIN 335 (12 decks)

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