LAB MIDTERM

Question 1

what is blood pressure

Answer 1

function of arterial blood flow per minute (Q) and the vascular resistance to the flow (TPR)

Question 2

1st Korotkoff Sound

Answer 2

Systolic - pressure against artery walls by blood when heart beats

Question 3

2nd Korotkoff Sound

Answer 3

Diastolic - pressure against artery walls by blood during rest

Question 4

increase in exercise effect on blood pressure

Answer 4

systolic increases, diastolic remains the same (or decreases slightly due to vasodilation)

Question 5

Normal BP

Answer 5

<120/<80

Question 6

Prehypertension

Answer 6

120-139/80-89

Question 7

Stage 1 Hypertension

Answer 7

140-159/90-99

Question 8

Stage 2 Hypertension

Answer 8

> 160/>100

Question 9

Cardiac Output (Q)

Answer 9

total volume of blood pumped by ventricle per minute [L of blood/min]

Question 10

Total Peripheral Resistance (TPR)

Answer 10

cumulative resistance (pressure) of vasculature - mostly located in arterioles

Question 11

Information that can be obtained from ECG

Answer 11

heart rate, heart rhythm, axis/orientation, hypertrophy, Ischemia/MI (depression/elevation), CAD

Question 12

Ischemia

Answer 12

reduced oxygen to myocardium, appears on ECG as ST segment depression

Question 13

Myocardial Infarction

Answer 13

ECG determines extent and location of damage, appears on ECG as ST segment elevation

Question 14

order of intrinsic conduction

Answer 14

SA node -> AV node -> AV Bundle -> Bundle Branches -> Purkinje Fibers

Question 15

P wave

Answer 15

atrial depolarization

Question 16

QRS Complex

Answer 16

ventricular depolarization (and atrial repolarization) - size of ventricles directly related to height/size of peak

Question 17

ST segment

Answer 17

early ventricular depolarization - elevation/depression represents problems with blood flow

Question 18

T wave

Answer 18

late ventricular repolarization

Question 19

purpose of resting ECG

Answer 19

taken laying on back, used to establish baseline for comparison, can be used to detect heart conditions such as hypertrophy, ischemia, MI damage, etc.

Question 20

graded exercise ECG

Answer 20

used to observe BP and HR response to exercise, some diseases may respond normally at rest, but abnormally with stress of exercise

Question 21

how does ECG work

Answer 21

electrodes attached to skin capture voltage that flows between 2 points and records on graph paper - ECG records electrical activity generated by heart muscle depolarizations which propagate in pulsating electrical waves towards the skin

Question 22

Premature Ventricular Complex (PVC)

Answer 22

occurs when a site in ventricle fires before the depolarization wave reaches the ventricle from the SA node (only serious if occurs in succession - common with caffeine use)

Question 23

absolute contraindications to stop GXT

Answer 23

• onset of moderate/severe angina
• drop in systolic BP
• serious arrythmia
• signs of poor perfusion
• ST elevation > 2mm
• severe shortness of breath
• technicians inability to monitor test
• subjects request

Question 24

relative contraindications to stop GXT

Answer 24

• increasing chest pain
• fatigue/shortness of breath/wheezing
• leg cramps
• hypertensive response (SBP>260, DBP>115)
• HR increasing
• ST depression > 2mm
• less serious arrythmias

Question 25

lead vs. electrode

Answer 25

lead - 12 different angles along which the heart's depolarization is measured and recorded, allows for all phases of cardiac cycle to be adequately observed electrode - stuck to skin, using gel to increase conductivity, connect lead to body

Question 26

VO2

Answer 26

oxygen consumption - volume of oxygen used by body tissues in order to produce energy per unit of time relative - mL/kg/min (relative to body mass) absolute - L of O2/min

Question 27

determinants of oxygen consumption

Answer 27

(1) oxygen delivery (Q = HR x SV) | (2) oxygen utilization - cellular capabilities of muscle for metabolism

Question 28

Oxygen Utilization

Answer 28

ability of cell to extract oxygen, ability of cell to use oxygen - dependent on metabolic enzymes, capillary density, mitochondria size and number

Question 29

Oxygen Delivery

Answer 29

CV and pulmonary systems to transport oxygen to cells - dependent on cardiac output and ventilation

Question 30

oxidative pathway

Answer 30

ability to make ATP to be used in metabolism to create energy

Question 31

mechanisms to increase oxygen delivery during exercise

Answer 31

- increased cardiac hemodynamics - shunting of blood to skeletal muscle - increase oxygen extraction by skeletal muscles

Question 32

What is a MET?

Answer 32

metabolic equivalent 1 MET = 3.5 mLO2/kg/min or 5kcal relative VO2 divided by 3.5 = MET value

Question 33

why SUB-maximal testing

Answer 33

maximal testing may not be practical due to equipment, expertise, etc. linear relationships between HR & power, VO2 & power and HR & VO2 allow for estimates

Question 34

factors that affect VO2 MAX

Answer 34

- training status - age - gender

Question 35

why do males have higher VO2 max than females

Answer 35

males have about a 15-30% higher VO2 than females - men have less fat and greater lean muscle mass which is what consumes oxygen men have more hemoglobin concentration than females due to increased testosterone

Question 36

Monark Cycle

Answer 36

mechanically braked cycle ergometer, can increase resistance by tightening on the flywheel, can also maintain a constant work rate as long as cadence is kept constnat (rev/min)

Question 37

work rate

Answer 37

product of force and distance divided by time (watts or kg*m/min)

Question 38

metronome

Answer 38

keeps an even steady cadence, typically 50 rev/min

Question 39

heart rate monitor

Answer 39

placed at level of breastbone - sensor at center of chest, use gel to increase conductvity - make sure belt is snug for accurate readings

Question 40

Borg's RPE scale

Answer 40

6-20 scale, "how hard do you feel the exercise work rate is?", should reflect total amount of exertion/fatigue

Question 41

what is sub-max testing

Answer 41

individual exercises to about 85% of estimated VO2 max value | designated steps with increasing intensity of stages - HR and work rate increase

Question 42

Fick Equation

Answer 42

Q = VO2/ (a-v)O2 Difference

Question 43

Peak VO2

Answer 43

highest VO2 achievable in a certain bout of physical activity - no plateau

Question 44

Maximal VO2

Answer 44

highest VO2 achievable in any bout of physical activity - VO2 plateaus after reaching VO2 Max with continued exercise

Question 45

VO2 equation using O2 measurements

Answer 45

``` VO2 = (Vi x O2i%) - (Ve x O2e%) Vi = volume inhaled O2i = percent oxygen inhaled Ve = volume exhaled O2e = percent oxygen exhaled ```

Question 46

how to measure room air and inhaled/exhaled air

Answer 46

- respiratory equipment (air volume meter, ventilator hose, etc.) - metabolic gas equipment (O2 and CO2 analyzers)

Question 47

criteria for a true max test

Answer 47

- respiratory exchange ratio (RER) > 1.15 - RPE >17 - venous lactate concentration > 8 mmol/L - plateau of VO2 despite an increase in WR - failure to increase HR with increase exercise intensity (reaching age-predicted max HR is not a good indicator that effort was because there is high inter-subject variability with this estimation)

Question 48

respiratory exchange rate (RER)

Answer 48

Volume CO2 produced divided by volume O2 consumed - estimates the composition of the fuels being used/oxidized RER ranges from 0.7 ("pure fat oxidation") to 1.0 ("pure carbohydrate oxidation")

Question 49

plateau of VO2 max

Answer 49

failure to increase oxygen uptake by 0.15 L/min with increased work load

Question 50

Bruce Protocol (modified)

Answer 50

diagnostic test used to measure cardiac function - modified protocol starts test off at a lower intensity level and reaches stage 1 of standard bruce protocol by stage 3