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Exercise Physiology > Lecture 20 > Flashcards

Lecture 20 Flashcards

1
Q

Lecture 20:

What is the Prevalence of Cardiovascular Disease?
- 4 points

A
  • it is the leading cause of death & serious illness
    ~48% of US adults;today have atleast 1 type of CVD
    ~18 million US deaths annually
  • over $350 billion in annual costs
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2
Q

Lecture 20:

What are some reasons for the decline in death rates of CVD since 1960’s?

A

1.) improved public awareness & lifestyle changes
2.) better & earlier diagnoses
3.) better treatment options
4.) projected 30% decline between 2010 & 2020

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3
Q

Lecture 20:

What are a few forms of Cardiovascular Disease?

A

1.) Coronary Artery Disease (CAD)
2.) Hypertension
3.) Stroke
4.) Heart Failure
5.) Other - peripheral, valvular, congenital, etc

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4
Q

Lecture 20:

How many deaths does Coronary Artery Disease account for?

A

CAD accounts for half of cardiovascular deaths

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5
Q

Lecture 20:

What is Coronary Artery Disease?

A

The progressive narrowing of coronary arteries
- plaque formation
- atherosclerosis
- compromised blood supply to myocardium

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6
Q

Lecture 20:

What can Coronary Artery Disease lead to & what is it?

A

Can lead to myocardial infarction which is a heart attack
- irreversible heart muscle cell death due to lack of O2

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7
Q

Lecture 20:

What is Atherosclerosis?

A

Begins early in life due to genetics & lifestyle
- it is the thickening/hardening of the arteries
—> fatty streaks when infant/child & in teen years spreads to coronary arteries & then turns to plaque in 20’s

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8
Q

Lectrue 20:

What is Hypertension & what % of adults have it?

A

High blood pressure - historically above 140/90 mmHg but updated to greater than 130/80 mmHg
- 46% of US adult population has hypertension

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9
Q

Lecture 20:

What are some negative associations of Hypertension?

A

Heart must work harder to eject blood which places greater strain on arteries
- causes enlarged heart & scarred/stiff arteries
- this eventually leads to atherosclerosis & MI

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10
Q

Lecture 20:

What is a Stroke & its 2 types?

A

Occurs when cerebral arteries are affected & blood flow to brain is restricted
- 2 types = Ischemic stroke & Hemorrhagic stroke

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11
Q

Lecture 20:

How many strokes occur per year in the US?

A

495, 000 annual strokes

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12
Q

Lecture 20:

What is an Ischemic Stroke?
- 2 causations

A

Most common type where O2 delivery to brain is limited by obstructed cerebral artery & can be caused by 2 things;
1.) Cerebral Thrombosis - blood clot in brain due to narrowing of cerebral vasculature
2.) Cerebral Embolism - blood clot in heart/upper chest

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13
Q

Lecture 20:

What is a Hemorrhagic stroke?

A
  • intracerebral hemorrhage = deep within brain
  • subarachnoid hemorrhage = in outer layer of brain & places pressure on it
  • rupture of vessel in or on the brain

Often a result of aneurysm (secondary to hypertension or atherosclerotic damage)

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14
Q

Lecture 20:

What can a vessel rupture lead to?

A

Ischemia & pressure on brain tissue which leads to death of brain tissue

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15
Q

Lecture 20:

What are the results of a Stroke?

A

Results depend on what region of brain is affected
- paralysis on one side of brain = most common
- each side of body controlled by opposite side of brain

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16
Q

Lecture 20:

What are the results of having a stroke in the right brain?

A

Vision problems, memory loss, & loss of quick inquisitive behaviour & issues on left side of body

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17
Q

Lecture 20:

What are the results of having a stroke in the left brain?

A

Speech/language problems, memory loss, & slow, cautious behaviour

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18
Q

Lecture 20:

What is heart failure?

A

The chronic, progressive weakening of the heart/myocardium due to damage to the heart & overworking it

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19
Q

Lecture 20:

What does heart failure cause & what contributes to it?

A

The heart is too weak to maintain cardiac output & hypertension is a major contributor to heart failure
- Causes include; atherosclerosis, valve diseases, viral infection, MI, edema, pulmonary edema

20
Q

Lecture 20:

What is an edema vs pulmonary edema caused by heart failure?

A

Edema = not enough blood pressure to bring blood back to the heart, resulting in blood pooling.

Pulmonary Edema = edema in lungs caused by vessels leaving the heart becoming too rigid

21
Q

Lecture 20:

What is the only fix/cure to heart failure?

A

Heart transplant as myocardium must be replaced as heart muscles = too weak

22
Q

Lecture 20:

What is Peripheral Vascular Disease?

A

Diseases in any vessel that isn’t a coronary artery
- eg; varicose veins = blood pools if these valves fail
- eg; phlebitis
- Peripheral Artery Disease (PAD)

23
Q

Lecture 20:

What are Valvular Diseases?

A

Diseases that impact heart valves & typically develop from viral infections
- limit the ability of blood to move through the heart chambers
- eg; rheumatic heart disease

24
Q

Lecture 20:

What is Congenital Heart Disease?

A

Congenital defects that you’re born with & has possible effects on aorta, valves, & septum
- septum = not properly formed so blood may move to other side of heart without going through lungs

25
Q

Lecture 20:

What is Coronary Artery Disease (CAD)?

A

Impacted vessel walls due to atherosclerosis (inflammation of tunica intima) & plaque buildup

26
Q

Lecture 20:

What are the 3 tunicas of the artery vessel wall & what are they made of?

A

1.) Tunica Intima = endothelium (vasodilators & vasoconstrictors)
2.) Tunica Media = smooth muscle & elastin (help regulate blood flow)
3.) Tunica Adventitia = collagen (supports & provides structure)

27
Q

Lecture 20:

What does the inflammation from atherosclerosis cause?

A

Inflammation from atherosclerosis causes endothelial dysfunction;
- platelets/monocytes adhere to injured endothelium
- debris collects in intima & forms plaque
- lipids from blood deposit in plaque

28
Q

Lecture 20:

What are the 4 steps of the swelling response of CAD?

A

1.) bloodborne irritant injures arterial wall & disrupts endothelial layer
2.) Blood platelets & immune cells (monocytes) adhere to exposed connective tissues at injury site & release migration substances
3.) a plaque composed of smooth muscle cells, connective tissues, & debris forms at injury
4.) plaque grows & narrows arterial opening, impeding blood flow

29
Q

Lecture 20:

When discussing CAD, what does the endothelial injury/disruption come from?

A
  • high blood LDL (lipid concentrate)
  • free radicals from cigarette smoke
  • hypertension
  • high plasma homocysteine
  • infection
30
Q

Lecture 20:

What does plaque consist of in CAD?

A
  • smooth muscle, inflammatory cells, lipids
  • fibrous cap (thick or thin)
  • thin caps = more unstable & easier to rupture
31
Q

Lecture 20:

What % of MI’s do ruptures & throbosus’ account for?

A

70%

32
Q

Lecture 20:

What is hypertension?

A

Constant high blood pressure levels & is poorly understood

33
Q

Lecture 20:

What % of hypertension cases are idiopathic & which are secondary to other issues?

A

1.) 90-95% of hypertension diagnoses are idiopathic meaning occur on own & unsure of contributors
2.) 5-10% are secondary to other issues like; kidney disease, adrenal tumours, congenital defect of aorta, etc

34
Q

Lecture 20:

What are 4 Uncontrollable risk factors for CAD?

A

1.) heredity/family history
2.) Race
3.) Sex (male>famale)
4.) Age
*goal is risk mitigation through controllable risk factors

35
Q

Lecture 20:

What are some controllable CAD primary risk factors?

A

1.) tobacco smoke
2.) hypertension
3.) abnormal blood lipid profile (want more HDL’s & less LDL’s {cholesterol})
4.) physical inactivity
5.) obesity/overweight
6.) diabetes/insulin resistance
*as # of risk factors increases, so does risk of CAD

36
Q

Lecture 20:

What are some controllable risk factors for Hypertension?

A

1.) insulin resistance (too much blood sugar or pancreas not releasing enough insulin to store sugars)
2.) obesity/overweight/diet/ inactivity
3.) tobacco use
4.) oral contraceptives (act on renin-angiotensin system which effects blood volume)
5.) stress

37
Q

Lectrue 20:

How can physical activity help reduce risk of Cardiovascular diseases?

A

Moderate-vigorous PA aids with Cardiorespiratory fitness which reduces risk of developing cardiovascular disease
- no evidence for increased risk with more PA & no “ best” amount

38
Q

Lecture 20:

What are 4 Physiological adaptations to exercise that may reduce risk of cardiovascular disease?

A

1.) increase contractility via LV hypertrophy
2.) increased diameter & capacity of coronary vessels
3.) endothelial function & vasodilation
4.) decreased vascular inflammation
*exercise improves ability of endothelium to regulate blood flow & enhance cardiac/vascular function

39
Q

Lecture 20:

What are some risk factors that are lowered with exercise?

A

Exercise leads to;
- lowered blood pressures
- higher HDL cholesterol & lowered LDL cholesterol
- decreased inflammation
- increased endothelial function

40
Q

Lecture 20:

What is the risk of heart attack & death during exercise?

A

Risk = very low; 1 death/396,000
*habitual exegesis = decreased risk of death by heart attack

41
Q

Lecture 20:

What are the likely causes of death from heart attack based on age?

A

If under 35, death likely caused by genetic abnormalities or aneurysm

If above 35, death more likely caused by arrhythmia due to CAD

42
Q

Lecture 20:

How does aerobic exercise help prevent future heart disease complications?

A

Aerobic exercise…
- increases capillary to muscle fibre ratio
- increases plasma volume e
- increases O2 supply & blood flow to heart
- increases LV function

43
Q

Lecture 20:

How does resistance exercise help prevent future complications?

A
  • decrease blood pressure & blood lipid values
  • decreased body fat
  • increases glucose control
  • decreases stress
44
Q

Lecture 20:

What is the optimal exercise trainign for reduced heart disease?

A

Combining resistance & aerobic training is optimal

45
Q

Lecture 20:

What are the 3 elements of a comprehensive program for rehabilitation patients with heart disease?

A

1.) exercise & physical activity
2.) counselling (nutritional & psychological)
3.) Support Forums

Exercise Physiology (12 decks)

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