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SMP - Cardiopulmonary Exam 2 > Lecture 32: Cardiopulmonary Response to Exercise > Flashcards

Lecture 32: Cardiopulmonary Response to Exercise Flashcards

1
Q

What does °VCO2 mean?

A

CO2 production

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2
Q

What is R/RER? 2 names and 1 formula

A

Respiratory equivalency ratio = respiratory quotient = VCO2/VO2

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3
Q

What is Qt?

A

Cardiac output

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4
Q

What is AT? Define it.

A

Anaerobic threshold = VO2 at which lactate production begins as aerobic metabolism is replaced by anaerobic metabolism

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5
Q

What leads to successful increase of VO2 during exercise?

A

Exquisite match of circulation and ventilation to tissue metabolism

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6
Q

How to calculate VO2 per kg of a person?

A

3-4 mL O2/kg/min

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7
Q

How high can VO2 get up to during exercise?

A

3,000 mL/min in moderately fit people

6,000 mL/min in athletes

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8
Q

How are VO2 and VCO2 measured?

A

Breath-to-breath with electrodes that directly measure amount of O2 going in and amount of CO2 coming out

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9
Q

VO2 equation based on ventilation?

A

VO2 = °Ve x (FiO2 - FeO2)

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10
Q

What are the determinants of maximal VO2 during maximal exercise? How does each vary?

A
  1. Peak heart rate: decreases with age
  2. Maximum SV: decreases with age
  3. Arterio-venous difference: decreases with age
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11
Q

CO of trained 22 yo at max exercise?

A

6.L/min

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12
Q

How will COPD affect the determinants of max VO2?

A

Decreased SV and O2 content

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13
Q

What are Type 1 muscle fibers used for? Describe them.

A

Red, slow, fatigue resistant, high oxidative capacity used for endurance

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14
Q

What are Type 2b muscle fibers used for? Describe them.

A

White, fast, fatiguable, high glycolytic capacity used for sprint

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15
Q

Describe initial cytoplasmic ATP production. Is it aerobic or anaerobic? Where does it occur? What is it catalyzed by? Reversible?

A

Initial source is anaerobic through phosphorylcreatine breakdown:

ADP + PCr => ATP + Cr

Occurs in cytoplasm and is catalysed by creatine kinase

YES, reversible

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16
Q

Describe aerobic metabolism. Which source is used first?

A

Initial O2 stores from myoglobin are used while DO2 increases:

  • Carbohydrate: C6H12O6 + 6 O2 => 6 CO2 + 2 H2O + 36 ATP
  • ***FAs: C16H32O2 + 23 O2 => 16 CO2 + 16 H2O + 140 ATP
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17
Q

RER of simple glucose metabolism?

A

1

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18
Q

RER of FA metabolism?

A

0.7

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19
Q

What will cause anaerobic metabolism to start?

A

When the intensity of exercise is too high and too quick for body to mobilize more DO2 and energy reserves are already used up

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20
Q

Describe anaerobic metabolism.

A

Glucose => 2 pyruvate => 2 lactate + 2 ATP

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21
Q

Is ATP replenishment more effective in aerobic or anaerobic metabolism? Which is faster?

A

Aerobic is more efficient

Anaerobic is faster

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22
Q

How is pH affected by lactate production? How will this be compensated for?

A

Decreased since it’s an acid => HCO3- will buffer => once it can’t buffer more => compensatory respiratory alkalosis

23
Q

Equation for glycolysis?

A

Glucose => 2 pyruvate + 2 ATP

24
Q

Equation for HCO3- buffer of lactate production?

A

Na+-HCO3- + H+-lactate => Na+lactate + H2CO3 => H2O + CO2

25
Q

How is RER affected by hyperventilation following anaerobic metabolism? Why?

A

> > 1

Because HCO3- is buffering so we are getting rid of the excess CO2 and no more O2 is being consumed

26
Q

VO2 increase per 100 watts of work in a constant load test?

A

+ 1L/min

27
Q

What is O2 debt?

A

Time and degree to which it takes the lungs, heart, and systemic vasculature to get VO2 to a new steady state when workload on muscles is increased (including initial stores)

28
Q

O2 debt in someone with diseased lungs or heart or vasculature?

A

Longer period of O2 debt

29
Q

Describe ramped load test. What does this mean for O2 debt.

A

Workload is increased at a constant rate along with VO2, so no O2 debt until VO2 max is reached

30
Q

VO2 of obese patient compared to normal?

A

Elevated

31
Q

Will VO2 increase at same rate in someone obese and in normal patient during ramped load test?

A

YUP

32
Q

How is RER measured?

A

Exhaled gases

33
Q

What does an RER&raquo_space; 1 indicate?

A

Lactic production and/or hyperventilation

34
Q

How to determine the anaerobic threshold on a graph?

A

V-slope method: graph of VO2 to VCO2 during ramped exercise: sudden upslope in rate of VCO2 (CO2 production)

35
Q

How do SV and HR increase to increase CO?

A
  • HR increases linearly

- SV increases in hyperbolic fashion (quickly initially)

36
Q

Equation for max HR?

A

208 - 0.7 x age (yrs)

37
Q

Where is VO2 max found on graph of VO2, SV, and HR?

A

When SV and HR curves cross

38
Q

How do TV and RR increase to increase Ve?

A
  1. Initially Ve increases linearly due to initial abrupt increase in TV
  2. Then, RR increases causing a sudden upslope of the Ve curve
39
Q

What does Ve increase in proportion to?

A

VO2

40
Q

How does Ve vary at the anaerobic threshold? What is this called?

A

Further increases to maintain pH and CO2 => isocapnic buffering

41
Q

What is maximal voluntary ventilation?

A

Max breathing capacity if breathing as deep and as fast as possible for 1 min

42
Q

How can you estimate maximal voluntary ventilation?

A

MVV = FEV1 x 35

43
Q

What is the respiratory reserve?

A

Difference between Ve at VO2 max and MVV

44
Q

Major difference between respiratory and cardiac pumps? What does this mean?

A

Cardiac limits are reached at peak exercise, respiratory limits are not => we are cardiac limited (unless we have severe lung disease)

45
Q

How does physiological VD/VT vary with exercise? By how much?

A

VD/VT decreases from 0.3 to 0.18 due to:

  1. Increased VT
  2. Increased perfusion to apices causing better V/Q matching
46
Q

How does diffusion capacity vary with exercise?

A

Increases by:

  1. Increased perfusion to apices causing better V/Q matching
  2. Increased CO = increased intrathoracic corpuscular BV
47
Q

How does the systemic circulation vary with exercise?

A
  1. MAP increases due to very high CO
  2. Systemic vascular resistance increased
  3. Blood preferentially directed to working muscle due to local neurohumoral mediators
48
Q

How do exercising muscles extract more O2?

A

Right shift of oxyhemoglobin dissociation curve due to tissue acidosis due to lactate production and Haldane effect of CO2 on Hb

49
Q

What does myoglobin due?

A

Stores O2 in muscles

50
Q

Describe Type 2a muscle fibers.

A

Fast, red, oxidative, glycolytic, and fatigue resistant

51
Q

Which muscle fibers have the highest capillary density? List them in order.

A

Type 1 > Type 2a > Type 2b

52
Q

Which muscle fibers have the highest phosphocreatinine content? List them in order.

A

Type 2b = Type 2a > Type 1

53
Q

What are the 6 effects of training?

A
  1. Increased SV and CO at rest and during exercise
  2. Increased capacity to extract O2 peripherally due to changes in muscle fibers
  3. Greater VO2 max
  4. LV hypertrophy with enlarged EDLV diameter, normal-supranormal contractility indices likes ejectrion fraction and velocity of myocardial fiber shortening
  5. Decreased resting HR due to increased SV
  6. Increased muscle fiber density that is more efficient for biochemical processes to allow for greater, faster, or longer work depending on the regimen

SMP - Cardiopulmonary Exam 2 (15 decks)

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