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Ex Phys > Bergdahl- Chapter 31 and 32 > Flashcards

Bergdahl- Chapter 31 and 32 Flashcards

1
Q

how does exercise affect the amount of medication one has to take ?

A

moderate exercise reduces the level of diabetic, hypertensive, and cholesterol medication

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2
Q

what is the pathophysiology of coronary heart disease ?

A

degenerative changes in tunica intima or inner lining of the larger arteries that supply the myocardium
basically damage to arterial walls due to a immunologically mediated inflammatory response to injury (smoking, hypertension, etc)

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3
Q

how does heart disease relate to cholesterol ?

A

1/2 of CHD patients have normal or near-normal cholesterol levels

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4
Q

what is a crucial component in the genesis of atherosclerosis ?

A

hyperlipidemia

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5
Q

what are 3 things to include in diet to favorably affect cholesterol and lipoprotein levels ?

A

1) water-soluble fibers
2) more polyunsaturated fatty acids
3) more omega-3 fatty acids and less trans fatty acids

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6
Q

how does a single exercise session produce changes in lipids ?

A

only transient changes

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7
Q

how do multiple exercise sessions produce changes in lipids and cholesterol ?

A

small reductions in LDL
effect on HDL

no effect on cholesterol

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8
Q

how does exercise stimulate the immune system ?

A

Regular exercise may stimulate the immune system to inhibit agents that facilitate arterial disease

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9
Q

what does homocysteine do ?

A

Homocysteine, a highly reactive, sulfur-containing amino acid, causes blood platelets to clump, fostering blood clots and deterioration of smooth muscle cells that line the arterial wall

Numerous conditions are linked to high homocysteine levels: Heart attack, stroke, dementia, venous thrombosis, osteoporosis, recurrent early miscarriage, birth defects, premature delivery, low birth weight

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10
Q

what is the most important modifiable CVD risk factor

A

Smoking is the single most important modifiable and preventable cardiovascular disease risk factor and one of the strongest predictors of premature CHD

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11
Q

what kind of exercise would you not prescribe someone with hypertension / kidney failure ?

A

resistance training, it would increase BP too much

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12
Q

what kind of exercise recommendation would you give someone who has a right side blood problem (bad venous return)?

A

blood pooled in legs, needs to lie down in exercise

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13
Q

what are 2 ways aerobic exercise may lower BP ?

A

decreases by 6-10 mmHg in those previously sedentary

1) reduced SNS decreases peripheral resistance to blood flow
2) altered renal function facilitates kidney’s elimination of sodium, reducing fluid volume

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14
Q

what effect does long term resistance training have on blood pressure ?

A

even if BP goes up during exercise, doesn’t long term elevate it

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15
Q

what is angina pectoris ?

A

chest pain, occurs in 30% of initial manifestations of CHD
inadequate coronary blood flow
1-3 min

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16
Q

what is the cause of a myocardial infarction ?

A

sudden insufficiency in myocardial blood flow, usually from coronary artery occlusion

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17
Q

what is a transient ischemic attack ?

A

precursor for something worse

develops when you cant get enough O2 in heart, like due to vascular occlusion

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18
Q

what is congestive heart failure ?

A

when the heart can’t pump adequately to meet other organ needs
can lead to kidney failure

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19
Q

what are the three causes of congestive heart failure ? what does this produce ?

A

1) hypertension
2) intrinsic myocardial disease
3) structural defects

gives a LV with a low ejection fraction and failure to increase HR with exercise

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20
Q

what is an effective treatment for congestive heart failure ?

A

exercise

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21
Q

what kind of exercise to treat CHF ?

A

40-60% VO2peak (light to somewhat hard)

exercise duration can increase to 20-40 min 3x/week

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22
Q

what is stenosis ?

A

narrowing that prevents heart valves from opening fully

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23
Q

what is insuffiency ?

A

heart valve closing improperly, blood moves back into chamber

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24
Q

what is prolapse ?

A

enlarged valve in mitral valve bulges backwards into left atrium during ventricular systole

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25
Q

what is dysrhythmia ?

A

affects the heart’s electrical function

26
Q

what should be included in screening for participation ?

A

1) exclude people with contraindications
2) identify people who need in depth eval due to age, symptoms, etc
3) identify people with clinically significant disease

27
Q

what is ACSM low risk ?

A

asymptomatic with 0 or 1 risk factors

28
Q

what is ACSM moderate risk ?

A

more than 2 risk factors

29
Q

what is ACSM high risk ?

A

more than one sign or symptom of CV/pulmonary disease

30
Q

what are radionuclide studies ?

A

injecting radioactive isotope into circulation in rest/exercise

31
Q

what are pharmacologic stress tests?

A

they benefit individuals unable to undergo routine exercise stress tests
receive intravenous drug infusion every 3 minutes, and then look for changes in wall motion abnormalities, coronary perfusion limitations

32
Q

what is cardiac catheterization ?

A

catheter inserted in a vein or artery, passes through heart to sample blood and assesses pressure differentials within chambers

33
Q

what is coronary angiography ?

A

radiography that images coronary circulation by injecting a dye that flows into vasculature
is the gold standard for assessing coronary blood flow

cannot be applied during exercise
cannot evaluate blood flow within portions of the myocardium

34
Q

what is echocardiography ?

A

pulses of reflected ultrasound assessing the functional and structural characteristics of the myocardium
(diagnose heart murmurs, lesions, defects)

35
Q

what is a CT scan ?

A

10 min non invasive electron CT beam to assess calcium deposition within plaque in coronary arteries
to see how to treat blood lipid abnormalities and other CHD risk factors

36
Q

what provides a reliable, quantitative index of someone’s functional impairment ?

A

graded exercise stress test

37
Q

what are 5 absolute contraindications for graded tests ?

A

1) ECG suggests acute cardiac disease
2) recent complicated MI
3) unstable angina pectoris
4) uncontrolled ventricular arrhythmias
5) uncontrolled atrial arrhythmias that compromise cardiac function

38
Q

can an acute CHF patient do a graded test ?

A

nope

39
Q

can a 3rd degree AV block with a pacemaker do a graded test ?

A

yes

40
Q

what is the BP that is a relative contraindication for stress test ?

A

DBP

41
Q

what are 6 exercise induced indicators of CHD ?

A

1) angina pectoris
2) ECG abnormalities- insufficient myocardial oxygen supply shown by significant ST segment depression which means there is a severe obstruction in 1+ coronary arteries
3) cardiac rhythm abnormalities
4) hypotensive exercise response
5) hypertensive exercise response
6) abnormal HR response

42
Q

what does resistance training do in cardiac rehab ?

A

it’s good, restores muscles, promotes FFM, increases glucose tolerance and insulin sensitivity

43
Q

is it better to combine resistance and aerobic training for heart patients

A

yep ! more pronounced adaptations

44
Q

what are 7 contraindications to resistance exercise for cardiac patients ?

A

1) unstable angina
2) uncontrolled arrhythmias
3) LV outflow obstruction
4) recent history of CHF
5) severe valvular disease
6) hypertension
7) poor LV function

45
Q

what is a contraindication to resistance training in exercise with an exercise capacity below 5 METS

A

anginal symptoms or ischemic ST segment depression

46
Q

what should cardiac patients use in resistance training ?

A

light resistance (bands, pulleys, cuffs)

47
Q

how many weeks should a MI patient wait before starting resistance training ? before starting barbells and machines ?

A

2-3 weeks

4-6 weeks

48
Q

what is the volume and intensity needed for cardiac patient resistance training ?

A

1 set 10-15 reps RPE 11-14
8-10 different exercises
2-3 days/ week

49
Q

what are 5 ways 1h physical activity daily reduces tumor formation ?

A

1) lowers circulating levels of blood glucose and insulin
2) increases corticosteroid hormones
3) increases cytokines
4) augments insulin-receptor expression in T cells
5) promotes interferon production

50
Q

how does regular physical activity prevent tumor formation ? (4 ways)

A

1) glycogen synthesis
2) leukocyte function
3) improves ascorbic acid metabolism
4) beneficial effects on provirus or oncogene activation

51
Q

why is it wrong for cancer patients to do high intensity sport ?

A

they’re too tired, + it will stimulate angiogenesis, which will supply more oxygenated blood to tumor cells

52
Q

6 risk factors for breast cancer

A

1) family history
2) personal cancer history
3) first menstrual period early
4) menopause late
5) first child born after 30 or no child
6) high fat diet

53
Q

what is the difference between obstructive and restrictive pulmonary disease ?

A

obstructive : obstruct airflow (asthma, COPD)

restrictive: reduction in ventilation, decreased, less compliance of lung

54
Q

what are the intensity and duration recommendations for exercise for patients with moderate lung disease ?

A

intensity no more than 75% of ventilatory reseve
20 min
3x/week

55
Q

what kind of exercise prescription for patients with severe lung disease ?

A

symptom-limited walking speed and distance

eg resistance training of ventilatory musculature through a positive airway pressure device or aerobic training

56
Q

what is asthma characterized by ?

A

hyperirritability of pulmonary airways

57
Q

what helps prevent asthma attacks during exercise ?

A

a warm up

58
Q

what is a stroke ?

A

reduction in brain’s blood flow from ischemia or hemmorrhage

59
Q

what kind of exercise is ideal for MS patients ?

A

climate controlled area that provides stable temperatures, level surface, rest frequently
3x/week for minimum 30 min (10 min periods)

60
Q

what movements are recommended for PD patients ?

A

slow, controlled movements that are functional

61
Q

what is the main symptom of renal disease ?

A

uremia

retention in the blood of waste products normally excreted in urine

62
Q

what does low level endurance traning do in renal disease ?

A

lowers muscle protein degradation, lowers resting BP, and improves aerobic capacity

Ex Phys (13 decks)

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