Chapter 7 Flashcards
General term to describe ability to perform physical work.
fitness (requires cardiorespiratory functioning, muscular strength and endurance, and musculoskeletal flexibility)
Measure of the body’s capacity to use oxygen.
VO2 max (mL/kg/min)
Endurance
ability to work for prolonged periods of time and the ability to resist fatigue (muscular and cardiorespiratory)
Aerobic exercise adaptations
- increased levels of oxidative enzymes in the muscles
- increased mitochondrial density and size
- increased muscle fiber capillary supply
mVO2
myocardial oxygen consumption - a measure of O2 consumed by heart muscle, supply of O2 to heart is dependent on coronary blood flow
Measurably increased rate of oxygen intake following strenuous activity intended to erase the body’s “oxygen deficit.”
EPOC (excess post-exercise oxygen consumption)
Deconditioning
- Occurs with prolonged bed rest
- Frequently seen in those with extended, acute illness or long term chronic condition
- Disease process will affect conditioning
- Prior level of training will influence conditioning
Phosphagen (ATP-PC System)
- phosphocreatine (fuel source) and ATP stored in muscle cell
- no O2 required
- max capacity is small but max power is large
- short, quick bursts of energy
- 15-30 sec
Anaerobic Glycolytic System
- glycogen (glucose) is fuel source
- no O2 required
- lactic acid byproduct
- max capacity and power is intermediate
- 30-90 sec of exercise
Aerobic System
- glycogen, fats, and protein for fuel
- O2 required
- max capacity is large but power is small
- predominates after 2 min
Deconditioning effects seen with prolonged bed rest:
Decreases in:
- muscle mass
- strength
- cardiovascular function
- total blood volume
- plasma volume
- heart volume
- orthostatic tolerance
- exercise tolerance
- bone mineral density
1 MET =
3.5 mL/kg/min
During exercise, there is a/an ________ in vagal stimuli as well as an increase in ____ stimulation.
decrease, SNS
Cardiovascular response to exercise:
SNS response:
- peripheral vasoconstriction in nonexercising muscles
- increased myocardial contractility (force)
- increased heart rate (SA depolarization increase)
- increased systolic blood pressure
- increase and redistribution in cardiac output
- decrease in vagal stimuli
Respiratory response to exercise occurs before exercise begins. (T/F)
True
To supply the additional oxygen needed and excrete the excess CO2 produced, ________ ventilation increases 10-20-fold during heavy exercise.
alveolar
Which factors result in increased oxygen extraction from the blood (increased dissociation of oxygen from hemoglobin)?
- decrease in local tissue PO2 because of use of more oxygen by working muscle
- production of more CO2 causes the tissue to become acidotic and the temperature increases
- increase of red blood cell 2,3-diphosphoglycerate (DPG) produced by glycolysis during exercise
Factors determining oxygen consumption:
- vascularity of the muscles
- fiber distribution
- number of mitochondria
- oxidative mitochondrial enzymes present in the fibers
Termination of stress testing:
- progressive angina
- significant drop in systolic pressure
- lightheadedness, confusion, pallor, cyanosis, nausea, or peripheral circulatory insufficiency
- abnormal ECG response including ST segment depression greater than 4 mm
- excessive rise in blood pressure
- subject wishes to stop
The most popular treadmill protocol for stress testing.
Bruce protocol
A conditioning response typically occurs at ___ to ___% maximum heart rate depending on the individual and the initial level of fitness.
60-90% (70% is minimum in healthy, young individuals)
When using the Karvonen formula, the exercise heart rate is ______ than when using the maximum heart rate alone.
higher
Which elicits greater improvement in VO2max: high-intensity, short duration or moderate intensity/longer duration?
high-intensity, short duration
Physiological responses to warm-up:
- increase in muscle temperature
- increased need for oxygen
- dilatation of capillaries with increases in the circulation
- adaptation in sensitivity of the neural respiratory center to various exercise stimulants
- increase in venous return
Guidelines for the warm-up:
- 10 minutes of total body movement exercises, such as calisthenics or walking
- attaining a HR that is within 20 beats/min of the target HR
Continuous Training
- submaximum energy requirement
- aerobic metabolism
- slow-twitch muscle fibers
- 20-60 minutes without exhausting the oxygen transport system
- overload through progressing duration
- most effective way to improve endurance
Interval Training
- improve strength and power over endurance
- passive or active recovery
- total amount of work that can be completed is greater
Circuit Training
- several exercise modes and mix of static or dynamic effort
- can improve strength and endurance
Circuit-Interval Training
- aerobic and anaerobic systems
- delay in need for glycolysis and production of lactic acid
Cool-down period benefits:
- prevent pooling of blood in the extremities by maintaining venous return
- prevent fainting by increasing the return of blood to the heart and brain as CO and VR decreases
- enhance recovery period with oxidation of metabolic waste and replacement of energy stores
- prevent myocardial ischemia, arrhythmias, or other cardiovascular complications
Physiological changes that occur with aerobic exercise (at rest):
- decreased heart rate
- decreased sympathetic tone (increased vagal tone)
- decreased blood pressure
- decrease in peripheral vascular resistance
- increase in blood volume and hemoglobin
- larger lung volume
- larger diffusion capacity in lung
- muscle hypertrophy
- increased capillary density
- increased number and size of mitochondria
Physiological changes that occur with aerobic exercise (during exercise):
- reduced heart rate
- increased stroke volume (increased contractility and blood volume)
- increase cardiac output
- increased extraction of oxygen by working muscles
- decreased blood flow of working muscle (muscles are more efficient at pulling out O2)
- decreased myocardial oxygen consumption
- larger diffusion capacity in lung
- increased maximal minute ventilation
- ventilatory efficiency increased
- decreased rate of depletion of muscle glycogen
- lower blood lactate levels at submaximal work
- less reliance on PC and ATP
Overall changes occurring in response to aerobic exercise:
- decrease in body fat
- decrease in blood cholesterol and triglyceride levels
- increased heat acclimatization
- increase in the breaking strength of bones and ligaments and the tensile strength of tendons
Inpatient Phase (Phase I) Cardiac Rehab
- 3 to 5 days
- initiate risk factor education
- initiate self-care activities, progress sit to stand
- provide an orthostatic challenge to the cardiovascular system, i.e. ambulation
- prepare patient and family for continued rehab
Outpatient Phase (Phase II) Cardiac Rehab
- 6-8 weeks
- heart rate and rhythm monitored
- increase exercise capacity in a safe, progressive manner
- enhance cardiac function
- produce favorable metabolic changes
- determine the effect of medications on increasing level of activity
- relieve anxiety and depression
- progress to an independent exercise program
Outpatient Program (Phase III)
- purpose is to continue to improve or maintain fitness levels from Phase II
- heart rate and rhythm no longer monitored but patient monitors own pulse rate
- swimming, hiking, etc.
Resting heart rate is influenced by age. (T/F)
False
Cardiac output is related to size. (T/F)
True
