17 Exercise and the CVS Flashcards

1
Q

What balance needs to be met in acute exercise?

A

increased VO2

maintained ABP

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2
Q

What are the responses produced in acute exercise?

A

metabolic vasodilation

increased CO to muscles

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3
Q

What causes metabolic dilation of blood vessels in acute exercise?

A
K+
H+
adenosine
ATP
Pi
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4
Q

What is the change in cardiac output to muscles in acute exercise?

A

1 L/min

to 22 L/min

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5
Q

What 3 factors determine rate of O2 transport and hence performane?

A

VO2 max
muscle perfusion
diffusion

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6
Q

What can be done to increase muscle perfusion?

A

vasodilation

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7
Q

What is VO2 max?

A

the rate of maximum O2 uptake from the air and/or the rate of maximum O2 use by mitochondria

these should be balanced

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8
Q

What is VO2 max dependent on?

A

max CO

haematocrit

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9
Q

what might the CO max of an athlete be?

A

25 L/min

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10
Q

What might the VO2 max of an untrained and trained person be?

A

3 L/min untrained

5 L/min trained

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11
Q

What might increase eccentric hypertrophy?

A

endurance training - growth factor release

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12
Q

What is eccentric hypertrophy?

A

new sarcomeres added in series, increasing muscle length and not width

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13
Q

What is the effect of eccentric hypertrophy on the heart?

A

increased chamber size
LV mass increase by 20%
increased contractility and inoropy of each myocyte

In a given pre-load we can produce a higher SV

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14
Q

What happens to the sarcomere in hypotension?

A

sarcomeres added in parallel

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15
Q

What is the significance of laplace’s law in eccentric hypertrophy?

A

the change in pressure generated would theoretically be less in the trained heart due to increased radius

however, this effect is outweighed by the increase in inotropy (and pre-load)

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16
Q

how does EDV increase in training?

A

increased chamber size

increased circulating blood volume

increased central venous pressure

17
Q

What is the effect of O2 demands being the same at rest for trained and untrained people?

A

trained people have a bigger SV

they hence have a decreased HR

18
Q

What 3 things causes a resting bradycardia?

A

increased tonic vagal activity
increased local ACh release
decreased intrinsic pacemaker activity

19
Q

What is enhanced respiratory sinus arrhythmia?

A

during inspiration, central inspiratory drive inhibits vagal activity, increasing HR

20
Q

What is the biggest factor for variability in HR?

21
Q

How might you increase cardiac perfusion?

A
increase in capillary number
increase capillary : fibre ratio
decreased diffusion distance
increased number of arterioles
increased coronary artery diameter
decreased vascular resistance
increased blood flow
22
Q

What does increased sheer result in?

A

upregulation of eNOS and antioxidant enzymes

increased bioavailability of NO, and vascular health

23
Q

What do antioxidant enzymes do?

A

maintain vascular health
they also quench NO, and reduce bioavailability of NOS

this is why we have to increase the release of NOS

24
Q

What intrinsic factors about the myocardium change with training?

A

increased mitochondria and myoglobin

25
What does training at altitude do?
stimulates Epo and increases performance back at sea level
26
Why is synthetic Epo detectable?
causes epigenetic changes which can be tested for
27
What are endothelial dysfunction and altered autonomic activity features of? how can we change this?
coronary artery disease HTN atherosclerosis training should improve this
28
what beneficial effects on the heart does training have?
eccentric hypertrophy | increase inotropy
29
Why is exercise helpful for CHF?
In CHF dilation of the ventricle, the pressure generated for a given tension is low
30
What 'other' benefits are associated with CVS rehab?
Better understanding of condition aids recovery encourages lifestyle changes reduces risk of further problems