Final Flashcards

1
Q

Outline the effects of increasingly higher altitudes on the following factor:
partial pressure of oxygen in ambient air

A

Hyperventilation from reduced arterial Po2 is the most important immediate response, is an attempt to increase the partial pressure of O2. Hypoxic drive can remain elevated for a year.

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2
Q

Outline the effects of increasingly higher altitudes on the following factor: oxygen saturation of hemoglobin in pulmonary capillaries

A

Change in PV happens quickly and stimulates processes which turn on EPO to form new RBCs. After a week at 1300m, PV declines by 8%, RBC concentration increases by 4% and Hb by 10%. Rapid PV reduction and hemoconcentration incr the O2 content of arterial blood.

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3
Q

Outline the effects of increasingly higher altitudes on the following factor:
VO2max

A

Vo2max is reduced

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4
Q

Discuss the immediate physiological adjustments to exercise at high altitude:

A
  • Hyperventilation, body fluids becoming more alkaline.
  • incr. in submax HR and CO. SV and max CO remain same or slightly decr.
  • incr. in respiration and BF
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5
Q

Discuss the longer-term physiological adjustments to exercise at high altitude

A
  • Hyperventilation, excretion of bicarbonate via kidneys and reduction in alkaline reserve. Blood pH restored to normal level.
  • Submax HR remains elevated, submax CO and SV decr, mac CO incr.
  • Possible incr capillarization of skeletal muscle, aerobic enzymes and mitochondrial density, loss of BW and LBM.
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6
Q

Give symptoms, possible causes, and treatment for: Acute mountain sickness

A
  • headache, nausea, dizziness, fatigue, insomnia, peripheral edema.
  • From acute reduction in cerebral oxygen saturation, headache from hyperventilation.
  • Slow altitude climb, oxygen and Diamox.
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7
Q

Give symptoms, possible causes, and treatment for: High altitude pulmonary edema

A
  • severe headache and fatigue, excessively high VE and HR, mucus cough, blueish skin, disruption of bladder, vision and bowel, loss of reflexes and coordination, paralysis on one side.
  • From rapid ascent, fluid accumulating in the brain and lungs, results from increased pulmonary artery pressure with damage to blood-gas barrier.
  • Descent by at least 1000 m, oxygen, medication, hyperbaric chamber.
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8
Q

Give symptoms, possible causes, and treatment for: High altitude cerebral edema

A
  • staggered gait, dyspnea, severe weakness/fatigue, cough with infection, confusion, impaired mental state, ashen skin color, LOC. - from increased intracranial pressure, cerebral vasodilation and elevations in capillary hydrostatic pressured moving fluid and protein from vascular compartment across blood brain barrier.
  • Treat by immediately descending.
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9
Q

Describe the lactate paradox and possible causes

A
  • On immediate ascent to altitude, a given submax exercise load increases BL concentration compared to SL values. Greater reliance on anaerobic metab w altitude hypoxia explains the increase in lactate accumulation.
  • After a few weeks, the same intensity exercise produces lower BL levels despite a lack of incr in Vo2max or regional BF.
  • Causes: reduced output of epinephrine, reduced glucose mobilization from the liver reducing capacity for lactate formation. Overall reduced CNS drive, reducing capacity for all out effort.
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10
Q

Summarize factors that affect the time course for altitude acclimatization

A

Depends on elevation, accl to one altitude ensures only partial adjustment to a higher elevation. After 2300 (two weeks) its an additional week per 610m altitude.

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11
Q

•Graph the relationship between increasing altitude exposure and the decrease in VO2max:

A

Altitude X, % decline in vo2max Y - straight down towards right.

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12
Q

Discuss alterations in circulatory function that offset the benefits of altitude acclimatization on oxygen transport capacity

A

After several months of acclimatization to hypoxia, Vo2max at altitude still remains below sea level values , despite incr in Hb concentration. Occurs because the reduced circulatory capacity (lowered max HR and SV) offsets benefits.

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13
Q

Discuss whether altitude training produces greater improvement than sea-level training on sea-level exercise performance.

A

does not improve after living at altitude when VO2max serves as improvement criterion. Any reduction in max CO from altitude exposure offsets benefits from an increase in the blood oxygen carrying capacity.

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14
Q

Describe the training concept of “live high train low.”:

A

Increase RBC count by eliciting benefits of both training at sea level and living at high altitude. Increase O2 transport by living at altitude, without detraining associated with hypoxic exercise.

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15
Q

Explain how the hypothalamus maintains thermal balance:

A

Hypothalamus contains the central coordinating center for temp regulation. Thermal receptors in the skin provide input to the central control center, and changes in the temp of blood that perfuses the hypothalamus directly stimulate this area.

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16
Q

Describe physical factors that contribute to heat loss and heat gain.

A

Conduction: warming air molecules and cooler surfaces that touch the skin.
Convection: transferring heat by notion of a gas or liquid across a heated surface. Air passes over skin and heat is exchanged w air molecules….
Radiation: all objects emit radiant energy or heat waves…
Evaporation: primary avenue for heat dissipation - liquid turns into gas. Three factors influence total amount of sweat vaporized from skin and pulmonary surfaces: surface exposed to env, temp and relative humidity of ambient air, convective air currents about the body.

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17
Q

Rate of conductive heat loss depends on two factors:

A
  1. temp gradient between the skin and the surrounding temperature, 2. the thermal qualities of the surface.
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18
Q

Discuss how the circulatory system adjusts during temperature changes:

A
  • In heat, HR and CO incr while superficial and venous blood vessels dilate to divert warm blood to the skin.
  • W/ extreme heat stress, 15-25% of CO passes thru the skin. Submax exercise produces a lower SV causing a higher HR at all submax intensities. Higher HR in max exercise does not offset SV decrease so max CO decreases.
  • Maintaining skin and muscle BF requires other tissues to compromise blood supply. These circulatory adjustments lead to incr blood lactate accumulation due to; decr lactate uptake by live from reduced hepatic BF, less muscle catabolism of circulating lactate because heat dissipation diverts CO to the periphery.
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19
Q

Quantify fluid loss during hot-weather exercise

A

Peak of 3L per hour of intense PA, 12L on daily basis. Intense sweating for hours can produce sweat-gland fatigue that ultimately interferes w/ core temp regulation.

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20
Q

Discuss the purpose of fluid replacement and pre-exercise hydration.

A
  • Maintaining fluid balance: must focus on maintain plasma volume so circulation and sweating progress normally.
  • Ideal conditions replace water loss from sweating during exercise at a rate close or equal to sweating rate. Each lb of weight reps 450 ml dehydration.
  • Hyperhydration before exercising in heat offers thermoregulatory protection: 500 ml of water before sleeping the night before, another 500 ml upon waking, and 400-600 ml 20 min before exercise.
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21
Q

Discuss factors that maintain cutaneous blood flow and blood pressure during exertion in heat.

A
  • Compensatory restriction of the splanchnic vascular bed and renal tissues rapidly counteracts active vasodilation of the subcutaneous vessels responsible for 80-95% of elevated skin BF.
  • Vasoconstriction in the viscera increases total vascular resistance. A balance between dilation and constriction maintains arterial BP during exercise in the heat. In intense effort, w/ accompanying dehydration, relatively less blood diverts to peripheral areas for heat dissipation. Reduced peripheral BF reflects the body’s attempt to maintain CO in the face of diminishing PV caused by sweating. circulatory regulation and muscle BF takes precedence over temp reg during PA in the head. When submax effort progresses without excessive physio strain, a greater dependence still exists on anaerobic metab.
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22
Q

Describe the cardiac output, heart rate, and stroke volume response during hot-weather physical activity.

A

Submax exercise produces a lower SV causing a higher HR at all submax intensities. Higher HR in max exercise does not offset SV decrease so max CO decreases

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23
Q

Explain how acclimatization, training, age, gender, and body fat modify heat tolerance during physical activity

A
  • Acclimatization: Incr BF to cutaneous vessels, more effective CO, low sweating threshold, quicker cooling, incr sweat capacity , more diluted sweat (less salt lost)
  • Training status: incr sensitivity and capacity of the sweat response to that sweating begins at a lower temp. Greater cutaneous BF at a given internal temp or % of vo2max.
  • Age: no age related decrements in thermoreg during marathon running. Children sweat less and have higher core temps during heat stress.
  • Gender: women sweat less and start to sweat at a higher skin and core temp, even after acclimatization. Likely make greater use of circulatory mechanisms for dissipating heat. Women are typically smaller and have a relatively larger body surface area per unit mass - favors greater heat dissipation.
  • BF level: fat incr the insulatory capacity of the body shell and limits heat conduction to the periphery. Larger individuals have a smaller surface area to body mass ratio - limits the effectiveness of sweat evaporation.
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24
Q

Give symptoms, causes, and treatments for heat cramps, heat exhaustion, and heat stroke.

A
  • Heat cramps: severe involuntary sustained and spreading muscle spasms during or after intense PA, usually in exercised muscle. Fatigue, excessive thirst, profuse sweating, cramps.
  • Heat exhaustion: occurs from ineffective circulatory adjustments compounded by depletion of extracellular fluid, principally plasma volume, from excessive sweating. Nausea, chills, headache.
  • Heat stroke: failure of heat regulating mechanisms from an excessively high core temp. Cessation of sweating, confusion, LOC.
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25
Q

Discuss the physiological adjustments to cold stress.

A
  • Vascular adjustments:
    Cutaneous cold receptors constrict peripheral blood vessels reducing flow of warm blood to the body’s surface and redirecting it to the core.
  • Muscular activity:
    PA provides greatest distribution defending against cold. Exercise energy metabolism sustains a constant core temp in air as cold as -30C. Shivering also generates metabolic heat. This rapid involuntary cycle of contraction and relaxation of skeletal muscles can cause a 4-5x incr in the body rate of heat production.
  • Hormonal output:
    Epinephrine and norepinephrine increase heat production during cold exposure. Prolonged cold stress stimulates thyroxine release from the thyroid which increases resting metabolism.
26
Q

Discuss airway remodelling due to exercise in cold air.

A

Sled dogs: can sustain speeds as high as 25 km/h, can endurance dogs can cover 200 km/day. 81% of dogs examined had abnormal accumulations of intraluminal debris, with 46% classified as moderate or severe. Supports that strenuous exercise in cold envs can lead to lower airway disease and suggest that racing sled dogs may be a useful animal model of the analogous human disease.

27
Q

Myocardial O2 supply and use…

A

At rest, myocardium extracts 70-80% of O2 from blood in the coronary vessels. Proportionate increase in coronary BF in exercise provides sole mechanism to incr myocardial O2 supply. Two factors increase BF: elevated myocardial metabolism dilates coronary vessels, and incr aortic pressure during exercise forces a proportionately greater volume of blood into coronary circulation.

28
Q

Extrinsic regulation of HR

A

nerves that directly supply the myocardium and chemical messengers that circulate in blood accelerate the heart in anticipation before PA begins and then rapidly adjust to intensity. Input from brain and peripheral NS continually bombards the CV control center in the ventrolateral medulla to regulate the hearts output of blood and its preferential distribution to all tissues

29
Q

Intrinsic regulation of HR

A

cardiac muscle maintains its own rhythm. Left to its inherent rhythmicity, it would beat 100 bpm. The SA node provides the innate stimulus for heat action - heart’s pacemaker.

30
Q

Exercise effect on BF

A

Any incr in energy expenditure requires rapid adjustments in BF that impact the CV system. During PA, local arterioles of active muscle dilate while vessels to tissues that can temp compromise their blood supply constrict. Two factors contribute to reduced BF to non active tissues: incr sympathetic NS outflow, local chemicals that directly stimulate vasoconstriction or enhance efforts of other constrictors

31
Q

Oxygen carrying capacity of hemoglobin

A

men - 15 g Hb/dL blood, women - 14 g Hb/dL blood. Each gram of Hb combines with 1.34 mL of O2. with full O2 saturation and normal Hb levels, Hb carries 20 mL O2 transported in each dL whole blood. Blood’s O2 capacity - Hb x Hb O2 capacity.

32
Q

The Bohr effect

A

any incr in plasma acidity and temp causes the oxyhemoglobin dissociation curve to shift downward and to the right: indicates the H+ and O2 alter hemoglobins molecular structure to decrease its O2 binding affinity. The reduced effectiveness of hemoglobin to hold 2 occurs in the Po2 range of 20-50.

33
Q

Physiological responses to cold - vascular adjustments:

A

Cutaneous cold receptors constrict peripheral blood vessels reducing flow of warm blood to the body’s surface and redirecting it to the core.

34
Q

Physiological responses to cold - muscular activity

A

PA provides greatest distribution defending against cold. Exercise energy metabolism sustains a constant core temp in air as cold as -30C. Shivering also generates metabolic heat. This rapid involuntary cycle of contraction and relaxation of skeletal muscles can cause a 4-5x incr in the body rate of heat production.

35
Q

Physiological responses to cold - hormonal output

A

Epinephrine and norepinephrine increase heat production during cold exposure. Prolonged cold stress stimulates thyroxine release from the thyroid which increases resting metabolism.

36
Q

Respiratory tract during cold weather exercise

A

Cold ambient air poses no special danger of damaging respiratory passages. Even in extreme cold, incoming air warms to 26-32C when it reaches the bronchi.
Athletes who exercise in very cold environments have a high incidence (30-45%) of airway hyper-reactivity of asthma, whereas athletes who exercise in a warmer environment at levels comparable to hockey players do not exhibit this compared to control group

37
Q

Degrees of hypothermia

A
  • Mild: 33-34C. Max shivering, incr BP → amnesia, dysarthria, poor judgement, behavior change → ataxia, apathy.
  • Moderate: 29-32C. Stupor → shivering ceases, pupils dilate → cardiac arrhythmias, decor CO → unconsciousness
  • Severe: 13.7-28C. Ventricular fibrillation, hypoventilation → loss of reflexes and voluntary motion → acid base disturbances, no response to pain → reduced cerebral BF → hypotension, bradycardia, pulmonary edema → no corneal reflexes, areflexia → electroencephalographic silence → asystole → lowest survival
38
Q

WADA prohibited list criteria, has to satisfy 2/3;

A
  • has potential to enhance sports performance,
  • it represents and actual or potential risk to athletes,
  • it violates the spirit of sport.
39
Q

6 mechanisms for ergogenic aids

A
  • Act as a CNS or PNS stimulant
  • Incr storage or availability of limiting substrate
  • Act as supplemental fuel source
  • Reduce/neutralize performance inhibiting metabolic by products
  • Facilitate recovery
  • Enhance resistance training responsiveness
40
Q

How does caffeine affect metabolism? (2 options)

A

directly on adipose and peripheral vascular tissues, or indirectly by stimulating epinephrine release from the adrenal medulla

41
Q

WADA banned substances list:

A

anabolic androgenic steroids, hormones and related substances, beta 2 agonists, hormone antagonists and modulators, diuretics and other masking agents, stimulants, narcotics, cannabinoids, glucocorticosteroids, alcohol, beta blockers.

42
Q

How does caffeine affect the CNS?

A

Caffeine and its metabolites readily cross the blood brain barrier to produce analgesic effects on the CNS, potentially reducing the perception of effort during PA. enhances motor neuronal excitability to facilitate motor unit recruitment. The stimulating effects do not occur from its direct action on the CNS. instead it blocks the receptors for adenosine that serve to calm brain and spinal cord neurons

43
Q

Sources of myocardial injury evidence

A

Creatine kinase and cardiac troponins

44
Q

Acute exercise induced CV risks

A

Sudden cardiac death, acute myocardial injury, cardiac dysfunction and cardiac fatigue

45
Q

Potential maladaptations to lifelong exercise

A

Myocardial fibrosis, long QT syndrome

46
Q

Why is there an increase in cardiac trononins

A

incr cardiomyocyte membrane permeability by mechanical stress, production of oxidative radicals, cardiac ischemia could cause proteolysis of the cTn complex, permitting troponin degradation products to pass through the cellular membrane.

47
Q

Mechanisms for impaired cardiac function during prolonged exercise → can lead to possible pulmonary congestion

A
  • Incr: circulating catecholamine, HR and LV contractility, heat prod, oxidative stress, BV redistribution, sweat rate, cardiomyocyte membrane damage
  • Decr: B-adrenergic sensitivity, venous return
48
Q

Myocardial fibrosis

A

characterized by the accumulation of collagen in the extracellular matrix of the heart. MF commonly occurs after myocyte injury from ischemia, but can have nonischemic causes. MF is divided into; reactive interstitial fibrosis, infiltrative interstitial fibrosis, replacement fibrosis.

49
Q

Long QT

A

time between depolarization and repolarization of the cardiac ventricles. Generated by passage of calcium, potassium and sodium ions through cardiac ion channels. Abnormal increases in the QT interval produce long QT syndrome, which can lead to sudden cardiac death.

50
Q

Pregnancy - physiological changes

A
  • Endocrine changes - gonadotropin, progesterone, estrogens
  • CV system - uterine BF
  • Renal system - renal BF, glomerular filtration rate
  • Respiration and acid base balance - increased VE and reduced PaCO2/respiratory alkalosis
51
Q

Absolute contraindications to aerobic exercise during pregnancy

A

hemodynamically significant heart disease, restrictive lung disease, incompetent cerviz, multiple gestation at risk for premature labor, persistent 2nd/3rd trimester bleeding, placenta praevia after 26 wks, premature labor during the current pregnancy, ruptured membranes, pregnancy related hypertension.

52
Q

Relative contraindications to aerobic exercise during pregnancy

A

: severe anemia, unevaluated maternal cardiac arrhythmia, chronic bronchitis, poorly controlled type I diabetes, extreme morbid obesity, extreme underweight, extremely sedentary history, intrauterine growth restriction in pregnancy, poorly controlled hypertension or pre eclampsia, orthopaedic limitations, poorly controlled seizure disorder or thyroid disease, heavy smoker.

53
Q

Hypothetical risks to aerobic exercise during pregnancy

A

acute risk associated w BF To uterus leading to fetal hypoxia, fetal hyperthermia, reduced carb availability to fetus as the mother used more CHO to fuel exercise, possibility of miscarriage.

54
Q

Risk of exercise catastrophe incr w/

A

genetic predisposition, history of fainting/chest pain w PA, unaccustomed vigorous exercise, exercise done with accompanying psychological stress, extremes of environmental temp, straining exercise with static muscle action (BP related), exercise during viral infection or when feeling ill

55
Q

Why is shovelling show a CV risk?

A

valsalva maneuver; incr BP, risk of cardiac event.

56
Q

Hormonal system changes due to aging

A

hypothalamic-pituitary-gonadal axis leading to menopause and andropause. Adrenal cortex leading to reduced output of DHEA. growth hormone/insulin-like growth factor axis leading to somatopause (decline in growth hormone and insulin like growth factors 1).

57
Q

Pulmonary function changes due to aging

A

mechanical constraints cause deterioration in static and dynamic lung function. Slowing of pulmonary ventilation and gas exchange kinetics during transition from rest to submax exercise. In elderly men, aerobic training increases gas exchange kinetics to levels approaching values for fit young adults.

58
Q

CV function changes due to aging

A

vo2max declines 1% yearly and occurs twice as fast in sedentary compared to physically active. Regular aerobic exercise cannot fully prevent age related decline in aerobic power with aging. Exercise max GR declines with age. Max CO decreases in trained and untrained due to lower max HR and SV. compliance of large arteries declines from changes in arterial wall properties. Decr capillary:muscle fiber ratio and arterial cross section causes lower BF to muscle.

59
Q

Central and peripheral CV function changes due to aging

A
  • HR - max HR declines w age. Reflects reduced medullary outflow of sympathetic activity (men and women). Max HR decline in athletes between 50-70y/o smaller than predicted (indicates training effect).
  • CO: max CO decr w age in trained and untrained due to lower max GR and SV. SV decline reflects combined effects of reduced left ventricular systolic and diastolic myocardial performance.
    Peripheral factors: reduced peripheral BF capacity accompanies age related decr in muscle mass.
60
Q

Competitive CV demands of performing exercise in heat

A

muscles require oxygen to sustain energy metabolism, arterial blood that diverts to the periphery to cool the body cannot deliver its oxygen to active muscle.

61
Q

clu value of clothing is determined by

A

wind speed, body movements, chimney effect, bellows effect, water vapor transfer, permeation efficiency factor