Cardiovascular System

Question 1

Cardiovascular system

Answer 1

consists of blood vessels, heart, blood, pulmonary and system circulations

Question 2

Hematopoletic stem cells

Answer 2

produce red & white blood cells and platelets

Question 3

Characteristics of blood vessels

Answer 3

Function
Pressure
Lumen diameter
Wall thickness
Wall layers
Connective tissue
Valves

Question 4

Layers of blood vessels

Answer 4

INNER: TUNICA INTIMA (endothelium
MIDDLE: Tunica Media
OUTER: Tunica Adventitia
Vasoconstriction vs vasovalidation

Question 5

Blood Flow, Blood Pressure, and Resistance

Answer 5

*Stiffening of arteries→increased resistance→higher pressure→ reduced flow→increased workload

*mmHg systolic: Pressure exerted when blood is ejected into arteries (any higher than 120 and it loses its ability to contract)

*mmHg diastolic: Pressure blood exerts within arteries between heartbeats (any higher than 80 and it loses its ability to expand)

Lower risk of CVD
* Fueled by aninflammatory response
* LDL cholesterol accumulation also further stimulates
body’s defense system
* May narrow the arterY which reduces blood flow
* Blood clots→thrombus, embolus
* Treated with blood thinning or blood dissolving drugs

Question 6

Aneurysm

Answer 6

most common place to have it in the aorta, has various causes

High blood pressure can cause it

Question 7

Ischemic Heart disease

Answer 7

• Also called coronary artery disease
• Fatty deposits occur in the coronary arteries that normally nourish heart muscle
• Angina pectoris serves as a warning sign
• Imbalance between myocardial blood supply and demand

Question 8

Symptoms of ischemic heart disease

Answer 8

• chest pain / tightness / heaviness
• unusual shortness of breath
• unusual fatigue
• unexpected sweating
• unexplained weakness
• Discomfort in the neck, jaw, teeth or back
• Nausea
• Stabbing pain instead of
  chest pressure
• Stomach (abdominal) pain

Question 9

Gender bias and cardiovascular disease

Answer 9

Estrogen, menopause and pregnancy ( to look this up)

Question 10

Framingham heart study

Answer 10

• Started in 1948 by the U.S. Public Health Service→5,209 participants in the town of Framingham, MA, USA
• To understand the natural history of CVD and identify their major causal factors
• The ‘crown jewel’ of epidemiology

Question 11

Who is at risk for cardiovascular disease

Answer 11

Cigarette smoking
Cholesterol (Totl cholesterol, LDL cholesterol)
Hypertension ( High blood pressure)
Age, sex
Typer 2 Diabetes
Overweight or Obesity ( BMI : KG/M^20

Question 12

Who should screen for high cholesterol

Answer 12

Men and women post-menopausal ( or over 40 years - inclusive of the forty years)

Question 13

Treating Ischemic Heart Disease

Answer 13

Medication, surgery - coronary bypass graft surgery
Rehabilitation programs after cardiac problem: * Take charge of their medical condition
* Develop strategies to improve risk factors for CVD
* Maintainanexerciseprogramtoimprovehealthandwellbeing
* Incorporate healthy food choices and practices
* Develop strategies to manage their psychosocial risks for CVD

Question 14

Exercise

Answer 14

Physical activity:
* Any bodily movement produced by skeletal muscles resulting in an increase over resting energy expenditure
* Execise:* Planned
* Structured
* Repetitive

Question 15

Heart rate

Answer 15

• Estimated max heart rate=220-age(in years)
• Moderate intensity: 50-75% of heart rate maximum * High intensity: >75% of heart rate maximum

Question 16

Rating of perceived exertion 0-10

Answer 16

• Moderate intensity: 3-7
• High Intensity: >7

Question 17

Current Recommendations

Answer 17

• 150 minutes per week of moderate intensity exercise or physical activity
• Strengthening exercises 2 times per week
• 75 minutes per week of high intensity exercise or physical activity
• Strengthening exercises 2 times per week
• How do these recommendations differ for individuals affected by a disability?

Question 18

Energy systems in exercise

Answer 18

1. Phosphagen system (or ATP-phosphocreatine)
   * 2. Anaerobic system (glycolytic)
   * 3. Aerobic system (oxidative)

Question 19

Outline of exercise

Answer 19

• How they work
• Major fuel source
• Rate/capacity
• Muscle fibre types
• How to improve rate/capacity

Question 20

Energy systems: Phosphagen System

Answer 20

• ATP→ADP through the enzyme ATPase * Produces energy
• ADP→ATP through the enzyme Creatine Kinase * Adds a phosphate group back to ADP
• Rate = very fast
• Capacity = limited

Question 21

Phosphagen System: Type IIx Muscle Fibres

Answer 21

• Type IIx (fast glycolytic) muscle fibres * Fast contraction
• Limited oxygen use
• Few mitochondria, capillaries
• High amounts of glycogen
• Best ability to regenerate ATP * Highly fatigable

Question 22

• Uses glycogen as energy
• Net output of 2 or 3 ATP molecules
• Rate = fast
• Capacity = limited (less limited than phosphagen system)

Answer 22

Energy Systems: Anaerobic System

Question 23

Anaerobic System: Type IIx Muscle Fibres

Answer 23

• Type IIx (fast glycolytic) muscle fibres * Fast contraction
• Limited oxygen use
• Few mitochondria, capillaries
• High amounts of glycogen
• Best ability to regenerate ATP * Highly fatigable

Question 24

• Maximum amount of force that a muscle or muscle group can exert during a single, maximal effort contraction
• Often measured with a one-repetition maximum isotonic contraction (i.e. maximum amount of weight that can be lifted with a single contraction)
• Muscle tissue= best calorie burning tissue
• Greater muscle mass= greater basal metabolic rate
  need to engage in resistance training

Answer 24

Muscular Strength

Question 25

Progressive overload

Answer 25

* Increasing the intensity of exercise over a period of time * Why is it needed? * Muscle will adapt quickly to receiving a constant stimuli * How can this be done? * Increase the resistance of the exercise (e.g. add more weight) * Add volume (i.e. number of sets or repetitions) * Perform the movement with more control (e.g. greater range of motion or slow the movement down)

Question 26

Energy Systems: Aerobic system

Answer 26

* Uses oxygen as energy supply * Net output of 32 or 33 ATP molecules * Rate = very, very slow * Capacity = unlimited

Question 27

* Moderate oxygen supply to meet energy demands of skeletal muscle * Type IIa (fast oxidative) muscle fibres * Fast contraction * Uses oxygen * Some mitochondria, capillaries * Moderate amounts of glycogen * Can regenerate ATP * Moderately fatigue resistant

Answer 27

Aerobic Exercise: Type IIa Muscle Fibres

Question 28

* Sufficient oxygen supply to meet energy demands of skeletal muscle * Type I (slow oxidative) muscle fibres * Slow contraction * Use oxygen * Lots of mitochondria, capillaries * Low amounts of glycogen * Low ability to regenerate ATP * Fatigue resistant

Answer 28

Aerobic Exercise: Type I Muscle Fibres

Question 29

Aerobic Exercise: Cardiorespiratory Fitness

Answer 29

* Purpose * To improve cardiorespiratory fitness (CRF) * CRF * efficiency of muscle to use oxygen to produce energy in skeletal muscle * Used as a predictor for heart transplant * Also known as VO2max or VO2peak * Units: ml of O2 per kilogram of body mass per minute of consumption * Improve CRF through a combination of high and moderate intensity aerobic exercise

Question 30

Beneficial Adaptations to Exercise

Answer 30

* 1. Increased number of adenosine receptors * 2. Increased capillary network * 3. Increased stroke volume * 4. Increased recruitment of glucose transporters to skeletal muscle cell membrane

Question 31

to study

Answer 31

Adenosine Receptors: Vasculature Adenosime Receptors: Central Nervous System Increased Capillary Density Increased Stroke Volume Elevated Heart Rate: Hypertrophic Cardiomyopathy Increased Recruitment of Glucose Transporters

Question 32

Increased stroke volume

Answer 32

* Conditions of exercise environment * Elevated heart rate * Increased blood flow demand to and away from skeletal muscle * Adaptation * Heart ejects more blood with each contraction * Less strain on the heart

Question 33

Example of impact muscle strength

Answer 33

Exercise is Medicine: Muscle Strength and Mortality * López-Bueno R et al. 2022 * 7 year follow up * 54 thousand men, 66 thousand women (average age: 64 years) * Increased muscle strength was associated with a 60% reduced risk of mortal 55 Exercise is Medicine: Muscle Strength and COVID-19 * Gil S et al. 2021 * 93 males, 93 females * Monitored during hospitalization for moderate to severe COVID-19 * Increased muscle strength and mass was associated with 2-3 days shorter hospital stay compared to those with the lowest muscle strength and mass Exercise is Medicine: Physical Activity and Blood Glucose * Buffey AJ et al. 2022 * Prolonged sitting (≥5 hours) * Interrupted with standing or light intensity walking for 2- 30 minutes

Question 34

Tips on exercise if you sit for very long

Answer 34

* Interruptions in sitting occurred every 20-60 minutes * Standing and light intensity walking reduced blood glucose, improved insulin sensitivity * Stronger effect of light intensity walking compared to standing

Question 35

Exercise is medicine: Physical Activity and Muscle Protein Synthesis

Answer 35

* Moore DR et al. 2022 * Prolonged sitting (7.5 hours) * Interrupted with light intensity walking (2 mins at 3.1mph) or 15 body weight squats * Interruptions in sitting occurred every 30 minutes * Rate of muscle protein synthesis was higher with “activity snacks” compared to sitting