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BRS YEAR 2 > Cardioresp - Exercise Capacity > Flashcards

Cardioresp - Exercise Capacity Flashcards

1
Q

What is physical activity

A

A holistic term for all muscular activity of all intensity

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2
Q

What is exercise

A

Structured, purposeful activity that improves gross muscular activity to improve physical condition

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3
Q

What are ADLs

A

Basic independent self-care tasks done on a day to day basis that require strength, coordination and range of motion

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4
Q

What factors affect exercise capacity in the airway

A

Inspired O2
Airway resistance/calibre
Pulmonary compliance and elastance
Diffusion distance from alveoli to the capillaries

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5
Q

What factors affect exercise capacity in the heart

A 
Valve structure
Myocardial contractility
Myocardial thickness
Myocardial perfusion 
Conduction system
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6
Q

What factors affect exercise capacity in the blood

A

Blood parameters e.g. MCV, HCT, Hb
Arterial blood pressure
Blood viscosity
Perfusion

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7
Q

What factors affect exercise capacity in the muscles

A

Capillary density
Mitochondrial density
Local vasodilation
Oxidative enzyme concentration

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8
Q

What is V/Q matching

A

Ventilation perfusion matching - alveoli that are not well ventilated undergo vasoconstriction as blood can be directed elsewhere where there is a greater rate of gas exchange, therefore a greater demand for increased blood flow.

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9
Q

Where is perfusion greatest

A

At the base of the lungs due to the gravity of intravascular pressure moving downwards

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10
Q

Where is ventilation greatest

A

At the base of the lungs due to a less negative intrapleural pressure therefore a lower trasnpulmonary pressure. This means that alveoli at the base are smaller due to a greater level of compliance and thus more ventilation

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11
Q

What 3 tests can we use to evaluate exercise

A

Cardiopulmonary exercise test
6 minute walk test
Incremental shuttle walk test

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12
Q

What’s involved in cardiopulmonary exercise test

A

Cycle ergometer or treadmill with incrementally increasing intensity.

We measure ECG, O2, Co2 and ventilation

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13
Q

What’s involved in six minute walk test

A

You walk a 20-30 metre flat course such as a corridor over 6 minutes, and the max distance you walk is recorded

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14
Q

What’s involved in incremental shuttle walk test

A

10 metre circuit that’s regulated by external audio - every minute you do a certain number of laps, the number of laps increases every minute (like a bleep test)

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15
Q

What are the outputs of a cardiopulmonary exercise test

A

ECG continually recorded - however we are most interested in peak VO2

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16
Q

What are the outputs of a six minute walk test

A

Distance walked, we may also measure heart rate, pulse oximetry and perceived exertion e.g. with Borg’s RPE scale (Rating of Perceived exertion)

17
Q

What are the outputs of a incremental shuttle walk test

A

Total distance walked before volitional end - we may also measure heart rate, pulse oximetry and perceived exertion e.g. with Borg’s RPE scale (Rating of Perceived exertion)

18
Q

What are the pros of a cardiopulmonary exercise test

A
  • Quantifies performance in relation to metabolism
  • Precise and reproducible
  • Continuous monitoring for safety
19
Q

What are the pros of a six minute walk test

A
  • Patient driven pace
  • Cheap
  • Validated in most clinical populations
20
Q

What are the pros of a incremental shuttle walk test

A
  • Cheap
  • Validated clinically
  • Can help achieve maximum levels due to external audio
21
Q

What are the cons of a cardiopulmonary exercise test

A
  • Requires skill/support
  • Very expensive
  • Needs dedicated space
22
Q

What are the cons of a six minute walk test

A
  • Needs unobstructed course therefore hard to do in hospital
  • Pace is not regulated
23
Q

What are the cons of a incremental shuttle walk test

A
  • Needs unobstructed course
  • Minimum pace = 1.8 km/hr therefore may be hard for some
  • Ceiling effect = 1020 m
  • Patient may be penalised for poor pace management therefore results may be skewed unnecessarily
24
Q

What is MVV

A

Maximum voluntary ventilation

25
Q

What is PET Co2/O2

A

End tidal partial pressure of Co2/O2

26
Q

What is HF

A

Heart frequency

27
Q

What is SpO2

A

Peripheral oxygen saturation

28
Q

What does a low rate of oxygen consumption indicate

A

There may be a problem in oxygen transport or excitatory impairment

29
Q

What is RER and how is it calculated

A

Respiratory exchange ratio - calculated by dividing VCO2 by VO2 - therefore the higher RER means the more reliant we are on anaerobic respiration

30
Q

How do we indicate the index of anaerobic metabolism

A

We can use a graph to see the different gradients of O2 and CO2 - when the gradients change so that CO2 starts to overtake O2 - we know that we’re becoming more anaerobic. This is because O2 coming in should be a surplus of CO2 going out

BRS YEAR 2 (37 decks)

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