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Exercise Physiology Flashcards

1
Q

Diffusive O2 transport

A

Passive movement of O2 down concentration gradient across tissue barriers

Based on metabolic rate, vascular resistance, tissue O2 amt

Depends on O2 tissue gradient and diffusion distance

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2
Q

O2 demand

A

Amount of O2 required by cells for aerobic metabolism

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3
Q

DO2

A

Volume of O2 delivered to systemic vascular bed per minute

CO x (arterial O2 content)

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4
Q

VO2

A

Amount of O2 that diffuses from capillaries to mitochondria

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5
Q

Oxygen Extraction Ratio

OER

A

Tissue oxygenation is adequate when tissues receive sufficient O2 to meet their metabolic needs

VO2/DO2

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6
Q

CO (Q)

A

SV x HR

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7
Q

SV affected by…

A

Pre-load (Left Ventricular End Diastolic Volume)

Myocardial distensibility (Diastolic mm length)

Myocardial contractility

After-load (Pressure that it has to push out against)

Can be measured via cardiac cath

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8
Q

How we measure VO2

A

Arterial and venous line in patient

Measure difference to see what is truly being consumed

NOT directly measured by PTs

Indirect measurement - VO2 max test

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9
Q

Open circuit spirometry

A

Occlude the nose and force breathing in and out from mouth

Look at differences and determine O2 use

Usually in cardiac rehab

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10
Q

Calculating VO2

A

(VO2 entering) - (VO2 leaving)

Convert to mL/min

Divide by bw in kg

Final unit = mL O2/kg/min

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11
Q

Basal Metabolic Rate

A

Rate of metabolism for an individual in a completely rested state

Work of breathing
Heart, renal, and brain fx
Thermal regulation (often looks at RMR)

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12
Q

MET

A

Amount of O2 consumed while sitting at rest

1 MET = 3.5 mL O2/kg/min

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13
Q

Energy cost of an activity

A

VO2/3.5

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14
Q

Corrected METs

A

Concern about accuracy of MET level for RMR because it can OVERESTIMATE the RMR values for those that aren’t doing things that aren’t quite there

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15
Q

VO2 max

A

Often use maximal and peak VO2 interchangeable

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16
Q

Maximal

A

True max of what body could do if exercising all muscles at once

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17
Q

Peak

A

When the body has “had enough”

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18
Q

Peak in comparison to Max

A

The more mm groups working at once, the more closely Peak approximates Max

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19
Q

LE vs UE

A

Max effort from LE gets a higher VO2 peak than if you were working all your mm in you UE

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20
Q

How does exercise affect DO2 and VO2?

A

VO2 could increase 20-fold depending on exercise type

Blood flow increases to peripheral mm
Blood vessel dilation
Increases availability of O2 and extraction from blood

Increase in VO2 and DO2

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21
Q

If DO2 declines…

A

VO2 will probably stay the same

Doesn’t necessarily mean you will have a decrease in your VO2

You might see a different in a critically ill patient because it might not meet metabolic demands

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22
Q

O2 debt

A

Difference btwn O2 demand and O2 consumption

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23
Q

PEOC

A

Post Exercise O2 Consumption

Needing more O2 to recover than body has available

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24
Q

After STRENUOUS exercise…

A

Replenishment of…

ATP
Myoglobin with O2
Glycogen

Removal of…

Lactic acid

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25
Gravitational Stress
Ability for the CV system to accommodate fluid shifts is impaired with recumbence Must adapt to gravity to restore fluid regulation
26
Emotional stress
Autonomic nervous system responses Sympathetic vs Parasympathetic
27
Factors that perturb O2 transport
Gravitational stress Emotional stress Exercise stress
28
Key when looking at CV and pulm fx...
Gravitational and exercise stress They stimulate the reticular activating system, which, when dysfunctioning, inhibits O2 transport
29
Upright positioning?
ALWAYS Adjust hospital beds (chair mode)
30
Sympathetic system
Fight or flight
31
Exercise Stress
GREATEST PERTURBATION TO HOMEOSTASIS AND O2 TRANSPORT IN HUMANS All steps of O2 transport affected Increased... CO, ventilation, HR, SV Enhanced... O2 extraction
32
Left ventricle output
Increased by increase in HR, SV, and contractile pressure which... Increases systolic pressure and ejection of force LV OUTPUT MUST EQUAL LV INPUT
33
Diastolic filling time relation to HR
Indirect
34
Diastole
Rapid and marked decrease in IV pressure Creates a LV suction effect
35
Systole
Increased systole leads to increased myocardial elastic recoil
36
Myocyte relaxation
Acceleration of this happens because of... Increase rate of Ca++ reuptake by sarcoplasmic reticulum
37
With ischemia
Lose LV distensibility LV wall stiffness Increase diastolic pressure Increases pulmonary congestion
38
Can LV augment diastolic filling in response to exercise?
NO
39
O2 diffusion at tissue level
Depends on QUANTITY and RATE of blood flow Tissue and capillary O2 pressures Capillary surface area Capillary permeability Diffusion distance
40
What causes more rapid diffusion during exercise?
Capillary dilation... Increases... Surface area Decreases... Resistance to flow Diffusion distance
41
Immediate energy
When you move from resting state and begin to exercise Use cellular ATP and Creatine Phosphate in mm fibers Used in first 10 seconds or so of exercise
42
Short-term energy
High intensity, near maximal efforts when immediate energy runs out Anaerobic production of ATP via glycolysis 90 seconds or so Sprinting short distances
43
Long-term energy
Moderate intensity activities, sustained physical activity Aerobic production of ATP Need O2 supply to match demand Long distance swimming
44
Aerobic metabolism
Uses oxidative phosphorylation (Krebs) Occurs in mitochondria Requires O2 Primarily used in Type I SLOW TWITCH MM FIBERS ***Used primarily during low and mod intensity exercise O2 should support demand needed for ATP Uses carbs, fats, proteins Yields 36 (skeletal) or 38 (cardiac) ATP per glucose ***Heart and CNS primarily use this
45
Krebs cycle
Oxidative phosphorylation Produces a lot of ATP, but SLOWER
46
Glucose
Main fuel that's used for high intensity exercise
47
Anaerobic Metabolism
Does NOT require O2 Anaerobic phosphorylation Uses ONLY carbs Occurs in cytoplasm By-product is lactic acid Yields 2 (skeletal) or 6 (cardiac) ATP per glucose ***Used primarily during high intensity exercise
48
Glycolysis
Doesn't yield a lot of ATP, but occurs QUICKLY
49
Anaerobic threshold
Around 55% of peak VO2... an individual cannot produce all ATP demanded aerobically and will need SOME anaerobic work to kick in Intensity beyond which body increases reliance on anaerobic metabolism to meet body's energy demands Produces lactic acid Why SOB with this? This leads to an inefficient O2 delivery situation; more acid build-up in body
50
Lactate threshold
Lactic acid being produced faster that it is metabolized
51
Anaerobic threshold
Results from increase in blood lactate OBLA - onset of blood lactate accumulation
52
Ventilatory threshold
Results from lactic acid broken down into lactate and H+ Leads to increase in CO2 Leads to increase in ventilation ***SUDDEN, HEAVY VENTILATION***
53
Metabolic respiratory quotient RQ)
(CO2 produced) / (O2 consumed) Used in calculations of BMR when estimated by CO2 production aka RER
54
Burning fat RQ
0.7
55
Burning pure carbohydrate RQ
1.0
56
Max RQ
1.15 If 1.08-1.1 shows subject gave good effort during an exercise test
57
Physiologic Changes with Exercise
% increase of... Frequency = 4x Tidal volume = 8x Minute ventilation = 32x
58
Normal cardiac response to exercise
Increases in linear fashion with the work rate and O2 uptake during exercise Increase in HR has expense of decreased diastole rather than systole
59
Abnormal cardiac response to exercise
Lack of linear increase in HR with increased work or VO2
60
Cardiac adaptation to training
Lower resting HR HR with max exercise is the SAME of SLIGHTLY LOWER
61
Normal SV response to exercise
Increases curvilinearly with work Max around 50% aerobic capacity Causes increased EF
62
Abnormal SV response to exercise
Depressed SV or impaired increase in SV with work due to impaired ventricular compliance
63
SV adaptation to training
SV and EF will increase
64
How to measure SV
Pulse strength to get an idea ONLY
65
Normal CO response to exercise
Increases linearly with increased work from 5 L/min to a max of 20 L/min Due to increase in HR and SV
66
Abnormal CO response to exercise
Failure to increase linearly with work rate
67
CO Adaptation to training
Max level will increase
68
Normal BP response to exercise
SBP increases linearly with CO during exercise DBP should either remain constant or decrease slightly
69
Abnormal BP response to exercise
Sudden sharp rise in SBP or lack of increase with exercise DBP increase > 10 mmHg OR drops sharply > 20 mmHg Should regulate after 3 min of standing
70
BP adaptation to training
In healthy people SBP should remain the same Only pt with HTN should get decrease in resting SBP with training
71
Rate Pressure Product
HR * SBP Very important to monitor during exercise with patient with heard disease Strong correlation between RPP and myocardial O2 consumption (0.9)
72
Normal RPP changes with exercise
RPP should increase with work rate
73
Abnormal RPP response to exercise
Does NOT increase with work rate Good marker of myocardial ischemia ***If no increase, NOT tolerating ex session well and at risk for ischemia
74
RPP adaptation to training
Resting RPP may decrease over time...same at max effort
75
Abnormal A-VO2 difference during ex
Impaired ability to extract O2
76
A-VO2 adaptation to training
Improved ability to extract O2, so you can increase your exercise tolerance independent of central hemodynamic changes
77
Normal VO2 max response to exercise
Can increase resting O2 consumption 10-fold
78
Abnormal VO2 max response to exercise
Inability to increase O2 transport with increased energy demands
79
VO2 max adaptations with training
Can increase resting O2 consumption 23-fold (endurance athlete)
80
What reflects disability
16-18 Disabled
81
Anaerobic threshold and exercise
Commonly associated with the onset of significant anaerobic contribution to exercise metabolism Blood lactate is buffered during exercise to maintain a tolerable acid-base balance
82
Anaerobic threshold response to training
Increased capacity to buffer and tolerate lactate Training increases the anaerobic threshold
83
Peripheral changes in response to training
Increased capillary density Increased oxidative enzymes Increased mitochondria
84
Effects of bed rest and immobilization on exercise tolerance
Absence of gravitational and exercise stress Resting tachycardia Reduced cardiac output Reduced VO2 max Reduced blood volume Reduced OE at tissue level
85
Pulmonary complications of bed rest
Reduced lung volumes and capacities Decreased thoracic volume Restricted chest wall motion Increased thoracic blood volume Increased blood viscosity and decreased venous flow result in INCREASED risk of embolic event
86
Convective O2 transport
Movement of O2 in air or blood Determined by Hb concentration, O2 sat, and CO Depends on active energy consuming processes

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