Exercise for CV and Pulmonary Conditions Flashcards
Primary impairment is an imbalance between _______ oxygen supply and _______ oxygen demand.
myocardial
There is a decrease in supply to the heart due to narrowing of the lumen of the _____ ______.
coronary artery
______ _____ occurs when the blood supply to part of the heart is interrupted.
heart attach
Heart attacks most commonly occur de to occlusion of a coronary artery following the rupture of an ______ ______.
atherosclerotic plaque
_______ _______ = an unstable collected of lipids and WBC’s in the wall of an artery.
atherosclerotic plaque
What are 2 basic mechanisms of exercise intolerance in CAD?
- Impaired LV function
2. Myocardial ischemia (angina)
When VCO2 increases faster than VO2, what will change with RER?
Will go over 1
VO2 plateaus due to a ______ in SV with VCO2 continues to _______.
plateau; increase
RER is significantly higher in CAD due to impaired O2 _______ and increased metabolic _______.
delivery; acidosis
Ve/VCO2 ratio is normal at rest and during exercise in CAD (T/F).
TRUE
_________ compensation for metabolic acidosis during heavy exercise is normal and effective in CAD.
respiratory
Is a lower or higher Ve/VCO2 ratio more efficient?
lower
The _____ _____ is similar in health and CAD (indicating normal sub maximal O2 delivery and utilization).
anaerobic threshold
Above the _______ _____, VCO2 increases more steeply in CAD than in healthy subjects.
ischemic threshold
During the onset of myocardial ischemia in patients with CAD, what occurs with HR response?
curvilinear response rather than normal linear response
During the onset of myocardial ischemia in patients with CAD, what occurs to O2 pulse?
O2 pulse remains below predicted values
CAD patients are usually ventilatory limited (T/F).
FALSE
_________ _______ = process by which pt’s with cardiac disease, in partnership with a multidisciplinary team of health professionals, are encouraged and supported to achieve and maintain optimal physical and psychosocial health.
cardiac rehabilitation
What are 3 goals of cardiac rehabilitation (CR)?
- Limit adverse physiological and psychological effects of cardiac illness
- Decrease the risk of sudden death or reinfarction
- Control symptoms
What are 3 components of CR?
- lifestyle
- psychosocial care
- long-term management strategy
What are 5 examples of lifestyle factors that are addressed in CR?
- Pa and exercise
- Secondary prevention
- Education
- Diet and weight management
- Smoking cessation
Phase I of CR?
in patient period
Phase II of CR?
- early post discharge
- up to 12 weeks of supervised exercise and/or education following discharge
Phase III of CR?
- supervised out-pt program including structured exercise
- variable length program, intermittent of no ECG monitoring
Phase IV of CR?
- long-term maintenance of exercise and other lifestyle changes
- no ECG monitoring and limited supervision
One of the goals of CR is to have pt’s reach __-__ MET activity level by discharge.
3-4
In CR, there should be a sow progression of activity intensity (increase by __ MET/day).
1
For inpatient CR, progress when pt can exercise continuously for __-___ min.
10-15
How many classes of activity classification are there for inpatient CR?
VI
What are 3 goals of outpatient CR?
- Return pt to pre-morbid vocational and/or recreational activities
- Help pt establish and implement a safe and effective home exercise program and recreational lifestyle
- Provide pt and family education and therapies to maximize secondary prevention
Beta blockers ____ HR response.
blunt
If a PT is on beta blockers, what are two other methods to to measure level of work besides HR?
- %VO2
2. RPE
_____-___ is very important in cardiac rehabilitation when exercising.
warm up
Why is warm up important in cardiac rehabilitation?
Allows pt to exercise more intensely before feeling chest pain.
Intensity for exercise in CR should be prescribed at a HR below the _______ threshold.
ischemic
When resistance training in CR, what should the RPE be?
~11-13
_____ is a beta blocker and it lowers HR and BP at rest and exercise.
metoprolol
_______ controls atrial fibrillation and lowers HR at rest and exercise.
digoxin
____ is a diuretic and has little effect on HR but increases urination frequency.
HCT
_____ ______ _____ = Chronic airway obstruction due to inflammatory narrowing, smooth muscle hypertrophy and airway hyper secretion.
small airways disease (COPD)
________ = loss of elastic lung recoil with attendant airway collapse during expiration; impaired pulmonary gas exchange and decrease in SA.
emphysema
What are 3 causes of COPD?
- cigarette smoking
- exposure to indoor pollutants and biomass fuels
- smoke from cooking in poorly ventilated conditions
Expiratory flow limitation will lead to an increase in ____ ______ , leading to lung hyperinflation.
air trapping
_______ ________ = acute increase in end expiratory lung volume relative to rest.
dynamic hyperinflation
Because pt’s with COPD breath very close to their TLC, _____ ______ ______ increase and tidal volume is unable to increase.
end expiratory volume
________ increase the work of breathing.
hyperinflation
The work and O2 cost of breathing at any given ventilation during exercise is considerably greater in COPD (T/F).
TRUE
In COPD pt’s there is a ____ level of neural drive to increase TV.
high
___________ dissociation refers to the connection, or lack thereof between the brain and respiratory system.
neuromechanical
What are 5 examples of causes of exercise intolerance in COPD?
- Ventilatory limitations
- Exertional symptoms
- Metabolic and gas exchange abnormalities
- Cardiac impairment
- Peripheral muscle dysfunction
What are 4 components of pulmonary rehabilitation (PR)?
- Exercise testing
- Education
- Psychosocial/behavioural interventions
- Outcome assessment
PR (does/does not) change lung structure and function.
does NOT
What 4 things does PR do?
- Reduce symptoms
- Improve exercise tolerance
- Increase functional ability
- Improve quality of life
What 3 things PR improve?
- Muscle reconditioning
- Increased respiratory muscle strength
- Desensitization to dyspnea
_______ ______ in COPD leads to functional changes in skeletal muscle function that can be partly or or completely reversed by exercise training,
activity avoidance
Is interval or endurance training more effective for PR?
Similarly effective
_______ muscle stimulation significantly improves muscle strength.
electrical
There is a greater increase in exercise endurance in patients that got ______ _______ and O2 compared to other groups.
noninvasive ventilation
Patients that improved exercise tolerance with ____ in pre-training tests had the greatest benefits during rehab exercise training.
O2
