ex phys final Flashcards
describe pulmonary hypertension
fibrosus formation
left vent pathology possible
ejection fraction low
blood backs up into lungs
becomes a problem in right vent
- hypertrophy
- called cor pulmonale
how to check pulse?
PT - radial only
pt - radial or carotid
normal - count to 30 or 60 sec
after exercise - count to 10 or 15 sec
where is blood pressure highest?
aorta
where are major arteries and veins of the heart?
outer surface of heart
not compressed in contraction
what is systole and diastole?
sys: contraction of ventricles
dia: relaxation of ventricles
what do purkinje fibers do?
rapidly spreads impulse to contract throughout ventricles
what part of QRS is ventricular systole?
s wave through t wave
describe the intrinsic control of the heart
autorhythmaticity: regular intervals
SA node: pacemaker
AV node: delays impulse by .10 sec
purkinje fibers
describe the extrinsic control of the heart
parasym nerve fibers: decre HR
sym nerve fibers: incr HR
bradycardia
tachycardia
describe cardiac muscle
capable of contraction and force generation
capable of initiating impulse
intercalated discs
snycytial contraction
describe cardiac wall thickness
thicker the wall, greater the force
L vent has greater thickness
reg training: thicker LV wall and incres LV mass
describe cardiac output
amount of blood pumped per minute
Q = HR x SV
5 L/min
trained have lower HR and higher SV
what is preload?
degree of ventricular stretch when heart is at the end of diastole
what is afterload?
pressure that heart needs to exert to eject blood during ventricular contraction
equation of SV
SV = EDV - ESV
define ejection fraction
ratio of available blood to pumped blood
EF = SV/EDV
what does training do to ventricular volume?
increases EDV and SV
decreases HR
SV increases with exercise intensity up to 40-50%
what are the laws that govern blood flow?
blood flows from higher pressure to lower pressure
rate of flow is proportional to pressure difference between 2 ends of vessel
increase in pressure difference increases flow
decreasing resistance increases flow
increase in radius of vessel increases flow
what does increased capacitance do to blood pressure?
decrease
what is the primary site of vascular resistance?
arterioles
what system (para vs sym) causes bronchoconstriction/dilation?
bronchoconstriction - parasym
bronchodilaton - sym
where is velocity highest?
aorta and other large arteries
velocity level in capillaries and why
very low
so that they can release oxygen
what is the pulse pressure of someone with a 120/80 BP?
120-80=40
what is the equation for MAP? use 120/80
MAP = DP + 1/3 (SP - DP)
93 = 80 + 1/3 (40)
what us the MAP that most people need to survive?
60 mmHg
70-100 is normal
when talking about blood pressure, what vessel is referenced?
arteries
what does BP drop so low in the capillaries?
there are so many of them
BP is slow to facilitate exchange of materials
what happens to plasma volume during intense PA?
decrease as much as 10%
due to sweating and heavy breathing
prolonged aerobic exercise vs chronic effect of LT aero training and plasma volume
PAE = decreases 10-20%
CELTAT = increases 12-20%
what are 3 adaptations due to endurance training?
increased Q during endurance training
increased oxygen delivery to skeletal muscle
increased endurance performance
what are Q levels to skeletal muscle at rest and during max exercise?
rest - 15-20% - 1000/5000
ex - 80-85% - 21000/25000
how does blood return to the heart?
venous return aided by muscle pump
what percentage does VO2 max decrease with prolonged bedrest?
25% for 2-3+ months
what are factors that decrease VO2 max with bedrest?
reduced blood plasma and formed elements
stroke volume
oxidative capacity of skeletal muscles
skeletal muscle atrophy
muscular strength and endurance
what are factors relates to decline in prevalence of cardiovascular disease?
lifestyle changes: nutrition, stop smoking, exercise
improved medical techniques and diag
improves emergency care and treatment
improved drugs
what is coronary artery disease?
blockage of arteries supplying cardiac tissue
at what % of blockage id an angioplasty performed?
70-75
what is ischemia?
insuff blood to tissue due to partial blockage
results in angina pectoris
what is an MI?
severe or complete blockage, leading to cell death in heart
what is atherosclerosis?
progressive narrowing of artery due to plaque
what is arteriosclerosis?
thickening and loss of elasticity of arterial wall
what type of CAD causes the most US deaths?
coronary heart disease (52%)
what happens at 20% of blockage of coronary arteries?
builds more capillaries to compensate
what is a stroke, the different types and the causes?
lack of blood supply to brain
ischemic: blockage
hemorrhagic: rupture
predisposing factors: hypertension, athero damage
what is heart failure and what are the different types?
ventricles cannot contract, so Q is insuff
acute: caused by heart attack from drugs or blockage
chronic: caused by hypertension, minor MIs, virus
what artery supplies majority of left ventricle?
anterior descending
what is hypertension?
high BP at rest
heart must work harder
cardiac tissue needs more oxygen
increases strain and risk of heart failure
what does increase in peripheral resistance cause?
DPB increase by 10+
what is peripheral artery disease?
affects arteries in legs
type of PVD
what is peripheral vascular disease?
can affect any blood vessel outside of heart and brain
what are the main forms of PVD?
blood clots - DVT
swelling
narrowing and blockage of vessels
what are the blood pressure categories?
normal: <120 and <80
elevated: 120-129 and <80
HTN stage 1: 130-139 or 80-89
HTN stage 2: 140+ or 90+
HTN crisis: 180+ and/or 120+
what are the risk factors for HTN?
PI
overweight and obesity
heredity
male
increasing age
sodium sensitivity
use of tobacco
excessive alcohol consumption
psychological stress
diabetes
oral contraceptive
pregnancy
what are the uncontrollable risk factors for CAD?
age
male
heredity
what are the controllable risk factors for CAD?
smoking
blood lipid profile
HTN
obesity
DM
PI
psychological stress
alcohol consumption
diet and nurtition
what are good exercises in early phases of diagnosis for cardiovascular pts?
stationary bike
swimming
yoga
pilates
breathing exercises
what are some tests for medical clearance?
EKG
graded exercise test
what are some types of aerobic exercise?
jogging
running
cycling
elliptical
swimming
aerobic dance
rowing
what is the minimal duration for exercise?
20-30 min per session
longer session recommended for most
minimal freq of training?
3 days/week
intensity of exercise?
minimal: 55-65 of max HR
upper end range for health: 94% of max HR
range for athlete near optimal gains: 77-90 of max HR
cardiovascular training: 70-85%
how to calculate HR max?
HR max = 220 - age in years
HR max = 207 - (.7 x age in years)
second more accurate
max HR in relation to VO2 max
VO2 max % will be less than max HR
values of risk for total cholesterol
little risk: <200 mg/dL
some risk: 200-239 mg/dL
serious risk: >240 mg/dL
values of risk for LDL-C
little risk: <130 mg/dL
some risk: 130-159 mg/dL
serious risk: >160 mg/dL
values of risk for HDL-C
little risk: >60 mg/dL
some risk: 40-59 mg/dL
serious risk: <40 mg/dL
values of risk for triglycerides
little risk: <150 mg/dL
some risk: 150-199 mg/dL
serious risk: >200 mg/dL
HRR (Karvenen) method
etilmate HR needed for specific % of peak O2 consumption
HRR = HRmax - HRrest
what % of HRmax is very light exercise?
less than 57%
3-4 mets
walking
what % of HRmax is light exercise?
57-63%
4-5 mets
jogging
what % of HRmax is moderate exercise?
64-76%
6-7 mets
running
what % of HRmax is vigorous exercise?
77-95%
7-10 mets
lactate deposition
what % of HRmax is maximal exercise?
96-100%
10-14 mets
180-190 HR
what is a class 1 CVD?
heart disease
no limits on activity
no complaints
max MET: 6.5 - can run
70-80% of max HR
what is a class 2 CVD?
slight activity limitations
comfort at rest
ordinary activity results in fatigue, pain, dyspnea, palpitations
max MET: 4.5 - stairs
what is a class 3 CVD?
marked activity limitation
comfort at rest
less than ordinary activity results in fatigue, pain, dyspnea, palpitations
max MET: 3.0 - walking
what is a class 4 CVD?
inability to carry out PA without discomfort
max MET: 1.5 - basically rest
maybe can stand, or walk slow
give seated exercises
what is total body resistance?
all muscles trained each session
what is a split routine?
some muscles on some days, others on others
how do you progress resistance training?
gradual increases in intensity and volume
shortening/lengthening rest periods
recover HR for different age groups
20-29 yo: 140 bpm
30-39 yo: 130 bpm
60-70 yo: 100 bpm
what is fartlek training?
alternating between bursts of sprinting and slower recovery jogging
what is the point of a cool-down?
avoid venous pooling
detraining effects on strength training
cessation: loss of strength and power
reduced volume: strength is maintained if intensity is
detraining effects on aerobic training
cessation: rapid decrease in peak O2 consumption (MET level decreases)
reduced volume: aerobic capabilities are maintained if intensity is
