Exercise Physiology Flashcards
1
Q
What are the immediate physiological responses to individual bouts of exercise?
A
Responses include increased heart rate, cardiac output, and local vasodilation.
2
Q
What are the health benefits of physical activity in adults (18-64) and older adults (64+)?
A
- all-cause mortality
- cardiovascular disease mortality
- incident hypertension
- incident site-specific cancers
- incident type-2 diabetes
- better mental health (less depression and anxiety)
- cognitive health
- better sleep
3
Q
What are the specific benefits for older adults?
A
- Falls prevention
- Reduction in falls related injuries
- Improvements in bone mineral density
- Functional Ability improvements
4
Q
True or False: The health benefits of physical activity are independent of the amount of activity performed.
A
False
5
Q
What is the principle behind resistance training (RT) and aerobic exercise training (AET)?
A
The principle of progressive overload.
6
Q
What is the typical resting heart rate range for an average individual?
A
60 to 80 beats per minute.
7
Q
What happens to heart rate just prior to exercise?
A
Heart rate rises to above normal resting levels due to increased sympathetic activity.
8
Q
What is the relationship between heart rate and exercise intensity?
A
Heart rate increases directly in relation to exercise intensity.
9
Q
What adaptations occur in the cardiovascular system during sustained dynamic exercise?
A
Increased cardiac output and oxygen extraction in active skeletal muscle.
10
Q
What is the recommended exercise intensity for inducing a training effect?
A
Above a minimal level required to induce a training effect but below the intensity that evokes abnormal clinical signs.
11
Q
What role does local vasodilation play during exercise?
A
It ensures sufficient blood supply to the working muscles.
12
Q
What are the potential benefits of increasing physical activity levels within the general population?
A
Reduction in disease risk and improvement in health outcomes.
13
Q
What is the importance of understanding the dose-response relationship in physical activity?
A
Some activity is better than none, but more activity generally confers greater benefits.
14
Q
What is maximal heart rate (HRmax)?
A
The highest heart rate value that is achieved in an all-out effort.
15
Q
How does maximal heart rate change with age?
A
Maximal heart rate declines steadily with age by about 1 beat per year starting at 10-15 years of age.
16
Q
What happens to heart rate during a submaximal workload held constant?
A
Heart rate usually achieves a steady state after an initial increase, plateauing at a constant workload.
17
Q
How long is required to ensure steady state heart rate is achieved?
A
At least four minutes of constant workload.
18
Q
What is cardiovascular drift?
A
The phenomenon where heart rate continues to drift upwards instead of maintaining a steady state during prolonged exercise, especially in hot conditions.
19
Q
What happens to stroke volume during exercise?
A
Stroke volume initially increases with incremental workload but does not continue to increase beyond 40-50% of maximal capacity.
20
Q
What factors contribute to the increase in stroke volume during exercise?
A
- Increased contractility of the heart muscle due to increased sympathetic activity
- Increased preload from greater volume of blood returned from the veins.
Both of these mechanisms result in an increase in the strength of ventricular contraction resulting in a greater volume of blood being ejected with each heart beat
21
Q
What happens to cardiac output as exercise intensity increases?
A
Cardiac output rises due to increases in heart rate and stroke volume.
22
Q
What is the maximum increase in cardiac output during strenuous exercise for relatively sedentary men?
A
Cardiac output can increase as much as four-fold above resting level.
23
Q
During maximal exercise, active muscle recieve how much of cardiac output?
A
80 - 85%
24
Q
How does systolic blood pressure change during exercise?
A
Systolic blood pressure increases in direct proportion to increased exercise intensity.
25
What is a typical at-rest systolic blood pressure, and how can it change at maximal exertion?
A typical at-rest systolic blood pressure is 120 mm Hg and may exceed 200 mm Hg at maximal exertion.
26
How does diastolic blood pressure (DBP) respond to increased exercise intensity?
Diastolic blood pressure hardly changes at all as exercise intensity increases.
27
Fill in the blank: Maximal heart rate declines steadily with age by about _______ per year.
1 beat
28
What can the Valsalva manoeuvre induce during resistance training?
A large increase in venous return, leading to increased cardiac output and BP.
## Footnote
This can raise myocardial oxygen demand.
29
How can the Valsalva manoeuvre be avoided during exercise?
By exhaling during muscular contraction and inhaling during the eccentric phase.
## Footnote
This technique is recommended for proper breathing during resistance training.
30
Why do arm exercises increase systolic blood pressure more than leg exercises
Because the muscle mass is relatively small therefore vasodilation is less that larger muscles (legs).
31
What happens to total peripheral resistance when a smaller muscle mass is used during exercise?
It is reduced less compared to exercises with larger muscle groups.
32
What is the rate pressure product (RPP) formula?
HR x SBP.
## Footnote
RPP is an indirect measure of myocardial oxygen consumption.
33
What type of work places greater stress on the myocardium for the same workload?
Static work or dynamic work restricted to the upper body.
## Footnote
Examples include pedaling with arms at 200 watts versus legs at 200 watts.
34
What percentage of cardiac output goes to skeletal muscle at rest versus during maximal exercise?
15-20% at rest; up to 80-85% during maximal exercise.
35
What does the sympathetic nervous system control during exercise?
Redistribution of blood from less active tissues (kidneys, liver, stomach, intestine) to more active tissues, such as skeletal muscle.
36
What is the efficiency of the human machine during exercise?
About 20% efficient.
## Footnote
This means only 20% of energy expended is converted to external work.
37
What happens to blood flow during prolonged exercise in hot or humid conditions?
Blood is redirected to the skin for heat loss, reducing blood volume due to sweating.
38
What is the effect of reduced venous return on stroke volume during exercise?
Stroke volume is reduced, necessitating an increase in heart rate to maintain cardiac output.
39
What is the arterial venous oxygen difference [(a-v) O2 diff]?
The difference in oxygen content between arterioles and venules, representing oxygen extracted by tissues as blood passes through the body
## Footnote
About 5ml per 100ml of blood difference between arteries and veins
40
How much oxygen is typically present in blood at rest in arterioles and venules?
20 ml of oxygen per 100 ml in arterioles; 15 ml per 100 ml in venules.
41
How does the (a-v) O2 diff change during exercise?
It may increase approximately threefold between rest and maximal exercise levels.
42
What is the arterial mixed venous oxygen difference at rest?
4-5 ml O2 per 100 ml blood
43
What happens to plasma volume with the onset of exercise?
Immediate loss of blood plasma volume to the interstitial fluid space
44
What is the reduction in plasma volume during prolonged periods of exercise?
10% to 20%
45
What does increased blood pressure (due to exercise) do to the capillary wall and tissues?
Pressure is exerted on the walls. This forced fluid from the blood into the tissues.
46
What does an increse in concentration of waste products in active muscle do to fluid in the blood?
It is sent from the blood into the muscle
47
What state is the myocardium in during rest?
Never really in a resting state.
48
What is hyperaemia
Increased blood flow
49
Why are the coronary vessels always in a state of hyperaemia?
Because the heart is always working, even at rest and the coronary vessels always needed to supply the heart with blood
50
What is the oxygen extraction rate of the myocardium at rest?
Around 70%
51
What is the oxygen extraction rate of skeletal muscles at rest?
25%-30%
52
How does coronary blood flow change during exercise?
Increases more than threefold
53
What is the primary mechanism for coronary artery vasodilation during exercise?
Increased metabolic activity of the myocardium
54
Why does the heart have to have an increased coronary blood supply during exercise?
Because it cannot increase the oxygen supply in the way muscles can as it is already extracting 70% of the available oxygen at rest
55
Coronary muscle has a good capacity to produce energy anerobically. T or F?
False
## Footnote
It's the opposite. The capicity is poor.
56
What happens if there is too much load on the heart during exercise?
Impared muscle function - ischaemia, possibly angina symptoms
57
Which substances contribute to vasodilation during exercise?
In the tissues adjacent to the coronary vessles, the following combined substances are produced:
1. Adenosine
2. hydrogen ions
3. potassium ions
4. acetylcholine
5. blood lactate
6. hypoxia (from a drop in oxygen content)
58
What role does the vascular endothelium play in vasodilation?
Produces and releases nitric oxide (NO) and prostacyclin which relax artery smooth muscles
59
True or False: The sympathetic drive has a strong vasodilatory effect on coronary vessels.
False
## Footnote
The vasodilatory effect is small
60
What compensatory mechanism occurs in patients with left ventricular dysfunction during exercise?
Heart rate rises rapidly which increases myocardial workload
## Footnote
These patients cannot rely on an increase in stroke volume
61
Why do heart patients need a prolongued warm up?
Because the endothelial lining of the coronary arteries are damaged and their vasodilation response is less as a result, they need more time for adequate vasodilation to take place
62
What should be monitored in patients with heart disease during exercise?
Potential for ischaemic or arrhythmic episodes
63
What is the consequence of a challenge to the oxygen supply to the heart?
Impaired muscle function (ischaemia and possibly angina symptoms)
64
What is the effect of exercise on the heart's oxygen extraction capacity?
Limited increase in extraction rates
65
What happens to systolic blood pressure in patients with severe heart failure during exercise?
Systolic blood pressure may not rise and may even decrease
## Footnote
This is due to reduced cardiac output.
66
What is myocardial workload determined by?
The product of heart rate and systolic blood pressure
## Footnote
This is also referred to as the rate pressure product.
67
What should be done if a patient's pre-exercise systolic blood pressure is higher than usual?
The training heart rate should be reduced for that particular session
## Footnote
This is important to offset any elevation in blood pressure and is patients with residual ischaemia will need this monitoring closely.
68
What medications can blunt heart rate and blood pressure responses during exercise?
Beta-blockers and some calcium channel blockers
## Footnote
These medications are commonly prescribed for coronary heart disease patients.
69
What is the role of sympathetic stimulation during exercise?
It causes vasodilation of blood vessels supplying active tissues
## Footnote
This helps redistribute blood to active skeletal muscle.
70
True of False?
The combinational of redistribution of blood to active skeletal muscles (as a result of sympathetic stimulation) along with the effect of meds that lower blood pressure (eg Beta Blockers and Ace Inhibitors) dramatically increases the potential for hypotensive episodes
True
71
Why should patients be encourage to keep their feet moving (or toes wiggling) during exercise?
Standing still between bouts of exercise or whilst doing arm work could increase the liklihood of hypotensive episodes and prevent good venus return
72
What other things should patients avoid to guard against hypotensive episodes during exercise?
Abrupt changes in position and breath holding
73
Why should patients be warned about the potential for hypotensive episodes after an exercise session has ceased?
Because total peripheral resistance is reduced for some time after exercise is finished
74
Why is fluid intake particularly important during exercise for individuals on diuretics?
Reduction in blood plasma volume occurs from the outset of exercise
## Footnote
This makes hydration critical for this population.
75
What adaptations occur with regular exercise training?
Longer-term cardiovascular and metabolic adaptations
## Footnote
These include functional, structural, and biochemical changes.
76
What does the effectiveness of exercise prescriptions depend on?
Manipulation of the FITT principle: frequency, intensity, time, and type of training
## Footnote
This is essential for tailoring exercise programs.
77
What is the relationship between initial fitness and potential for change with exercise training?
The lower the initial fitness, the greater the potential for change
## Footnote
This applies to both men and women, young and old, with and without cardiac disease.
78
What benefits do both Aerobic Exercise Training (AET) and Resistance Training (RT) offer?
Cardioprotective benefits
## Footnote
A combination of both is suggested for optimal results.
79
What specific benefit does AET provide for people living with coronary heart disease?
Lowers resting heart rate
## Footnote
This brings additional anti-ischaemic benefits.
80
What should exercise programming incorporate for patients with coronary heart disease?
RT following FITT principle guidelines and structured progressive AET
## Footnote
This combination is essential for effective management.
81
What does VO2 peak stand for?
Peak oxygen uptake
## Footnote
VOzpeak is a measure of the maximum amount of oxygen the body can utilize during intense exercise.
82
What health risk is associated with Type II diabetes?
Risk of poor glycaemic control
## Footnote
Poor glycaemic control can lead to various complications in individuals with Type II diabetes.
83
How does resistance training affect bone mineral density?
Increasing effect
## Footnote
Resistance training is particularly beneficial for enhancing bone mineral density.
84
True or False: Aerobic training has a decreasing effect on insulin signaling.
False
## Footnote
Aerobic training typically improves insulin signaling, which is beneficial for metabolic health.
85
What does VOmax stand for?
Maximal oxygen uptake
86
What type of exercise leads to greater increases in VO2 max?
Aerobic exercise training (AET)
## Footnote
RT does increase VO2Max but not as much as aerobics
87
What is the highest rate of oxygen consumption attainable during maximal or exhaustive exercise called?
VOmax
88
What percentage increase in VOmax can healthy individuals expect after 12 to 16 weeks of training?
10% to 25%
89
What two factors determine maximal oxygen uptake?
* Maximum cardiac output
* Maximal ability of active skeletal muscle to extract and utilise oxygen
90
What is the primary reason for increased maximal cardiac output due to training?
Increased maximal stroke volume
91
What training-induced changes lead to an increase in left ventricular mass?
* Increased chamber size
* Increased total blood volume
* Reduced total peripheral resistance
92
What is a common characteristic of cardiac patients regarding training-induced changes?
Lack of training-induced increases in left ventricle mass and volume
93
Why do cardiac patients miss out on significantly increasing the max cardiac output?
Because rehab programs are too brief and there is insufficient intensity
94
What are the peripheral changes that contribute to increased oxygen extraction and utilization?
* Improved capillarisation
* Increased myoglobin concentration
* Increased number and size of mitochondria
* Increased oxidative enzyme activity
95
How does improved capillarisation affect muscle blood flow during maximal exercise?
It accommodates increased blood flow without shortening capillary transit time
96
What is improvement in Vo2 max put down too for CHD patients?
Peripheral adaptations in skeletal muscles resulting in increased oxygen extraction by active muscles
97
What type of adaptations are most relevant for cardiac patients?
Adaptations at submaximal levels of exercise (not maximal)
98
What factors influence training adaptations in individuals with heart disease?
* Severity of disease
* Co-morbidity
* Medication
* Psychological status
* Motivation
99
What happens to heart rate at rest and during submaximal work after training?
It is lower after training
100
What is the proposed mechanism behind the reduction in heart rate after training?
increased parasympathetic activity and reduced sympathetic activity
101
What is the effect of reduced circulating catecholamines and increase in ischaemic threshold on potential arrhythmias?
It lessens the potential for arrhythmias
102
What happens to stroke volume at rest after training?
Stroke volume increases after training
## Footnote
This increase may result from greater filling of the left ventricle, a greater volume of blood entering the left ventricle, and increased ventricular mass.
103
What are the factors contributing to increased stroke volume in trained individuals?
* Greater filling of the left ventricle during diastole
* Greater volume of blood entering the left ventricle
* Increased ventricular mass
104
How does cardiac output change after training at the same exercise intensity?
Cardiac output decreases after training
## Footnote
This is due to increased muscle oxygen extraction and improved oxygen usage economy of the skeletal muscle.
105
What changes occur to blood pressure as a result of training?
Resting and submaximal blood pressures are reduced
## Footnote
The reduction may be as much as 10 mm Hg for SBP and 8 mm Hg for DBP.
106
What is the Rate Pressure Product (RPP) and its implication in coronary artery disease?
RPP is reduced during submaximal exercise after training
## Footnote
This reduction benefits symptom control and quality of life for individuals with coronary artery disease.
107
What is the effect of training on the ischaemic threshold for patients suffering from angina?
The ischaemic threshold is improved due to reduction in heart rate and BP
## Footnote
This means patients can perform more work before experiencing angina symptoms.
108
What happens as a result of an increased period of diastole?
There is treater time for blood to flow into the coronary circulation
109
What occurs to muscle perfusion at rest following training?
Muscle perfusion at rest remains unaltered
## Footnote
However, at a given submaximal workload, blood redistribution to active muscle is reduced.
110
True of False...?
The oxygen amount extracted from blood flowing through active skeletal muscle will be less than before training
False
## Footnote
The difference in oxygen content before and after training is greater.
111
What happens to plasma volume after approximately 5 training sessions?
There is a significant increase in plasma volume
## Footnote
This enhances oxygen transport and temperature regulation.
112
How does coronary blood flow improve as a result of training?
The reduction in heart rate leads to an extended period of diastole
## Footnote
This improves myocardial perfusion since blood flow to the left ventricle occurs during diastole.
113
Fill in the blank: Following training, the reduction in heart rate and blood pressure at any specified workload allows for a delayed _______.
ischaemic threshold
114
What effect does training have on blood pressure?
Blood pressure is reduced
## Footnote
Training is effective in lowering blood pressure as part of modifying CAD risk factors.
115
How does training affect total cholesterol levels?
Total cholesterol is reduced and even more effectively when combined with weight loss
116
What change occurs in high-density lipoprotein cholesterol due to training?
High-density lipoprotein cholesterol is increased
## Footnote
Increased HDL is beneficial for cardiovascular health.
117
How does training influence glucose metabolism?
Glucose metabolism is improved with an increased sensitivity to insulin
## Footnote
Enhanced insulin sensitivity is crucial for managing blood sugar levels.
118
What happens to fibrinolytic activity with training?
Fibrinolytic activity is increased with a reduction in platelet 'stickiness'
## Footnote
Improved fibrinolytic activity helps in reducing clot formation.
119
What is the impact of training on body fat?
Body fat is lost without loss of lean body mass, thereby preserving resting metabolic rate
## Footnote
Maintaining lean mass while losing fat is vital for metabolic health.
120
List the benefits of resistance training (RT) on chronic disease.
* Improved body composition
* Improved blood lipid profile and vascular function
* Improved blood pressure
* Improved immune system function
* Improved blood glucose and insulin sensitivity
* Increased muscle mass and strength
* Improved physical function and mobility
* Greater oxidative capacity
## Footnote
These benefits highlight the role of RT in countering age-related chronic diseases.
121
What is the increase in coronary blood flow during vigorous exercise?
4-6 times above resting levels
## Footnote
This increase is essential for meeting the heightened metabolic demands of the body during exercise.
122
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