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Clinical Exercise Prescription > Cardiac Rehabilitation > Flashcards

Cardiac Rehabilitation Flashcards

1
Q

Health definition

A

a state of complete physcial, mental and social well being not just the absence of disease or illness

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2
Q

effect of fitness on mortality rate

A

higher levels of fitness = lower mortailty rate

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3
Q

effect of being unfit and becoming fit

A

increases mortality slightly

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4
Q

effects of being fit and becoming unfit

A

mortality increase

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5
Q

effect of being unfit and staying unfit

A

hgihest mortality level

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6
Q

every 1 MET increase in areobic fitness = ?% decline in mortality

A

10-15% decline

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7
Q

when are the greatest health benefits achived
A. sedentary to mod
b. mod to high

A

A. when increasing PA from sedentary to moderate

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8
Q

each 10mins of MVPA results in a ?% decrease mortaility risk

A

10%

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9
Q

each 150mins of MVPA results in a ?% decrease mortaility risk

A

30-40%

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10
Q

each 750mins of MVPA results in a ?% decrease mortaility risk

A

50%

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11
Q

PA reduces relative risk of dementia by ?%

A

30%

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12
Q

PA reduces relative risk of depression by ?%

A

30%

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13
Q

PA reduces relative risk of T2D by ?%

A

40%

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14
Q

PA reduces relative risk of CVD by ?%

A

35%

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15
Q

PA reduces relative risk of all-cause mortailty by ?%

A

30%

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16
Q

questions to ask when assessing PA

A 
medical history 
medications 
PA levels  - current and historic 
likes/dislikes 
lifestyle/employment
motivations
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17
Q

stroke volume equation

A

SV = preload - afterload

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18
Q

preload def

A

the amount of blood in the ventricles before contraction

end diastolic volume

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19
Q

afterload def

A

amount of blood in the ventricles after contraction

end systolic volume

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20
Q

ejection fraction equation

A

EDV-ESV/EDV x100 or SV/EDV

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21
Q

shortening fraction def

A

how much the chambre reduces in size at rest

35%

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22
Q

factors affecting HR

A

PNS
SNS
adrealine

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23
Q

factors affecting preload

A

ventricle size
venous return
ventricular plasticity

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24
Q

factors affecting afterload

A

contractility

systematic vascular resistance

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25
effect of PNS and SNS on HR
PNS decrease, from 100 to 0 | SNS increase, from 100+
26
effect of SNS on contractility
increases
27
limiting factor of heart hypertrophy
pericardium
28
what is the frank starling mechanism
increased stretching of the myocardial will increase strength of contractions
29
cardiac muscle properties
same length-tension properties to skeletal | operates well below optimum length
30
typical blood volume in adults
5L
31
distribution of blood during rest
``` 5000ml liver - 27% kidneys 22% brain 14% (700ml) heart 4% muscle 20% ```
32
distrbution of blood during exercise
25,000ml
33
how much blood resides in veins during rest
2/3s | 70%
34
vasodilators
``` increased NO K+ Co2 lactate prostaglandins bradykinis ```
35
vasoconstrictors
increased SNS activity relases NE
36
factors that increase venous return during exercise
increased SNS activity constriction of venous smooth muslce venoconstraiction muscle contraction
37
how much of the blood is shunted through venoconstricition
20%
38
explain venous return pumps
high pressure during contraction low pressure during relaxation creates a vaccum sucking blood towards heart
39
what is ventricular rotation
due to the order the heart contracts from the elcetrical signal the heart twists as it contracts atrial twists clockwise ventricles - anticlockwise
40
effect of ventricular rotation
helps faciliate blood ejection | means it moves over a gretaer distance so recolis further allwoing more blood to enter
41
what is the respirtatory venous pump
pressure increases in the thorax during expiration - blood returns to heart low pressure during inspiration creates a vaccum sucking blood towards heart
42
factors which affect afterload
any that impede ejection of blood - volume of blood in the arterial contraction - pressure in the aorta at onset of ejection (DAP) - compliance of aorta - size of pulmonary/aorta lumen
43
at what blood pressure does Q decrease
approx 150mmHg
44
effect of increase afterload
SV reduces in the acute phase preload increases (to restore SV) reduced velocity of contraction and ejection in acute phase markes rise in myocaridal O2 consumption
45
Mechanoreceptors
detect stretch and contraction faciliate reflex signal to brain to alter HR
46
Metaboreceptors
chemical activation of the afferent receptors in interstitum of the muscle type IV unmyleinated afferent receptor
47
what are metaboreceptors sensitive to
increased - lactacte - prostaglandins - phosopahte
48
Baroreceptors
detect changes in BP in walls of carotid sinus and aortic arch sense arterial pressure stretched activated
49
Baroflex for decreased BP
``` baroreceptor stimulated cardioacceleratory centre inhibited cardioinhibitory centre stimulated vasomotor centres = decreased Q and vasodilation ```
50
chemoreceptors
detect changes in levels of O2 and CO2 | located in walls of carotid sinus and aortic arch
51
bainbridge reflex
increased cardiac filling elicts tachycardia increase right atrium filling from increase venous return stretch receptors in rigth atrium and vena cava stretched increased firing to brain increased HR and SV
52
effect of tachycardia on diasolic time
decreases diastolic time
53
what is the endothelium
inner most layer of artery | permable barrier that allows through flow of nutritents and metabolic end products
54
what does the endothelium produce /release
produces growth factor | releases platlets aggregation, clotting and anti-clotting substances
55
process of atherosclerosis | damage to endotehlium
``` damage monocytes adhere to endothelium become macrophages secrete growth factor and vasocontraction substances infitraion of LDL casues inflammation LDL oxidised caused ```
56
process of atherosclerosis | what do marcophages secrete
growth factor and vasocontraction substances
57
what does the infiltraion of LDL into the intima cause
inflammation
58
what does LDL release when its oxidises
leukocyte adhesion molecules
59
what happend when LDL taken up by macropahges
macrophages become foam cells
60
what do vascular cell adhesion molecules cause endothelium to become
becomes sticky rather than smooth
61
what adhere and attract to VCAM
platlets monocytes lymphocytes
62
what do t cells release and whats the effect
release growth factors | cause proliferartion and attract smooth muscle cells
63
what are fatty plaques filled with
``` cholestrol laden particles platlets calcium lymphocytes, macrophages abnormally spreading smooth muscle cells connective tissue cells ```
64
what reduces plaque stability
inflammatory response - increase inflammatory cytokines - release protease - release prothrombotic and procoagulant factors
65
effect of protease
weaken collagen
66
effect of prothrombotic and procoagulant factors
cause a clot when plaque ruptures
67
what damages the endothelial layer
``` normal microvasuclar wear and tear viral attack high BP turbulent flow free radicals carbon monoxide elevated blood glucose and lipids ```
68
stenosis
narrowing of arteries

Clinical Exercise Prescription (12 decks)

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