Fitness Assessment Test #1

Front 1

How do you distinguish phase 4 and phase 5 Korotkoff sounds?

Back 1

1. Phase 4 = whooshing, muting sound.
2. Phase 5 = no sound heard - diastolic pressure

Front 2

What is Blood Pressure?

Back 2

1. Force exerted on walls of arteries (aorta is what we try and measure) as blood is pumped through circulation.
2. We measure SYSTEMIC (not pulmonary) circulation.

Front 3

Explain how you hear sounds when taking blood pressure.

Back 3

1. Normally blood is in laminar/smooth flow.
2. When you cut off circulation with cuff, the blood will begin to spurt at systolic producing turbulence and a sound.
3. As it approaches diastolic, turbulence decreases to a more smooth flow, making sounds more muffled until diastolic reached and you hear nothing.

Front 4

Flow is due to what concept?

Back 4

1. Pulse pressure - difference in pressures
2. High pressure at aorta --> low pressure in right atrium
3. Flows from high to low pressures.

Front 5

What is systolic pressure? Diastolic? Pulse Pressure?

Back 5

1. Systolic - highest pressure in arteries due to ejection of blood into aorta
2. Diastolic - lowest pressure occuring during relaxation of heart (4th and 5th phases)
3. Pulse Pressure - difference between systolic and diastolic - driving force!

Front 6

Why do we measure 4th phase AND 5th phase?

Back 6

1. Sometimes, during exercise, when blood flows very rapid you will hear 5th phase all the way to 0 mmHg, but that isn't accurate, so you want to take the first muffled sounds (4th phase) as your diastolic instead.

Front 7

What changes occur in systolic and diastolic pressures during exercise?

Back 7

1. Systolic increases linearly and should plateau at maximal effort.
2. Diastolic should stay about the same - if it increased you would not have an increase in pulse pressure because the difference would stay the same, so you need it to stay the same to have an increase in pulse pressure overall to drive blood faster.

Front 8

What types of individuals usually have a lower blood pressure or lower exercise blood pressure?

Back 8

1. Females tend to have overall lower blood pressures
2. Fit individuals tend to have lower exercise blood pressures.

Front 9

What are normal values for blood pressure? Hypertension (stage 1 and stage 2)?

Back 9

1. Normal --> 120 / 80 mmHg
2. Stage 1 Hypertension --> 140-160 / 90-99
3. Stage 2 Hypertension --> >160 / >100

Front 10

What is Heart Rate?

Back 10

1. Number of ventricular contractions per minutes - usually same as pulse rate.

Front 11

What is the power equation we use? What if we need watts?

Back 11

kgm*min-1 (power) = (kg)(RPM)(Flywheel)

Flywheel - constant - 6

Watts = (kg)(RPM)

Front 12

Heart rates measured at steady power output should be measured for how long? How about after exercise has stopped?

Back 12

1. During constant power output, measure for a minimum of 15 seconds up to 60 seconds.
2. After exercise stopped - measure for 6, 10 or 15 seconds (the shorter the better, but make sure you are accurate).

Front 13

What is resting heart rate determined by?

Back 13

1. Genetics and Fitness level

Front 14

More fit individuals usually have a _____________ resting heart rate.

Back 14

1. Lower resting heart rate for more fit (can't compare between individuals though due to genetic component).

Front 15

A decrease in resting HR denotes an _______________________ in cardiovascular fitness. Why?

Back 15

1. Increase in CV fitness
2. Stroke volume is higher, so the HR doesn't have to be as high to get the same amount of blood to the body in a given time period.
3. Cardiac output does NOT change with fitness level (depends on mass of person).

Front 16

What is the relationship between heart rate and power output?

Back 16

1. Linear
2. As power output goes up, heart rate goes up - until maximum then it plateaus.

Front 17

CR fitness ______________________ submaximal heart rate at any power output.

Back 17

1. Decreases (better fit, lower HR)

Front 18

What is the determining factor for maximal heart rate?

Back 18

1. AGE!!!!!!!!!
2. Fitness, body mass, gender DO NOT affect maximal HR

Front 19

What are the two methods for estimating max HR? What is the SEE of those?

Back 19

1. Traditional (220-age)
2. Best [208 - (0.7 x age)]
3. SEE = 10-12 BPM

Front 20

How are Korotkoff sounds produced?

Back 20

1. Turbulent blood flow!

Front 21

What are general indications for stopping an exercise test in low-risk adults?

Back 21

1. Onset of angina-like symptoms (chest pain, etc)
2. Drop of 20 mmHg or more in SBP during steady state
3. Failure of SBP to rise during increase intensity
4. Excessive rises in BP (>260 sys or >115 dia)
5. Failure of HR to increase with increasing power

Front 22

Where is oxygen used in the body during exercise for energy?

Back 22

1. Electron Transport Chain
2. Connects with hydrogen ions to form metabolic water in order to allow for continued ATP synthesis.

Front 23

What is the difference between a normal person VO2 and an elite VO2?

Back 23

1. Elite has a genetical component that allows them to have a higher stroke volume and a greater ability to pump blood out of the heart.
2. Body can always use more oxygen, just hard to pump enough to the body by the heart (limiting factor).

Front 24

1 MET = resting VO2 = __________ ml*kg-1*min-1

Back 24

1 Met = resting Vo2 = 3.5 mlkgmin

Front 25

2.75 L*min-1 = _________ ml*min-1 = _________ ml*kg-1*min-1

50 kg person

Back 25

2.75 = 2750 = 55

Front 26

50 watts is a little above what level of exercise?
100 watts is a little above what level of exercise?
150 watts if a little above what level of exercise?

Back 26

1. rest - low (50 watts)
2. medium (100 watts)
3. High (150 watts)

Front 27

Resting heart rates are usually around?? Max??

Back 27

1. Resting = 60 BPM
2. Max = 180-200 BPM

Front 28

What are the 5 things included in the health-related fitness category?

Back 28

1. Muscular strength
2. Muscular endurance
3. Flexibility
4. Body Comp
5. Cardiorespiratory fitness

Front 29

What are the benefits of regular physical activity or exercise?

Back 29

1. Reduces risk of dying prematurely
2. Reduces risk of dying from heart disease
3. Reduces risk of developing diabetes
4. Reduces colon cancer risk
5. Helps control weight
6. Reduces depression/anxiety
7. Promotes psychological well-being

Front 30

What does the correlation of coefficient (r) do?

Back 30

1. Expresses relationship between two variables
2. Correlations range from -1.0 -- 1.0
3. Closer to 1.0, better the relationship

Front 31

Positive r correlation means what?

Back 31

1. As one variable increases, the other increases
2. OR as one decreases, the other decreases

Front 32

Negative r correlation means what?

Back 32

1. As one variable increase, the other decreases

Front 33

________ % chance that actual value is within predicted value +- 1 SEE
_______ % chance that actual value is within predicted value +- 2 SEE

Back 33

67 % for 1 SEE
95 % for 2 SEE

Front 34

Test validity versus test reliability?

Back 34

1. Validity - ability of test to measure what it is designed to measure.
2. Reliability - ability of test to provide consistent results if repeated.

Front 35

You are 21 years old, what is your estimated max HR and go out 1 and 2 SEE...

Back 35

199 max HR
189-209 (67 % confidence 1 SEE)
179-219 (95 % confidence 2 SEE)

Front 36

A test can be ________________, but not ______________. For example...

Back 36

1. Reliable, but not valid
2. For example - if scale read 180, but your'e 185
- two weeks later it reads 175, but you're 180.

It shows weight loss and measures what it is supposed to, but not accurate valid numbers.

Front 37

What is Low risk, medium risk and high risk ACSM Risk Strat?

Back 37

1. Low
- Younger individuals (M<45, F<55)
- no symptoms
- no more than ONE risk factor
2. Medium
- Older (M>45, F>55)
- 2 or MORE risk factors
3. High
- signs/symptoms of CV or pulmonary disease present

Front 38

What are the positive (correlation) risk factors for CAD?

Back 38

1. Family history
2. Cigarette smoking
3. Hypertension
4. Dyslipidemia (cholesterol high)
5. Impaired fasting glucose (pre-diabetes)
6. Obesity
7. Sedentary lifestyle

Front 39

What are the negative (correlation) risk factors for CAD?

Back 39

1. High HDL cholesterol

Front 40

What is coronary artery disease? (CAD)

Back 40

1. Blockages in arteries surrounding the heart that supply blood/oxygen to the heart muscle.
2. Cerebral infarction (stroke - brain)
3. Myocardial infarction (heart attack)
Infarction means dead tissue

Front 41

What are signs/symptoms of CV, pulmonary or metabolic diseases?

Back 41

1. Pain, discomfort in chest, neck, jaw, arm - may due to ischemia (insufficient blood flow) (ANGINA PECTORIS)
2. Shortness of breath at rest or mild exertion
3. Dizziness or syncope (fainting)
4. Orthopnea or nocturnal dyspnea
5. Ankle edema
6. Palpitations or tachycardic

Front 42

What are cut off points for high cholesterol?

Back 42

1. Total cholesterol > 200 mg/dL
2. LDL Cholesterol >130 mg/dL
3. HDL Cholesterol <40 mg/dL

Front 43

When should you recommend medical exam before exercise?

Back 43

1. Never with low risk
2. Moderate risk and vigorous testing
3. ALWAYS with high risk

Front 44

What is total cholesterol made of?

Back 44

1. LDL + HDL + VLDL

Front 45

Vigorous exercise __________ METS
Moderate exercise ____________ METS

Back 45

Vigorous - ABOVE 6 METS
Moderate - 3-6 METS

Front 46

More oxygen that can supply the mitochondria, the more ___________________________.

Back 46

ATP can be produced

Front 47

What is the limiting factor in terms of increasing VO2 or oxygen consumption during exercise?

Back 47

1. The amount of blood the heart can pump.
2. The mitochondria and lungs are pretty much same in terms of capability to use oxygen, it just depends on the overall amount that the body can pump to muscles.

Front 48

Females, on average, have _____________________ hemoglobin amounts compared to males?

Back 48

1. Lower in females

Front 49

Explain the relationship between cardiovascular, respiratory and muscular systems for functional (vo2) capacity?

Back 49

1. The lungs bring in the air, alveoli get into bloodstream.
2. Hemoglobin takes oxygen, heart pumps blood out to muscles
3. Muscles use oxygen in mitochondria to resynthesize ATP (electron transport chain) because oxygen combines with H+ ions to form metabolic water and keep the process from backing up.

Front 50

What is VO2? VO2max?

Back 50

1. VO2 = is a measure of the volume of oxygen that is used by your body to convert food to energy.
2. VO2 max = the maximum capacity of an individual's body to transport and use oxygen during incremental exercise - max amount of VO2

Front 51

Where does error occur in submaximal testing?

Back 51

1. Max VO2 based on average age formula (220-age)
2. Slope of the line is based on population data - not the individual
3. Things like caffeine may inflate heart rate

Front 52

What is VO2 and Heart Rate reserve? What does this tell us?

Back 52

1. VO2max - VO2resting (same for HR)
2. Amount of increase that we have in our capacity relative to those variables.

Front 53

When small muscles are used, what happens to HR response? Why?

Back 53

1. HR response is exaggerated.
2. This is because HR goes up without cardiac output going up - so VO2max is hard to reach with small muscles

Front 54

If you have good cardiovascular system, you may have to do what to reach maximal VO2 levels?

Back 54

1. Use more muscle mass i.e: arms + legs instead of just legs or similar concept.

Front 55

Cardiovascular response is related to the ________________________ that has to be perfused.

Back 55

1. Amount of muscle mass that has to be perfused.

Front 56

The more fit you are the ________________ chance of morbidity due to cardiovascular disease.

Back 56

1. Lower chance cardio disease when more fit

Front 57

It is the __________________________ that produces the results that are protective longer term, not VO2max.

Back 57

1. Process of exercise that produces results longer term

Front 58

What assumptions must be made to do submaximal testing and predict VO2max?

Back 58

1. HR and Power output response is linear
2. Max power output occurs at max HR
3. Max HR is used as 220-age

Front 59

How are we able to keep increasing power output even after achieving VO2max?

Back 59

1. We switch over and use the anaerobic system

Front 60

What are the equations for VO2reserve and HRreserve?

Back 60

1. VO2max - VO2resting
2. HRmax - HRresting

Front 61

During maximal testing, HR is not a good variable, why?

Back 61

1. It is age related (220-age = max HR) and age is not an indicator of overall fitness level.

Front 62

Why is it important to maintain constant pace for entire distance 1 mile run/walk?

Back 62

1. Need to maintain constant HR
2. If you speed up right near the end, your results will be skewed because HR will show higher, meaning lower VO2 max

Front 63

What is the effect on predicted VO2 if you drank 2 cups of coffee, 30 minutes before testing?

Back 63

1. Increased heart rate, which would lead to decreased VO2 max

Front 64

What is something that will lower HR?

Back 64

1. MEDICATION

Front 65

What SEE would correspond to the greatest accuracy of a test?

Back 65

0

Front 66

Why is it better to use 2 points on a predictive graph rather than 1 point?

Back 66

1. With 2 points, you can individualize the slope and better predict VO2max

Front 67

Primary factor for difference in performance of world class versus normal athlete is....

Back 67

1. Cardiac output (stroke volume)

Front 68

SEE for predicted max heart rate is 10 BPM, what would 95 % confidence level be for 20 year old?

Back 68

180-220

Front 69

Which of the following assumptions are used/important when predicting VO2max from submaximal tests?
1. Relationship between workload and heart rate is linear
2. Everyone has the same heart rate at same workload
3. Maximal heart rate is the same for everyone
4. All of the above

Back 69

1. Relationship between workload and heart rate is linear

Front 70

If both male and female of 55 ml/kg/min were doing mile walk test, who would be expected to have highest heart rate if they walked at the same pace?

Back 70

1. They would be the same

Front 71

If both male and female of 55 ml/kg/min were doing 1.5 mile max test who would have fastest time?

Back 71

1. Both would be the same (ignore height, stride, etc)

Front 72

If both male and female of 55 ml/kg/min were doing 1.5 mile max test, who would have highest HR at the end?

Back 72

1. Both would be the same, max HR is dependent upon age

Front 73

During a max running test, which of the following will result in most accurate prediction?
1. Running in 70 temp instead of 90
2. Several practice runs
3. Don't eat several hours before
4. All of the above

Back 73

1. All of the above

Front 74

Max test is less desirable in adults aged 30-60 yrs because....

Back 74

1. Maximal tests are potentially more dangerous in the adult population

Front 75

What level of intensity for %Vo2Reserve, METS, HRR, %HRmax and RPE is needed for at least some health benefit?

Back 75

40 % - VO2reserve
40 % - HRR
50 % - HRmax
RPE - 7 or 1
METS - 3-6

Front 76

Recommendations for aerobic activity for healthy adults 18-65?

Back 76

1. Minimum of 30 min on 5 days each week or vigorous-intensity aerobic physical activity for a minimum of 20 min on 3 days each week.

Front 77

What is moderate activity?

Back 77

1. Moderate-intensity aerobic activity, which is generally equivalent to a brisk walk and noticeably accelerates the heart rate
2. 3-6 METS

Front 78

What is vigorous activity?

Back 78

1. Vigorous-intensity activity is exemplified by jogging, and causes rapid breathing and a substantial increase in heart rate.
2. >6 METS

Front 79

Recommendations for muscular strength activity for healthy adults 18-65?

Back 79

2 days/week minimum

Front 80

What is the MET value that accumulates to meet the guidelines for exercise?

Back 80

450-750 MET*min

Front 81

How do you calculate METS?

Back 81

1. Take MET value for certain activity and multiply it by the amount of time the activity was done

Front 82

Exponential increases in health are seen with what type of exercise? (article 2)

Back 82

1.Curve III
represents a non-linear relationship where health
benefits are obtained from high levels of activity

Front 83

Linear increases in health are seen with what type of exercise? (article chart 2)

Back 83

1. Normal exercise moderate guidelines CURVE II

Front 84

Plateauing increases in health are seen with what type of exercise? (article figure 2)

Back 84

1. CURVE I
2. Low to moderate levels of exercise non linear increases