Exercise Testing And Prescription Exam 1

Front 1

cardiopulmonary cycle

Back 1

right atrium, tricuspid valve, right ventricle, pulmonary valve, pulmonary artery, lung, pulmonary vein, left atrium, bicuspid (mitral) valve, left ventricle, aortic ventricle, aorta, arteries, capillaries, veins, superior and inferior vena cava, right atrium

Front 2

layers of cardiac tissue

Back 2

1. endocardium
2. myocardium
3. pericardium
a. serous pericardium (visceral)
b. serous pericardium (parietal)
c. fibrous pericardium

Front 3

characteristics of cardiac conduction (4)

Back 3

1. automaticity
2. excitability
3. conductivity
4. contractility

Front 4

Cardiac Conduction Pathway (5)

Back 4

1. SA Node (60-100 bpm)
2. AV Node (40-60 bpm)
3. Bundle of His
4. R/L Bundle Branch
5. Purkinje Fibers (25-40 bpm)

Front 5

Sympathethic and Parasympathetic Innervation of Heart

Back 5

Para: SA Node/Atrium
Symp: AV node, ventricle, some atrium

Front 6

Fick Equation

Back 6

VO2=cardiac output x (a-v)O2 diff

Front 7

Rate Pressure Product (RPP)

Back 7

relative myocardial work

Front 8

Myocardium oxygen consumption (mVO2)

Back 8

mVO2=HR * SBP

Front 9

Resting MAP

Back 9

MAP=DBP + 1/3(SBP-DBP)

Front 10

Pulse Pressure

Back 10

SBP-DBP

Front 11

Ohm's Law

Back 11

Flow = change in pressure/resistance

Change in pressure = flow * resistance

Front 12

Resistance

Back 12

Resistance = (Length * Viscosity)/radius^4

Front 13

MAP2

Back 13

MAP=cardiac output * total peripheral resistance

Front 14

Starling's Law of the Heart

Back 14

increased EDV = increased SV

Front 15

Boyle's Law

Back 15

Pressure * Volume = Constant

Front 16

lung division

Back 16

trachea, R & L main bronchi, lobar bronchi, segmental bronchi, bronchioles, terminal bronchioles

Front 17

carina & acinus

Back 17

carina - bifurcation into lt and rt main bronchi
acinus - functional respiratory unit

Front 18

Diffusion Rate

Back 18

VGas = A*D*DeltaP/T
A=surface area
D=diffusion constant
T=thickness
DeltaP=pressure gradient

Front 19

Diffusion Constants of O2 and CO2

Back 19

CO2=0.01
O2=0.00053

Front 20

Regulation of Respiration

Back 20

Central Command: pns and medulla oblangata

SNS: inc depth and rate of ventilation, bronchodilation, dec pulmonary secretion

Cortex level: volitional control

Front 21

chemoreceptors

Back 21

central: 4th ventricle, CO2 and H+ in CSF
peripheral: aortic arch and carotid bodies, PaO2, PaCO2, and H+

Front 22

Hering-Breuer Inflation Receptor

Back 22

stretch receptors within lungs

Front 23

Minute Ventilation

Back 23

VE=fb*Vt
fb=breathing rate
Vt=tidal volume

Front 24

Dead Space Ventilation

Back 24

VD=fb*Vd
Vd=amount of air that doesn't make it to alveoli

Front 25

Alveolar Ventilation

Back 25

VA=VE-VD
VE=VD+VA

Front 26

Cause of shift of O2 dissociation curve (4)

Back 26

1. inc temp
2. inc DPG
3. inc PCO2
4. dec pH

Front 27

Specific responses to acute exercises (9)

Back 27

1. inc HR
2. inc SV
3. inc Q
4. inc (a-v)O2
5. inc O2 consumption
6. inc SBP and MAP
7. dec TPR
8. inc coronary blood flow
9. inc SNS activity

Front 28

1. Increased HR

Back 28

rest to mild: withdraw of vagal input
moderate-high: inc SNS and dec vagal

Front 29

2. inc SV

Back 29

EF=SV/EDV
inc preload
inc contractility of L ventricle

Front 30

3. Inc Q

Back 30

rest to mild: from inc HR and inc SV
mos-high: mainly from inc HR

Front 31

4. Inc (a-v)O2

Back 31

(a-v)O2 increases with exercise as muscles use up more O2

Front 32

6. Inc SBP

Back 32

SBP inc linearly with ex b/c of inc SV and Q

DBP does not inc or decreases due to decreased vascular resistance

Front 33

7. TPR

Back 33

initially, inc arteriole dilation in muscle, dec elsewhere

then vasodilation for sweating occurs

Front 34

8. Coronary Blood Flow

Back 34

at rest cardiac muscle uses 75% of O2 supply
ex, coronary artery dilation by endothelial-derived-relaxing factor

Front 35

Isometric Exercises

Back 35

inc in SBP, DBP, MAP, and RPP
1. mechanical compression of muscle
2. stimulate afferent nerves
3. possible Valsalva maneuver

Front 36

Arm vs Leg

Back 36

Arm Leg
Ven Ret 2x 2x
HR 2x 4x
SBP 1x 3x
DBP same or dec
Q 1x 1x

Front 37

Ventilatory Equivalent

Back 37

ratio of minute ventilation to oxygen consumption (VE/VO2)

Front 38

Ventilatory Threshold

Back 38

point at which pulmonary ventilation inc disproportianately with O2 consumption during graded exercise (due to anaerobic use of buffing lactate)

Front 39

Endergonic Reactions

Back 39

require energy to be added

Front 40

Exergonic Reactions

Back 40

- release energy
- (break down of glucose and fat)

Front 41

Couppled Reactions

Back 41

liberation of energy in an exergonic reaction drives an endergonic reaction

Front 42

Oxidation

Back 42

removing an electron [H+]
coupled with reduction

Front 43

Reduction

Back 43

addition of an electron [H+]
coupled with oxidation

Front 44

Formation of ATP

Back 44

1. anaerobic pathway
2. aerobic pathway

Front 45

Formation of ATP:
1. anaerobic pathways

Back 45

- do not involve O2
- Two pathways
-- phosphocreatine (PC) breakdown
-- glycolysis

Front 46

Formation of ATP:
2. aerobic pathways

Back 46

- require O2
- oxidative phosphorylation (oxidative formation of ATP)

Front 47

Type and Duration:
ATP-PCR

Back 47

- anaerobic
- 10 seconds

Front 48

Type and Duration:
Glycolysis

Back 48

- anaerobic
- 2 minutes

Front 49

Type and Duration:
aerobic

Back 49

- proteins and fat
- aerobic
- long duration

Front 50

oxidize

Back 50

lose H+ or gain O2

Front 51

Aerobic Pathway of ATP Production

Back 51

1. Krebs Cycle
2. Electron Transport Chain

Front 52

Aerobic Pathway of ATP Prod:
Krebs Cycle (Citric Acid Cycle)

Back 52

- completes oxidation of substrates
- produces NADH and FADH to enter ETC

Front 53

Aerobic Pathway of ATP Prod:
Electron Transport Chain

Back 53

- oxidative phosphorylation
- remove electrons from NADH and FADH to enter ETC
- H+ from NADH and FADH join with O2 to form water

Front 54

ATP

Back 54

energy currency

Front 55

Anaerobic Pathway for ATP Production

Back 55

ATP-PC System

Front 56

Anaerobic Pathway for ATP Prod: ATP-PC System

Back 56

- immediate source of ATP
- PC + ADP --> ATP + C
- uses creatine kinase

Front 57

ATP + H20 -->

Back 57

--> ADP + Pi + 7.3 kcal/mole
- uses ATPase

Front 58

1 ATP =

Back 58

= 7.3 kcal/mole

Front 59

glycolysis

Back 59

- anaerobic
- from glucose (2 ATP) or glycogen (3 ATP)

Front 60

end product of glycolysis

Back 60

2 aTP and 2 pyruvate

Front 61

pyruvate used in

Back 61

- aerobic metabolism
- accepts H+ from NADH to form lactic acid

Front 62

Energy released from glycolysis

Back 62

- occurs in cytosol
- glucose is oxidized
- NAD is reduced to NADH
- limited quantities of ATP produced
- cleaved into 2 pyruvate molecules

Front 63

Energy released from fat

Back 63

- 460 ATP
- most plentiful source of energy
- first step: lipolysis using lipase

Front 64

Two sources of fat

Back 64

1. triacylglycerol in fat cells (adipocytes)
2. intramuscular triacylglycerol

Front 65

Lipolysis stimulated by:

Back 65

1. epinephrine
2. norepinephrine
3. glucagon
4. growth hormone

Front 66

Intracellular mediator of lipolysis:

Back 66

cyclic AMP (cAMP)

Front 67

Three stages of Oxidative Phosphorylation

Back 67

1. micronutrient digestion, absorption, and assimilation
2. degradation of subunits into acetyl-CoA
3. oxidation of acetyl-CoA to CO2 and H2O

Front 68

Energy Release from Lipid
Source: 1 molecule glycerol

Back 68

Pathway: glycolysis + Kreb's cycle
ATP per molecule of fat: 19

Front 69

Energy Release from Lipid:
Source: 3 molecules of 18-carbon

Back 69

Pathway: Beta-oxidation and Kreb's Cycle
ATP Yield per molecule neutral fat: 441

Front 70

Fats burn in a carbohydrate flame

Back 70

glycolytic production of pyruvate keeps required levels of oaxeloacetate to maintain activity of beta oxidation

Front 71

Slower rate of energy release from fat

Back 71

- fat oxidation slower than carbohydrate
- carb ox maintains fat ox
- carb depletion impairs exercise performance

Front 72

Krebs called citric acid because

Back 72

of citrate

Front 73

Carbs -->

Back 73

glucose, protein, fat

Front 74

Fats -->

Back 74

glycerol --> glucose, fat, protein

Front 75

Protein -->

Back 75

glucose, protein, ketogenic amino acids

Front 76

What regulates energy metabolism?

Back 76

- overall energy state dictates direction of metabolic pathways
-

Front 77

Rate-limiting modulators of energy metabolism

Back 77

- ATP
- ADP
- cAMP
- NAD
- Calcium
- pH

Front 78

Short-term, high-intensity activities

Back 78

- greater contribution of anaerobic systems

Front 79

Long-term, low to moderate-intensity exercise

Back 79

- majority of ATP produced from aerobic sources

Front 80

Steady state VO2

Back 80

O2 consumed meets demand of energy requirement at cellular level

Front 81

O2 deficit

Back 81

difference of O2 consumed to O2 required at cellular level

Front 82

Trained vs untrained difference in steady state

Back 82

trained reach steady state faster

Front 83

O2 deficit and debt during light-moderate and heavy exercise

Back 83

- inc CO2 and HR
- at rest 1 met=3.5 ml/kg VO2

Front 84

O2 debt

Back 84

O2 still required post-exercise as body cools down

Front 85

another term for O2 debt

Back 85

excess post-exercise oxygen consumption (EPOC)

Front 86

"Fast" portion of O2 debt

Back 86

1. resynthesis of stroed PC
2. replacing muscle and blood O2 stores

Front 87

"Slow" portion of O2 debt

Back 87

1. elevated HR and breathing, inc energy need
2. elevated body temp, inc metabolic rate
3. elevated epi and nor-epi, inc metabolic rate
4. conversion of lactic acid to glucose (gluconeogenesis) in the liver (Cori Cycle)

Front 88

Cori Cycle

Back 88

conversion of lactic acid to glucose (gluconeogenesis) in the liver

Front 89

High-intensity, short-term exercise (2-20 sec)

Back 89

- immediate response
- ATP production through ATP-PC system

Front 90

Intense exercise longer than 20 sec

Back 90

- short-term
- ATP production via anaerobic glycolysis

Front 91

high-intensity exercise longer than 45 seconds

Back 91

- long term
- ATP production through ATP-PC, glycolysis, and aerobic systems

Front 92

VO2

Back 92

"ability to deliver and use oxygen"
-
VO2=Q*(a-v)O2 difference

Front 93

oxygen uptake increases linearly until

Back 93

VO2 max is reached

Front 94

physiological factors influencing VO2 max

Back 94

1. ability of cardiorespiratory system to deliver oxygen to muscles
2. ability of muscles to use oxygen and produce ATP aerobically

Front 95

what determines VO2 max

Back 95

stroke volume

Front 96

effect of hot/humid environment on VO2

Back 96

inc body temp requires vasodilation leading to more O2 consumption

Front 97

effect of high-intensity exercise on VO2

Back 97

body accumulates more lactate, electrolyte imbalance and inc temperature

Front 98

definition of OBLA

Back 98

the level at which blood lactic acid systemically rises to 4.0 mM during incremental exercise

Front 99

implication of OBLA

Back 99

maximal exercise intensity that a person can sustain for a prolonged period of time

Front 100

mechanisms for lactate threshold

Back 100

- low muscle O2
- accelerated glycolysis or slower mitochondrial respiration
- recruitment of fast-twitch fibers
- reduced rate of lactate removal from the blood

Front 101

Above lactate threshold ->
Below lactate threshold ->

Back 101

-> anaerobic
-> aerobic

Front 102

removal of lactic acid following exercise (active vs passive)

Back 102

active removes lactic acid faster than passive

Front 103

Sources of fuel during exercise:
carbohydrate

Back 103

- blood glucose
- muscle glycogen

Front 104

Sources of fuel during exercise:
fat

Back 104

- plasma FFA (from adipose tissue lypolysis)
- intramuscular triglycerides

Front 105

Sources of fuel during exercise:
protein

Back 105

- only a small contribution to total energy (~2%)
- may increase to 5-15% in prolonged exercise

Front 106

Sources of fuel during exercise: blood lactate

Back 106

gluconeogenesis from the Cori cycle

Front 107

Respiratory exchange ratio

Back 107

VCO2/VO2
- indicates fuel utilization
= respiratory quotient

Front 108

McArdle's Syndrome

Back 108

- disease with deficiency of glycogen phosphorylase
- no lactate production with ischemic exercise

Front 109

1. Mass
2. Distance
3. Time
4. Force
5. Work

Back 109

1. kilogram (kg)
2. meter (m)
3. second (s)
4. Newton (N)
5. Joule (J)

Front 110

6. Energy
7. Power
8. Velocity
9. Torque

Back 110

6. Joule (1 kcal=4.186 joules)
7. watt (W)
8. meters per second (m/s)
9. newton-meter (N-m)

Front 111

one calorie=

Back 111

the quantity of heat required to raise 1 L of water 1 degree celsius

Front 112

Heat of Combustion

Back 112

- heat liberated by oxidizing (burning) food in a bomb in a bomb calorimeter

Front 113

Heat of Combustion Values
1. Lipid
2. Carb
3. Protein

Back 113

1. 9.4 kCal/gram
2. 4.2 kCal/gram
3. 5.65 kCal/gram

Front 114

Coefficient of Digestibility
1. Lipids
2. Carbohydrates
3. Protein

Back 114

1. 95%
2. 97%
3. 92%

Front 115

Atwater General Factors
1. Lipids
2. Carbs
3. Protein

Back 115

1. 9 kCal/gram
2. 4 kCal/gram
3. 4 kCal/gram

Front 116

total kCal =

Back 116

= Atwater factor and food (grams)

Front 117

Measurement of Energy Expenditure

Back 117

1. Direct Calorimetry
2. Indirect Calorimetry

Front 118

Direct Calorimetry

Back 118

measurement of heat production as an indication of metabolic rate
(heat)

Front 119

Indirect Calorimetry

Back 119

measurement of oxygen consumption as an estimate of metabolic rate
(oxygen used)

Front 120

Indirect Calorimetry (methods)

Back 120

1. Closed Circuit
2. Open Circuit
a. Portable spirometry
b. bag technique
c. stationary computerized metabolic system
3. doubly layered water technique

Front 121

Closed Circuit

Back 121

- good for stationary
- large resistance

Front 122

portable spirometry

Back 122

- small and carried in pack
- air volume is metered
- sample collected to measure concentrations of gases
- breathe normal air

Front 123

Bag Technique

Back 123

- air collected in Douglas Bag
- gold standard, more accurate
- small sample measured

Front 124

Stationary Computerized metabolic system

Back 124

- air flow measured for volume
- gas analyzers measure O2 and CO2
- stationary

Front 125

Doubly Layered Water Technique

Back 125

- truly, truly gold standard
- isotope-based
- Oxygen-18 and Deuterium
- isotopes eave body through sweat
- estimates total daily energy expenditure

Front 126

Respiratory Quotient =

Back 126

CO2 produced/ O2 consumed

Front 127

RQ values
1. Carbohydrate
2. Fat
3. Protein
4. Nonprotein RQ
5. RQ for a mixed diet

Back 127

1. 1.00
2. 0.696
3. 0.818
4. 0.86
5. 0.82

Front 128

Basal Metabolic Rate

Back 128

energy to maintain vital functions in awake state

Front 129

Resting Metabolic Rate

Back 129

energy to maintain vital functions plus digestion (measured 3-4 hours after meal)

Front 130

main factors of increased metabolic rate

Back 130

- increased surface area
- decreases with age

Front 131

Effects of Regular Exercise
1. resistance training
2. Endurance training
3. Exercise

Back 131

1. increases BMR by increasing FFM
2. increases BMR without increasing FFM
3. offset the age-related decline in BMR

Front 132

Resting Daily Energy Expenditure =

Back 132

= BMR x m^2

Front 133

Factors that affect energy expenditure

Back 133

- physical activity
- diet-induced thermogenesis (DIT)
- climate
- pregnancy

Front 134

Physical Activity Ration
1. Light work
2. Moderate
3. Heavy work
4. Maximal Work

Back 134

1. 1-3 x BMR
2. 3-6 x BMR
3. 6-8 x BMR
4. >9 x BMR

Front 135

1 MET =

Back 135

3.5 mL/kg/min