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Applied Physiology > Cardiovascular Control During Exercise And Adaptations > Flashcards

Cardiovascular Control During Exercise And Adaptations Flashcards

1
Q

Neural Control of the CV System

A
  • Cerebral cortex (central command)
  • Cardiovascular control center (CVC)
  • Peripheral afferents
    • Baroreceptors
    • Chemoreceptors
    • Muscle Afferents
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2
Q

Cardiovascular Control Center

A
  • Cells in reticular formation of brain stem
  • Vasomotor center (4 areas)
    • Pressor Area – Increases BP (vascoconstriction)
    • Depressor Area – Decreases BP – Inhibits vasoconstriction and HR)
    • Cardioaccelerator center – Increases HR
    • Cardioinhibitory center – Decreases heart activity, Vagus N.
  • Exercise
    • Stimulates CVC Center
      • Increase HR
      • Increase Cardiac conduction
      • Increase impulse conduction
      • Vasoconstriction
    • Decreases parasympathetic influence
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3
Q

Stoke Volume and Cardiac Output

A
  • Stroke Volume
    • SV = EDV/ESV
      • EDV = Blood filling in diastole just before systole
      • ESV = Volume of blood at the end of systole (contraction)
    • SV= Volume blood ejected/contraction
  • Cardiac Output (Q)
    • Volume bloof pumped/min from L ventricle
    • Q = SV x HR
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4
Q

Ejection Fraction (EF)

A

Portion of blood pumped out of the left ventricle after each beat

EF = SV/EDV

Average is 60% at rest

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5
Q

Blood Pressure - Resting

A

In people 60 and older with no Diabetes and no CKD, Goal SBP <150 and Goal DBP <90

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6
Q

Blood Pressure

A
  • BP may range during exercise testing. Make a clinical decision on factors don’t automatically stop the test if you see these values.
    • >250mm Hg Systolic
    • >115 mm Hg Diastolic
  • Linear increase in Systolic BP with increased workloads (Same goes for HR)
    • Due to Increased cardiac output
    • ~10 mm Hg per MET
    • BP can be increase significantly during resistance training and pooing due to abdominal pressure.
      • Must be careful as massive release of blood back to the system can dislodge blood clots
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7
Q

BP and Exercise

A
  • Diastolic BP
    • Remains the same or will decrease slightly
    • Due to decrease in TPR (vasodialation)
  • Systolic BP
    • Linear increase with increase workloads
  • Post exercise response 
    • Decrease in systolic BP
    • Lower than pretest BP for several hours (12-18) based on duration and intensity
      • The more exercise the greater the effect
      • The higher the BP the lower the BP after exercise
        • Hypertension vs Normal
          • Hypertension drops more
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8
Q

Cardiac Medications

A
  • Medication and BP
    • Diuretics
      • Pee more
    • Beta Blocker
      • Slow Heart Rate
    • ACE inhibitor
      • Decreased reabsorption of NA and water
    • Ca+
      • Decreased reabsorption of NA and water?
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9
Q

Abnormal BP and Exercise

A
  • Decrease in systolic BP or failure to increase BP with increase workloads
  • Exercise-induced hypotension
    • CAD
    • Valvular heart disease
    • Cardiomyopathies
    • Arrhythmias
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10
Q

Hematocrit

A

Ratio of formed elements to total blood volume

Female: 35-47%

Male 42-52%

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11
Q

Cardiovascular Response to Acute Exercise

A
  • HR increases as workload  increases
  • SV is NOT linear; Starts linear and starts curving depending on training
    • The more training the less of a curve; heart is more efficient at pumping
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12
Q

Resting & Max HR

A
  • Normal: 60-80
  • >100 Tachycardia
  • <60 Bradycardia
  • Max Heart Rate
    • HRmax = 220 – age in years [sd + or – 10-12] OR
    • HRmax = 208 - (0.7 x age)
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13
Q

Cardiac Output (Q)

A

Q is linear

SV x HR

HR makes it linear; HEART RATE IS LINEAR

More fitness 

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14
Q

Frank Starling – “Preload”

A
  • (Amount of blood that is in the heart before contraction)
    • More blood -> more stretch -> more contraction
    • Sympathetic (Ionotropic)
      • Ionotropic = stronger
    • Decrease in TPR (Total Peripheral Resistance)
    • Resting Value ~ 5.0 L/min
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15
Q

What is the relationship between Q and workloads?

A

Linear

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16
Q

What are max values for Q?

A

20-40 L/min

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17
Q

Arterial Venous Oxygen Difference

A
  • Amount of oxygen extracted from the blood
    • At capillary level
  • Fick Equation
    • VO2 = Q x a-VO2diff
  • Arterial = 20
  • Venous = 15
  • AVO2 difference
    • Extract ~5ml O2/100mL
18
Q

Vascular Smooth Muscle

A
  • Controlled by metabolic and neural/hormonal factors:
    • Nitric Oxide (NO)
      • Vasodialation – Increase bloow flow
    • NE and EP (Beta2 receptors on smooth muscle)
      • Vasodialation
19
Q

Poisseuille’s Law

A
  • Flow varies to the r^4
    • Example: Radius decreases by half
      • Flow [1/16 of original value]
    • Small decrease in radius
      • Huge decrease in blood flow
20
Q

Regional Blood Flow

A
  • Blood flow to brain is critical – CNS increased by 25%
  • Heart > 3.5 fold increase in blood flow
    • AVO2 for cardiac cell = Nearly 200%
    • Cannot increase O2 extraction
    • Must increase flow
    • Control mostly metabolic and autoregulation
21
Q

Rate-Pressure Product – RPP

A
  • Indirect measure of myocardial O2 consumption
  • RPP = HR x Systolic BP
  • Range 
    • Rest and submax levels are decreased with training; Max has no change
    • Rest
      • 5,400-14,000
    • Max
      • 25,000 – 40,000
  • With Training: Rest and submax levels are decreased; max does not change.
22
Q

Example of clinical significance

With Training: rest and submax levels of RPP are decreased

What are the functional limitations of this statement?

A

Symptoms come on when they reach a multiplicitant of that HR and Systolic

The lower the functional capacity the larger the impact one has on fitness

23
Q

Changes in Q and VO2max with Training

A

Higher VO2max with more training

Cardiac Output (Q) increases with training

Relative change depends on how fit you are

24
Q

Differences in Heart Size, HR and SV

A

More training = lower HR

SV is greater after training 

SV gets larger therefore Q greater

SV Graph

25
Q

Training - EDV

A

More blood in diastole

Higher preload coming back

26
Q

Training - ESV

A

More blood at rest in ventricle at end of systole

At higher loads we have less

27
Q

Training - EF

A

With training get a greater EF

28
Q

Resting HR

A

Variable!

Sedentary individuals can decrease RHR by 1 beat/min per week during initial training

Aerobic elite athletes have lower HR

29
Q

HR Recovery period

A
  • The time after exercise that it takes your heart to return to its resting rate
  • With training, HR returns to resting level more quickly after exercise
    • CV Risk if too slow
  • Recovery is a better indication of cardiovascular status than submax test
30
Q

BP and Training

A
  • If hypertensive or pre-HTN
    • Resting BP is lowered for both SBP and DBP
  • Submax
    • BP is less at each submax exercise work rate
  • Max
    • SBP is higher (can do more work); DBP is lower
31
Q

Heritage Family Study

A
  • VO2 increases with exercise
  • 18% average increase VO2max 
  • Attributed change due to genetics (47%)
32
Q

Adaptations to Aerobic Training

A
  • Increase number, size, and oxidative enzymes (mitochondria)
  • Increase number of capillaries in skeletal muscle
  • Increase myoglobin content of muscles (75-80%)
  • Small transition of muscle fiber type
    • Increase % slow twitch
    • Decrease % fast twitch
  • Genetics
  • Efficiency of energy production
33
Q

Capillarization of Muscles

A
  • Increase up to 15% of capillaries in trained individuals
  • Angiogenesis: Creation of capillaries
    • Transport and utilize more O2
34
Q

Total Energy Change Training

A

Same amount of work to do the exercise trained or untrained

Receive higher levels of CHO as energy preexercise than postexercise.

35
Q

Adaptations affecting energy sources

A
  • Trained
    • Use more glycogen and triglycerides
    • FFAs are better mobilized and more accessible
    • Ability to oxidize fat increases
    • Ability to rely on fat store conserves glycogen during prolonged exercise
36
Q

Use of Energy Sources with increasing intensity

A

Fat becomes less of an energy source as you get closer to max

Carbohydrates become more of an energy source as you get closer to max

With training we see a shift in the cross over point to the right

Fats can be used at a higher period of time at a higher intensity

37
Q

Aerobic training considerations

A
  • Volume
    • Frequency and duration
  • Intensity
    • Interval or continuous training
      • Interval training is superior for aerobic
38
Q

Training Volume and VO2max

A
  • Training effect occurs initially but hits a point in which everyone plateaus
  • Genetic predisposition represents the difference between the two runners
39
Q

Anaerobic Training

A
  • Increase in muscular strength, increases fast twitch muscles
  • Slight increase in ATP-PCr and glycolytic enzymes
  • Increased muscle buffering capacity
  • If you overload the system, increase strength and adapt until the body hits a plateau
40
Q

Lactate Threshold

A
  • LT shifts to the right with training
  • LT would occur at a higher workload with training

Applied Physiology (11 decks)

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