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ClinE 470 > HRV + dyslipidaemia > Flashcards

HRV + dyslipidaemia Flashcards

1
Q

What are the neurotransmitters of the SNS and PNS?

A

SNS:
presynaptic - acetylcholine
postsynaptic - noradrenaline

PNS:
presynaptic - acetylcholine
postsynaptic - acetylcholine

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2
Q

HR is a balance between … and … activity

A

PNS

SNS

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3
Q

Additional SNS pathway:

A

Adrenal pathway with adrenaline released from adrenal medulla

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4
Q

Which parts of the heart does the PNS innervate?

A

Atria
SAN
AVN

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5
Q

Which parts of the heart does the SNS innervate?

A

SAN
AVN
Atria
Ventricles (inotropic effect)

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6
Q

Name the 2 receptors involved in the PNS pathway

A

Presynaptic - nicotinic

Postsynaptic - muscarinic

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7
Q

5 effectors of autonomic nervous system

A 
Smooth muscle
Cardiac muscle
Exocrine glands/cells
Some endocrine glands/cells
Some adipose tissue
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8
Q

Post synaptic receptors of SNS include … and …-receptors

A

alpha

beta

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9
Q

Pacemaker cells of heart have membrane potentials … than that of cardiac muscle cells with naturally … membranes allowing … depolarisation to threshold producing an AP

A

lower
leaky
spontaneous

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10
Q

SNS … HR and increases …

A

increases

strength of contraction

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11
Q

Pacemaker membrane potential is usually …

A

-60mV (versus -80 to -90mV for other cardiac cells)

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12
Q

Describe the process of SNS increasing HR

A
  1. Increased SNS tone
  2. Increased adrenaline and NA
  3. activation of beta-receptors and increased calcium (and Na+) influx into myocardial cells
  4. Depolarisation threshold reached quicker –> increased HR
  5. Increased calcium availability –> increased contraction force
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13
Q

The … of calcium from … is important for the speed of contraction

A

undocking

troponin

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14
Q

The SNS causes a … forceful contraction with a … duration

A

more

shorter

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15
Q

With a slower HR (predominantly PNS), there is a … depolarisation with …

A

slower

hyperpolarisation

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16
Q

With a faster HR (predominantly SNS), there is a … depolarisation with … repolarisation

A

rapid

reduced

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17
Q

Describe the process of PNS decreasing HR

A
  1. Increased vagal tone
  2. Increased ACh release
  3. Increased outflow of K+ from cells and decreased calcium influx leading to hyperpolarisation of myocardial cells
  4. Depolarisation threshold reached more slowly
  5. decreased HR
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18
Q

Beta-1 receptor main location and effects:

A

Myocardium:

Increases HR, increases contractility

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19
Q

Beta-2 receptor main locations and effects:

A

Bronchiolar and arterial smooth muscle:
Relaxation of bronchial smooth muscle
Arteriolar dilation

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20
Q

Differential effect of cardiac SNS fibres: left fibres have a greater effect on …; right fibres have a greater effect on increasing …

A

contractility

HR

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21
Q

The intrinsic HR of the heart is …

A

100bpm

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22
Q

As exercise intensity increases, there is more … control of HR

A

sympathetic

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23
Q

In a study, participants were given propranolol (Beta-blocker) then atropine and vice versa: what HR response would you see?

A

Initial HR decrease with propranolol, then increase with atropine to reach intrinsic HR (as both receptors blocked)

Initial increase of HR with atropine, then decrease to intrinsic HR with propranolol as both SNS and PNS receptors blocked

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24
Q

Mean HR is an … rate over one minute, sometimes the HR will be faster and other times are slower

A

average

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25
Demands of the body for HR response:
``` Respiration BP control Temperature control Delivery of O2 and removal of wastes Hormonal influences ```
26
HR variability on breathing:
Breathe out: slows down HR (PNS nerves inhibited) | Breathe in: speeds up HR (PNS nerves fire)
27
During a slower HR with more ... influence, there is ... variation between heart beats
PNS | more
28
During a quicker HR with more ... influence, there is ... variation between heart beats
SNS | less
29
Advantages of greater HR variability (3)
So the body can vary HR with all the demands Variation reflects a healthy vagal system Lack of variation indicates SNS predominance - hyperpolarised membrane with increased arrhythmia risk
30
3 ways neurotransmitters are usually removed from synapse
Enzymes break them down Diffusion away from cell Transport into cells
31
Why is the PNS system more variable?
ACh effects are very short lived due to the abundance of acetylcholinesterase in the heart clearing away ACh. The HR is only temporarily slowed and HR increases back toward intrinsic HR and another ACh is released.
32
Why is the SNS system less variable?
Noradrenaline is cleared from synapses by re-uptake into neurone, or by diffusion away from cell into blood. This is a much slower process with longer lasting effects on HR
33
At rest, HR is ... with a ... predominance, but has ... variation
slower PNS greater
34
How does blood pressure control affect HRV?
Angiotensin increases SNS tone increasing BP and decreasing variability Baroreceptors increase BP with increased vagal tone thereby decreasing HR and increasing HRV
35
Decreased temperature ... SNS tone, causing vaso... and ... HRV
increases constriction less
36
How does hypoxia, hypercapnia or acidosis affect HR and HRV?
Increases HR but decreases HRV
37
How does the Bainbridge reflex affect HRV?
Increases SNS increasing HR and decreasing HRV
38
2 time domain methods of measuring HRV
SDNN: standard deviation of all RR intervals; the bigger the deviation the better = shows more variation in HR. NN50: number of pairs of adjacent RR intervals differing by more than 50ms; the more the better = more PNS tone
39
If one cycle takes 5 seconds (12/min), what would the frequency be?
(1/5 cycle)/second = 0.2 Hz
40
What do frequency domain methods of measuring HRV involve?
Using frequency power spectrum charts and identifying the frequency (in Hz) of spikes on graph
41
What are the high frequency modulation (0.2Hz) peaks in frequency domain methods due to?
Fluctuations every 2.5-7 seconds caused by: Ventilation, PNS modulation
42
What are the low frequency modulation (0.04-0.15 Hz) peaks in frequency domain methods due to?
Fluctuations every 7-25 seconds caused by: BP control, chemoreceptor control, PNS/SNS modulation
43
What are the very low frequency modulation (0.0033-0.04 Hz) peaks in frequency domain methods due to?
``` Fluctuations every 25 seconds to 3 minutes caused by: Thermoregulation, Renin-angiotensin system, Catecholamines, Sympathetic modulation ```
44
In light/moderate exercise, ... tone is withdrawn ... HR.
PNS | increasing
45
In moderate/heavy exercise, ... tone dominates causing increased ... and ... effects
SNS chronotropic inotropic
46
When sleeping, there is ... dominance, with ... variance of HR. There is enhanced ... activity immediately after waking
PNS Increased SNS
47
People with CHD have ... HRV.
decreased
48
Little HRV is reflective of a predominance of ... tone
SNS
49
Saturation of SNS tone can lead to ...
arrhythmias
50
HRV ... with ... age
declines | increasing
51
True or false, aerobically trained individuals have less HRV than sedentary peers?
False - they have greater HRV
52
Endurance training can ... HRV
increase
53
More HRV causes more ... tone and therefore a ... resting HR
PNS | lower
54
Why does training decrease resting and exercise HR?
Decreased SNS activity due to: lower sensitivity and number of beta receptors in heart lower adrenaline release during submax exercise lower SNS component of arterial baroreflex control of HR Increased vagal activity due to: prolongation of AVN conduction time due to hyperpolarisation caused by increased vagal tone Decreased intrinsic HR
55
How does training influence affect SV?
Increased blood volume --> more filling time --> greater EDV --> greater Frank-Starling --> greater SV
56
4 roles of lipids in the body
Sex hormones - cholesterol (progesterone, testosterone, oestrogen) Cell membranes Protection of organs Thermal insulation
57
What is the function of lipoproteins?
To transport lipids in the blood (as lipids are insoluble in blood) to allow binding with cell receptors to enter cells
58
5 types of lipoprotein
``` Chylomicrons VLDL (triglycerides - cells) LDL (cholesterol - cells) HDL Apolipoproteins - Lp(b) is the carrier molecule for LDL, Lp(a) is carrier molecule for HDL ```
59
How does HDL clear cholesterol?
1. HDL exchanges a triglyceride for cholesterol with LDL via the enzyme lecithin cholecterol acyltransferase (LCAT) 2. HDL binds to liver and offloads cholesterol where it is involved in production of bile salts etc. 3. HDL can also 'scavenge' free cholesterol from tissue and transport to liver.
60
What is dyslipidaemia?
A poor blood lipid profile
61
What is hyperlipidaemia?
Abnormally high levels of cholesterol, triglycerides, or both in the blood (can be hypercholesterolaemia, hypertriglyceridaemia, or both)
62
Dyslipidaemias alone provoke....
No physical symptoms (silent disease)
63
2 signs of dyslipidaemias
``` Corneal arcus (rings around eyes) Tendon xanthomas ```
64
Ideal cholesterol level
<5.2 mmol/L
65
Mildly high cholesterol level
5.2 - 6.2 mmol/L
66
Moderately high cholesterol level
6.2 - 7.8 mmol/L
67
Very high cholesterol level
> 7.8 mmol/L
68
3 dietary interventions of dyslipidaemia
Decrease total fat intake to 25-35% of total calories Reduce saturated fat intake Increase fibre (reduces LDL)
69
3 pharmacological interventions for dyslipidaemia
Bile acid sequestrants - body replaces bile by using LDL to make it, LDL levels drop Statins - reduces production of cholesterol Fibric acids - reduce fatty acid uptake by liver
70
True or false, pharmacological interventions for dyslipidaemia have an affect on the exercise response.
False - they do not
71
As physical activity levels increase, ... concentration increases
HDL
72
... of exercise is most important in changing cholesterol profiles, rather than ...
Volume | intensity
73
... of exercise has most consistent effect on HDL levels
Volume
74
Exercise training needs to last ... ... to show an effect on HDL/LDL profiles
12 weeks
75
Minimum intensity threshold for dyslipidaemia is ... METS
5-7
76
The biggest changes in lipid profiles with chronic exercise training occur in people with ... profiles
poorest
77
Resistance training effects on dyslipidaemia
Small increase in HDL, small decrease in TC, LDL and triglycerides Higher volume better than higher intensity Resistance exercise coupled with aerobic for max effect
78
Changes in lipid profile after single exercise session (immediate)
18-48hr post: Decreased serum triglycerides, increased HDL Increased lipoprotein lipase activity --> increased LCAT activity
79
3 chronic effects of exercise on lipid profile
Increased capillary density from training increasing lipoprotein lipase binding sites Increased lipoprotein lipase activity reducing breakdown of HDL and increase triglyceride usage Increased LCAT
80
Why is HDL cholesterol more favourably increased after endurance training?
Due to increases in LCAT facilitating increased ester transfer to HDL, and increases in lipoprotein lipase activity.
81
What role might HIIT aerobic training have in improving cholesterol profiles?
Higher intensity aerobic training will directly reduce LDL-cholesterol and triglyceride levels
82
What %1RM, reps & sets would you prescribe for resistance exercise?
Moderate-intensity (50-85% 1RM) | Higher volume of reps/sets will have a greater impact upon lipid profile versus higher intensity.
83
Exercise enhances the ability of skeletal muscles to utilise ... as opposed to ...
lipids | glycogen
84
In order to directly reduce LDL and triglyceride levels, aerobic exercise ... must be increased
intensity

ClinE 470 (9 decks)

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