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SPR2015_WEEK4 > exercise and CV disease > Flashcards

exercise and CV disease Flashcards

1
Q

How does exercise affect homeostasis

A

1) incr muscular demand for O2

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2
Q

Circulation of O2 with exercise

A

1) Lung ventilation produces O2
2) goes to LA –> LV
3) incr blood volume, Hb O2 affinity
4) vasodilation of arterioles
5) muscles extract more O2

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3
Q

Factors that affect maximal O2 uptake

A

1) genetics
2) training
3) age
4) gender- male
5) heat, altitude

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4
Q

peak VO2 vs. VO2 max

A

peak VO2 = top level of exercise before stop

max VO2 max = max O2 uptake

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5
Q

what is VO2

A

oxygen consumption (uptake)

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6
Q

what is VO2 related to

A

1) workload
2) energy req with exercise

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7
Q

shape of VO2 curve with exercise

A

1) linear incr
2) then plateau at VO2 max (not often reached)

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8
Q

what is VO2 max

A

plateau (aerobic capacity)

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9
Q

what is Fick’s principle measure

A

connects respiratory VO2 with O2 delivery (circulatory) and O2 extraction (muscle

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10
Q

Fick’s equation

A

CO = VO2 / (CaO2 - Cmixed venousO2)

VO2 = CO x a-v O2

Ca or vO2 = [Hgb] x 1.34 x O2 saturation (%)

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11
Q

mixed venous

A

when all venous blood gets mixed and goes to lung to be oxygenated (USU MAIN PULM ARTERY)

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12
Q

sympathetic nervous system effect on HR and SV

A

1) incr HR
2) incr contractile strength (incr SV)

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13
Q

effect of PNS on HR

A

decr HR

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14
Q

based on frank starling, incr contractile strength and stretch, incr ____

A

EDV

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15
Q

what does frank starling tell you

A

more LV is filled (LV EDP), more it will contract (SV)

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16
Q

how does incr preload affect SV

A

increased SV (and CO) for the same inotropic state

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17
Q

circulatory adjustments with exercise

A

1) incr blood flow (CO, muscle blood flow)
2) redistrib blood flow (from inactive organ to skeletal muscle)
3) maintain blood pressure (supply vital organs and brain)

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18
Q

where is most blood volume?

A

64% in veins at rest

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19
Q

effect of HR on ventricular filling and contraction

A

1) incr HR with exercise (decr diastolic time)
2) @ high HR, systolic time decr

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20
Q

what happens to systolic time at high heart rate

A

systolic time decr

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21
Q

@ rest what controls heart rate

A

parasympathetic control 60-80 bpm

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22
Q

what is the anticipatory response

A

just before exercise HR increased

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23
Q

what controls anticipatory response

A

central command from CNS (sympathetic activity) incr HR

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24
Q

what happens to HR with exercise

A

1) incr HR proportional to intensity
2) linear response up to near max exercise

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25
Q

Theoretical max HR

A

220-age = max HR decline after age 15

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26
Q

early exercise (

A

parasympathetic

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27
Q

moderate to heavy exercise is ___ stim

A

sympathetic stim

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28
Q

stop exercise –> ____ activated a

A

parasympathetic

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29
Q

a

A

a

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30
Q

effect of exercise on stroke volume

A

1) vasodilation
2) incr venous return
3) venoconstriction
4) preserve ventricular filling
5) incr SV

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31
Q

effect of incr HR at rest on stroke volume

A

1) decr ventricular filling time 2) decr SV

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32
Q

equation for SV

A

EDV (filling) - ESV (emptying)

33
Q

factors influencing SV during Exercise

A

1) EDV = preload - venous return - ventricular distensibility - pericardial constaint
2) strength of contraction
3) avg aortic or pulm pressure = afterload

34
Q

components of preload (EDV)

A
  • venous return - ventricular distensibility - pericardial constaint
35
Q

factors influencing venous return

A

1) venoconstriction (reflex sympath in venous return)
2) muscle pump (upright exercise)
3) respiratory pump (upright exercise with neg throacic pressure)

36
Q

effect of preload on SV curve

A

on steep portion, incr EDV or pressure incr SV

37
Q

left shift in Starling curve leads to ___

A

greater SV at same EDV or pressure

38
Q

which people have left shift of STarling

A

endurance athletes

39
Q

what is frank starling law of heart

A

force of contraction proportional to initi resting length

40
Q

effect of incr ventricular contractility on SV

A

1) incr sympath
2) direct innerv and epi + NE
3) incr stretch, incr contractility

41
Q

SV curve with exercise

A

SV incr up to 40-60% of max and then plateau

42
Q

how does SV change with upright exercise in normal vs. endurance athlete

A

normal: SV doubles endurance: greater resting SV before doubling

43
Q

compare SV with supine exercise vs upright exercise

A

greater resting SV than upright (20-40% incr) (more blood back to chest)

44
Q

mechanisms of incr SV in elite athletes

A

SV continues to rise

1) incr EDV with incr Starling forces at lower workload
2) incr contractility with lower ESV at higher workload

45
Q

relationship btwn cardiac output and % VO2 max

A

linear

46
Q

cardinal rule of CO with exercise

A

6L/min of CO required for each 1 mL/min incr in O2 uptake above rest

47
Q

with upright exercise and

A

HR and SV

48
Q

with upright exercise and >50% VO2 max, you see changes in __

A

only HR b/c SV plateaus unless elite athlete

49
Q

___ difference in resting CO btwn untrained and trained

A

No

50
Q

compare trained person and normal at rest SV and HR

A

trained = greater SV, slower HR

51
Q

compare trained person and normal at max exercise

A

trained = similr HR, greater SV

52
Q

factors affecting blood flow with exercise

A

1) exercise
2) decr vascular resistance (incr flow NOT BLOOD PRESSURE)
3) sympath nervous system and autoregulation control vesel diameter

53
Q

is blood viscosity important during exercise

A

important at rest but NOT with exercise

54
Q

define mean arterial pressure

A

avg blood pressure during cardiac cycle rate of flow thru systemic circuit MAP = diastolic BP + (1/3(SBP - DBP))

55
Q

how do pressures change with exercise

A

incr systolic P, CO, HR, MAP little change in diastolic P

56
Q

where does blood redistribut during exercise

A

incr skeletal muscle and brain decr splanchnic (liver, kidney, GI) decrease

57
Q

how does blood flow change with exercise in non-exercising vascular beds

A

1) incr sympath
2) vasoconstriction regul by muscle ergoreceptors and CV control center (medulla)

58
Q

how does blood flow change with exercise in exercising vascular beds

A

1) autoregulation –> vasodilation
2) incr capillary recruit for O2 delivery and extraction

59
Q

where does autoregulation occur

A

arterioles and small arteries

60
Q

Metabolic changes with autoregulation

A

1) decr PO2, incr PCO2
2) NO, K+, acidosis, adenosine

61
Q

a

A

a

62
Q

effect of sympathetic activity with moderate to heavy exercise

A

1) sympatholysis - vasodilation
2) MAP constant due to vasoconstriction

63
Q

effect of sympathetic activity with moderate to very high exercise

A

person usu has large amount of active muscle mass MUSCLE vasodilation > heart pump capacity sympathetic mediated vasoconstriction to preserve MAP (NOT AVERAGE PERSON)

64
Q

coronary blood flow during exercise

A

1) incr CO, incr coronary blood flow
2) decr O2 saturation esp coronary compared to mixed venous blood

65
Q

how does HCT, arterial O2 saturation, and CV O2 sat change with exercise

A

HCT = incr due to hemoconcentration arterial O2 saturation = no change

CV O2 = coronary venous O2 saturation= decr

66
Q

how does cardiac and leg blood flow change with VO2 during exercise

A

incr peak VO2, incr leg flow and CO with CHF and normal patients

67
Q

equation of O2 delivery

A

O2 delivery = flow x O2 content Flow = CO, leg blood flow

68
Q

mechanism to incr O2 availability to exercising muscle

A

1) incr O2 delivery (supply)
2) incr O2 extraction
3) incr metab efficiency of skeletal muscle

69
Q

what is PaO2

A

partial pressure driving force of tissue oxygenation from arteriole –> capill –> tissue –> vein PO2 decr over time so need PaO2

70
Q

what is CaO2

A

O2 content quantity of deliverable O2

71
Q

what is SaO2

A

relative quantity

72
Q

how to incr O2 delivery during exercise

A

1) exercise training
2) blood doping (incr CaO2) with transfusion and EPO
3) high altitude (incr [Hgb])

73
Q

how does a-v O2 change with exercise

A

3x incr

74
Q

how much does blood flow change with exercise

A

`5x

75
Q

a

A

a

76
Q

factors leading to incr muscle O2 extraction (a-v O2 difference)

A

1) incr skeletal muscle microcirculation- recruit more capillaries (decr venous O2 sat) 2) incr aerobic activity of skeletal
3) incr size + # mito
4) local vascular and metab improvements

77
Q

after age 30, ___ decr in max CO for men and women due to decr in max HR____ is not a factor in incr muscle O2 extraction

A

decr max CO

incr arterial O2 content

78
Q
A

SPR2015_WEEK4 (14 decks)

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