Lecture 2: Normal Physiology Flashcards
normal HR fo seniors, adults, children, small children, and babies
seniors = 80-100
adults = 60-80
children = 85-90
small children = 100-120
babies = 140
2+ pulse meaning
normal pulse
no resting pathologies
1+ pulse meaning
diminished pulse
reduced stroke volume and ejection fraction; increased vascular resistance
3+ pulse meaning
full pulse, increased strength
slightly increased stroke volume and ejection fraction
4+ pulse meaning
bounding pulse
increased strike volume and ejection fraction
can be diminished with vasoconstriction
primary limit to max O2 consumption during activity
cardiac output
what is angina threshold
first perception of angina
based on myocardial O2 demand
strongly correlated to HR and systolic BP
normal exercise response
increased linearly as O2 and workload demands increase
remains mostly the same at steady state
decreased linearly with decrease in O2 and workload
type of exercise that causes increased HR response
upper extremity
karvonen formula for max HR
220-age
unreliable; SD of +/- 15 bpm
precise formula for max HR
207-(0.7xage)
more accurate in >40 yo
normal BP
less than 120/80
normal MAP and what is it good for
70-110 mmHg
better indicator of organ perfusion
MAP = {SBP + (DBPx2)}/3
MAP you would not exercise patients with
<65 mmHg
stage 1 HTN values
130-139 / 80-89
stage 2 HTN values
140+ / 90+
HTN crisis values
180+ / 120+
what is systolic BP
pressure in peripheral arteries during ventricular contraction
force to send blood into distal arteries while aortic valve is open
what is diastolic BP
pressure in peripheral arteries during ventricular relaxation while heart is filling with blood
force to send blood into coronary arteries while aortic valve is closed
normal BP, PVR, and temp response to exercise
SBP increased linearly with work
DBP only fluctuates about 10 mmHg
PVR drops with activity
temp rises with activity
UE exercise raises greater SBP increase; LE exercise results in greater blood redistribution
women = less pronounced BP response
rise in CO is greater than drop in PVR
describe normal redistribution of blood flow
at rest = 15-20% cardiac output supplies skeletal mm
intense exertion = CO to skeletal mm increased to 80-85%
sympathetic system = vasodilation in working mm area and vasoconstriction to mm without need
what is a ECG and positive/negative wave
ECG = visual representation of heart’s electrical activity
positive wave = electrical activity moving towards electrode
negative wave = electrical activity moving away from electrode
electricity moves through heart on 60 degree axis
what do the different ECG waves/segments mean: P, PR, QRS, ST, and T
P wave = atrial contraction
PR segment = ventricular filling
QRS complex = ventricular contraction
ST segment = “plateau phase” of ventricular relaxation
T wave = ventricular relaxation
describe the voltage and depolarization/contraction that is happening with each wave/segment of the ECG
P wave = low voltage; atrial depolarization
QRS complex = high voltage; ventricular depolarization
ST segment = time between completion of depolarization and onset of repolarization
T wave = should be in same direction as QRS deflection; ventricular repolarization
describe the ECG leads
standard ECG has 12 leads and 10 electrodes
electrode = adhesive on skin
lead = visual representation of activity from multiple electrodes
describe ECG placement for 5 lead (standard)
electrodes are: RA (white), LA (black), RL (green), and LL (red)
lead: V or C
upper right = white RA
bottom right = green RL
upper left = black LA
bottom left = red LL
lead (V1) = at heart
12 lead ECG components
electrodes = RA, RL, LA, LL, V1-V6
limb leads = I-III, AVR, AVL, AVF
chest leads = V1-V6
used diagnostically
how to determine HR from big/little boxes on ECG
big = 300/# of big boxes between R waves
little = 1500/# little boxes between R waves
what to look at on an ECG
rate
rhythm
regular QRS complex?
does each QRS have P wave?
P waves regular or irregular?
normal arterial blood gas values
pH = 7.35-7.45
PaO2 = 80-100
PaCO2 = 35-45
Bicarb (HCO3) = 22-26
