Lecture 2: Normal Physiology

Question 1

normal HR fo seniors, adults, children, small children, and babies

Answer 1

seniors = 80-100
adults = 60-80
children = 85-90
small children = 100-120
babies = 140

Question 2

2+ pulse meaning

Answer 2

normal pulse

no resting pathologies

Question 3

1+ pulse meaning

Answer 3

diminished pulse

reduced stroke volume and ejection fraction; increased vascular resistance

Question 4

3+ pulse meaning

Answer 4

full pulse, increased strength

slightly increased stroke volume and ejection fraction

Question 5

4+ pulse meaning

Answer 5

bounding pulse

increased strike volume and ejection fraction

can be diminished with vasoconstriction

Question 6

primary limit to max O2 consumption during activity

Answer 6

cardiac output

Question 7

what is angina threshold

Answer 7

first perception of angina

based on myocardial O2 demand

strongly correlated to HR and systolic BP

Question 8

normal exercise response

Answer 8

increased linearly as O2 and workload demands increase

remains mostly the same at steady state

decreased linearly with decrease in O2 and workload

Question 9

type of exercise that causes increased HR response

Answer 9

upper extremity

Question 10

karvonen formula for max HR

Answer 10

220-age

unreliable; SD of +/- 15 bpm

Question 11

precise formula for max HR

Answer 11

207-(0.7xage)

more accurate in >40 yo

Question 12

normal BP

Answer 12

less than 120/80

Question 13

normal MAP and what is it good for

Answer 13

70-110 mmHg

better indicator of organ perfusion

MAP = {SBP + (DBPx2)}/3

Question 14

MAP you would not exercise patients with

Answer 14

<65 mmHg

Question 15

stage 1 HTN values

Answer 15

130-139 / 80-89

Question 16

stage 2 HTN values

Answer 16

140+ / 90+

Question 17

HTN crisis values

Answer 17

180+ / 120+

Question 18

what is systolic BP

Answer 18

pressure in peripheral arteries during ventricular contraction

force to send blood into distal arteries while aortic valve is open

Question 19

what is diastolic BP

Answer 19

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

Question 20

normal BP, PVR, and temp response to exercise

Answer 20

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

Question 21

describe normal redistribution of blood flow

Answer 21

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

Question 22

what is a ECG and positive/negative wave

Answer 22

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

Question 23

what do the different ECG waves/segments mean: P, PR, QRS, ST, and T

Answer 23

P wave = atrial contraction

PR segment = ventricular filling

QRS complex = ventricular contraction

ST segment = “plateau phase” of ventricular relaxation

T wave = ventricular relaxation

Question 24

describe the voltage and depolarization/contraction that is happening with each wave/segment of the ECG

Answer 24

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

Question 25

describe the ECG leads

Answer 25

standard ECG has 12 leads and 10 electrodes

electrode = adhesive on skin

lead = visual representation of activity from multiple electrodes

Question 26

describe ECG placement for 5 lead (standard)

Answer 26

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

Question 27

12 lead ECG components

Answer 27

electrodes = RA, RL, LA, LL, V1-V6

limb leads = I-III, AVR, AVL, AVF

chest leads = V1-V6

used diagnostically

Question 28

how to determine HR from big/little boxes on ECG

Answer 28

big = 300/# of big boxes between R waves

little = 1500/# little boxes between R waves

Question 29

what to look at on an ECG

Answer 29

rate
rhythm
regular QRS complex?
does each QRS have P wave?
P waves regular or irregular?

Question 30

normal arterial blood gas values

Answer 30

pH = 7.35-7.45

PaO2 = 80-100

PaCO2 = 35-45

Bicarb (HCO3) = 22-26