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Ex Phys > Bergdahl- Chapter 16 and 17 > Flashcards

Bergdahl- Chapter 16 and 17 Flashcards

1
Q

what is the formula to calculate the volume of flow ?

A

F= (P1-P2) / R
so flow is directly proportional to the pressure gradient between the two ends of the vessels
and indirectly proportional to the resistance encountered to fluid flow

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2
Q

how does resistance come about ?

A

from the friction between blood flow and the internal vascular wall

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3
Q

what are the three factors that determine resistance ?

A
  • blood thickness/ viscosity
  • length of the conducting tube
  • blood vessel radius
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4
Q

what does Poiseuille’s Law express ?

A

the general relationship among pressure difference, resistance, and flow

Q= (pressure gradient x vessel radius ^4)
/ (vessel length x fluid viscosity)

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5
Q

in Poiseuille’s law, which variables remain constant ? which are the most impactful ?

A

vessel length won’t change much
blood viscosity too

the radius affects the blood flow the most because it’s ^4

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6
Q

how is flow related to resistance ?

A

resistance = 1/flow

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7
Q

during exercise, how does the body adjust its blood flow ?

A

local arterioles of active muscles dilate

non-active tissues will constrict

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8
Q

what 2 factors contribute to reduced blood flow to non-active muscles ?

A

1) increased SNS outflow which will inhibit blood flow to non-essential organs
2) local metabolites that directly stimulate vasoconstriction or enhance the effect of other vasoconstrictors

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9
Q

how does skeletal muscle couple to metabolic demands ?

A

at rest, 1 out of 30-40 capillaries stay open

so the opening of dormant capillaries have a tremendous effect

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10
Q

the opening of dormant capillaries in active skeletal muscle serves three purposes

A

1) increase total muscle blood flow
2) deliver a large blood volume with only a minimal increase in blood flow velocity
3) increase the effective surface for gas and nutrient exchange between blood and muscle fibers

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11
Q

what increases or decreases act as stimuli for vasodilation within the active muscle ?

A

decreased tissue oxygen

increase in blood flow, temperature, Co2, acidity, adenosine, magnesium, potassium, nitric oxide

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12
Q

where is the nitric oxide produced ?

A

in endothelial cells lining the blood vessels

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13
Q

what can happen with endothelial dysfunction, for example in diabetes or CHD?

A

not enough nitric oxide produced

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14
Q

how does nitric oxide regulate blood flow ?

A

endothelial cells lining the blood release NO

this reduces SNS vasoconstriction, induces vasodilation to increase blood flow

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15
Q

when does vasodilation occur as related to NO ?

A

when NO penetrates smooth muscle cells

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16
Q

how is NO released ?

A

released from endothelial cells by autonomic neurons, or drugs like Viagra that stimulate its release

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17
Q

what is the definition of cardiac output ?

A

the amount of blood pumped by the heart during a 1 minute period

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18
Q

what variable reflects the functional capacity of the cardiovascular system ?

A

cardiac output (Q)

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19
Q

what are three methods to assess cardiac output ?

A

1) direct fick
2) indicator dilution
3) CO2 rebreathing

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20
Q

in what environment is the Direct Fick usually done ?

A

in a hospital

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21
Q

how do you measure the different variables in the Direct Fick Method?

A

Q= VO2 / a-vO2 (mixed venous) difference

VO2 with open-circuit spirometry during 1 min
a-vO2 (mixed venous) difference- sampling from pulmonary artery, or RA

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22
Q

which method to assess cardiac output is the standard but is invasive ?

A

Direct Fick

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23
Q

what is the Indicator Dilution method to measure cardiac output ?

A

known quantity of inert dye on venous side mixes with blood, goes to lungs and returns to heart
photosensitive device assesses arterial blood samples

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24
Q

what is cardiac output at rest ?

A

can vary with different emotional conditions

however, 5L approx for males, 4L for females

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25
Q

what are the average values for HR and SV in endurance athletes at rest ?

A

HR 50 bpm
SV 100 mL

meaning 5L

26
Q

what two factors can explain the large SV and low HR of endurance-trained athletes ?

A

for HR: increased vagal tone and decreased sympathetic drive

for SV: increased blood volume, myocardial contractility, and compliance of LV, which augment SV

27
Q

how does cardiac output increase during exercise ?

A

increase rapidly during transition from rest to steady state and then rides gradually until it plateaus when blood flow meets the exercise metabolic requirements

28
Q

how is cardiac output different in exercise for endurance athletes ?

A

they achieve a large maximal CO solely through a larger stroke volume

29
Q

what are three mechanisms that increase the heart’s SV during exercise ?

A

1) enhanced cardiac filling in diastole followed by a more forceful systolic contraction
2) normal ventricular filling followed by a subsequent forceful ejections and emptying during systole
3) training adaptations that expand blood volume and reduce resistance to blood flow in peripheral tissues

30
Q

explain the enhanced diastolic filling which increases the heart’s SV during exercise ?

A

any factor that increases venous return or slows the heart produces greater preload during diastolic phase
increase in EDV which produces a more powerful ejection stroke
ejects normal SV + additional blood

31
Q

explain the Frank-Starling law of the heart

A

the force of contraction of the cardiac muscle remains proportional to its initial resting length
this means that when the ventricles are stretched more due to a higher preload (EDV) the ejection is then more forceful proportionally

32
Q

when SV increases during exercise, will ESV be higher or lower ?

A

lower. the ventricles will more forcefully eject blood leaving less since systolic emptying is facilitated

33
Q

what is cardiovascular drift ?

A

the phenomenon in which, with time (usually 15 min submax) some responses decrease
eg SV decrease with a concomitant HR increase

34
Q

what should a person do during cardiovascular drift ?

A

work out at a lower intensity

35
Q

in a cardiovascular drift, SV decreases. what happens ?

A

compensatory heart rate increase to maintain a nearly constant cardiac output

36
Q

what is the cardiac output distribution during rest ?

A

5L output with
1L to muscle
4/5 L to digestive tract, liver, spleen, brain, etc

37
Q

what is the cardiac output distribution during exercise ?

A

most of exercise cardiac output goes to ACTIVE muscles

more precisely to oxidative portions of muscles at the expense of those with high glycolytic capacity

38
Q

what is the difference in blood (CO) redistribution during exercise between trained and untrained individuals ?

A

for trained begins in the anticipatory period

39
Q

which two tissues cannot tolerate a compromised blood supply ?

A

heart and brain

40
Q

at rest, the myocardium uses what percentage of the oxygen flowing in coronary circulation ?

A

75%

41
Q

during exercise, what changes in the coronary circulation ?

A

it has a 4-5 fold increase

42
Q

during exercise, what changes in the cerebral blood flow ?

A

it increases during exercise by 25-30% compared with the resting flow

43
Q

arterial blood carries how much mL of O2 / L ? how do we calculate mL of O2 available to body from that ?

A

200 mL O2/ L (or 20 mL/dL)

if SV is 5 L, that means that per minute, 1000 mL of oxygen is available to the body

44
Q

what happens to extra oxygen circulating above the resting requirement ?

A

it’s in reserve

45
Q

what is the amount of oxygen circulating each minute in exercise ?

A

CO increases 4-5 fold to 16 L/ min

therefore since there is 200 mL O2/L, this gives us 3200 mL O2 available to body during exercise

46
Q

what is the association between cardiac output an VO2 max ?

A

a close one.

it’s a direct proportion on graph

47
Q

how does a lower Hb change CO ?

A

women and children have a 5-10% larger CO in submax exercise due to lower levels of Hn

48
Q

kids have a smaller CO in exercise. why ?

A

they have a smaller stroke volume for which a higher HR does not fully compensate.
it’s the a-v (mixed) O2 difference that expands to meet the oxygen requirements

49
Q

during rest what is the a-v O2 difference in tissues ?

A

20 mL/ dL blood
5 mL
this means that 15 mL of O2 (75% of blood’s O2) still remains bound to Hb

50
Q

exercise oxygen consumption increases due to two things:

A

Q= VO2 / (a-v mixed O2 difference)
so VO2= Q x a-v O2 difference

in this manner, VO2 will increase with an increase in Q (cardiac output)
and with an increase in a-v O2 difference (Hb releases a considerable quantity of reserve O2)

51
Q

how does arterial blood oxygen content vary during exercise ?

A

it doesn’t. throughout the whole exercise range it’s about 20 mL/ dL blood or 200 mL/ L blood

52
Q

how does mixed venous blood oxygen content vary during exercise ?

A

between 12-15 mL/dL during rest to 2-4 mL/dL during maximal exercise

53
Q

what does progressive expansion of the a-v O2 difference result from ?

A

a reduced venous oxygen content

54
Q

what is hemoconcentration ?

A

increased concentration in RBC
results from the progressive mvmt of fluid from the plasma to the interstitial space

basically the capacity of arterial blood to carry oxygen increases due to hemoconcentration

55
Q

how do central and peripheral factors ensure increased oxygen extraction in active tissue during exercise ? (4)

A
  • by diverting CO to active muscle
  • augmenting aerobic enzyme activity
  • increased capillary to fiber ratio
  • increase in size and number of mitochondria
    etc
56
Q

how does O2 consumption and MHR differ in MAXIMAL upper body and lower body exercise ?

A

arm exercise max consumption still 20-30% lower than leg and smaller MHR values
due to relatively smaller muscle activated in upper body

57
Q

how does arm exercise compare to leg exercise in terms of oxygen consumption SUBMAXIMALLY ? why ?

A

higher levels during arm exercises submaximally

because UB uses O2 that doesn’t directly help mvmt since it needs stabilizing muscles and such

58
Q

SUBMAX: does arm or leg exercise produce the greatest physiologic strain ? why ?

A

arm produces higher HR, pulmonary ventilation, effort, BP

elevated HR because of greater feed-forward stimulation from brain’s central command to medullary control center
and increased feedback stim to medulla from peripheral receptors in active tissue

59
Q

what will produce greater metabolic and physiologic strain- arm or leg exercise, submaximally ?

A

arm

60
Q

do exercise prescriptions based on running and cycling apply to arm exercises ?

A

nope

Ex Phys (13 decks)

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