Exam 6 (Exercise Physiology, Vital Signs, GI and Endocrine Phys.) Flashcards
Importance of Vital Sign Assessment
1) Establish a baseline
2) Monitor responses to rest and progressive work/activity
3) Identify status of vital organ function
4) Determine need for further testing
5) Establish parameters for exercise/activity
4 Vital Signs
1) Temperature
2) HR
3) BP
4) Respiratory Rate
Normal HR values
· Adult: 60-100bpm
· Infant (1-12mo): 100-120
· Children (1-8yr): 80-100
· Tachycardia > 100
· Bradycardia < 60
Pulse/HR Assessment
1) Rate
2) Rhythm (regular vs irregular)
3) Amplitude or quality
- thready, normal, bounding
4) Assess symmetry by assessing bilaterally
Predicted Maximal HR
220- age = HR max
HR Response to Exercise
Increase of 10 (+/- 2) BPM per MET (untrained individuals)
HR Reserve and Target HR
· HR Reserve: Max HR - Resting HR
· Target HR: ((HR Reserve) x (%)) + Resting HR
HR Recovery
· (HR Peak - HR after 1min of recovery)
· Normal: HR decreases by 12 or more beats after 1min OR 22 beats after 2mins
What is HR?
Amount of myocardium contractions per minute
What is Blood Pressure (Systolic vs Diastolic) ?
· BP: indirect measure of pressure on the arterial walls as the heart contracts and relaxes
- BP= CO x PVR
· Systolic BP: force against arterial walls during ventricular systole contraction)
· Diastolic BP: force against arterial walls during ventricular diastole (relaxation)
Importance of measuring BP? (BP = CO x PVR)
· Measurements reflect:
- CO
- Vascular resistance
- Blood volume and viscosity
- Ability of vascular walls to expand and contract
- Critical perfusion (MAP)
Normal BP Range
· Systolic: <120 mm HG
· Diastolic: <80 mm HG
What determines a cell’s sensitivity to a hormone?
· Number of receptors (which can change over time)
Primary vs Secondary Endocrine Disease
· Primary: originates in the specific gland
- ex: Primary Hyperthyroidism is a result of defect in the thyroid itself
· Secondary: change in one organ as a result of disease in another organ
- ex: TSH- secreting pituitary adenoma
Clinical Presentations SPECIFIC to Type 1 Diabetes
· Polyphagia (excessive hunger)
· Weight loss
· Ketonuria
Hyperglycemia Clinical Symptoms
· Frequent urination
· Excessive thirst
· Lethargic
· Blood glucose > 240 mg/dl
Hypoglycemia Clinical Symptoms
· Nervousness
· Tachycardia
· < 70 mg/dl
Leading cause of blindness in adults?
Diabetic Retinopathy
What does gestational diabetes increase the risk of developing?
Type 2 Diabetes
Energy substrates and clinical relevance to exercise testing a patient with COPD?
Energy substrates produce CO2 so its important to help patients alter eating habits to manage metabolism and thus decrease the amount of CO2 being produced
MET
· Energy expended solely to stay alive
· Can convert VO2 level to MET and then to activity
· Used to identify a patient’s capacity and make reommendations
· 1 Resting MET = 3.5 mlO2/kg/min
* Ability to perform basic ADL’s is 3.5-4 METS
· MET = VO2 / 3.5
How does CV function limit maximal VO2?
1) oxygen delivery alteration (ex: hypoxia)
2) Increase VO2max with training due to increased CO but not increased a-vO2 difference (need to improve avo2)
3) Over-perfusion of smaller muscles
What’s the best indicator of aerobic performance?
· Lactic acid
· In trained individuals, the onset of lactic acid occurs much later into exercise (occurs at 80% of VO2max)
What happens to cardiac output during exercise?
Increases mostly due to HR (bc stroke volume only really increase significantly then in the beginning before it plateus then HR is what allows for progression to stages)
What happens to cardiac output around 160-180 bpm?
CO begins to decrease because you’re at peak EDV and the heart can’t fill/contract any faster
CV Response to UE exertion?
· Valsalva maneuver is more likely to occur (increasing intra-thoracic pressure for stability)
· UE = smaller muscle mass so more of the body is not exercising thus experiencing a greater amount of vasoconstriction
· Increased HR and systolic BP
Valsalva Effects
· Increase BP
· Decrease venous return
· Reflexive tachycardia
· Decreased cerebral blood flow
Why does BP increase with age?
Due to decreased vascular compliance/elasticity
What physiological factors increase with age?
1) Systolic and Diastolic BP
2) Residual volume