Hormone Regulation of Exercise

Question 1

Adrenal Medulla (Kidney)

Answer 1

Catecholamines
NE & EP
Increases HR, BP, Respiratory Rate
Increases Metabolic Rate, glycogenolysis; Release of FFA and glucose into blood

Question 2

Aldosterone

Answer 2

Released by Adrenal Gland - Cortex in response to low BP or blood flow

Promotes sodium retention in kidneys and plasma volume

Question 3

Antidiuretic hormone (ADH)

Answer 3

Released by Posterior Pituitary in response to low blood osmolarity

Promotes water conservation by plasma volume

Question 4

Renin-angiotensin Mechanism

Answer 4

Sweat->Decreased blood flow to kidney->kidney creates renin->converts to angiotensin 1 -> converts to angiotensin II when converting enzyme is present (Na+ and Water Reabsorbed)

Question 5

What does an ACE inhibitor do?

Answer 5

Stops Angiotensin II from being made by stopping the enzyme from working

Lower BP

Question 6

Hormones Increasing Fat Metabolism

Answer 6

Cortisol (Stress) from adrenal cortex
Epinephrine
Norepinephrine
GH from anterior pituitary

*When CHO is low hormones accelerate fat breakdown to provide muscles with energy

Question 7

Hormones from Pancreas and function

Answer 7

Insulin - released when hyperglycemic (plasma glucose high)

Glucagon - released when hypoglycemic

Question 8

Plasma levels of glucose and insulin-exercise (Graph)

Answer 8

Receptors are more sensitive to insulin when exercising. More sensitive so we need less insulin.

Question 9

Glucose Transporters

Answer 9

Glut 1 and Glut 4

Glut 1 is on sarcolemma, produces some glucose

Glut 4 is in cell muscle membrane, produces a lot of glucose. Alpha a subunit insulin receptor

Autophosphorylation of tryosin residues on the alpha a subunit

Nore and Epi act on alpha receptors, cause constriction.

Question 10

What is special about the Glut 4 receptor?

Answer 10

Insulin or exercise can stimulate glucose release. Those with high glucose levels should use exercise as a natural remedy.

Question 11

Diabetes

Answer 11

Metabolic Disease that affects bodies ability to use glucose; Systemic disorder

Hyperglycemia (defects in)
-insulin secretion
-Insulin action

Type 1 - complete insulin deficiency
Type 2 - (90-95%) resistance to insulin; impairment to secretion of insulin; excess glucose production by liver

Question 12

Diabetes Risk Factors

Answer 12

Non-Modifiable: Age, Race, Family Hx

Modifiable: Obesity, hypertension, inactivity, Polycystic Ovary Syndrome, gestational diabetes

Question 13

Diabetes - Diagnostic Criteria

Answer 13

Any positive on 2 occasions:
1. Hemoglobin A1C: Greater than or equal to 6.5%
2. Sx and causal plasma glucose: Greater than 200 mg
3. Fasting Plasma Glucose: Greater than or equal to 126 mg
4. Oral Glucose Tolerance Test: Greater than 200 mg
-Drink 75 mg of glucose in water
-2 hours after drink measure

Question 14

Pre-Diabetes - Diagnosis

Answer 14

Impaired Oral Glucose Test: 140 to 199 mg after 2 hours after drink

Impaired Fasting Glucose: Greater than 100 mg and less than 126 mg

A1C: 5.7-6.4%

Question 15

What is insulin resistance?

Answer 15

Associated with Pre-Diabetes Type 2
Disorder in which target tissues fail to use insulin effectively (muscles, fat and liver)

Question 16

What happens during the onset of insulin resistance?

Answer 16

Pancreas compensates and creates more insulin
-Body has high levels of plasma glucose and insulin
Gradually capacity to create insulin fails
Timing of insulin secretion is abnormal

Question 17

Screening for Diabetes

Answer 17

Testing for Type 2 in asymptomatic persons:
-Overweight or obese and have 1 or more RF
-Physical inactivity
-1 degree family member with diabetes

RF:
High risk race
Women with baby greater than 9 pounds or gestational D
HTN
HDL less than 35
Triglycerides greater than 250
A1C greater than 5.7%
Hx of CVD

Question 18

Hypoglycemia

Answer 18

Too low glucose available

Most common problem

Too much insulin present
Accelerated absorption at injection site
Can occur during Ex or 4-6 hours after

Question 19

Symptoms of Hypoglycemia

Answer 19

Sweating
Anxious
Irritable
Hunger
Dizziness
Impaired Vision
Weakness, Fatigue
Headache

Question 20

Tx of Symptomatic Hypoglycemia

Answer 20

Less than 70 mg/dl
If symptomatic
-Ingest 15 g CHO, recheck after 15 min
-If still give additional 15 g CHO

Ex: 4 oz fruit juice

Question 21

Pre-Ex Hypoglycemia (Not Symptomatic)

Answer 21

Glucose: Less than or equal to 100

If taking insulin or oral agent (Ex:Metforamen)
-Giver 15 g CHO w/ fat/protein

If not taking I or O,
-No need for snack, low risk

If they have a pump, self management

Question 22

Post-Ex Hypoglycemia (Not Symptomatic)

Answer 22

Goal is to have glucose equal or above 100 mg/dl

If less and using Insulin or oral agent
-Give 15 g CHO w/ fat/protein
-If continues medical consult

Question 23

Signs of Hyprglycemia

Answer 23

Hunger
Nausea
Excessive Thirst
Frequent Urination
Excessive Dry Skin
Drowsiness
Impaired/Blurred Vision

HI FED NE

Question 24

Pre-Ex Hyperglycemia

Answer 24

Greater than or equal to 300mg/dl
Acute setting Type 2:
-Can exercise with caution if feeling well and hydrates
-Do not need ketones tested unless prescribed

Type 1
-Can exercise greater than 300 if no ketosis (blood or urine)

Ketone (byproduct of fat)

Question 25

Fatigue and Causes

Answer 25

PCr depletion after 14 seconds

Glycogen depletion around 30 minutes

Accumulation of lactate and H+
-Decreases muscle pH, impairs energy production and muscle contraction

May serve as a protective mechansim

Question 26

Metabolic By-Product and Fatigue

Answer 26

Cells buffer H+ with biarbonate around 6.4 to 7.1

pH lower than 6.9 slows glycolysis and energy production

pH reaches 6.4, stops glycolysis and results in exhaustion

Question 27

Basal Metabolic Rate (BMR)

Answer 27

Minimum required energy for essential physiological function

~1,200-2,400 kcal/24 hr

Question 28

Factors affecting BMR

Answer 28

Fat Free Mass
Body Surface Area
Age
Body Temperature
Stress
Thyroxine and epinephrine