ex phys final Flashcards
1
Q
describe pulmonary hypertension
A
fibrosus formation
left vent pathology possible
ejection fraction low
blood backs up into lungs
becomes a problem in right vent
- hypertrophy
- called cor pulmonale
2
Q
how to check pulse?
A
PT - radial only
pt - radial or carotid
normal - count to 30 or 60 sec
after exercise - count to 10 or 15 sec
3
Q
where is blood pressure highest?
A
aorta
4
Q
where are major arteries and veins of the heart?
A
outer surface of heart
not compressed in contraction
5
Q
what is systole and diastole?
A
sys: contraction of ventricles
dia: relaxation of ventricles
6
Q
what do purkinje fibers do?
A
rapidly spreads impulse to contract throughout ventricles
7
Q
what part of QRS is ventricular systole?
A
s wave through t wave
8
Q
describe the intrinsic control of the heart
A
autorhythmaticity: regular intervals
SA node: pacemaker
AV node: delays impulse by .10 sec
purkinje fibers
9
Q
describe the extrinsic control of the heart
A
parasym nerve fibers: decre HR
sym nerve fibers: incr HR
bradycardia
tachycardia
10
Q
describe cardiac muscle
A
capable of contraction and force generation
capable of initiating impulse
intercalated discs
snycytial contraction
11
Q
describe cardiac wall thickness
A
thicker the wall, greater the force
L vent has greater thickness
reg training: thicker LV wall and incres LV mass
12
Q
describe cardiac output
A
amount of blood pumped per minute
Q = HR x SV
5 L/min
trained have lower HR and higher SV
13
Q
what is preload?
A
degree of ventricular stretch when heart is at the end of diastole
14
Q
what is afterload?
A
pressure that heart needs to exert to eject blood during ventricular contraction
15
Q
equation of SV
A
SV = EDV - ESV
16
Q
define ejection fraction
A
ratio of available blood to pumped blood
EF = SV/EDV
17
Q
what does training do to ventricular volume?
A
increases EDV and SV
decreases HR
SV increases with exercise intensity up to 40-50%
18
Q
what are the laws that govern blood flow?
A
blood flows from higher pressure to lower pressure
rate of flow is proportional to pressure difference between 2 ends of vessel
increase in pressure difference increases flow
decreasing resistance increases flow
increase in radius of vessel increases flow
19
Q
what does increased capacitance do to blood pressure?
A
decrease
20
Q
what is the primary site of vascular resistance?
A
arterioles
21
Q
what system (para vs sym) causes bronchoconstriction/dilation?
A
bronchoconstriction - parasym
bronchodilaton - sym
22
Q
where is velocity highest?
A
aorta and other large arteries
23
Q
velocity level in capillaries and why
A
very low
so that they can release oxygen
24
Q
what is the pulse pressure of someone with a 120/80 BP?
A
120-80=40
25
what is the equation for MAP? use 120/80
MAP = DP + 1/3 (SP - DP)
93 = 80 + 1/3 (40)
26
what us the MAP that most people need to survive?
60 mmHg
70-100 is normal
27
when talking about blood pressure, what vessel is referenced?
arteries
28
what does BP drop so low in the capillaries?
there are so many of them
BP is slow to facilitate exchange of materials
29
what happens to plasma volume during intense PA?
decrease as much as 10%
due to sweating and heavy breathing
30
prolonged aerobic exercise vs chronic effect of LT aero training and plasma volume
PAE = decreases 10-20%
CELTAT = increases 12-20%
31
what are 3 adaptations due to endurance training?
increased Q during endurance training
increased oxygen delivery to skeletal muscle
increased endurance performance
32
what are Q levels to skeletal muscle at rest and during max exercise?
rest - 15-20% - 1000/5000
ex - 80-85% - 21000/25000
33
how does blood return to the heart?
venous return aided by muscle pump
34
what percentage does VO2 max decrease with prolonged bedrest?
25% for 2-3+ months
35
what are factors that decrease VO2 max with bedrest?
reduced blood plasma and formed elements
stroke volume
oxidative capacity of skeletal muscles
skeletal muscle atrophy
muscular strength and endurance
36
what are factors related to decline in prevalence of cardiovascular disease?
lifestyle changes: nutrition, stop smoking, exercise
improved medical techniques and diag
improves emergency care and treatment
improved drugs
37
what is coronary artery disease?
blockage of arteries supplying cardiac tissue
38
at what % of blockage id an angioplasty performed?
70-75
39
what is ischemia?
insuff blood to tissue due to partial blockage
results in angina pectoris
40
what is an MI?
severe or complete blockage, leading to cell death in heart
41
what is atherosclerosis?
progressive narrowing of artery due to plaque
42
what is arteriosclerosis?
thickening and loss of elasticity of arterial wall
43
what type of CAD causes the most US deaths?
coronary heart disease (52%)
44
what happens at 20% of blockage of coronary arteries?
builds more capillaries to compensate
45
what is a stroke, the different types and the causes?
lack of blood supply to brain
ischemic: blockage
hemorrhagic: rupture
predisposing factors: hypertension, athero damage
46
what is heart failure and what are the different types?
ventricles cannot contract, so Q is insuff
acute: caused by heart attack from drugs or blockage
chronic: caused by hypertension, minor MIs, virus
47
what artery supplies majority of left ventricle?
anterior descending
48
what is hypertension?
high BP at rest
heart must work harder
cardiac tissue needs more oxygen
increases strain and risk of heart failure
49
what does increase in peripheral resistance cause?
DPB increase by 10+
50
what is peripheral artery disease?
affects arteries in legs
type of PVD
51
what is peripheral vascular disease?
can affect any blood vessel outside of heart and brain
52
what are the main forms of PVD?
blood clots - DVT
swelling
narrowing and blockage of vessels
53
what are the blood pressure categories?
normal: <120 and <80
elevated: 120-129 and <80
HTN stage 1: 130-139 or 80-89
HTN stage 2: 140+ or 90+
HTN crisis: 180+ and/or 120+
54
what are the risk factors for HTN?
PI
overweight and obesity
heredity
male
increasing age
sodium sensitivity
use of tobacco
excessive alcohol consumption
psychological stress
diabetes
oral contraceptive
pregnancy
55
what are the uncontrollable risk factors for CAD?
age
male
heredity
56
what are the controllable risk factors for CAD?
smoking
blood lipid profile
HTN
obesity
DM
PI
psychological stress
alcohol consumption
diet and nurtition
57
what are good exercises in early phases of diagnosis for cardiovascular pts?
stationary bike
swimming
yoga
pilates
breathing exercises
58
what are some tests for medical clearance?
EKG
graded exercise test
59
what are some types of aerobic exercise?
jogging
running
cycling
elliptical
swimming
aerobic dance
rowing
60
what is the minimal duration for exercise?
20-30 min per session
longer session recommended for most
61
minimal freq of training?
3 days/week
62
intensity of exercise?
minimal: 55-65 of max HR
upper end range for health: 94% of max HR
range for athlete near optimal gains: 77-90 of max HR
cardiovascular training: 70-85%
63
how to calculate HR max?
HR max = 220 - age in years
HR max = 207 - (.7 x age in years)
second more accurate
64
max HR in relation to VO2 max
VO2 max % will be less than max HR
65
values of risk for total cholesterol
little risk: <200 mg/dL
some risk: 200-239 mg/dL
serious risk: >240 mg/dL
66
values of risk for LDL-C
little risk: <130 mg/dL
some risk: 130-159 mg/dL
serious risk: >160 mg/dL
67
values of risk for HDL-C
little risk: >60 mg/dL
some risk: 40-59 mg/dL
serious risk: <40 mg/dL
68
values of risk for triglycerides
little risk: <150 mg/dL
some risk: 150-199 mg/dL
serious risk: >200 mg/dL
69
HRR (Karvenen) method
etilmate HR needed for specific % of peak O2 consumption
HRR = HRmax - HRrest
70
what % of HRmax is very light exercise?
less than 57%
3-4 mets
walking
71
what % of HRmax is light exercise?
57-63%
4-5 mets
jogging
72
what % of HRmax is moderate exercise?
64-76%
6-7 mets
running
73
what % of HRmax is vigorous exercise?
77-95%
7-10 mets
lactate deposition
74
what % of HRmax is maximal exercise?
96-100%
10-14 mets
180-190 HR
75
what is a class 1 CVD?
heart disease
no limits on activity
no complaints
max MET: 6.5 - can run
70-80% of max HR
76
what is a class 2 CVD?
slight activity limitations
comfort at rest
ordinary activity results in fatigue, pain, dyspnea, palpitations
max MET: 4.5 - stairs
77
what is a class 3 CVD?
marked activity limitation
comfort at rest
less than ordinary activity results in fatigue, pain, dyspnea, palpitations
max MET: 3.0 - walking
78
what is a class 4 CVD?
inability to carry out PA without discomfort
max MET: 1.5 - basically rest
maybe can stand, or walk slow
give seated exercises
79
what is total body resistance?
all muscles trained each session
80
what is a split routine?
some muscles on some days, others on others
81
how do you progress resistance training?
gradual increases in intensity and volume
shortening/lengthening rest periods
82
recover HR for different age groups
20-29 yo: 140 bpm
30-39 yo: 130 bpm
60-70 yo: 100 bpm
83
what is fartlek training?
alternating between bursts of sprinting and slower recovery jogging
84
what is the point of a cool-down?
avoid venous pooling
85
detraining effects on strength training
cessation: loss of strength and power
reduced volume: strength is maintained if intensity is
86
detraining effects on aerobic training
cessation: rapid decrease in peak O2 consumption (MET level decreases)
reduced volume: aerobic capabilities are maintained if intensity is
87
define % body mass
ratio of total body mass to total fat mass
88
BMI levels
overweight: 25-29.9
obese: 30+
89
prevalence of obesity in adults
65% are overweight or obese
31% are obese
90
number 1 disease associated with obesity
cardiovascular disease
91
causes of obesity
ingesting more calories than expended
genetics
lack of appetite control
PI
cultural factors
92
how to calculate total caloric expenditure?
RMR + caloric expenditure in PA
93
what are factors so someone having higher % fat mass but same fat free mass as another person?
increased total body mass, reducing performance
lower VO2 max
94
what does a correlation between body comp and performance task depend on?
measure of body comp
physical performance task to be performed
95
define anthropometry
measurement and study of body size
96
define BMI and the equation for it.
ratio of body mass divided by height
BMI = weight in kg / height in meters^2
BMI = weight in lbs * 703/height in inches^2
97
what are the methods to measure % body fat?
skinfold calipers - not reliable
body circumference - waist:weight is most accurate
hydrostatic weighing - accurate, impractical
BIA - most unreliable
air-displacement plethsmography
3D body scan - more available
DEXA - x-ray, diff in density
98
wasit to hip ratio norms
excellent: <0.85
good: 0.85-0.89
average: 0.90-0.95
at risk: >0.95
99
what is the bod pod?
air displacement
unreliable
100
relationship between BMI and % body fat
high correlation when measured by waist circumference
discrepancy when used more precise measures like DEXA
101
guidelines for diet and weight loss
drink water
make sensible fate choices
minimize empty calories
do not reduce calories too drastically
keep portions small
102
what does estimating energy expenditure depend on?
body mass
training intensity
which muscles are engaged
sets and reps
length of rest periods
103
what is the most effective for weight loss?
combo of diet, aerobic and weight training
104
what does exercise do to appetite?
immediately, decrease it
in the long run, increased overall due to expenditure
105
what is the optimal weight loss per week?
1-2 pounds
106
how many kcals should be in weight loss diet?
1200-1600
107
what is the mean % fat?
men: 5%
women: 12-14%
108
when does gestational hypertension present?
typically after 20 weeks of pregnancy
109
what is preeclampsia?
high BP accompanied by protein in the urine or other organ damage
it can damage liver, kidneys, brain
110
warning signs in pregnancy
palpitations accompanied by chest pain, trouble breathing, dizziness or confusion
111
lifestyle adjustments during pregnancy
diet and exercise can help manage BP
112
what benefits does exercise have for pregnancy?
benefits to mother
reduce incidence of fetal morbidities
reduce risk of gestational DM and preeclampsia
113
effects of maternal exercise on fetal outcomes
exercise in first 2 trimesters results in normal birth weight
exercise into 3rd can have lower birth rate
no risk or less risk of preterm labor
decrease risk in c-section
114
what are some safe activities for pregnancy?
walking
swimming
stationary bike
yoga classes
low-impact aerobics class
strength training
115
what are the effects of exercise on growth?
childhood:
girls and boys can compete together
something for them to enjoy
normal participation does not effect growth
muscle hypertrophy less than in adults
minimal injuries with proper instruction
ados:
sharp increase in height
increase muscle mass in males
no longer fair to compete together
116
cardiovascular capacity and exercise responses in children
smaller hearts and blood volumes
much lower Q, SV, oxygen uptake
higher HR - strength of contraction not as strong
lower BP
decreased improvement in VO2max
117
anaerobic capacity in children
limited potential to perform anaero
lower anaero power
lower blood and muscle lactate concentration
lower glycogen in muscles
diminished glycolytic enzyme activity in muscle tissue
tired super easily
lower creatine and ATP-PC storage
118
thermoregulation in children
sweating mech less efficient
greater blood flow to skin, greater heat loss
increased risk of hyperthermia
need ample hydration in hot environments
119
what factors contribute to obesity in children?
increase in sedentary leisure-time activities
decrease in structured and unstructured PA
120
older adults and exercise
decrease VO2
decline in max Q
reduction in max SV
reduction in ventricular contractility
arterial wall stiffness - decreased compliance
higher MAP
increased BP - leads to higher MAP
reduction in blood delivered to contracting muscles - tired quicker
121
what are the effects of aging on skeletal muscle?
strength declines beginning at 50 years old
- 10% between 50 and 60
- 15% per decade beyond 60
power declines at 40, much faster than strength
122
what causes age related strength and power loss?
loss of muscle mass - sarcopenia
greater proportion of type I fibers remaining
123
what causes age related atrophy and cell death?
age related denervation
less motor units remain to move the muscle
124
age related cardiovascular adaptations
relative improvements in Vo2 max
men: increased Q and SV
women: peripheral adaptations
lower HR and MAP
reduction in body fat up to 3 kg
125
endurance training in postmenopausal women
enhances bone mineral density, but only in WB bones and joint in lower body
resistance training increases bone mineral density throughout body
126
exercise prescription for older adults
dame fitness guidelines in younger population for endurance and resistance
balance and coordination to prevent falls
medical conditions could limit
for frail: decrease intensity, volume and progress slower
127
asthma and exercise
obstructive - cannot breath out
labored breathing
allergens, obesity, PI
exercise encouraged
preventative measures - inhaled corticosteroids, warm up, cool down, avoid allergens
128
exercise and DM
exercise beneficial to health but does not improve T1D
exercise can treat and even prevent T2D
helps sensitivity of target tissue to insulin
129
exercise and metabolic syndrome
aerobic helps
130
HIV/AIDS and exericse
HIV/AIDS causes decrease Vo2 max and increased fatigue
aerobic exercise improves Vo2max
resistance increases muscle mass
131
epilepsy and exercise
moderate exercise regimen can reduce incidence
132
hypertension and exercise
endurance can reduce resting BP
resistance reduced resting BP
exercise training reduces BP both during and for some times after
133
what is the equation for velocity in vessels?
flow (Q) / area
134
what does constriction of blood vessels do to BP?
increase diastolic BP
135
who gets angina pectoris?
inactive older adults
get tired easily
136
describe cor pulmonale
enlargement of R vent
backup into R atrium and veins
137
describe angina pectoris
chest pain from reduced blood flow to heart
tightness or pain in chest
symp of CAD
138
describe congestive heart failure
heart unable to pump blood at a rate needed for tissue fuction
inc ESV
139
symptoms of CHF
SOB
leg swelling
breathing worsens with lying flat
fatigue
140
systolic heart failure
decreased pumping function
fluid back up in lungs
141
diastolic heart failure
heart does not fill properly
thickened or stiff heart muscle
fluid backup in lungs
142
risk factors of heart failure
CAD
hypertension
valvular heart disease
diabetes
heart defects
obesity
age
smoking
abnormal hematocrit
143
what is the key indicator for diagnosing heart failure?
dec ejection fraction
% of blood pumped out during each beat
144
why do those with heart problems cough?
pulmonary congestion
heart isnt pumping blood and backflowing into lungs
coughs to try to clear fluid
145
ascites
fluid in abdomen
146
which meds improve symptoms?
diuretics - water pills
digoxin
147
which meds improve survival?
betablockers
ACE-inhibitors
aldosterone blokers
angiostensin receptor blockers
148
lifestyle changes for chronic diseases
eat low sodium diet - sodium bad for BP
lose weight - strain on heart
stay active - reduce stress and BP
reduce alc and caff - weaken heart
quit smoking - damage vessels
149
light - less than 3 METS
walking
toilet
driving
cooking
fishing
150
moderate - 3-6 METS
walking 3-4 mph
washing windows
vacuuming
light gardening
low dancing
swimming
level bicycling
151
vigorous - > 6 METS
jogging - 5 mph = 8
running - 7 mph = 11.5
shoveling
carrying heavy loads
digging ditches
basketball
backpacking
152
what symptoms should you stop a session and contact dr for?
any unusual discomfort, chest pain/angina
nausea
extremely heavy breathing
severe fatigue
extreme sweating
abnormal changes in HR - low or high
abnormal blood pressure - low or above 240/120
systolic BP less than 100
blood sugar below 80 or above 250
153
what are the benefits of exercise for T2D?
reduced blood glucose levels
improved glucose tolerance
improved blood lipid levels
dec blood pressure
dec risk of CAD
improved physical fitness
154
what polysaccharide is stored primarily in the cells of the liver?
glycogen
155
where is somatostatin formed and what does it do?
formed in the delta cells of pancreas
balances insulin and glucagon
156
what is the amount of circulating glucose a healthy body requires?
60-100 mg/dl
157
what is insulin resistance?
when the cells dont response properly to insulin
leads to hyperglycemia and diabetes
can develop many years before appearance of T2D
158
what is an exercise prescription for the general population?
type: aerobic
intensity: 60-90% max HR or 50-85% VO2max
duration: 20-60min + 5-10 warmup/cooldown
freq: 3-5x/week
159
guidelines for exercise
monitor blood glucose before, during and 15 minutes after
delay exercise if BG greater than 250
consume carbs if BG less than 70
monitor HR, BP, RPE during
160
what is pulmonary HTN?
anything that causes right side to work harder to pump blood to the lungs
blood can be forced backward through the tricuspid valve
161
what is the name for right ventricle hypertrophy and dilation?
cor pulmonale
162
what are common causes of jugular vein distention?
congestive heart failure
constrictive pericarditis
hypervolemia - inc blood volume
superior vena cava obstruction
tricuspid valve stenosis - narrowing of valve
163
what are the underlying causes of pulmonary HTN?
congenital heart disease
connective tissue disease
coronary artery disease
high blood pressure
liver disease
blood clots to the lungs
chronic lung diseases like emphysema
164
exercise for pulmonary rehabilitation
low and slow
165
what is bronchiectasis
larger sized bronchial tubes that become wider and eventually are destroyed
long term condition
166
symptoms of bronchiectasis
cough that will not go away
difficulty breathing
fever
167
what is bronchitis?
inflam of trachea and bronchial tubes
168
symptoms of bronchitis
cough that may produce sputum
chest pain
lasts 7-21 days to recover
169
what is pursed lip breathing?
breathing out with pursed lips
can help breathe deeper and exercise longer
slows down breathing to take in more O2
170
what activities are ideal for bronchiectasis?
swimming
walking
171
what activities help your heart and lungs work efficiently?
walking
running
jumping rope
172
what activities improve posture and tone breathing muscles?
weight lifting
pilates
173
plan of progress for pulmonary rehab
comprehensive disease management counseling
exercise therapy
breathing techniques
educational programs
behavior mod for nutrition and stress
174
what is emphysema?
causes breathlessness
caused by smoking
no cure
can be managed with meds and lifestyle adjustments
175
when does blood lose its affinity for oxygen?
high temp and high acidity
176
compar rectal temp to oral temp
rectal will be .5-1 deg F above the oral temp
177
what do temps above normal do to the body?
denature enzymes and block metabolic pathways
178
what do temps below normal do to the body?
slow down metabolism and affect the brain
179
what is a normal oral temp?
97-99 deg
180
what is thermogensis?
heat production
181
what is thermolysis?
heat loss
182
when it is cold, what part of the body is temp concentrated in?
core
183
what works with the body's temp-regulating system?
hypothalamus
184
what layer of the skin stores most of the body's water?
dermis
185
when (vasodilation/vasoconstriction) is there heat loss?
vasodilation because superficial vessels are larger
