Chapter 17/21 Flashcards
what type of cells synthesize insulin in the pancreas
beta cells in the pancreas –> bring in glucose
When plasma glucose is high what happens to decrease this
high plasma glucose causes beta cells in the pancreas to increase insulin secretion –> decrease plasma glucose
What is diabetes mellitus
group of metabolic diseases characterized by an inability to produce enough insulin or use it properly
- characterized by hyperglycemia
explain what type 2 diabetes is
* explain the pathway and how it effects the muscle
- insulin sensititivity – downregulated
- sufficient insulin secreted into the blood stream –> increased glucose in the blood stream & obesity, inheritance and other factos leading to insulin resistance –> muscle unable to use glucose due to insulin resistance
- also increased glucose absorption with excess loss in the urine –> sweet urine –> kidney damage
explain what type 1 diabetes is
* explain the pathway and how it effects the muscle
- dont produce enough insulin
- low insulin secreted from the pancreas into the blood stream –> increased blood glucose due to low insulin & glycogen and protein breakdown causing keto-acidosis –> muscle unable to use glucose due to low insulin
- also increased glucose absorption with excess loss in the urine –> sweet urine –> kidney damage
What are the 6 signs and symptoms of diabetes
- polydipsia (excessive thirst)
- polyuria (frequent urination)
- unexplained weight loss
- infection and cuts that are slow to heal
- blurry vision
- fatigue
** flux b/t hypo and hyper glycemic**
will exercise help type 1 diabetes
help translocate GLUT 4 to bring glucose into the muscle cells == worried more about hypo-glycemia NOT hyperglycemia
what is the effect of prolonged exercise in diabetics
- control of glucose is important – if dont inject enough insulin before exercise == high in plasma glucose
what happens to type 1 diabetics who do not inject the adequate amount of insulin before exercise
increase in plasma glucose
What is the effect of plasma insulin concentration, liver glucose release, glucose uptake by muscle, and blood glucose concentration with normal insulin levels
- plama insulin concentration = normal or slightly decreased
- high liver glucose release
- high glucose uptake by muscle
- unchanged blood glucose concentration
What is the effect of plasma insulin concentration, liver glucose release, glucose uptake by muscle, and blood glucose concentration with hypoinsulinemia
- plasma insulin concentration = markedly decreased
- high liver glucose release
- lower glucose uptake by muscle
- small increase blood glucose concentration
What is the effect of plasma insulin concentration, liver glucose release, glucose uptake by muscle, and blood glucose concentration with hyperinsulinemia
- plasma insulin concentration = increased
- small increase liver glucose release
- very large glucose uptake by muscle
- small decrease blood glucose concentration
Does exercise alone control blood glucose in type I diabetics
NO does not alone control blood glucose
what is a major concern during exercise for type 1 diabetics
hypoglycemia – may result in insulin shock
- if take normal dose of insulin and exercsie –> both decrease blood glucose –> hypoglycemia
What chance can result in lowering the odds of exercise-induced hypoglycemia
regular exercise schedule
* intensity, frequency, and duration
* altering diet and insulin
at what blood sugar values should you avoid exercise and when should you ingest CHO
- if fasting glucose is >300 mg/dl
- ingest CHO if glucose is <100 mg/dl
What should you do to manage your blood sugar with exercise
blood glucose monitoring before and after exercise
* identify needed changes in insulin or food intake
* learn how blood glucose responds to different types of exercise
where should you inject insulin
away from working muscle –> prevent increased rate of uptake and hypoglycemia
interaction could cause hypoglycemia in that region
What is the primary treatment for type 2 diabetes
exercise is a primary treatment
* helps treat obesity
* helps control blood glucose and reduce insulin resistance
* helps treat CVD risk factors
combination of diet and exercise may eliminate need for diabetic drug treatment
may need to adjust med dosages when sedentary become trained – prevent hypoglycemia
Explains what happens to plasma glucose after ingesting glucose with no exercise, exercise, and control
- no exercise = highest reaction and increase in plasma glucose
- w/ exercise = lower spike in plasma glucose – more controlled
- control = small spike but for most part maintained
Explains what happens to plasma insulin after ingesting glucose with no exercise, exercise, and control
- no exercise = increases slowly and peaks at an hour an a half
- exercise = overall low plasma insulin and lower spike/release of insulin even than control
- control = spike early and then decrease over time
when there is a decrease in blood glucose with less insulin how is insulin sensitivity effected
more insulin sensitive
What is asthma
a respiratory problem characterized by shortness of breath and a wheezing sound
What is asthma due to
- contraction of smooth muscle of airways
- swelling of mucosal cells
- hypersecretion of mucus
- vasoconstriction of the bronchioles
How do you diagnose asthma
using a pulmonary-function testing
what does pulmonary function testing look at? What 2 variables
- Vital Capactity (VC) – max volume of air expelled after max inhalation
- forced expiratory volume (FEV1) – volume of air expired in 1 second during maximal expiration
What are the triggers of an asthma attack
allergens (dust, pollutants), exercise, stress
Explain the response once an asthma attack is triggered
- plasma cells produce IgE antibodies which attach to mast cells lining bronchial tubules
- mast cells release inflammatory mediators
what is exercise enduced asthma (EIA)? triggered by?
- caused by cooling and drying of respiratory tract – trigger release of chemical mediators and airway narrowing
- more common in asthmatics
- does not necessarily impair performance if medically controlled
how is exercise enduced asthma diagnosed?
make you run with strenuous running > or equal to 85-90% of maxHR
** if PFT test shows > or equal to 10% decrease in FEV1 indicates EIA (vasoconstriction or narrowing)**
Explain the influence of different sports on exercise enduced asthma
- not a large decrease in FEV1 % of pre-exercise value in asthmatic swimmers because they are breathing in high humidity air
- running has the greatest decrease in FEV1 %
What are 3 ways to prevent EIA
- warmup (15 min at 60% of VO2max)
- perform short-duration exercise
- use a mas or face mask in the cold weather
What are 2 treatments for EIA
- Beta2-agonist in case of attack during exercise (need higher dosage to effect credibility of racing) == Epinephrine binds to Beta-adrenergic receptor
- other medications to prevent attack
What is the influence on performance for Beta2-agonists
- inhaled Beta2-agonists do not improve performance
- ingested salbutamol (beta2-agonist) does improve strength, anaerobic power, and endurance (at 10-20x inhaled dose)
What is the leading cause of death from cardiovascular diseases
CAD
Explain the normal, elevated, and hypertension blood pressures
- normal: systolic <120mmHg and diastolic <80mmHg
- elevated: systolic b/t 120-129 and diastolic <80mmHg
- hypertension: stage 1 = systolic b/t 130-139mmHg OR diastolic b/t 80-89 mmHg stage 2 = systolic > or equal to 140mmHg OR diastolic > or equal to 90mmHg
What is the prevalence of hypertension in the US
- 1/3 of the U.S. adults
- hypertension increases with age
What is the effect of hypertension on the body? What 2 major effects
- damages the endothelium – predisposition for atherosclerosis (scar blood vessel - less elasticity and more plaque buildup) and other vascular pathologies
- increased afterload (high MAP) – lead to left ventricular hypertrophy that can lead to heart failure
What is the treatment for mild or borderline hypertension
- lose weight if overweight, limit alcohol, reduce sodium, eat diet rich in fruit, vegetables, low-dairy, reduced in saturated fat and cholesterol, stop smoking, exercise
What type of exercise is best for hypertension
- aerobic (b/c dont want spikes in BP) exercise on most or all days of the week
- moderate intensity for 30-60 min
Explain how strength changes in children with exercise
- strength increases as muscle mass increases with age
- peaks around 20 yrs. for women and 20-30 for men
- extend of muscular development depends on relative maturation of nervous system – if dont send signal to muscles the muscles will not grow
Explain thermoregulation in children during exercise
- children have increased surface area:mass ratio
- greater conductive heat loss, gain
- less evaporative heat loss (decreased sweat) – havent developed as much surface area to lose heat quickly
- slower heat acclimation (or acclimitization)
explain children’s cardiovascular function in comparison to an adults
- resting and submax BP is lower in adults (related to body size)
- smaller hearts, lower peripheral resistance during exercise
Explain the differences in HR, SV, Q, and (a-v)O2 difference in boys vs. men
- HR: children have higher HR because they have a smaller heart –> almost compensates for low SV
- SV: becuase children have a smaller heart they have a lower blood volume and lower SV
- Q: children have a slightly lower cardiac output than an adult becuase they have a high HR
- (a-v)O2 difference: the difference between a and v will increase to further compensate for being a child
Explain the cardiorespiratory changes that occur with aging: specifically VO2max: kids –> adults
- Avsolute VO2max increases with age (both boys and girls)
- relative VO2max is steady with age in boys and decreases with age in girls
explain the physiology behind why relative VO2max is steady in boys as they age but decreases with aging in girls
- becuase from 6-18 boys put on more weight and are taller
- men have more testosterone which causes them to increase their lean body mass –> this consumes more O2 that maintains the VO2max
- women have more estrogen and create more adipose tissue that does not absorb O2
Explain the change in lung function between a child and adult
- lung volume increases with age
- peak flow rates increase with age
Why are children’s economy of effort worse than adults
- child’s O2 consumption per kilo is greater than adults – b/c biomechanics and body development
- with age, skills improve, stride lengths improve
How does endurance running pace increase with age
- only a result of economy of effort
- occurs regardless of VO2max changes or training status
Explain why children have limited anaerobic performance compared to adults
- children have lower glycolytic capacity in the muscle: less muscle glycogen, less glycolytic enzyme activity, lower blood lactate
- resting stres of ATP-PCr are similar to adults
What are some common beliefs to why strength training in children is controversial
concern of damage to articular cartilage, epiphyseal growth plate, and muscle tendon insertion –> fuse too soon and not proper growth
Why is weight lifting safe and beneficial for children
- injuries can be avoided by attention to proper technique
- exercise can promote muscular strength and bone density – weight bearing to help build bone
Explain the difference between anaerobic and aerobic training in children
- aerobic = improve VO2 max like adults and performance increases due to improved running economy – change in anatomy
- anaerobic = leads to higher resting PCr, ATP, Glycogen, higher PFK activity, higher maximal blood lactate
explain the physical activity patterns among the youth
- physical activity patterns established in childhood carry into adulthood
- intervention aimed at getting children more active are ineffective –> hard to force children to be mroe active - need to be motivated
- early specialization in one sport reduces “fun” physical activities –> more discouraging
What is sudden cardiac death in young athletes caused by
abnormal, leathal heart rhythms
* medical exam can identify those risks == graded exercise test
can be thickening of ventricular septum
What happens to the basal metabolic temp during the luteal phase
thermoregulation is imparied during luteal phase of menstrual cycle
Define athletic amenorrhea
cessation of menstruation
* 12-9% of female athletes and 3% in gen population
What are the four concerns for female athletes
- exercise and the menstrual cycle
- eating disorders
- bone mineral density
- exercise during pregnancy
What are the three potential causes of athletic amenorrhea
- amount of training
- phychological stress
- low evergy availability
explain the relationship between % incidence of amenorrhea and weekly training distance
linear relationship – % chance increases with further distances
Explain the psychological stress that cuases amenorhea
- stress causes hormones to be released inhibiting a period
Explain how low energy availability causes athletic amenorrhea
if there is an imbalance between calories consumed (eating) and energy expenditure: resting calories, activity, exercise
- less food intake relative to E expenditure
explain why menstruation ceases in women
- prevent more energy to be burned within the menstrual cycle when not enough energy consumed
- maintain blood volume/iron values
- provide more energy to more vital organs – divert more E to maintaining survival
how does training effect menstruation
- no reason to limit training during menstruation
What is dysmenorrhea
painful menstruation due to prostaglandins
* prostaglandins released in the uterus causes contractions
* may limit training due to discomfort
What is the prevlance of disordered eating in athletics
- more prominent in female and less in male but always exist
What is anorexia nervosa
- extreme steps to reduce body weight
- starvation, exercise, laxative use
Effects: excessive weight loss, amenorrhea, death
What is bulimia
- pattern of overeating (binging) followed by vomiting (purging)
Effects: damage to teeth and esophagus
What are the 6 warning signs for anorexia nervosa
- rapid weight loss
- mood swings
- excessive exercise
- avoiding food-related activities
- wearing baggy clothing
- preoccupation with food, calories and weight
What is osteoporosis
loss of bone mineral content
What are the 6 warning signs for bulimia
- noticeable weight loss
- depressive moods
- strict dieting followed by eating binges
- excessive concern about weight
- bathroom visits after meals
- increasing criticism of one’s body
What are the 2 major causes of osteoporosis
- estrogen deficiency due to amenorrhea (post-menapause = no period = lower estrogen)
- inadequate calcium intake due to eating disorders
Explain the difference in bone mineral content between untrained and women who run
overall runners will have a higher bone mineral content than undtrained
* they have more weight bearing exercise
Explain the three components of the female athlete triad
low energy availability –> menstrual dysfunction & low bone density
menstrual dysfunction –>low bone density
What is the only bidirectional arrow in the RED-S? why?
between RED-S and phychological
- low energy availability –> RED-S –> disappointment –> characteristics of elite athletes –> control –> obsessive exercise, eating restriction…
What is relative energy defiiciency in sports (RED-S)
includes female triad into the other physiological processes during sports
- where all the energy goes to in the body and how it effects different processes
What is the equation for energy availability
energy availability (kcal/kg FFM) = (energy intake - exercise energy expenditure) / fat free mass
In what individuals can you not use the energy availability equation
cannot use for sedentary individuals
What is the treatment for RED-S
primary objective is to increase energy availability by:
* increasing energy intake
* reducing energy expenditure (i.e. training volume)
* combination of both
depending on athlete and training season – change intake with how much training
- athletes practicing restrictive eating behaviors should recieve nutritional counseling and psychotherapy
Explain the different processes of recovery from RED-S in: energy status, menstrual status, and bone mineral density
- energy status: improves in days or weeks
- menstrual status: months
- bone mineral density: years
Explain the outcomes with recovery from RED-S for: energy status, menstrual status, and bone mineral density
- energy status = increase in energy status will stimulate anabolic hormones (IGF-1) and bone formation, increase energy status will reverse energy conservation adaptions
- menstrual status = increase reproductive hormones, increase estrogen exerts an anti-resorptive effect on bone
- bone mineral density = estrogen continues to inhibit bone resportion, energy status will stimulate anabolic hormones (IGF-1) and bone formation –> slow rate of decline
Explain the risk of knee injury in female athletes
- injured at a higher risk for knee injuries compared to men (3.5x higher risk for non-contact ACL
What are the three assumed reasons why female athletes have more knee injury
- fluctuation in hormones during menstrual cycle –> compromize ACL strength
- knee anatomy – joint laxity
- dynamic neuromuscular imbalance –> imbalanced strength, proprioception, landing mechanics
What are the two major adaptations to pregnancy
- cardiovascular system and blood = increase plasma volume, Q, SV, and HR
- lungs = increase tidal volume and minute ventilation
Explain exercise in individuals who are pregnant
- regular endurance exercise poses little risk to the fetus and beneficial –> reduce risk of gestational diabetes and preeclampsia
- pregnant should consult physician prior to beginning exercise program
Explain the effect pregnancy has on VO2max
- absolute VO2max is increased or maintained == b/c increase in plasma volume
- combination of training and pregnancy results in greater adaptations than training alone
What are the exercise recommendaitons for individuals who are pregnant
30 min/day of moderate intensity
* intensity determined by RPE or HR (HR changes so much with age and across pregnancy so not definite) OR “talk test”
What are the three main factors that need to be checked with exercise during pregnancy
- monitor body temperature to prevent hyperthermia: limit body temp increase < or equal to 1.5 degrees C, and aquatic exercise is recommended
- maintain adequate hydration: consume fluids at regular interval, monitor fluid balance by measuring body weight
- reduce training intensity and volume as pregnancy advances: regular examinations by physician
explain the physiological response to acute exercise with aging
- endurance performance declines after age 60
- time of exercise increases exponentially
What is the effect of VO2 max with aging
VO2max declines about 1% per year – more for women
What is the mechanism for age related decline in endurance exercise performance
age –> max HR decrease, max SV decreases, (a-v) O2 difference decreases, economy and lactate threshold decreases
decline in VO2 max because driving decline in endurance exercise performance
Explain the physiological adaptations to aerobic trainingin elderly
training can slow but not prevent this decline in VO2max
* trained has a higher overall VO2max with increasing age
Explain how when you train into your 80s how it effects your VO2 max and overall independence vs. dependence and risk of mortality
- if you train == individuals are much fruther from threshold of independence and have higher overall VO2 max
- if sedentary == individuals are much closer to the threshold of independence and risk becoming immobile and a higher risk of mortality
Explain how height changes with aging
height decreases with age
* starts at 35-49 years
* compression of intervertebral disks
* poor posture
* osteopenia and osteoporosis
Explain how weight changes with aging
weight increases then decreases
* increase 25 to 45 years: decrease physical activity and increase caloric intake
* decrease 65+ years: loss of body mass, and decrease appetite
during 30-45 lack physical activity, from 50-70 loss of appetite
Explain how body composition changes with aging
- body fat content tends to increase: active vs. sedentary older adults vary –> older athletes decrease body fat content and decrease central adiposity
- fat-free mass decreases starting at around 40: decrease muscle, bone mass, sarcopenia (decrease protein synthesis), inactivity, decrease in groth hormone, insulin-like growth factor 1
explain age-related muscle mass loss
- after 45 there is a continuous decline in uscle mass but men will have more muscle mass
explain the loss of strength with aging
- due to lower level of activity in older adults
- due to sarcopeia: decrease in muscle size (both type I and II), decrease in number of fibers (both type I and II), greater reduction in type II fibers with aging
Explain what happens to reflexes with age
- slow with age
- exercise preserves reflex response time
What happens to motor unit activation with aging
decreases with age
* exercise retains maximal recruitmenet of muscle
* some studies show decreases strength due to local muscle (changes fiber type) –> not neural factors
How does bone mineral conent change with aging
especially among women bone mineral content decreases
* bone resorption > bone synthesis
* due to lack of weight bearing exercise
What is the main cause for osteoporosis and how can this be improved medically
osteoporosis is more common in women over 50 b/c lack of estrogen
* estrogen replacement is a way to improve bone mass and stop decline
What is the best type of exercise for bone health
- weight bearing 3-5 times per week, resistance exercise 2-3 times/week
- better with activities that involve jumping
What are the physiological adaptations to strength training
- resistance training is most effective
- combination of resistance and balance training can reduce risk of falls
- trained = resistance,, active = endurance
If an indivdual has a blood pressure 124/88 what stage of blood pressure would they be in and why?
hypertension stage 1 == because eventhough their systolic blood pressure is normal their diastolic is within hypertension stage 1
