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800 > Week 1 - 4 (Midsem Notes) > Flashcards

Week 1 - 4 (Midsem Notes) Flashcards

1
Q

What is physical activity?

A

Any bodily movement produced by skeletal muscles that results in energy expenditure

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2
Q

What is physical fitness?

A

Related to a set of attributes that people have or achieve

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3
Q

Measurements of PA?

A

Questionnaires and surveys, diary or log, direct observation, pedometers, accelerometers, GPS

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4
Q

What is sedentary behaviour?

A

A class of behaviours that don’t produce much energy expenditure like sitting, driving and lying down

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5
Q

What are the benefits of PA?

A

Reduced all cause mortality, lower blood pressure, reduced CVD risk, better physical fitness, increase bone health and metabolic markers

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6
Q

Diseases and conditions that benefit from PA?

A

Diabetes, hypertension, CVD disease, blood cholesterol, stroke

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7
Q

PA recommendations for children?

A

60 mins or more of vigorous PA each day - mainly aerobic activities
Several hours of a variety of light PA
Muscle and bone strengthening activities 3x a week

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8
Q

PA recommendations for adults?

A

Any is better than none, if you do none start and build up gradually to recommended amount
150-300 mins of vigorous PA or 75-150 mins of moderate PA or an equivalent combination of both
Muscle strengthening activities 2x a week

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9
Q

PA recommendations for older adults?

A

Some form of PA regardless of age, weight, health problems or abilities
Active in every way as possible doing a range of PA that incorporates flexibility, balance, and balance
30 minutes of moderate PA on most, or preferably all days of the week

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10
Q

Who is ActivPAL good for?

A

Athletes, runners, swimmers

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11
Q

Who is Actigraph good for?

A

Tracking cycles of activity and sleeping over several days and weeks

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12
Q

Who is the pedometer good for?

A

Rehab population - disabled, amputee or those transitioning to an active lifestyle

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13
Q

What is the respiratory function?

A

Ventilation and gaseous exchange

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14
Q

What is the function of the URT?

A

Nose cavity, pharynx, larynx
Warms and humidifies air
Traps particles >5um
Filtration by nasal hairs and trapping by impaction

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15
Q

What is the function of the LRT conducting part?

A

From trachea to terminal bronchioles
Traps particles 1-5um via sedimentation on mucus layers
Trapped particles move to MCC

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16
Q

What is the function of the LRT gaseous exchange?

A

Gas exchange between O2 and CO2 via diffusion in alveoli that are both ventilated and perfused

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17
Q

Anatomy of the right lung

A

3 lobes: UL, ML, LL
2 fissures: horizontal and oblique
10 segments

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18
Q

Anatomy of the left lung

A

2 lobes: UL, LL
1 fissure: oblique
8-10 segments:

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19
Q

Anatomy of pleural cavity

A

Visceral layer attaches to lungs

Parietal layer attaches to chest wall

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20
Q

What creates the negative pressure in the pleural cavity?

A

Lungs are elastic and want to recoil inwards
Chest wall wants to expand outwards
Negative Ppl is a result of both of these pulling in opposite direction - keeps the lung expanded

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21
Q

What is pneumothorax?

A

Air in pleural cavity
Pleural pressure becomes positive
Lungs collapse inwards

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22
Q

Surface anatomy of lungs?

A

Anterior
Apex: 2.5cm above clavicle
Base: anterior to rib 6
Horizontal fissure: 4th rib or male nipple

Posterior
Apex: C7
Base: T10
Oblique fissure: T3/T4

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23
Q

Movement of lungs?

A

Anterior-posterior direction: pump handle (sternum)

Lateral direction: bucket-handle (lateral rib cage)

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24
Q

Primary muscles of inspiration?

A

Diaphragm, external intercostals, scalenes

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25
Diaphragm origin, insertion, innervation?
Origin: Lower costal ribs, lumbar vertebrae, xiphi-sternum Insertion: central tendon innervation: C3, 4, 5
26
How do the inspiratory muscles move
Diaphragm: descends 2cm and compresses abdominal contents and pulls the lower rib cage outwards and increases the lateral dimension of the thoracic cavity Other primary muscles: contract to lift the ribs and expand upper half of ribcage
27
Accessory muscles of inspiration?
Inspiration: sternocleidomastoid, pectoralis major and minor, upper trapezius, serratus anterior Expiration: abdominals, internal intercostals
28
Route of blood flow?
Deoxygenated blood enters systemic veins > superior and inferior vena cava > right atrium > tricuspid valve > right ventricle > pulmonary valve > pulmonary arteries > gas exchange in the lungs Oxygenated returns via pulmonary veins > left atrium > biscuspid valve > left ventricle > aortic valve > aorta > gas and nutrient exchange in peripheral tissues
29
Tidal volume
Volume of air inspired/expired in a normal respiratory cycle (500ml)
30
Inspiratory reserve volume
Volume of air forcibly inspired after normal TV
31
Expiratory reserve volume
Volume of air forcibly exhaled after normal TV
32
Residual volume
Volume of air remaining in lungs after maximum exhalation
33
Vital capacity
Total amount of air exhaled after maximum inspiration to maximum expiration
34
Functional residual capacity
Volume of air remaining lungs after normal exhalation
35
Total lung capacity
Sum of all lung volume compartments
36
Inspiratory capacity
Maximum volume of air that can be inhaled following resting state
37
What can change static lung volumes?
Exercise: increase VE, decrease IRV Obstructive disease: increase TLC, increase RV Restrictive disease: decrease VC
38
What happens to the breathing at rest?
Pa = Pb therefore no airflow
39
What happens to breathing during inspiration?
Pa < Pb therefore air flows into lungs Inspiratory muscles contract Thoracic cage expands Lung volume increases Intra-pleural and intra-alveolar pressure become more negative Barometric pressure at mouth is greater than the alveolar pressure therefore air flows into the lungs
40
What happens to breathing at end inspiration?
Pa = Pb therefore air flow stops | Intra-alveolar pressure = barometric pressure
41
What happens to breathing during expiration?
Pa > Pb therefore air flows out of lungs Respiratory muscles relax Lungs passively recoil Alveolar pressure is higher than barometric therefore air leaves the lungs
42
Anatomical dead space
Gas conducting airways from nose to terminal bronchioles
43
What affects the distribution of breathing?
Pressure gradients in lung Lung volume at which you breathe in Flow rate Pattern of breathing
44
When is intrapleural pressure more negative?
During inspiration | At lung apices
45
Why is Ppl more negative at apices
Because gravity pulls down on lungs Alveoli are more stretched Alveoli are more open at FRC
46
Is Ppl more negative at the apices or basal
Apices
47
Lung compliance
Change in volume produced by change in pressure
48
Non-dependent region
Uppermost lung
49
Dependent region
Lowermost lung
50
Which part of lungs takes in more ventilation
Lowermost
51
Which part of lungs are more compliant
Lowermost
52
Where does MCC occur
Conducting part of LRT
53
What is mucus?
Mechanical, biological and chemical barrier
54
What does cilia do?
Moves particles caught in mucus to pharynx to be swallowed
55
What are the 2 layers of MCC?
Sol - cilia here | Gel - mucus here
56
What produces mucus?
Goblet cells and bronchiole submucosal glands
57
Mucus contains...
Natural enzymes and antibiotics that destroy bacteria and viruses
58
Cilia are...
hair-like projections that power stroke and recovery stroke stimulus increased by mucus load 12-15 beats/second
59
When is a cough needed?
Functions to assist in removal from airways When MCC isn't working When mucus load is too large Exercise
60
What is alveolar clearance?
Only small particles reach here Particles engulfed by macrophages and move to MCC via MCC or removed by lymphatic system Small particles that reach alveoli are expired
61
Zones of auscultation
Upper: above 2nd ant. rib Middle: btw. 2nd and 4th ant. rib Lower: below 4th rib
62
What does the P wave represent
Atrial depolarisation
63
What does the QRS complex represent
Ventricular depolarisation
64
What does the T wave represent
Ventricle repolarisation
65
What does the PR interval represent
Delay at AV node
66
What does the ST segment represent
Beginning of ventricular repolarisation
67
What are the 3 systems of energy?
1. Anaerobic - ATP-CP 2. Anaerobic - Glycolysis 3. Aerobic - Oxidative Phosphorylation
68
What is oxygen consumption?
Amount of oxygen taken up by the lungs
69
What is cellular oxygen consumption?
Amount of oxygen taken up by the cells
70
What is maximal oxygen consumption?
Maximum volume of oxygen that a body can take up and use
71
What determines maximal oxygen consumption?
Age, gender, genetics, environment, mode, intensity and volume of training, physical state of health
72
Equation: VO2 max?
Fick principle: | VO2max = Cardiac output x difference on contents of oxygen in arterial blood and mixed venous blood
73
Equation: ventilation?
Tidal volume x Frequency of breathing | Average man: 6L min
74
Fick's law of diffusion:
Proportional to tissue area, diffusion coefficient of gas, and difference in partial pressure of gas on two sides of tissue and inversely proportional to thickness
75
Transit time of RBC
Total transit time of RBC in pulmonary capillaries: 0.75s Only takes 0.25s for gas exchange to occur Therefore velocity of blood can increase significantly and still allow enough time for RBC saturation with O2
76
Oxygen-Haemoglobin dissociation curve
Shows relationship between partial pressure of oxygen at alveoli or tissue level and the degree to which hb is saturated with o2
77
What happens to VO2 during dynamic constant workload
Starts at fairly stable level then increases up to a steady-state then plateueas Oxygen deficit and oxygen debt
78
What happens to ventilation at dynamic constant workload
1. Central command active skeletal muscles to active and contract according to amount of exercise being performed, mechnoreceptors provide afferent input to respiratory control at onset of exercise 2. Short-term potentiation increases minute ventilation exponentially to steady level related to metabolic gas exchange demands 3. Peripheral sensory feedback
79
What factors increase breathing during exercise
``` Higher brain centres Other receptors (pain and emotional state) Respiratory centres Peripheral chemorecetors Central chemoreceptors Stretch receptors in lungs Receptors in muscles and joints Irritant receptors ```
80
What happens to ventilation during incremental exercise
Increases with workload Threshold ultimately reached (65-85% vomax) in where ventilation increases exponentially Increase after threshold due to peripheral chemoreceptor stimulation
81
Equation: Cardiac output
CO = HR x SV | Average man: 6Lmin
82
How is HR controlled and regulated?
By autonomic nerves and circulating catecholamines | - PNS (HR decrease) and SNS (HR increase) activation
83
Stroke volume is determined by...
1. Preload - degree of cardiomyocytes prior to contraction 2. Contractility - influenced by sympathetic nerve activity catecholamines and b-agonists 3. Afterload - pressure ventricle must overcome to eject blood
84
What happens to an increased cardiac output during dynamic constant workload
Increase in CO then plateaus during exercise and comes down during recovery. Driven by increase in SV and HR.
85
What causes a change in HR?
Vagal withdrawal Stimulation causes decrease in HR De-stimulation causes increase in HR
86
Heart rate recovery
Decrease in CO | Parasympathetic reactivation strongest in first 30s
87
Increased HR during exercise and increased HR during recovery is associated with
Risk of sudden cardiac death and all-cause mortality | Linked to decrease vagal activity
88
What happens to SV during dynamic constant workload
Training increases SV | Lowers HR via contraction, EDV and MAP
89
What happens to contractility during dynamic constant workload
Increased sympathetic nerve activity | Increased circulating catecholamines
90
Why is there venoconstriction in splanchnic vessels
Blood from kidney, abdominal organs venoconstrict and move to wider circulation for skeletal muscles, heart and skin to use contributes to increased EDV
91
Skeletal muscle pump
Contributes to increased diastolic volume Muscular contractions in lower extremity propel blood in veins against gravity towards right atrium Squeezes capillaries within that muscle
92
Equation: Blood pressure
CO x TPR
93
Equation: MAP
DAP + 1/3rd PP
94
Changes to SBP, DBP, PP and MAP during exercise
SBP increases to push blood to body DBP decreases to cool down body PP increase MAP slight increase
95
What happens to cardiac output during dynamic constant workload
Vagal withdrawal, central command, skeletal muscle pump, vasodilation in active muscles, release of vasodilator factors, baroreceptors
96
Training improves vo2 max: Central circulatory adjustments
``` Increased SV, decreased HR improved vagal tone through training improved contraction strength increased plasma volume increase ventricular volume increased filling time and VR ```
97
Training improves vo2 max: Peripheral circulatory adjustments
Improve delivery Hypertrophy of slow twitch muscle fibres Skeletal muscle O2 extraction
98
What is blood pressure
Pressure exerted by blood against inner wall of an artery
99
Systolic BP is
Pressure in blood vessels when heart beats
100
Diastolic BP is
Pressure in blood vessels when heart rests between beats
101
What impacts BP?
increased/decreased co peripheral vascular resistance heart rate stroke volume
102
Definition: sPo2
Oxygen saturation - oxygen carrying capacity of blood, the % of haemoglobin that is bound with oxygen
103
What effects the calculations of BP?
``` Cuff too small Used over clothing Not resting Arm/feet/back unsupported Alcohol/caffeine Temperature Full bladder Time of day Talking Emotional state ```
104
What effects the calculations of the pulse oximeter
``` Cold weather nail polish low battery old model bright light on probe moving around a lot ```
105
Precautions and contraindications to exercise testing
``` HR too low unstable angina or myocardial infarc in last month Resting HR above 120bpm SBP/DBP too high Low sPO2 ```

800 (12 decks)

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