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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
Q

effect of PNS and SNS on HR

A

PNS decrease, from 100 to 0

SNS increase, from 100+

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26
Q

effect of SNS on contractility

A

increases

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27
Q

limiting factor of heart hypertrophy

A

pericardium

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28
Q

what is the frank starling mechanism

A

increased stretching of the myocardial will increase strength of contractions

29
Q

cardiac muscle properties

A

same length-tension properties to skeletal

operates well below optimum length

30
Q

typical blood volume in adults

A

5L

31
Q

distribution of blood during rest

A 
5000ml 
liver - 27%
kidneys 22%
brain 14% (700ml)
heart 4%
muscle 20%
32
Q

distrbution of blood during exercise

A

25,000ml

33
Q

how much blood resides in veins during rest

A

2/3s

70%

34
Q

vasodilators

A 
increased 
NO
K+
Co2
lactate
prostaglandins 
bradykinis
35
Q

vasoconstrictors

A

increased SNS activity relases NE

36
Q

factors that increase venous return during exercise

A

increased SNS activity
constriction of venous smooth muslce
venoconstraiction
muscle contraction

37
Q

how much of the blood is shunted through venoconstricition

A

20%

38
Q

explain venous return pumps

A

high pressure during contraction
low pressure during relaxation
creates a vaccum sucking blood towards heart

39
Q

what is ventricular rotation

A

due to the order the heart contracts from the elcetrical signal the heart twists as it contracts
atrial twists clockwise
ventricles - anticlockwise

40
Q

effect of ventricular rotation

A

helps faciliate blood ejection

means it moves over a gretaer distance so recolis further allwoing more blood to enter

41
Q

what is the respirtatory venous pump

A

pressure increases in the thorax during expiration - blood returns to heart
low pressure during inspiration creates a vaccum sucking blood towards heart

42
Q

factors which affect afterload

A

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
Q

at what blood pressure does Q decrease

A

approx 150mmHg

44
Q

effect of increase afterload

A

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
Q

Mechanoreceptors

A

detect stretch and contraction
faciliate reflex
signal to brain to alter HR

46
Q

Metaboreceptors

A

chemical activation of the afferent receptors in interstitum of the muscle
type IV unmyleinated afferent receptor

47
Q

what are metaboreceptors sensitive to

A

increased

  • lactacte
  • prostaglandins
  • phosopahte
48
Q

Baroreceptors

A

detect changes in BP
in walls of carotid sinus and aortic arch
sense arterial pressure
stretched activated

49
Q

Baroflex for decreased BP

A 
baroreceptor stimulated 
cardioacceleratory centre inhibited 
cardioinhibitory centre stimulated 
vasomotor centres 
= decreased Q and vasodilation
50
Q

chemoreceptors

A

detect changes in levels of O2 and CO2

located in walls of carotid sinus and aortic arch

51
Q

bainbridge reflex

A

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
Q

effect of tachycardia on diasolic time

A

decreases diastolic time

53
Q

what is the endothelium

A

inner most layer of artery

permable barrier that allows through flow of nutritents and metabolic end products

54
Q

what does the endothelium produce /release

A

produces growth factor

releases platlets aggregation, clotting and anti-clotting substances

55
Q

process of atherosclerosis

damage to endotehlium

A 
damage 
monocytes adhere to endothelium 
become macrophages 
secrete growth factor and vasocontraction substances
infitraion of LDL casues inflammation 
LDL oxidised caused
56
Q

process of atherosclerosis

what do marcophages secrete

A

growth factor and vasocontraction substances

57
Q

what does the infiltraion of LDL into the intima cause

A

inflammation

58
Q

what does LDL release when its oxidises

A

leukocyte adhesion molecules

59
Q

what happend when LDL taken up by macropahges

A

macrophages become foam cells

60
Q

what do vascular cell adhesion molecules cause endothelium to become

A

becomes sticky rather than smooth

61
Q

what adhere and attract to VCAM

A

platlets
monocytes
lymphocytes

62
Q

what do t cells release and whats the effect

A

release growth factors

cause proliferartion and attract smooth muscle cells

63
Q

what are fatty plaques filled with

A 
cholestrol laden particles 
platlets 
calcium 
lymphocytes, macrophages
abnormally spreading smooth muscle cells 
connective tissue cells
64
Q

what reduces plaque stability

A

inflammatory response

  • increase inflammatory cytokines
  • release protease
  • release prothrombotic and procoagulant factors
65
Q

effect of protease

A

weaken collagen

66
Q

effect of prothrombotic and procoagulant factors

A

cause a clot when plaque ruptures

67
Q

what damages the endothelial layer

A 
normal microvasuclar wear and tear 
viral attack 
high BP
turbulent flow 
free radicals 
carbon monoxide 
elevated blood glucose  and lipids
68
Q

stenosis

A

narrowing of arteries

Clinical Exercise Prescription (12 decks)

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