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EXERCISE PRESCRIPTION LAB > LAB 1- HR + BP > Flashcards

LAB 1- HR + BP Flashcards

1
Q

cardiovascular system is composed of what 3 things

A

-heart
-blood
-vasculature

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2
Q

arteries carry blood toward/away from the heart

A

away from

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3
Q

veins carry blood toward/away from the heart

A

toward

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4
Q

capillaries are arteries or veins

A

NEITHER
-capillaries are neither arteries nor veins

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5
Q

**flow of blood through the heart

A
  1. superior + inferior vena cava
    right atrium
    tricuspid valve
  2. right ventricle
    pulmonary semilunar valve
  3. pulmonary trunk
  4. pulmonary arteries
    lung tissue (pulmonary circulation)
  5. pulmonary veins
    left atrium
  6. bicuspid valve
  7. left ventricle
    aortic semilunar valve
  8. aorta
    coronary arties
    either body tissues (systematic circulation) or heart tissue (coronary circulation)
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6
Q

flow of blood through the heart- pulmonary valve goes to what

A

pulmonary trunk

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7
Q

flow of blood through the heart- bicuspid valve to what

A

aortic arch + out into circulation

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8
Q

**anatomy of heart

A

-4 chambers
-UPPER: left and right atrium
-LOWER: left and right atrium

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9
Q

**4 valves of the heart

A

-tricuspid
-pulmonary
-mitral
-aortic

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10
Q

**what are the 2 circuits for blood flow

A

-systemic: goes to whole body
-pulmonary: goes to lungs

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11
Q

systemic circuit: serves ____

A

entire body

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12
Q

systemic circuit: low/high resistance

A

high resistance

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13
Q

systemic circuit: low/high pressure head

A

high pressure head

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14
Q

systemic circuit: hypoxic vasodilation/vasoconstriction

A

vasodilation

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15
Q

systemic circuit: few/many vasomotor control

A

many vasomotor control

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16
Q

pulmonary circuit: serves ____

A

only the lungs

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17
Q

pulmonary circuit: low/high resistance

A

low resistance

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18
Q

pulmonary circuit: low/high pressure head

A

low pressure head

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19
Q

pulmonary circuit: hypoxic vasodilation/vasoconstriction

A

vasoconstriction

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20
Q

pulmonary circuit: few/many vasomotor controls

A

few vasomotor controls

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21
Q

hypoxic

A

body doesn’t receive enough oxygen
-lack of oxygen

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22
Q

systole

A

period of ventricular contraction

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23
Q

what occurs in the ventricles during systole

A

blood is ejected from ventricles

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24
Q

diastole

A

period of ventricular relaxation

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25
Q

what occurs in the ventricles during diastole

A

blood fills the ventricles

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26
Q

systole is on top or bottom of blood pressure

A

top

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27
Q

diastole is on top or bottom of blood pressure

A

bottom

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28
Q

differences in pressure are based on what 2 things

A

-contraction
-relaxation

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29
Q

blood pressure

A

the FORCE exerted by circulating blood on the walls of the vessels

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30
Q

blood pressure is 1 of ___ major factors that determine the regulation of blood in the cardiovascular system

A

3

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31
Q

what are the 3 major factors that determine the regulation of blood in the cardiovascular system

A

-blood pressure
-blood flow
-blood resistance

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32
Q

what is the biggest influence short term for blood pressure

A

diameter

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33
Q

vasoconstriction/vasodilation occurs from muscular contractions

A

vasoconstriction

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34
Q

volume Renin-Angiotensin-Aldosterone (RAAS system)

A

increase of sympathetic nervous system activity

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35
Q

viscosity

A

-seen in blood doping, thus increasing RBC count by 2x
-high risk of stroke + heart attack

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36
Q

blood pressure equation

A

Q = change in pressure/resistance

aka Q= delta P/R

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37
Q

blood pressure stays the same/changes throughout the cardiovascular system

A

changes

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38
Q

blood pressure iin healthcare

A

integral part of any health screening or fitness assessment

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39
Q

blood pressure should be based on how many properly measured recording

A

2 or more

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40
Q

what 2 numbers make up blood pressure

A

-systolic blood pressure
-diastolic blood pressure

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41
Q

systolic blood pressure

A

pressure exerted against arterial walls when the heart is contracting

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42
Q

peak blood pressure occurs during ____

A

systole

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43
Q

diastolic blood pressure

A

pressure exerted against arterial walls when heart is relaxing

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44
Q

lowest blood pressure is during ____

A

diastole

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45
Q

pulse pressure

A

the difference between systolic and diastolic blood pressure

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46
Q

how is blood pressure written

A

systolic/diastolic
ex: 120/80

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47
Q

in what unit is blood pressure measured

A

millimeters of mercury (mmHg)

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48
Q

even though all blood pressure is still measured in mmHg, most blood pressure monitors no longer use mercuery in the apparatus due to what

A

due to the toxic nature of mercury

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49
Q

what influences blood pressure

A

-changes in blood flow (Q)
-resistance

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50
Q

the direct factors that influence blood pressure can be seen in what equation

A

Hagaen-Pouiselle’s equation

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51
Q

Hagaen-Pouiselle’s equation

A

delta P = (8Ln) /(pi r^4)

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52
Q

variables of Hagaen-Pouiselle’s equation

A

-L = length of vessel
-n = viscosity of blood
-r = radius of blood vessel

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53
Q

**what variable has the biggest impact on blood pressure and is the variable the body uses to regularly control blood pressure

A

radius
-think of boba metaphor

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54
Q

gold standard of measuring blood pressure

A

direct measure of INTRA-ARTERIAL blood pressure
-best way to measure blood pressure
-intra-arterial because arteries are where blood pressure is found

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55
Q

clinically, what 2 ways do we measure blood pressure INDIRECTLY

A

-auscultation
-oscillometry

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56
Q

auscultation

A

stethoscope + sphygmomanometer

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57
Q

oscillometry

A

automated electronic manometer

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58
Q

stethoscope- fat side

A

drum

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59
Q

stethoscope- small side

A

bell

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60
Q

when taking blood pressure using a stethoscope, what side do we usually use

A

drum (fat side)

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61
Q

stethoscope- when hole is closed

A

on drum setting

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62
Q

stethoscope- when hole is open

A

on bell setting

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63
Q

sphygmomanometer

A

blood pressure cuff

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64
Q

mobile (exercise) sphygmomanometer

A

exact same function as a standard aneroid sphygmomanometer just has a stand with wheels and a bigger display
-recommended during any exercise test

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65
Q

oscillometric automated blood pressure cuff

A

-use the maximum volume change as an indication of the average of the systolic + diastolic blood pressure within the artery

-by combining this average with the rate of change of the pressure wave, the machines then use a variety of algorithms to estimate the systolic + diastolic blood pressure

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66
Q

dynamics of taking blood pressure

A

NO FLOW -> TURBULENT FLOW -> LAMINAR FLOW

  1. no blood flow (no flow, no sound, cuff pressure above 110 mmHg)
  2. turbulent flow in compressed artery makes audible vibrations aka Korotkoff sounds (turbulent flow, Korotkoff sounds, cuff pressure between 70-110 mmHg)
  3. laminar flow in noncompressed artery makes no sounds (laminar flow, no sound, cuff pressure below 70 mmHg); the state we are naturally in
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67
Q

how to take blood pressure

A

-pump it to a certain pressure when there is no blood flow (high enough pressure where the artery is completely cut off)
-when entering turbulent flow, there is still some pressure that can get through, KNOW that the thumps are the Korotkoff sounds
-after last Korotkoff sound, we enter laminar aka natural state

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68
Q

**first Korotkoff sound/thump when taking a blood pressure reading is ____

A

systolic

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69
Q

**last Korotkoff sound/thump when taking a blood pressure reading is ____

A

diastolic
-after last thump, returns to laminar, which is the state we are naturally in right now

70
Q

what blood pressure state are we naturally in

A

laminar

71
Q

protocol for measuring blood pressure PRE-READING

A

-ensure hands are clean before starting
-ask client if there are any injuries that would prevent the use of a pressure cuff on their arm
-ensure client is relaxed + seated comfortably, with their back supported + feet uncrossed + flat on the floor
-ensure the blood pressure cuff is the correct size
-try to have the client’s arm at roughly heart level

72
Q

protocol for measuring blood pressure- DURING reading

A

-wrap the cuff so that the bottom is roughly 2-3cm above the palpation point of the brachial artery
-locate the brachial or radial pulse -> then inflate the cuff until the pulse can no longer be felt; this is a rough estimation of systolic pressure
-deflate the cuff completely + wait for 30 seconds
-palpate the BRACHIAL artery + place the center of the stethoscope drum on top
-inflate the cuff to about 30 mmHg above the rough estimation of systolic
-deflate the cuff at a rate of 2 mmHg
-once no sound is heart deflate the cuff fully + remove it from the client’s arm

73
Q

factors that can artificially change blood pressure

A

-caffeine
-stress
-medications
-bladder
-etc.

74
Q

blood pressure categories table are accepted by what organization

A

American Heart Association

75
Q

ACSM recognizes what blood pressure as a cardiovascular risk factor

A

130/80 mmHg

76
Q

hypertension

A

high blood pressure

77
Q

what are the 5 blood pressure categories

A

-normal
-elevated
-high blood pressure (hypertension) stage 1
-high blood pressure (hypertension) stage 2
-hypertensive crisis (consult your doctor immmediately)

78
Q

**normal blood pressure

A

systolic: less than 120
AND
diastolic: less than 80

79
Q

**elevated blood pressure

A

systolic: 120-129
AND
diastolic: less than 80

80
Q

**hypertension stage 1

A

systolic: 130-139
OR
diastolic: 80-89

*only need 1 of these values to be considered this

81
Q

**hypertension stage 2

A

systolic: 140 or higher
OR
diastolic: 90 or higher

*only need 1 of these values to be considered this

82
Q

**hypertensive crisis

A

systolic: higher than 180
AND/OR
diastolic: higher than 120

*only need 1 of these values to be considered this

83
Q

**blood pressure ex: 119/85

A

-119 is normal
-85 is stage 1 hypertension

SO, we would classify as stage 1 hypertension

84
Q

what physiological thing determines blood pressure + heart rate

A

PRESSURE GRADIENTS
-ex: bladder can affect heart rate

85
Q

**classes of blood pressure medications for hypertension (5)

A

-diuretics
-beta-blockers
-calcium channel blockers
-angiotensin-converting enzyme (ACE) inhibitors
-vasodilators

86
Q

diuretics

A

increasing excretion, therefore reducing total body water + reducing pressure

87
Q

beta-blockers

A

blocking beta-receptors that function in the sympathetic nervous system, thereby reducing sympathetic response

88
Q

calcium channel blockers

A

blocking the calcium channels in the heart to reduce heart contractility

89
Q

angiotensin-converting enzyme (ACE) inhibitors

A

stopping the creation of angiotensin II + the increase release of aldosterone

90
Q

vasodilators

A

increasing the diameter of arterial walls by inducing relaxation in smooth muscle + therefore vasodilation

91
Q

white-coat hypertension

A

clients who have a normal blood pressure outside of a clinical environment + are not taking any prescribed antihypertensive medications develop higher than normal values when their blood pressure is measured by a health professional

92
Q

masked hypertension

A

clients who exhibit higher than normal blood pressure readings outside of a clinical environment yet have normal reading in a clinical setting

93
Q

masked hypertension is more common in younger/older adults

A

younger

94
Q

miscuffing (undercuffing/overcuffing)

A

caused by using a blood pressure cuff with a bladder that is not appropriately scaled for the client

95
Q

undercuffing

A

when the bladder of the blood pressure cuff is too small for the client
-this can also lead to cuff hypertension, because there is SO much pressure trying to contain the artery

96
Q

overcuffing

A

when the bladder of the blood pressure cuff is too large for the client
-this can lead to an underestimation of blood pressure

97
Q

undercuffing can lead to

A

cuff hypertension

98
Q

overcuffing can lead to

A

underestimated blood pressure

99
Q

sources of measurement error

A

-inaccurate sphygmomanometer
-improper cuff width or length
-cuff not centered, too loose, or over clothing
-back, feet, or arm unsupported
-poor auditory acuity or reaction time of the technician
-improper rate of inflation or deflation of the cuff pressure
-improper stethoscope placement or pressure
-background noise leading to error
-parallax error in manometer
-client has a full bladder

100
Q

parallax error in manometer

A

when the pointer of the meter looks like it’s a different reading because the angle of view the technician has
-leads to blood pressure measurement error

101
Q

if a client has a full bladder, it would increase/decrease systolic + diastolic blood pressure

A

increase

102
Q

after measuring blood pressure, what can be estimated

A

mean arterial pressure (MAP)

103
Q

MAP (mean arterial pressure)

A

average pressure occurring in the arteries during one cardiac cycle

104
Q

what else does MAP indicate

A

the number for full organ perfusion
-SO, we don’t want an abnormally high MAP

105
Q

to perfuse vital organs requires what

A

requires the maintenance of a minimum MAP of 60 mmHg

106
Q

what can estimation of MAP can help decide what

A

if a blood pressure is too low

107
Q

equation 1 for MAP

A

MAP = [SBP + (2 x DBP)] / 3

108
Q

equation 2 for MAP

A

MAP = DBP + [(SBP - DBP) / 3]

109
Q

we spend more time in systole or diastole

A

diastole

110
Q

heart rate

A

the number of times the heart beats per minute
-number of full cardiac cycles per minute

111
Q

what units is heart rate expressed in

A

beats per minute (bpm)

112
Q

what is heart rate regulated by

A

automatic nervous system (ANS)

113
Q

heart rate increases ____ + therefore ____

A

cardiac output
VO2

114
Q

besides manually, what other ways can heart rate be measured

A

-EKG
-chest strap that measures electrical activity
-photoplethysmography in smartphones + wearable sensors

115
Q

what 3 pulse points are commonly used for measuring heart rate

A

-carotid pulse
-brachial pulse
-radial pulse

-think ABC- radial, brachial, carotid

116
Q

what fingers must be used to take heart rate

A

index + middle finger
-not thumb, because thumb has its own pulse

117
Q

carotid pulse

A

-located along the anterior border of the sternocleidomastoid muscle + lateral to the larynx
-the common carotid artery can be located + pushed against the thyroid cartilage
-however, too much pressure can stimulate baroreceptors activating a carotid sinus reflex

118
Q

brachial pulse

A

-located directly above superior border of the antecubital fossa (roughly 1 inch) + inferomedial to the biceps brachii
-the artery location used for measuring blood pressure

119
Q

radial pulse

A

-located on the anterolateral aspect of the forearm directly in line with the thumb
-this point is used most often for resting + exercise measurements

120
Q

chest strap wired monitors

A

-these monitors have electrode sensors embedded in the strap + accurately detect depolarization
-in 1978 Polar released the 1st wearable heart rate monitor
-these are a terrific option for exercise testing as they are valid + reliable option for measuring heart rate
-the majority of cardiovascular equipment have the capability to read any chest strap monitor that has an ANT signal

121
Q

wrist/forearm/finger monitors

A

-these monitors use photoplethysmography to monitor heart rate
-using an infrared light to see the expansion of the artery as blood pumps through it
-many of these devices can estimate oxygen saturation levels of the blood as well

122
Q

protocol for measuring resting heart rate PRE-READING

A

-wash your hands before starting
-explain what you’re about to do + why it is important
-ask whether the client has walked for an extended period of time, climbed any stairs or heavily exerted themselves in the past 20 minutes; if the answer is yes, wait 5-10 minutes at a minimum before proceeding
-make sure the patient is relaxed + comfortable

123
Q

protocol for measuring resting heart rate DURING READING

A

-place the tips of your first + second finger on the radial artery pulse point; don’t use the thumb because it may result in counting your own pulse due to the priceps pollicis artery in the thumb
-press against their wrist + take your time to note any irregularities in strength or rhythm
-for resting measurements, count the number of beats for at least 30 seconds (measuring for 1 minute will yield the most accurate results); if you start timing on a beat, begin counting at 0
-compare the results to normative data

124
Q

**what artery is in your thumb that has a pulse

A

priceps pollicis

125
Q

on the practical, how must we take heart rate

A

using 30 by 2
-solid 30 seconds to let body relax

126
Q

heart rate

A

a vital sign that holds important prognostic value, with a lower resting HR being associated with lower all-cause + cardiovascular mortality

127
Q

what does the American Heart Association define normal sinus heart rate as

A

60-100 bpm

128
Q

does outside the normal range of heart rate indicate a medical problem

A

not always
-people with higher levels of cardiorespiratory fitness generally have a bradycardiac heart rate

129
Q

bradycardiac heart rate

A

less than 60 bpm

130
Q

normal heart rate

A

60-100 bpm

131
Q

tachycardiac heart rate

A

greater than 100 bpm

132
Q

what is the “normal within the normal” heart rate

A

72 bpm

133
Q

why are elite individuals bradycardiac

A

due to higher stroke volume
-heart is working more efficiently

134
Q

brady = low/high
tachy = low/high

A

brady = low
tachy = high

135
Q

**bradycardiac/tachycardiac is more dangerous

A

tachycardiac

136
Q

are heart rate + blood pressure dramatically influenced by exercise

A

yes
-but the type of exercise can significantly alter the response

137
Q

dynamic exercise

A

-rhythmic pumping action of muscles
-any exercise where the muscle is consistently changing lengths while contracting is dynamic
-ex: running, resistance training

138
Q

dynamic exercise on the body

A

-historically known as volume work for the cardiovascular syste,
-increase in skeletal muscle pump = increase in venous return

139
Q

static exercise

A

-isometric contractions of skeletal muscle
-any exercise where the muscle stays the same length throughout contraction

140
Q

static exercises on the body

A

-historically known as pressure work for the cardiovascular system
-the heart rate + blood pressure response with static exercise is largely proportionate to the tension exerted
-prevents skeletal muscle pump = decrease in venous return

141
Q

all exercise, REGARDLESS OF TYPE, will increase what 2 things

A

-heart rate
-systolic blood pressure (SBP)

142
Q

with exercise, SBP should increase in what manner

A

linearly

143
Q

TPR

A

also known as systemic vascular resistance

144
Q

TPR (systemic vascular resistance)

A

the amount of force exerted on circulating blood by the vasculature of the body

145
Q

3 factors that determine the force of TPR (systemic vascular resistance)

A

-length of blood vessels
-diameter of blood vessels
-viscosity of blood

146
Q

cardiac output equation

A

Q = heart rate x stroke volume

147
Q

what does cardiac output change based on

A

stroke volume
-heart rate is CONSTANT, so therefore Q much change based on stroke volume

148
Q

**dynamic exercise effects on heart rate

A

increase

149
Q

**static exercise effects on heart rate

A

increase

150
Q

stroke volume

A

the amount of blood ejected from the ventricle with each cardiac cycle

151
Q

**dynamic exercise effects on stroke volume

A

increase

152
Q

**static exercise effects on stroke volume

A

decrease

153
Q

**dynamic exercise effects on cardiac output (Q)

A

increase

154
Q

**static exercise effects on cardiac output (Q)

A

decrease

155
Q

**dynamic exercise effects on TPR (systemic vascular resistance)

A

decrease
-relative to static

156
Q

**static exercise effects on TPR (systemic vascular resistance)

A

increase

157
Q

**dynamic exercise effects on MAP

A

increase

158
Q

**static exercise effects on MAP

A

increase

159
Q

**dynamic exercise effects on SBP

A

increase

160
Q

**static exercise effects on SBP

A

increase

161
Q

**dynamic exercise effects on DBP

A

decrease or stays the same

162
Q

**static exercise effects on DBP

A

increase

163
Q

rate pressure product is also called what 2 things

A

-cardiovascular product
-double product

164
Q

rate pressure product

A

the product of heart rate + SBP

165
Q

what is rate pressure product sometimes used as

A

an indirect index of myocardial oxygen consumption, predicting cardiac function

166
Q

typically a low RPP (rate pressure product) indicates what

A

a healthy client

167
Q

most research shows what about RPP

A

-RPP should be below 10,000 at rest
-during maximal exercise the value can reach over 30,000

168
Q

while isometric exercise is still warned against with clients who are hypertension, what has research shown about RPP

A

that RPP is lower in maximal isometric resistance exercise than in maximal aerobic exercise

169
Q

**RPP requation

A

RPP = HR x SBP

170
Q

what variable changes RPP

A

SBP
-because heart rate is constant

EXERCISE PRESCRIPTION LAB (10 decks)

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