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Prev & Rehab Physiology > Exam 1: Physical Activity and Health & Hypertension > Flashcards

Exam 1: Physical Activity and Health & Hypertension Flashcards

1
Q

Evidence-Based Practice

A

Clinical decision making that integrates the best available research with clinical expertise and patient characteristics/preferences

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2
Q

Physical Activity Guidelines

A

150-300 mins of aerobic activity/week OR 75-150 mins of aerobic activity/week
Minimum of 2 days/week of resistance training
Minimum of 3 days/week flexibility training

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3
Q

Health Related Physical Fitness

A

Parts of physical fitness that help a person stay healthy; includes cardiovascular fitness, flexibility, muscular endurance, and strength

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4
Q

Skill Related Physical Fitness

A

Parts of fitness that help a person perform well in sports and activities requiring certain skills; includes agility/balance, coordination, power, reaction time, and speed

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5
Q

Biologic Plausibility

A

Finding a correlation between 2 variables and believing there is a causation between them

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6
Q

Cofounder

A

Variable effecting an outcome measure

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7
Q

Herman Hellerstein

A

First to believe cardiac patients should be going back to work ASAP
Transformed cardiac rehab into what we know today

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8
Q

Right Atrium

A

Receives blood from 3 veins: Superior/Inferior Vena Cava and the Coronary Sinus
Blood passes from the RA into the RV through the tricuspid valve

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9
Q

Right Ventricle

A

Blood passes from the RV through the pulmonary valve into the pulmonary trunk which divides into the right/left pulmonary trunk

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10
Q

Left Atrium

A

Receives blood from the lungs through 4 pulmonary veins
Blood passes from the LA into the LV through the bicuspid valve

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11
Q

Cardiac Cycle

A

The alternating period of contraction and relaxation of the heart

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12
Q

Iso-volumetric Contraction Period

A

Brief period where ventricles contract but DO NOT eject blood

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13
Q

Ejection Period

A

Portion of systole where blood is ejected from the heart

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14
Q

Iso-volumetric Relaxation Period

A

Brief period where ventricles are relaxing BUT NOT filling with blood

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15
Q

Ventricular Filling Period

A

Portion of diastole where ventricles fill with blood

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16
Q

Frank Starling Law of the Heart

A

An increased stretch of the myocardium enhances the contractile force causing more blood to eject

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17
Q

Afterload

A

The pressure that the ventricle has to generate in order to eject blood out of the chamber

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18
Q

Ejection Fraction

A

Diastole - Systole
How much blood is coming in - how much blood is going out

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19
Q

Chronic Heart Failure (CHF)

A

Impairment in the ability of the ventricle to eject blood or to fill with blood

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20
Q

Systolic Dysfunction

A

Impaired emptying of the left ventricle, with a resulting fall in cardiac output

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21
Q

Diastolic Dysfunction

A

The left ventricle is non-compliant resulting in impaired filling

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22
Q

Myocardial Infarction (MI)

A

Death of cardiac myocytes resulting from prolonged ischemia caused by complete vessel occlusion

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23
Q

Coronary Artery Bypass Graft (CABG)

A

Surgery that improves blood flow to the heart

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24
Q

Stable Angina

A

Transient pain/discomfort in the chest caused by myocardial ischemia brought on by increased physical exertion

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25
Q

Unstable Angina

A

Chest pain that lasts for a longer duration, at increased frequency, or at a lower level of exertion than usual

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26
Q

Heart Attack

A

A condition in which blood flow to the heart muscle is blocked, causing heart cells to die

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27
Q

CABG - Exercise Considerations

A

No upper body RT before 5 weeks following
May need lower intensity initially due to musculoskeletal discomfort or health issues at incision

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28
Q

Nitroglycerin

A

Relaxes coronary arteries and other vessels

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29
Q

Valve repair

A

Procedure to treat stenosis or regurgitation

30
Q

Mitral Stenosis

A

A narrowing of the mitral valve opening

31
Q

Mitral Regurgitation

A

A leaking mitral valve which allows blood to flow in two directions

32
Q

Coronary Stent: Percutaneous Coronary Intervention

A

Small metal mesh tube used to treat narrow/weak arteries

33
Q

Pacemaker

A

Small device implanted in the chest to control arrhythmias

34
Q

Implantable Cardioverter Defibrillator (ICD)

A

Same as pacemaker + uses electrical impulses to shock the heart to control life threatening arrhythmias

35
Q

Implantable Devices - Exercise Considerations

A

ICD patients have low function capacity due to severe myocardial dysfunction
More formal and prolonged EKG monitoring
Prescribe intensities below ICD/pacemaker thresholds

36
Q

Transplant

A

Removal of damaged heart and replaced with a donor heart

37
Q

Transplant - Exercise Considerations

A

HR (95-115) and BP are often elevated at rest due to loss of parasympathetic innervation of the donor heart
Peak HR only slightly lower than predicted
May have delayed HR response at onset and post exercise
Can typically use light to moderate aerobic Rx

38
Q

Atrial Fibrilation

A

Atria beats irregularly and fast
Meds: anticoagulants

39
Q

Systolic Blood Pressure

A

Amount of pressure during contraction

40
Q

Diastolic Blood Pressure

A

Amount of pressure during relaxation

41
Q

Essential Hypertension

A

Unknown cause for high blood pressure
Anything that increases sympathetic response

42
Q

Secondary Hypertension

A

High BP caused by the effects of another disease/condition

43
Q

Hypertension in Older Persons

A

More than 2/3 of people over 65 have HTN
Lowest rates of BP control due to chronic conditions, med adherence, and/or rate of aging decline

44
Q

Hypertension in Children and Adolescents

A

Secondary hypertension most common
Use lifestyle interventions before pharmacological
Effective doses are often smaller

45
Q

Blood Pressure Classifications

A

Normal: ≤120/80
Elevated: 120-129/≥80
Stage 1 Hypertension: 130-139/80-89
Stage 2 Hypertension: ≥140/≥90

46
Q

Hypertensive Crisis

A

Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage

47
Q

Benefits of Lowering BP

A

Stroke incidence: 35-40%
Myocardial Infarction: 20-25%
Heart Failure: 50%

48
Q

Severe Hypertension Associated with:

A

Headache
Dizziness
Palpitations
Easy fatiguability
Blurring of vision

49
Q

Athersclerosis

A

Thickening/calcification of lipids in the arteries
Leading cause of CHD/stroke
Chronic immune-inflammatory disease

50
Q

CVD Risk Factors

A

Hypertension
Cigarette smoking
Obesity (BMI ≥30)
Physical inactivity
Dyslipidemia
Diabetes mellitus
Age (men under 55/women under 65)
Family history or premature CVD

51
Q

Lifestyle Modifications for CVD Prevention and Management

A

Stop smoking
Limit alcohol intake
Lose weight if overweight
Increase aerobic physical activity
Reduce sodium intake
Maintain adequate potassium intake

52
Q

Cigarettes and CVD Risk Factors

A

Promoting platelet activation and aggregation
Decrease NO release (endothelial dysfunction)
Oxidizes LDL
Chronic, low-grade inflammation

53
Q

Alcohol and CVD Risk Factors

A

Stimulates sympathetic nervous system
Increases renin which increases inflammatory response
Down-regulates calcium
Impairs electrolyte transport

54
Q

Renin Angiotensin Aldosterone System (RAAS)

A

A hormone cascade pathway that helps regulate blood pressure and blood volume

55
Q

Angiotensin I

A

THE potent vasodilator

56
Q

Angiotensin II

A

Causes increases in blood pressure, influences renal tubuli to retain sodium and water, and stimulates aldosterone release from adrenal gland.

57
Q

Sodium and Potassium Intake

A

Goal for adults is to consume less than 2,300 mg of sodium per day
Individuals are encouraged to increase their consumption of foods rich in potassium (lowers BP by vasodilating)

58
Q

Sodium Sources in the Diet

A

Food Processing: 77%
Inherent in foods: 12%
Added at the table: 6%
Added during cooking: 5%

59
Q

DASH Diet

A

Low in saturated and trans fat
Rich in potassium, calcium, magnesium, fiber, and protein
Emphasizes vegetables, fruits, and fat-free/low-fat dairy products
Limits sodium, sweets, and sugary beverages, and red meats

60
Q

Acute Aerobic Exercise and BP

A

10-20% mmHg reduction during initial 1-3 hours
Effects decrease as time goes on from previous bout

61
Q

Chronic Aerobic Exercise and BP

A

Exercise lowers BP at fixed exercise workloads
Benefits increase in a dose dependent manner
Decrease in plasma norepinephrine levels
Increase in circulating vasodilators
Reduces renal release to A2 to reduce vasoconstriction

62
Q

Resistance Training and HTN

A

Elicits a “pressor” response: greater elevation of SBP and DBP due to local vasoconstriction with contraction
Generally reduces resting BP in HTN adults

63
Q

HTN Exercise Prescription - Cardiovascular Training

A

Frequency: aerobic exercise on most days of the week
Intensity: moderate-intensity (40-60% VO2R/HRR)
Time: 30-60 mins of continuous/intermittent (10 min bouts) aerobic activity
Type: Large muscle groups

64
Q

HTN Exercise Prescription - Resistance Training

A

Frequency: 2-3 d/wk
Sets: 1 - volitional fatigue
Reps: 8-12 (60-80% 1RM) per set for healthy adults/10-15 per set at a lower level of resistance for older adults
Stations/Devices: 8-10 exercises that condition the major muscle groups

65
Q

Volitional Fatigue

A

Fatigue that has caused form to be impaired

66
Q

Hypertension Contraindications

A

Systolic BP greater than 200 mmHg or diastolic BP greater than 110 mmHg at rest
Untreated/uncontrolled HTN may hinder exercise tolerance and/or performance

67
Q

Diuretics

A

Indications: edema, HTN, HF, kidney dysfunction
Actions: assists kidneys in excretion of excess fluids (Na+, water)
Names: “-ide” (amiloride)

68
Q

Beta Blockers

A

Indications: HTN, angina, arrhythmias, a-Fib, HF, anxiety
Actions: Reduces HR and force of contraction by increasing blood flow through the vessels; blunts sympathetic nervous system (max HR)
Names: “-lol” (Antenlol)

69
Q

Angiotensin II Receptor Blockers (ARBs)

A

Indications: HTN, diabetes, HF
Actions: decreases effectiveness of angiotensin II (blocks response) resulting in blood vessel vasodilation (relaxation)
Names: “-tan” (Losartan)

70
Q

Angiotensin Converting Enzyme (ACE) Inhibitor

A

Indications: HTN, CAD, diabetes
Actions: decreases hormone ACE-II preventing vasoconstriction, inhibit angiotensin I from turning into angiotensin II
Names: “-pril” (Ramipril)

71
Q

Ca+ Channel Blockers

A

Indications: HTN, angina, diabetes, ischemic heart disease
Actions: causes blood vessels to dilate by blocking Ca+ from entering the muscle cells of the heart; decreases stroke volume and resistance to flow
Names: “pine” (Amlodipine)

Prev & Rehab Physiology (1 decks)

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