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Cardiopulmonary Practice > 2 Inactivity/Physiology > Flashcards

2 Inactivity/Physiology Flashcards

1
Q

What are the CDC Guidlines for Physical Activity?

A
  • Moderate intensity 150-300 minutes a week under 6 mets (moderate activity)
  • High Intensity 75-150 minutes a week > 6 mets
  • At least 10 minutes duration for each session
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2
Q

What is the difference between Physical activity and Exercise?

A
  • PA is any bodily movement by skeletal muscle that requires energy
    • Playing, exercise, working, active transport
  • Exercise is planned, structured, and purposeful movement for maintenance or imporice of physical fitness
    • goal of making physiological adaptaions
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3
Q

What is Frailty?

A
  • Increased state of vulnerability and decreased ability to cope with routine/stressors due to decine in reserve and function across multiple systems
    • reduced adaptive capacity
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4
Q

What is the critera for frailty?

A
  • 3/5
  • Low grip strength
  • low endurance/easy fatigue
  • Slow walking speed
  • Low physical Activity
  • Unintentional Weight loss
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5
Q

Describe the compenents in the Cycle of frailty

A
  • Dec strength
  • Dec Energy/Exhaustion/VO2max
  • Dec walking speed
  • Dec Activity
  • Weight loss
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6
Q

What is Dynapedia?

A
  • Poverty of strength or force
    • Age associated
    • impaired ability to contract muscle, produce force/speed
      • not due to nervous system
  • Functional limitation - Physical diability
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7
Q

What is the 6th vital sign?

A
  • Gait speed
    • .8m/s significantly impaired
    • 1.2 m/s normal rate for gait speed
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8
Q

What is sarcopenia?

A
  • Loss of muscle fibers
  • aging adults tend to selectivly lose type 2 fibers
  • Inc when inactive
  • Decrease in muscle tissue begins around 50, more dramatic at 60
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9
Q

What are cardiovascular adaptations to Deconditioning?

A
  • Reduced:
    • total blood volume
    • SV
    • Max cardiac output
    • Peak O2 uptake
    • Ventricular compliance
    • Baroreflex sensitibity
    • POTS (orthostatic intolerance)
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10
Q

When can you notice cardiovascular adaptations to deconditioning?

A
  • Some changes detected in 20hrs of bedrest
  • Hypersenstivty
  • Typeically related to atrophy of the heart when not loading
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11
Q

What are exercises for the Frail?

A
  • Continuous Aerobic exercise
    • good mortality reduction
  • resistance exercise
    • Greater imporives in function and reduction in falls
    • Better for ADL’s
  • Combined AT/RT
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12
Q

What are some risks for training with the Frail?

A
  • Potential U shaped curve with activity and mortality
  • Some may not respond well
    • increased intensity = possible adverse affects
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13
Q

What is the normal and obese BMI levels?

A
  • 18.5 - 25 = normal
  • 25-30 Ovreweight
  • 30-35 Obese I Moderate
  • 35-40 Obese II severe
  • 40 + Obese III Very severe
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14
Q

What are some diseases related to obesity?

A
  • Coronary Heart disease
  • Type 2 Diabetes
  • Cancers
    • endometrial, breast, colon
  • Hypertension
  • Dyslipidemia
  • Stroke
  • increased risk of falls
  • Liver diease
  • Gall bladder
  • Sleep Apnea/respiratory problems
  • OA
  • LBO
  • Gynecological problems
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15
Q

What are functional limitations of obesity?

A
  • Difficult with
    • vigorus/moderate activities
    • Lifting/Carrying groceries
    • Walking 1 or more flight of stairs
    • Bending/Kneeling
    • Walking 1 or more blocks
    • Bathing/dressing
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16
Q

What is the difference between White and Brown fat?

A
  • White: Lipid storage and undergoes pathological expansio during obesity
  • Brown: Thermogenic, large amounts of mitochondria, dissipate lage amoutn of chemical energy as heat
  • defends core body temp
  • Contributes to energy expenditure
  • Large amounts in infants, dimiishes with age
  • Body weight regulation
  • Regions: Axilla, adrenal regions, ect
17
Q

What are the 3 types of adipose tissue?

A
  • Viscceral/intra-abdrominal
    • surrounds organs
    • pro inflammatory cytokines, Tumor necrosis factor (TNF-a) and IL 6)
    • Increased sympathetic activity
    • Strongly lined to CVD, DM@ and various other conditions
  • Subcutaneous
    • concerning if around organs
  • Perivascular
18
Q

What are the Physiological implications of obesity?

A
  • Chronic low grade inflamation
  • abromal production of proinflammatory cytokines
    • TNF a (-ve)
  • Reuction in Nitric oxide and Endothelin (ET-1)
19
Q

What is perivascular Adipose Tissue (PVAT)?

A
  • Specific to anatomic location, amount and disease state
  • Adiponectin - imporves NO and bioavailibility (modulator of vascular tone)

OBESE patients have LOWER adiponectin and loss of tone regulation

20
Q

What is cornoary PVAT?

A
  • INC results in smooth muscle responsiveness between obese and lean coronary arteries
  • Atherosclerotic plaques have been shown to occur predominantyly in epicardial Coronary arties that are encased in PVAT
21
Q

What is the obesity paradox?

A
  • obese patients more favorable prognosis compared to lean patients with cardiac problems
  • purposeful weight loss in obese patients led to a slight statisically insignificant reduction in mortality
  • 3 year mortality was smaller than leaner subjects

FOCUS ON FITNESS AND NOT LOOSING WEIGHT

22
Q

What are some clinical impliations of BMI and cardiorespiratory fitness?

A
  • BMI less accurate refelction
  • Cardiorespiraty fitness more closely linked to mortality risk populations
  • Emphasize CRF than weightloss
23
Q

What are surgical interventions for Obesity?

A
  • Gastric Bypass
  • Lap Band
    • less complications compared to gastric bypass
  • Bariatric surgery
24
Q

What are some considerations for obese patient exercise?

A
  • long term diet isnt affective, exercise increase energy expenditure
    • more calorie burn, more fat burn
  • Goals
    • Weight loss/Energy balance
      • 5-10% of inital BW over 3-6 months
    • Improve Cardiorespiraty fitness
    • Improve functional mobility
25
Q

What is resistance exercise for Obese patients

A

May facilitate Spontanouse Activity Outside compared to AT

  • greater compliance
26
Q

What is the ideal format for obese exercise?

A

combined AT/RT

27
Q

What is interval training for the obese patient?

A
  • <80VO2max
    • Variable duration bouts
    • may include active or passive recovery periods
    • May enhance adherence to an exercise program
    • enhance weight loss
    • Produces similar changes, greater than continuous in cardiorespiratory fitness
28
Q

What are some confounders to obese exercise?

A
  • Need reduction in net energy expendture (despite good compliance)
    • increase Energy intake/Reduction in SAEE
  • Be broad, what is causing weight gain, refer to dietician, give activty trackers
  • Social component
  • Behavior/social barrioers
    • low economic. low education
    • be a educator and motivator
29
Q

What is Diabetes?

A
  • Metabolic disease where body has inability to produce any or enough insulin sensitive resulting in elevated levels of glucose
    • A1C aboce 6.5%
    • Normal 4-6%
30
Q

What abnormalities do you see with diabetes?

A
  • Endothelial and vascular smooth muscle cell function to thrombosis
  • Contributes to atherosclerosis and complications
  • Decreases Endothelium derived NO
  • Increased vasoconstricuve prostanoids and endothelin -1
  • Increased activate platelets, increased coagulation factors , inhibited pathways for fibrinolysis
31
Q

What are risk factors for Type II diabetes?

A
  • 3/5
  • Large waist circumference/abdominal obesity
  • Elevated triglycerides
  • Low HDL
  • Hypertension
  • Elevated blood glucose level (fasting)

Increased C reactive protien

  • increased risk of atherosclerosis and HTN
32
Q

What is Type I diabetes?

A
  • Onset 6-13 years old but also occur in adults
  • Beta cells in Islets of Langerhan fail to produce insulin

Etiology: autoimmine diease that attack beta cells, beta cells display improper antigens to T cells

Hallmark: Beta cells fail to produce sufficent insulin

33
Q

What is Type II diabetes?

A
  • Onset >40 years
  • obesity epidemic = kids

Hallmark: Insulin resistnace

Chronic uncontrolled cases progress to beta cell burnout (stops producing isulin)

34
Q

What are complications of Diabetes?

A
  • Heart disease
  • Stroke
  • Retinopathy/glaucoma
  • Kidney disease
  • Peripheral nerve damage
  • Autonomic dysfunction
  • Integumntary issues
35
Q

How does exercise affect the diabetic patient?

A
  • Increases glucose uptake during and after
  • Increased insulin independant gluose uptake 1-3 hours
  • Increased sensitivty lasts hours to days
36
Q

What is exercise for Type I patient?

A
  • Check blood glucose before every exercise session
  • Check every 30 min
  • Criteria: >100 <250
37
Q

What is exercise for Type 2?

A
  • Check glucose before and after exercise for first few weeks
  • >100 <250

Cardiopulmonary Practice (4 decks)

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