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Exercise Physiology > EXAM 4 > Flashcards

EXAM 4 Flashcards

1
Q
  • person being measured differs from the standard reference body only in the amount of fat
  • density of fat is 0.901 gm/cc
  • density of fat-free body is 1.100 gm/cc
A

assumptions for all body compositions

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2
Q
  • estimating body composition from body density
  • principle/theory: density = mass/volume
  • underwater weighing, hydrostatic weight or hydrodensitometry
    • bod pod
A

densitometry

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3
Q

Accuracy of H20 weighing:
- considered the _ of body composition assessment <1% BF
- pros: accurate, based on assumptions
- cons: original reference body was based on a few cadavers, only one female
- can be difficult for individual who is hydrophobic
- can be expensive for all of the equipment

A

“gold standard”

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4
Q
  • same principle as hydrostatic
  • determine body volume differently
  • body volume determined in a capsule
  • accuracy, similar to hydrostatic
  • expensive ($65K)
A

Bod Pod

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5
Q

_ principle/theory:
- percentage of body weight that is 70-75% at birth
- methods that determine total body water can in turn, predict body fat and lean mass
- tracers/dilution
- BIA
- TOBEC

A

hydrometry

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6
Q

Total body water measurement by dilution:
- tracer is distributed only in the _
- tracer is _ distributed in all anatomical water compartments
- rate of equilibration of the tracer is rapid
- neither the tracer nor the body of water is _ during the time of tracer equilibration

A
  • body of water
  • equally
  • metabolized
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7
Q

Types of _:
- Tritium
- Deuterium
- Oxygen-18
- accuracy: can be as accurate as a precision of 1-5%

A

tracers

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8
Q

Tracers:
- Pros: does not require _
- Cons: can be _, does us radioactive isotopes (can be fearful for some)

A
  • subject cooperation
  • expensive ($5-100)
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9
Q

Bioelectrical Impedance and Total Body Electrical Conductivity:
- principle/theory:
- tissues high in water are _
- electrical current flows the path of _
- volume of tissues can be determined from measurements of combined resistances
- accuracy of BIA: 1-2% precision, 3.5-5% accuracy
- assumptions:
- assumes that the _ has uniform conductivity, is homogenous, a constant cross-sectional area, and known length
- no conduction in the “non conductive” components of the body

A
  • highly conductive
  • least resistance
  • cylinder
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10
Q
  • first used to asses the lean mass of hogs
  • in 1985 commercial devices to measure body comp in animals, children and adults
  • in 1994, took off the market
  • can be influenced significantly by electrolytes
A

TOBEC

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11
Q

TOBEC:
- principle/theory:
- underlying principle is the _, conductivity of a tissue is dependent on its water content and free electrolyte concentration, temperature, and frequency of the current
- _ to the volume of the fat and the bone-free body mass
- accuracy: 2.5% body fat is considered marginally superior to BIA
- method: an electric current is induced into the body using an _ rather than a current using electrodes

A
  • same as for BIA
  • directly proportional
  • electromagnetic field
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12
Q

Pros/Cons of all hydrometry
- pros:
- BIA: easy, little subject cooperation
- TOBEC: easy to use, little subject cooperation
- cons:
- BIA: _ can significantly alter results, as an electrode placement
- TOBEC: expensive and equipment is _ by manufacturer

A
  • hydration levels
  • no longer supported
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13
Q

challenges of hydrometry
- body is not cylinder, with uniform CSA
- smaller cylinder (arm) = _
- arm is 4% of weight
- leg is ~17%
- arm has 47% resistance, leg ~50%
- trunk is 46% of BW, little to no influence on resistance
- appropriate for _ studies

A
  • most of the resistance
  • epidemiologic
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14
Q

Whole body counting and neutron activation analysis:
- based on early whole body counters to count radiation exposure
- principle/theory:
- _ measurement of the body’s radioactivity. including naturally occurring potassium
- Three types of potassium in the body:
- 93.1% is 39K
- 6.9% is 41K
- 0.0118% is 40K
- isotope 40K is _
- TBK for average male is ~ 140g, average female ~ 100g

A
  • in-vivo
  • radioactive
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15
Q

Whole body counting and neutron activation analysis:
- assumptions/accuracy:
- while precision is very good, _ is not as good, 4-6% greater in the young
- Pros/cons
- Pros: easy, precise
- Cons: Expensive ($30,000-300,000)

A

accuracy

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16
Q

Dual energy X-ray absorptiometry (DXA)
- principle/theory:
- calculate the mineral content and then the _ can be measured with each pixel
- estimate fat, not adipose tissue (CT)
- calculate _ tissue and _ tissue

A
  • pure fat
  • lean, fat
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17
Q

Dual energy X-ray absorptiometry (DXA)
- assumptions:
- _ does not change body comp data (minimal)
- measurements not affected by anterior-posterior thickness of the body
- area of the body analyzed to determine _ and the degree to which the fat content of the area analyzed is associated with the fat content of the area that is not analyzed
- Accuracy:
- 2.5-3.5% SEE
- Pros/Cons
- Pros: easy to do, does not require subject cooperation
- Cons: expensive ($150,000)

A
  • hydration levels
  • body comp
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18
Q

CT Scan
- Pros: _
- Cons: radiation, expensive

A

accurate

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19
Q

Anthropometric: circumferences, skinfolds, stature
- can be applied to laboratory and field settings
- principle/ theory and assumptions:
- tissues included in the measurement are in the _, muscles are relaxed and soft tissues are normally hydrated
- the bigger it is, the _ the body fat
- accuracy: skinfolds
- technician and equation _, +/- 3.5% error
- Pros/Cons: skinfolds
- Pros:
- easy to perform, can test a large population, _
- Cons:
- depending on equation utilized, can have errors
- large technician error

A
  • “standard” state
  • greater
  • dependent
  • inexpensive
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20
Q
  • developed in agricultural research
  • product uses same wavelength for animals as humans
  • accurate for animals, not accurate for humans
A

infared

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21
Q
  • anorexia nervosa
  • bulimia nervosa
  • binge-eating
A

disordered eating

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22
Q
  • psychotherapy
  • nutritional counseling
  • medical supervision
  • athletic trainer/exercise physiologist
  • did you know… 4/10 americans have either suffered or have known someone who has suffered from an eating disorder
A

treatment for disordered eating

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23
Q

Drive for thinness:
- 42% of _ grade girls want to be thinner
- 81% of _ are afraid of being fat

A
  • 1st-3rd
  • 10 year olds
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24
Q

Newer facts for drive for thinness
- average american woman is _ and weighs _
- the “ideal girl” (described by caucasian teenage girls) is _ and weighs _, and wears a size 5
- at age 13, 53% of american girls are “unhappy with their bodies”
- increases to 78% by the time girls reach age _

A
  • 5’4”, 163lbs
  • 5’7”, 110lbs
  • 17
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25
Q

Facts about women and ideals:
- 1 in 40,000 women meet the requirements to be a fashion model
- average woman is a size _ (Marilyn Monroe)
- models 20 years ago weighted 8% less than average woman; today they weigh _
- if mannequins in shops were real, they would not menstrate

A
  • 14
  • 23% less
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26
Q
  • Ana Carolina Reston: died 11/15/06 at age 21, weighing 88 lbs
  • Luisel Ramos: died 8/26/06 at age 22, 98 lbs
  • Eliana ramos (sister of Luisel): died 2/13/07 at age 18, 84 lbs
  • Mariara Galvo Vierira: died 1/6/07 at age 24, 84 lbs
  • Hila Elmalich: died 11/04/07 age 34, 60 lbs
A

Tragedy of modeling

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27
Q
  • at risk: athlete (not necessarily competitive)
  • controlling figure in her life (often male)
  • strives for perfection
  • physiologic vulnerability
A

female athlete triad

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28
Q

Energy Balance equation
- weight change =

A

total energy intake - total energy expenditure

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29
Q

Weight management: intervention strategies
- _: appetite, thermogenesis, resting metabolism
- _: food absorption
- _: food intake, physical activity

A
  • drugs
  • surgery
  • behavior therapy
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30
Q

Control of food intake;
- control center is the _
- hunger center
- satiety center

A

hypothalamus

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31
Q

Resting energy expenditure:
- _ necessary to live, resting
- anything above is additional energy requirements

A

metabolic requirements

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32
Q
  • most common treatment for excess weight
  • consumption of diet is also important
  • not “one size fits all” evidenced by twins study
  • most regain weight after
A

caloric restriction

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33
Q

physical activity began during caloric restriction and maintained after resumption of previous caloric intake

A

Most effective for maintenance of weight loss

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34
Q

Greatest rates of overweight/obesity after _, people ate more typical “American diet”
- Prima indians

A

WWII

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35
Q

Chronology:
Ancel Keys, fat is bad, the Mediterranean diet is better (post-WWII)
- Naples
- poorer were heavier
- 2,400 kcals vs 3,800 kcals
- working-class women were overweight

A

1951

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36
Q

Chronology:
Prima Indians
- more than 1/2 of boys and girls obese
- widespread poverty

A

1954

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37
Q

Chronology:
Durbin, SA
- among Zulu 40% of women Obese
- numerous signs of malnutrition
- ~20% heavier and 4” shorter than men

A

1960

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38
Q

Chronology:
Nauru, South Pacific
- everyone past puberty is grossly overweight

A

1961

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39
Q

Chronology:
Trinidad, West Indies
- malnutrition and obesity serious problem
- ~ 1/3 of women obese
- caloric intake <2,000 kcal/day

A

1961-1963

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40
Q

Chronology:
Chile
- obesity: main nutrition problem of adults
- factory workers
- 35% males OB
- 39% female OB
- significant physical labor

A

1963

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41
Q

Chronology:
Joburg, SA
- Urban Bantu prisoners 60+ year olds
- 30% women OB

A

1964-1965

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42
Q

Chronology:
North Carolina
- 29% adult Cherokee on Qualla Reservation OB

A

1965

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43
Q

Chronology:
Ghana
- 25% women and 7% men OB
- 1/2 of all women in 40’s OB

A

1969

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44
Q

Chronology:
Lagos, Nigeria
- 5% men OB
- 30% women OB
- women: 55-65 year olds - OB

A

1970

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45
Q

Ketogenic Diet:
- _: 70% fat, 20% protein, 10% CHO
- _: SKD for 5 days, 2 days high CHO
- _: add CHO for workouts
- _: 60% fat, 35% protein, 5% CHO

A
  • standard keto diet
  • cyclical keto diet
  • targeted keto diet
  • high protein keto diet
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46
Q
  • epilepsy
  • cancer cachexia
  • cancer with tumor metabolism drugs
  • inflammatory diseases
  • CAD
  • diabetes
A

positives for keto diets

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47
Q
  • can be dangerous
  • loss of lean body mass
  • associated with serious cardiac arrhythmias
  • many people have died of cardiac arrest
  • loss of hair
  • thinning of skin
  • coldness in the extremities
  • gallbladder stones
  • gout
  • elevated cholesterol
A

very low calorie diets

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48
Q
  • religious and/or health
  • alternate day fasting
  • 1 day/wk or 5 days every 5 week
  • 25% of energy restriction: alternating days, SaMW
  • time-restricted eating, 8-22 hrs
  • often for weight loss
A

intermittent fasting

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49
Q

Intermittent fasting:
- hypothesized to influence _ via effects on:
- cicadian biology
- the gut microbiome
- modifiable lifestyle behaviors
- negative perturbations of these biological and physiological systems
- hostile _
- _ individuals to developing obesity, diabetes, cardiovascular disease, and cancer

A
  • metabolic influence
  • metabolic milieu
  • predisposes
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50
Q
  • diuretics
  • impermeable clothing
  • weight loss is due to this, but not fat loss
  • usually re-hydrate after the loss
A

dehydration

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51
Q
  • prolonged fasting
  • gastric/bariatric bypass
  • lipectomy (liposection)
A

medical procedures

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52
Q
  • appetite suppressants
  • thermogenic drugs
  • orlistat (xenical & Alli): fat absorption in the gut 30% less
    • 7-10# more than if diet alone
  • Sexenda: slows gastric emptying
A

drugs to control weight

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53
Q

Behavior modification:
- focus on elimination of behavior that is associated with _ and _
- many theories of behavior change
- 30% of participants _ after one year and continue to lose

A
  • poor eating, exercise habits
  • maintain weight loss
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54
Q

Exercise:
- vigorous exercise _
- single session of exercise will result in little fat loss
- regular exercise training will lead to adaptations that increase with utilization of fat
- 1977: NIH OB & Wt control
- increase in _ leads to an increase in _

A
  • stimulate appetite
  • energy expenditure, energy consumption
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55
Q
  • begin to utilize fats earlier in the exercise bout
  • utilize more fats
  • females utilize more fats more efficiently than males
A

exercise adaptations

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56
Q
  • females are more efficient at _
  • females store _
  • females may store more from a similar meal of fat than a male would
A
  • storing fat
  • more fat
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57
Q

Fat metabolism:
- _ process and store lipids
- procedure a variety of _
- _: reduced or absent fat deposits
- insulin resistance
- Type II diabetes

A
  • adipocytes
  • hormones
  • Lipoatrophy
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58
Q

Leptin gender differences

A

greater in females

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59
Q

Best activity for weight loss
- 1 mile = ~ 100 kcal
- whether walk/run the mile

A

HITT

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60
Q
  • should be small
  • should become part of your lifestyle
  • ~21 days to make a habit
  • eat at the same time everyday
A

reasonable changes

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61
Q
  • meal planning
  • physical activity
  • behavior therapy
  • lifestyle therapy
  • pharmacotherapy
  • weight reduction surgery
  • weight maintenance plan
A

weight loss strategies

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62
Q
  • eat a colorful diet
  • close to the ground
  • if it’s white, it’s probably not right
A

recommendations

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63
Q

_ is more important than a “diet” or weight loss
- better long-term outcomes and long-term health
- if it took 5 years to gain weight, unlikely to lose it in 3 months

A

weight maintenance

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64
Q

Altitude:
< 12,000 ft = _
12,000-18,000 = _
> 20,000 ft = _

A
  • moderate
  • high
  • very high
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65
Q

Stress at altitude:
- The 4 “H”s

A
  1. hypoxia
  2. hypothermia
  3. hypoglycemia
  4. hypohydration
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66
Q

Stress at altitude:
- additionally
- suppressed _ and _

A

immune system, emotional state

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67
Q

Stress of altitude:
- O2% at sea level = 21%
- O2% at 22,000 ft = 21%
- decreased PO2 results in _

A

hypoxia

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68
Q

Adaption to the new natural environment

A

acclimatization

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69
Q

Acclimatization:
- respiratory
- hyperventilation
- body fluids become more base as a result of reduction in CO2 with hyperventilation
- cardiac
- increased heart rate at rest and a submax work = increased cardiac output
- stroke volume remains the same or decreases
- max VO2 remains the same

A

immediate

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70
Q

Acclimatization:
- respiratory
- hyperventilation
- excretion of base via kidneys and concomitant reduction in alkaline reserve
- cardiac
- increased submax heart rate
- submax cardiac output falls
- stroke volume decreases (Starling’s law)
- max VO2 decreases (decreased max HR and stroke volume)

A

longer term (days to weeks)

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71
Q

Acclimatization:
- decreased plasma volume
- increased plasma volume
- increased # of RBCs
- possible increase in capillary density
- increased 2,3 DPG
- increased mitochondrial density
- increased aerobic enzymes in muscle

A

hematological response

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72
Q

Acclimatization:
- nor-epinephrine
- increased 7 days and then stabilizes
- epinephrine
- shows little to no increase
- regulates HR, BP, SV, vascular resistance, and substrate use

A

catecholamine response

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73
Q

Acclimatization (Acid Base Balance):
- _ leads to a decrease in CO2 thus increasing pH of all bodily fluids
- this blunts respiratory control
- body begins to excrete base through _ to normalize pH
- this increases respiratory sensitivity and allows for greater hyperventilation
- this decrease in “base” creates a loss of the _ reserve inhibiting the body’s buffering ability
- this is made up for by a decrease in _ and a reduction in _

A
  • hyperventilation
  • renal tubules
  • absolute alkaline
  • intercellular ADP, epinephrine output
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74
Q

Acclimatization schedule:
- rapid ascent 0-7,500 ft _ to adjust
- then _ per 2,000 ft up to 15,000 ft

A
  • 2 weeks
  • 1 week
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75
Q

Acclimatization schedule:
climb to camp altitude
- active acclimatization
- move to next camp
- repeat as necessary
- summit
- get outta dodge

A

stage ascent

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76
Q

all are exacerbated by:
- speed of ascent
- altitude
- health of individual
- general susceptibility of individual

A

altitude related illness

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77
Q

Altitude related illness:
- _ symptoms:
- diminished exercise capacity
- shortness of breath
- elevated HR
- Cheyne-strokes (irregular nighttime breathing)

A

slow ascent

78
Q

Altitude related illness:
- _ symptoms:
- most common altitude disorder
- can appear within 2 hrs of ascent
- headache
- insomina
- irritability
- weakness
- vomiting
- tachycardia
- breathing problems

A

rapid ascent - acute mountain sickness (AMS)

79
Q

Altitude related illness:
- Rapid ascent
- 12-96 hrs of ascent
- can be treated on site but reduction in elevation is best

A

high altitude pulmonary edema (HAPE)

80
Q

Altitude related illness:
- Rapid ascent:
- results from vasodilation, increased capillary hydrostatic pressure
- must descend to accurately diagnose and treat

A

high altitude cerebral edema (HACE)

81
Q

Altitude related illness:
- Rapid ascent:
- can occur after months or years at altitude
- polycythemia
- genetically linked EPO response to stress

A

chronic mountain sickness (CMS)

82
Q

Altitude related illness:
- Rapid ascent:
- all climbers experience over 21,000 ft
- hemorrhage of the macula results in vision loss
- eye surgery

A

high altitude retinal hemorrhage (HARH)

83
Q

Body composition and nutrition:
- _ and _ occur at altitude
- depressed appetite
- dehydration
- increased BMR
- increased energy output

A

muscle atrophy and weight loss

84
Q

Body composition and nutrition at altitude:
- increased respirations = dehydration
- low relative humidity at altitude
- greater loss in fecal matter
- less adsorption in gut
- inadequate fluid intake
- lose desire
- difficult to obtain

A

hypohydration

85
Q

Physical performance at altitude:
- max strength is _
- capacity for repeated contractions is progressively impaired
- endurance is _ but improves with _
- decrease _

A
  • unaffected
  • initially decreased, acclimatization
  • motor skills
86
Q

Mental performance at altitude:
- decreased _ (Ex: “where did I park my car?”)
- mental activity (Ex: Let’s see it’s “I” before “E” except after no wait it’s …)
- _
- brain blood flow _

A
  • short term memory
  • judgment/decision making
  • not impacted
87
Q

Altitude:
As we gain altitude the _ drops resulting in inadequate hemoglobin saturation and a decrease in _

A
  • PO2
  • aerobic activities
88
Q

Altitude:
ability to perform _ physical activity is not affected

A

high intensity short duration (sprint)

89
Q

Altitude:
reduced PO2 results in physiologic responses that improve _

A

altitude tolerance

90
Q

Altitude:
_ and increased submax cardiac output via elevated HR and the primary _ responses to altitude

A
  • hyperventilation
  • immediate
91
Q

Altitude:
- medical problems may emerge as a result to _ to altitude
- _, _, and _ are the most common conditions

A
  • travel
  • AMS, HAPE, and HACE
92
Q

Altitude:
_ entails:
- reestablishment of acid-base balance
- increased synthesis of RBC and hemoglobin
- improved local circulation and cellular metabolism

A

acclimatization

93
Q

Altitude:
Rate of acclimatization depends on the _
- major adjustments takes about _ but may require 4-6 weeks at higher altitude

A
  • elevation
  • 2 weeks
94
Q

Altitude:
acclimatization does not fully compensate for the stress of altitude, as a result, _ remains depressed

A

VO2 max

95
Q

Altitude:
training at altitude provides _ benefit to sea-level performance than equivalent sea-level training

A

no more

96
Q

Chilean miners:
- trapped for 69 days at 2,050 ft below sea level
- pressure increases _ for every _
- _ below sea level

A
  • 1 atmosphere (760 mm Hg), 10m (33 ft)
  • 62.1 atmospheres
97
Q

Effects of exposure to high pressure
- _
- dangers stem from changes in gas volumes within enclosed spaces and increased solubility of gases
- think about soda bottle opening after flight

A

hyperbia

98
Q
  • tissue injury caused by changing pressure
  • human body had a limited ability to distend and compress
  • trauma comes from exceeding those limits
  • humans, sea otters and sea lions as diving mammals is unnatural - need continuous air
A

barotrauma

99
Q
  • Boyle’s law applies: volume of gas decreases or increases as diver goes up and down
  • pressure is not allowed to equalize with air from outside the space
A

barotrauma

100
Q
  • gases like O2, CO2, CO, N2, and He can be dangerous under certain conditions
  • need to manage toxicity with depth and length of dive
A

gas toxicity

101
Q

CO: dangerous to all life forms
- compressed air may have been contaminated by exhaust fumes
- danger due to high affinity for _: 240 more times the affinity than O2
- problem is compounded if diver is a _ or exposed to air pollution

A
  • hemoglobin
  • smoker
102
Q
  • O2 at higher pressure is toxic to all life forms - depends on its concentration and length of exposure
  • _ speeds up development of toxicity
  • principal sites of O2 toxicity and lungs and CNS
A

O2 toxicity
- physical exercise

103
Q
  • substernal distress with soreness in chest
  • airway resistance on inspiration
  • histological changes in alveoli
  • pulmonary edema
  • flushing of the face
  • couch that starts out dry and gets wet
  • decreased surfactant
A

pulmonary symptoms of toxicity

104
Q
  • nausea
  • contraction of the field of vision
  • convulsions
  • lack of sphincter control
  • unconsciousness
  • death
  • can also cause arrhythmias
    • mechanism that causes it is unknown
A

CNS symptoms

105
Q

CNS symptoms
- _ may interfere with CO2 transport
- hemoglobin doesn’t desaturate thus isn’t available for O2 transport
- _ vasodilates cerebral blood vessels causing _ and increased PO2 in the brain
- cell function may also be disrupted as well as neural transmission in CNS

A
  • hyperbaric O2
  • increased CO2, acidosis
106
Q
  • most common in closed-circuit scuba systems and hose-supplied helmets
  • inadequate respiratory exchange leads to _ with heavy exercise at high pressures
  • happens if diver tries to suppress their _ in order to conserve air, CO2 builds up
A

CO2 toxicity
- hypercapnia
- ventilation

107
Q
  • uncomfortable breathing
  • mental deterioration
  • violent respiratory distress
  • unconsciousness
  • convulsions
A

symptoms of CO2 toxicity

108
Q
  • some gases exert a narcotic or anesthetic effect at high pressure
  • effects depend on partial pressure of the gas and its solubility in the body’s tissue and fluids
A

nitrogen narcosis

109
Q
  • nitrogen can cause conditions: nitrogen narcosis ~30m (100ft)
  • progression of symptoms:
    • euphoria
    • impaired performance
    • weakness
    • drowsiness
    • unconsciousness
  • caused by interference in the _ across the neural synapses
  • this is why the use of compressed air is limited to _
  • replace nitrogen with helium
A
  • transfer of signals
  • ~50m (165 ft)
110
Q

Nitrogen narcosis:
- below 150m (500ft) can cause neuromuscular disorder called _: tremors, vertigo, and nausea
- slowing compression rate during dive and adding nitrogen to O2 mixture and help prevent this
- nitrogen narcosis is a limiting factor during _
- almost impossible to avoid in commercial dives
- slows down information processing in the brain, but does not distort perception
- _ activity level can help

A
  • high-pressure nervous syndrome (HPVS)
  • deep dives
  • slowing down
111
Q
  • caused by a nitrogen bubble formation in the tissue due to too rapid of an assault
  • symptoms include:
    • itchy skins
    • fatigue
    • pain in the muscles, joints and bones
    • persisting perspiring, nausea
A

decompression sickness (the bends)

112
Q

The bends:
- more serious ones include respiratory distress, ataxia (loss of muscle), vascular obstruction, paralysis, unconsciousness, and death
- called _ when it affects the lungs and the _ when it affects the CNS
- symptoms appear about _ after surfacing but can occur either immediately or _

A
  • “the chokes”
  • “the staggers”
  • 1 hour
  • up to 12 hours post
113
Q

The bends:
- if _ is too rapid, N2 returns to gaseous state, and bubbles form in blood and tissues
- decompression tables help divers figure absorption levels
- decompression time increases with _ and _ of dives
- must also consider body fat, age, physical condition, gas mixtures, alt of dive

A
  • decompression
  • depth, length
114
Q
  • studies are conducted in _ or underwater
  • chamber provides opportunity to isolate variables like partial pressures, temperature, and gas mixtures
  • can stimulate ocean dives too, to help understand differences
A

hyperbaric exercise
- hyperbaric chamber

115
Q
  • expensive equipment and facility
  • technically exacting
  • open water measurements are complex because of restraints of aqueous environment
A

biological measurement difficulties in hyperbaric environment

116
Q
  • increased air density
  • cold
  • decreased efficiency
  • CO2 retention
  • inert gas narcosis
A

factors adding difficulty to exercise underwater

117
Q

Ve may be limiting factors:
- maximal voluntary Ve _ with depth
- results in progressively smaller difference between exercise Ve and max capacity
- higher densities of air _ in scuba equipment and airways, causes _

A
  • decreases
  • increases flow resistance
  • hyperventilation
118
Q

Ventilation:
- _ leads to loss of CO2. which leads to increased _
- ability to increase _ is limited
- after reaching max flow rate, further effort results in

A
  • work to breath
  • expiratory flow rate
  • partial airway collapse
119
Q
  • increased energy cost to breath
  • maintaining body temperature
  • movement in higher hydrostatic pressures
A

O2 consumption increases with submax work with increasing depth

120
Q

Experienced divers can achieve _ of their land-measured max O2 but work efficiently is _
- max capacity is dictated by _ attained before reaching critical PCO2
– swimming angle and drag produced by scuba equipment greatly affects _ and individual differences in swimming efficiency

A
  • ~91%, reduced
  • tolerance to high levels of CO2 and % of max O2 consumption
  • energy cost of underwater work
121
Q
  • HR decreases as water temperature decreases and pressure increases
  • divers should not use land-measured relationships between HR and O2 consumption, dangerous
  • HR can be used to estimate energy cost in diving only when HR/VO2 relationships is known for a certain diver at a certain depth
A

diving bradycardia

122
Q

Exercise in the cold & hot:
- _: at mercy of the elements
- _: can function independently of the environment
- ability to maintain constant temperature

A
  • poikilotherms
  • homeotherms
123
Q

Exercise in the cold & hot:
- temperature always _ from hot to cold
- _: temperature differences from one point to another lead to movement of heat

A
  • equilibrates
  • thermal gradients
124
Q

Normal body temperature: _
- during exercise can increase to _ with no ill effects
- core temperature: temp of the _ - temperature regulatory of the body

A
  • 36.5-37.5 degrees C
  • 40 degrees C
  • hypothalamus
125
Q
  • metabolism
  • shivering
  • nonshivering thermogenesis
  • metabolic rate
  • heat loss
A

temperature regulation

126
Q

Metabolism:
- heat is produced naturally during normal metabolic reactions
- most reactions lose ~75% of _
- at BMR heat loss is _
- BMR is proportional to 3/4 _ (surface rule)

A
  • energy as heat
  • ~ 100 kcal/hr
  • power of body weight
127
Q
  • main mechanism for increasing heat during negative heat balance
  • involuntary muscle contraction
A

shivering

128
Q

Shivering:
- maximum shivering can increase body’s heat production by _
- pre-shivering tone can increase heat production _
- an effective way to increase body temperature because _ by the muscles, and most of the energy is expended as heat

A
  • 5x
  • 50-100%
  • no work
129
Q

Shivering:
- increases Q by increasing SV via increased _
- _: glycogen depletion, hypoglycemia, fatigue (Ex: hypoxia, drugs - alcohol & barbiturates)

A
  • venous return
  • limits
130
Q
  • increased thyroxin secretion (thyroid) and catecholamine secretion (adrenals) increase metabolic rate
  • thyroxin increases the rate of all cells
  • Cats., especially norepi. release FFA, increasing metabolic rate
A

nonshivering thermogenesis

131
Q

Metabolic Rate (Q10 and food):
- _ is rate of physiologic process at a particular temperature to the rate as a temperature 10 degrees C lower
- increased metabolic rate can be _ (dangerous)

A
  • Q10
  • self-perpetuating
132
Q

Metabolic Rate (Q10 and food):
- at high temperatures, _ loses ability to cool the body
- Rate of temperature increases _ at higher temperatures
- metabolic rate _ following food intake, especially proteins

A
  • hypothalamus
  • faster
  • temporarily increases
133
Q
  • radiation
  • conduction
  • convection
  • evaporation
A

heat loss

134
Q

Radiation:
- loss or gain in the form of _
- at rest, in a comfortable environment, radiation accounts for 60% of _
- varies with body position and clothes
- human skin, regardless of color, absorbs _ of radiant energy that strikes it

A
  • electromagnetic waves
  • total heat loss
  • ~97%
135
Q

Conduction:
- transfer of heat from a _ to an _
- or, heat transfer within an organism down a _
- ~3% of _ at room temperature occurs this way

A
  • body, object
  • thermal gradient
  • total heat loss
136
Q

Convection:
- conduction of heat to _
- amounts to ~12% of _ at room temperature

A
  • air or water
  • all heat lost
137
Q
  • heat is conducted to water or air, moves so that other molecules can be heated
  • greater in the wind (air movement)
  • wind chill effect
  • can also occur in the circulatory system
  • heat moves with the blood from the _
  • as skin temperature increases, _ to environment increases
  • rate is affected by blood flow and temperature gradient (core/periphery)
A

Convection
- core to the periphery
- heat loss

138
Q

Evaporation:
- _ of heat is lost this way in a comfortable environment
- Quantity of heat absorbed by _ as it evaporates: latent heat of vaporization
- Body loses 0.58 kcal/gm H2O
- only means of cooling at high _
- critical for _

A
  • ~25%
  • sweat
  • environmental temperatures
  • exercise
139
Q

Evaporation:
- if body cannot lose heat this way, body temperature _
- sweat is only effective if it _
- _: evaporation reduced or prevented
- effective evaporation also hampered by little air movement

A
  • increases rapidly
  • evaporates
  • high humidity
140
Q

Evaporation:
- women have a lower sweating capacity than men do
- process occurs by _: ventilation, diffusion through skin, does not include sweat, urine and feces
- sweat rates are at 0 when temperature is _

A
  • sweating and insensible water loss
  • low
141
Q
  • temperature regulatory center
  • set-point it tries to keep
  • sweating normally occurs at 37 degrees C
  • set-point can change in response to dehydration, starvation, and fever
  • responds to heat primarily through _ in the preoptic area of anterior portion
A

Hypothalamus and temperature regulation
- heat-sensitivity neurons

142
Q

Hypothalamus and temperature regulation:
- more _ than _ receptors in the skin
- _ transmit impulses to the spinal cord, to hypothalamus, initiates response
- _ stimulates the sweat glands, evaporates heat loss
- “hunting reflex” primarily in _

A
  • cold, heat
  • thermoregulators
  • anterior hypothalamus
  • hands and feet
143
Q
  • clothing
  • oxygen consumption
  • ventilation
  • heart
  • muscle strength
  • metabolic changes
A

exercise in the cold

144
Q

Exercise in the cold:
- oxygen consumption
- maximum uptake is _ by the cold
- _ increases in the cold

A
  • unaffected
  • submax VO2
145
Q

Exercise in the cold:
- ventilation
- _ in the cold, particularly if exposure is sudden
- abrupt exposure can lead to _

A
  • increases
  • gasping reflex
146
Q

Exercise in the cold:
- Heart
- changes in cardiac performance _ in men
- incidence of arrhythmias _ in cold

A
  • more common
  • increase
147
Q

Exercise in the cold:
- muscle strength
- strength _ with lower muscle temperature

A

decreases

148
Q

Exercise in the cold:
- Metabolic changes
- increase use of _ as substrate
- _: glycogen depletes faster
- _: depletion is independent of temperature
- _: hypoglycemia, suppresses shivering, core temperature drops, lactate higher
- fat metabolism suppressed, even through cat. response is higher

A
  • CHO
  • light exercise
  • max exercise
  • prolonged exposure to cold
149
Q
  • _: physiologic compensation to environmental stress over time
  • _: lessening of the sensation associated with an environment
A
  • acclimatize
  • habituation
150
Q

Acclimatization and habituation to cold:
- shivering threshold
- _ test of acclimatization
-_ maintain heat production with less shivering, more _

A
  • first
  • cold-acclimatized people, nonshivering thermogenesis
151
Q

Acclimatization:
- _ and _ temperature
- _ test for acclimatization
- acclimatized: maintain almost normal temperature
- habituation also plays a role

A
  • hand, feet
  • second
152
Q

Acclimatization:
- ability to _ in the cold
- _ test for acclimatization
- seems to depend on extent of nonshivering thermogenesis induced by increased secretion of norepi

A
  • sleep
  • third and final
153
Q
  • depresses the CNS. lose ability to shiver, sleepiness, coma, death
  • lower temperature: lower cellular metabolic rate, further lowering temperature
  • profound effects on the CV system
  • central BV decreases; plasma sequestration, inadequate fluid intake, cold diuresis
A

hypothermia

154
Q
  • cold exposure
  • lack of protective clothing
  • leanness
  • inadequate fluid intake
  • high wind chill
  • use of alcohol and/or drugs
  • use of snow to relieve thirst
  • glycogen depletion
A

hypothermia risk factors

155
Q
  • caused by ice crystal formation within the tissue
  • occurs in exposed skin
  • can lead to tissue death
A

frostbite

156
Q

plasma volume _ during exercise in the heat
- becomes acute as _
- decreases of plasma volume is made worse by loss of _
- may not be enough blood to adequately perfuse all areas during exercise in the heat

A
  • decreases
  • intensity increases
  • body fluids through sweating
157
Q

Plasma volume:
- central blood volume may decrease and cause a decrease in _
- results in increased _ in attempt to compensate for lower SV
- submax heart rate increases also
- at max levels, skin vessels vasoconstrict to help maintain _ and _

A
  • cardiac filling pressure
  • heart rate
  • blood pressure and Q
158
Q

Plasma volume:
- _ response on heat transfer
- _ regulation takes precedence over temperature regulation in this case
- VO2 max is _ in the heat unless the person was experiencing thermal imbalance before beginning the exercise

A
  • negative
  • circulatory
  • not impaired
159
Q

Sweating response:
- primary means of _ during exercise (evaporation)
- in heat, sweating is very important because the body tends to _ rather than lose heat by radiation, conduction, and convection
- during exercise, sweating is related more to _ than environmental temperature

A
  • heat dissipation
  • gain
  • intensity
160
Q

Acclimatization to heat:
- _ of heat exposure results in
- lower heart rate
- lower core temperature
- lower RPE
- lower skin temperature at rest and during exercise

A

first 2 weeks

161
Q

Acclimatization to heat:
- primary _ are increased
- peripheral heat conductance
- plasma volume
- sweating
- _ core temperature at onset of sweating, and improved distribution of sweat over the skin

A
  • physiological adjustments
  • decreased
162
Q

Cardiovascular adaptations:
- acclimatization induces a _ increase in plasma volume if acclimatization is done with exercise training
- increased plasma volume helps to maintain _, _, and _
- also increases in vasopressin, renin, and aldosterone in the early days

A
  • 3-27%
  • SV, central blood volume, and sweating capacity
163
Q

Cardiovascular adaptations:
- blood flow to the skin _
- decreased skin blood flow helps to maintain _ , which is vital for maintains BP, SV, and muscle blood flow during exercise
- _ is lower during exercise
- decrease in skin blood flow is accompanied by a _ in sweating and evaporative cooling capacity

A
  • decreases
  • central blood volume
  • core temperature
  • large increase
164
Q
  • acclimatization increases _ almost 3X, from ~1.5 L/hr to 4 L/hr
  • accompanied by a _ distribution of sweating
  • sweat losses of sodium chloride decrease because of increased secretion of _
A
  • sweating response
  • more even
  • aldosterone
165
Q
  • includes dehydration, heat cramps, heat exhaustion, heat syncope, and heat stroke
  • hypothermia is caused by an imbalance between heat gain and heat loss
A

thermal distress

166
Q

Optimizing hydration:
- approximately 7-20 ounces 2-3 hours before activity
- consume another 7-10 ounces after the warm-up (10-15 minutes before exercise)

A

pre-exercise

167
Q

Optimizing hydration:
- approximately 28-40 ounces every hour of exercise (7-10 ounces every 10-15 minutes)
- rapidly replace lost fluids ( sweat and urine) within 2 hours after activity to enhance recovery by drinking 20-24 ounces for every pound of body weight lost through sweating

A

during exercise

168
Q
  • can decrease sweat rate, plasma volume, Q, Vo2 max, work capacity, muscle strength, and liver glycogen
A

Dehydration

169
Q

Dehydration:
- loss of fluid from the body
- at fluid deficit of _ of BW, symptoms include discomfort and alternating states of lethargy and nervousness
- _is extremely dangerous

A
  • 5%
  • level >7%
170
Q

Dehydration:
- at _, ability to walk is impaired and is accompanied by discoordination and spasticity
- as _is neared, the person experiences delirium, shriveled skin, along with decreased urine volume, loss of ability to swallow food, and difficulty swallowing water
- _ the skin bleeds and cracks

A
  • levels >10%
  • 15%
  • > 20%
171
Q

Dehydration:
- _ does not keep up with fluid requirements
- physical fitness helps prevent this
- during prolonged exercise, can develop hypothermia, caused by excessive _ in the sweat without adequate replacement

A
  • thirst
  • sodium loss
172
Q

Heat cramps:
- it occurs in people who have exercised and sweated heavily
- often the individual is _ and _
- _ and _ replacement, rest, some may say magnesium helps

A
  • conditioned and acclimatized
  • fluid and electrolyte
173
Q
  • characterized by involuntary cramping and spasm in muscle groups used during exercise
A

Heat cramps

174
Q

Heat cramps:
- electrical activity plays a role
- _ and/or _ are the background for cramps

A
  • mild dehydration
  • low electrolytes
175
Q

rapid, weak pulse, hypotension, faintness, profuse sweating, and psychological disorientation

A

heat exhaustion

176
Q

Heat exhaustion:
- results from acute _ and inability of the circulation to compensate for the concurrent _ in the skin and the active working muscles

A
  • plasma volume loss
  • vasodilation
177
Q
  • have person lie down in a cool area
  • administer fluids
  • rest and drink plenty of fluids for next 24 hours
  • not allowed to participate for rest of the day
A

treatment of heat exhaustion

178
Q
  • related to heat exhaustion. but can occur without major sweat loss
  • typically, it occurs after exercise when the individual stops moving and blood pools
  • can occur secondary to heat exhaustion or independently
A

Heat syncope

178
Q
  • related to heat exhaustion. but can occur without major sweat loss
  • typically, it occurs after exercise when the individual stops moving and blood pools
  • can occur secondary to heat exhaustion or independently
A

Heat syncope

179
Q
  • failure of hypothalamic temperature regulatory center: represents a major medical emergency
  • principally caused by failure of the temperature regulatory center in the hypothalamus, which causes failure of the body’s heat loss mechanisms
A

heat stroke

180
Q
  • characterized by a:
    • high core temperature,
    • hot, dry skin, and
    • extreme CNS dysfunction
  • associated with increases in plasma norepinephrine, epi, and endotoxin levels that have been associated with vascular collapse
A

heat stroke

181
Q

Heat stroke:
- risk is greatest in _ temperatures, _, _ time of day, and on days with _

A
  • high
  • humidity
  • hottest
    little wind
182
Q
  • cool person with tepid water
  • ice packs on groin, neck, and axilla
  • send to hospital ASAP
A

treatment of heat stroke

183
Q

Heat stroke prevention:
- ensure athletes are well-conditioned
- avoid _
- be aware of _: thirst, fatigue, lethargy, and visual disturbances
- athletes should not train harder than normal intensity
- should not compete if have an illness accompanied by a _

A
  • overheating
  • early symptoms of heat stress
  • fever
184
Q

Heat stroke prevention:
- schedule practice during the _ times of the day
- modify or cancel sessions when the wet bulb temperature is _ or greater
- plan regular fluid breaks
- supply a drink that is cold and contains some _ and _

A
  • cooler
  • 25.5 degrees C
  • CHO and electrolytes
185
Q
  • hyperhydrate before activity
  • fluid replacement should be encouraged during the early stages of practice and competition
A

Heat stroke prevention

186
Q

Heat stroke prevention
- athletes should be weighed every day before and after practice
- if a 2-3% decrease in weight, should _
- if 4-6%, should _
- if 7% loss, _

A
  • consume more fluid
  • decreases activity levels
  • consult a physician
187
Q
  • striated muscle breakdown
  • myoglobin excretion is increased
  • cola-colored urine
  • myoglobin is cleared by the kidneys
    • kidneys shut down, especially with heat
A

Rhabdomyolysis

188
Q

can lead to:
- acute renal failure
- sudden cardiac death- athletes
- acuter compartment syndrome

A

Rhabdomyolysis

189
Q

Rhabdomyolysis:
- occurs with _
- _
- may be a _, latent metabolic disorder
- diuretics contribute to this
- CHO as well, but a rare possibility
- deconditioned
- previous _

A
  • excessive exercise
  • rare
  • predisposition
  • heat injury
190
Q

Rhabdomyolysis causes:
- _
- multiple trauma; crash injury
- surgery
- comma
- immobilization
- _
- exertion
- health illness
- seizures
- metabolic myopathies
- malignant hyperthermia

A
  • Traumatic
  • exertional
191
Q

Rhabdomyolysis causes:
- _
- _
- ETOH
- Drugs- statins, OTC, illegal
- infection
- electrolytes

A
  • nontraumatic
  • nonexterional

Exercise Physiology (9 decks)

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