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Exercise Physiology > Pulmonary System & Response to Exercise > Flashcards

Pulmonary System & Response to Exercise Flashcards

1
Q

Pulmonary Ventilation

- what is it driven by?

A

gas exchange from high partial pressure to low partial pressure

Fick’s Law of Diffusion: amt of gas that can move across a sheet of tissue is proportional to the thickness & area

  • increased thickness = decreased diffusion
  • increased area (# of alveoli) = increased diffusion
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2
Q

Minute ventilation (VE)

A

amount of air you can breath in per minute (L/min) - tidal volume x breaths per minute

Increases w/ exercise linearly until reaching AT (then increased due to increased respiratory rate)

controlled by CO2 levels
- normal PCO2 = 40

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3
Q

Respiratory Pattern & Exercise

  • light exercise
  • > 80% intensity
A

During light exercise…

  • increased tidal volume & increased RR
  • tidal volume generally plateaus at 50-60% of vital capacity

> 80%, tidal volume will decrease & RR will increase
- less O2

ventilation tends to match the rate of energy metabolism during mild steady-state activity

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4
Q

Tidal volume

A

amount of air inhaled and exhaled in one NORMAL breath

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5
Q

Vital Capacity

A

max inspiration to max expiration

IRV + TV + ERV

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6
Q

Pulmonary function & regulation of acid-base balance

A

respiration will increase as H+ increases allowing more C)2 to be released into the blood and transported to the lungs for exhalation

-bicarbonate is responsible for buffering a rise in H+ (due to lactate accumulation or CO2)

Best to do an ACTIVE cool down to reduce blood lactate levels

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7
Q

Dyspnea

A

shortness of breath

often caused by inability to readjust the blood PCO2 and H+ due to poor conditioning of respiratory muscles

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8
Q

Hyperventilation

A

increase in ventilation that exceeds metabolic need for O2

reduces ventilatory drive by increasing blood pH

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9
Q

Valsava Maneuver

A

breathing technique to trap and pressurize air in the lungs; often used during heavy lifting

dangerous, can reduce cardiac output

ESPECIALLY if patient has HTN

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10
Q

Respiratory limitations to exercise

A

respiratory muscles use 15% of O2 during heavy exercise
- more resistant to fatigue

pulmonary ventilation, airway resistance & gas diffusion NOT a limiting factor

Can be limited if abnormal or obstructive respiratory disorders
…aka COPD (@ risk for hyperventilation & O2 desaturation) due to reduced max ventilation, diminished lung volumes & increased physiologic dead space

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11
Q

Objectives of exercise training for those w/ Pulmonary disease

A
  1. increase functional capacity & functional status
  2. reduce severity of dyspnea
  3. improve QOL
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12
Q

Pulmonary Function Test

A

Spirometry - purpose - classify lung function into 4 categories

  1. normal
  2. restrictive
  3. obstructive
  4. combination of restrictive/obstructive

based on patient’s effort, can be challenging

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13
Q

Contraindications to pulmonary function test

A 
pneumothorax
thoracic aneurysm
recent eye surgery
recent abdominal or thoracic surgery
recent MI or unstable angina
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14
Q

Forced Vital Capacity

A

FVC

  • maximal volume of air that can be forcefully exhaled after deepest possible inspiration
  • Restriction = decreased
  • obstruction is normal
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15
Q

Forced Expiratory Volume in 1 second

A

FEV1

  • normal value should be >80% of predicted
  • indicator for large airway obstruction & asthma
  • obstruction = decreased
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16
Q

FEV1/FVC

A

ratio used to classify lung function

BEST INDICATOR of obstruction - below 80% of predicted

17
Q

Forced Expiratory Flow or Midflows

A

FEV25-75%

Represents the small airway function

  • Obstruction = decreased
  • normal value: > 60-70% of predicted
18
Q

Exercise induced SOB - spirometry protocol

A
  1. Pre-exercise PFT
  2. Brief warm up
  3. Exercise: elevate HR to 160-180 bpm & sustain that intensity for 6-8 minutes
  4. Post-exercise PFT @ 5, 10, & 15 min
19
Q

Obstruction Pulmonary Diseases

A

any disease affecting the diameter of the airways
i.e. mucous production, inflammation, bronchoconstriction (asthma)

Characterized by low flow rates relative to lung volume
- Diagnosed by FEV1/FVC or FEV1 alone

20
Q

Classifications of Asthma

A

based on FEV1

Mild = 65-80% predicted
Moderate = 50-65%
Severe =

21
Q

Restrictive Pulmonary Disease

A

restriction of lung tissue or capacity of the lungs to expand & hold predicted volumes of air
i.e. sarcoidosis, insterstitial fibrosis, scoliosis

Characterized by low volumes & normal flow rates

22
Q

Obs + Rest Pulmonary Disease

A

main example = cystic fibrosis - excessive mucous production & damage to lung tissue

23
Q

3 most common causes of chest pain (in pediatrics)

A
  1. Asthma
  2. Vocal Cord Dysfunction
  3. GERD

Others:cardiac (ischemia, anomalies), pericarditis, mitral valve prolapse, esophagitis, costochondritis, sickle cell disease

24
Q

Asthma

  • symptoms
  • parameters & response to PFT
A

Symptoms usually begin 5-20 min after exercise
- coughing, wheezing, chest tightness, SOB

Parameters for PFT:

  1. FEV1: primary value - increase of 200mL or 12% is positive
  2. FVC: increase of 10% or more is positive
  3. FEV25-75: increase of >20% is positive

if 2/3 parameters are positive after given albuterol (or other short acting beta agonist) then the patient has reversible airway obstruction & should be prescribed an inhalor

25
Q

Vocal Cord Dysfunction

  • what is it
  • symptoms
  • treatment
A

parodoxical closure or adduction of vocal cords during INSPIRATION which causes partial to severe air way obstruction

Symptoms mimic EIA:

  • tightness, suffocation, choking , stridor, chronic cough or hoarseness, tingling in arms/legs, feeling faint, SOB
  • abrupt onset & resolution in 2-3 min W/O meds

More common in females (2:1)

Treatment by respiratory therapist - education, recognition, breathing techniques, etc

26
Q

Gastroesophageal Reflux Disease

A

GERD

2/3 of patients w/ asthma have underlying reflux & GERD that provokes their asthma;
therefore anti-reflux medications may help asthma symtpoms

95% of athletes w/ VCD also have GERD

Dehydration increases incidence

27
Q

Treatment of Asthma

A

have an asthma action plan!

For EIA:
- use prescribed medications 10-20 min prior to exercise
2-4 puffs w/ 1 min in between

Exercise Physiology (8 decks)

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