cardiopulm Flashcards
for a conditioned older adult is there normally a chnage in resting heart rate
no
what chnage in heart rate do we expect as we age
max heart rate
why does max heart rate change as we age
90% of the SA cells are gone
the cells are less responsive the hormones that tell the heart to speed up
what makes up CO
SV and Max HR
how are work load and CO related
increase in workload requires a increase in CO
in the young how does the heart react to increased workload
the HR will increase rapidly
in the old how does the heart react to increased workload
the heart rate increase less rapid and there is instead a marked increase in SV
what does chrotropic mean
timing
what does inotropic mean
contratibility
what is the chrotropic response to aging
contractility slowed
myocardium pumping ability changes
- decreased SV
- decreased CO
what is the inotropic response to aging
the cardiac vavles of the traffic directiors of the heart
control the flow of blood, can become to complient or stiff
what does aortic valve degeneration lead to
too much blood is left in the heart
greater end systolic voume
more blood is left in the left ventricle
what does mirtrial valve degeneration lead to
too little blood is returned to the heart
less end systolic volume
chronotropic - conduction system
decreased responsiviness to changes in the level of activties
fibrosis in manin bundle branches
decreased number of the pace maker cells
chronotropic - cardio relfexes
decrease baroreceptor activity
- lag in the response times
- rhythm problems common
inotropic - peri vascularture
thickening of vessel walls
stiffness leads to increase BP and ESV
what si decreased pre load
there is not enough blood in the heart to start with
how can we combat decreased pre-load
try to increase blood return to the heart
- LE exercises
- working larger groups of muscles
what is increase afterload
this is when there is too much blood in the heart following contraction
how can we combat increased after load
improve per resistance
- low to mod instensity, consider HITT, may improve autonomic sensitivity
- avoid UE exercises and breath holding
what does ESV mean
end systolic volume
greater ESV - too much blood is left in the heart
what does EDS mean
end diastolic volume
lesser end diastolic volume - returns too little blood to the heart
what is the overall change occured with chrontropic and inotropic changes
reduced left ventrical ejection fracture
a LVEF of what is considered compromised
<30%
what are some age related chnages that we see with the lungs
reduced elasticity of the lungs
less alveoli
increased stiffness of the rib cage
what are the functional consequence of:
reduced elasticity of the lungs
less alveoli
increased stiffness of the rib cage
reduced vital capacity
reduced forced expiatory volume
increased functional residual capacity
what are is the response to these changes in structure and function of the lung
increase cost of breathing - seen in increased RR
what is functional residual capacity
the amount of air that is left in your lungs after normal passive exhalation
what is vital capacity
maximum amount of air a person can expel from the lungs after a maximum inhalation
what is forced expiatory volume
the volume of air that an individual can exhale during a forced breath in t seconds.
what is the overall effect of the age changes of lungs
more air is left in the lungs with each breath the usual
what is tidal volume
the amount of air that moves in or out of the lungs with each respiratory cycle
with reduced tidal volume what happens to the rate of breathing
the freq of breathing increases
this has an energy cost impact
exercise older adults - what HR do we want to get to
55-70%
70-90 for high instensity
exercise older adults - what do we want the staring heart rate to be
<100 bpm
exeercise older adults - HR and sedentary and cardiac history patients
take a more conservative approach 20-30 BPM above resting HR
exercise older adults - SBP
15 - 20 increase
start <180 (suggest poorer health)
limit: 220 or a drop of >10
exercise older adults - DBP
min rise or slight decrease
start: <95
limit: >110
what are the goals for cardiac rehab in older adults
increase SV
improve O2 extraction
(decrease HR at rest)
improve resitory muscle function
general body conditioning
what is the target HR when working with older adults
55-70% of max
max: 220-age
how do we calculate the max heart rate reserve
220-resting HR
target HR : 55-70 of HR reserve - resting HR
what is the max safe range of the borg and the mBORG
17 borg
7/9 mBORG
tachypnea - what is a high rate
> 20 breath per min
what are some signs to stop exercise in an older adult
HR does not increase
VO2 plateuas are workload increases
RER >1.01
what is respiratory exchange ratio
the ratio between the volume of CO2 being produced by the body and the amount of O2 being consumed.
