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36 Cards in this Set

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What is the REO2?
Respiratory Equivalent for O2
What is the normal resting REO2 and that at moderate exercise?
20:1
-For every 1 L/min increase in oxygen consumption, total ventilation has to increase by 20L/min
What happens to the REO2 at severe exercise levels?
It increases to more like 25:1
Why does the REO2 increase at severe exercise levels?
Due to an increase in lactate buffering which gives a CO2 byproduct. That requires increased ventilation to blow off the CO2
Why doesn't O2 consumption continue to increase as the ventilation increases?
Because O2 consumption is limited by the heart rate and cardiac output - it is already at O2 Vmax
So what is the normal resting
-Ve (total)
-VO2 (oxygen consumption)
-VEo2
Ve = 6 L/min
VO2 = .25L/min
VEo2 = 24 (unitless)
What is the normal resting
-Ve (total)
-VCO2 (CO2 production)
-VECo2
Ve = 6 L/min
VCO2 = 0.2 L/min
VECO2 = 30
Why is the normal O2 consumption higher than CO2 production?
Because on our diet the normal respiratory quotient is 0.8
(0.8 = 0.2/0.25)
So what is the strenuous Exercising
-Ve (total)
-VO2 (oxygen consumption)
-VEo2
-Ve = 100
-VO2 = 4
-VEo2 = 25
How much does VCO2 increase during exercise? So what is the VECo2 during strenuous exercise?
VCO2 = 3.47
29
In general how do the VEO2 and VECO2 compare at rest?
The VECO2 is higher than VEo2
Normal value for VEo2
Normal value for VECO2
VEO2 = 26 +/- 4
VECO2 = 29 +/- 4
What happens to the difference in VEO2 and VECO2
-At the anaerobic threshold
-Beyone the AT
AT it they are equal
BEYOND it the VECO2 is LOWER than the VEO2
What is the MET?
Metabolic equivalent
What is the MET used for?
Estimating the metabolic cost of physical activity
What does 1 MET refer to?
3.5 ml of O2 uptake/min/kg
When would you be using 1 MET?
4 METS
6 METS?
8 METS?
12-18 METS?
At rest
Housework/bowling
Farming/tennis
heavy manual labor/skiing
hocky/rowing/swimming
How is METS calculated?
VO2/weight (kg)
-------------
3.5 ml/min/kg
So for a person with an oxygen ventilation of 4 L/min and a weight of 80 kG what is their METS?
14.3 (unitless)
How is oxygen pulse calculated?
VO2/HR
For a person with a VO2 of 4 L/min and a heart rate of 165 what is their O2 pulse?
24 ml O2/beat
What is the normal o2 pulse
-male
-female
Male = 12 ml O2/beat
Female = 10 ml O2/beat
What are 3 subjective ways to evaluate whether an exercise stress test was maximal or submaximal?
-Chest pain
-Fatigue
-Shortness of breath
What are 4 objective ways to determine if the test was maximal?
-Heart rate
-RQ (greater than 1)
-Lactate levels
-Bicarb levels
How much will lactate and bicarb change if the test was maximal?
4 mEq/L above normal Lactate
4 mEq/L below normal Bicarb
How are the "normals" for lactate and bicarb determined?
Whatever it was before exercise
When will the AT be reached in
-A normal sedentary person
-A trained athlete
Sedentary - at 4-6X resting O2 consumption
Trained athlete - at 10-12X resting O2 consumption
Does the exercise stress test done in a pulmonary lab normally reach maximum?
No - its generally submaximal
What is the purpose of an exercise stress test investigating a limitation??
To determine if its due to
-Pulmonary problems
-Cardiac problems
-Deconditioning
-Poor effort
What would be a pulmonary limitation?
-Restrictive/obstructive impairments
-Gas exchange defects
-Neuromuscular disease
-Thoracic cage deformity
What would be a cardiovascular limitation?
-CAD
-Anemia
-HTN
-Arrythmia
What is the Breathing reserve?
The maximum predicted min ventilation - actual Ve reached
What is the A-a O2 gradient?
The Alveolar-arterial oxygen gradient
What are 3 ways to evaluate a Ventilatory limitation?
Ve only 70-80% max
Breathing freq <55-60
Breathing reserve of 20-30%
What are 3 ways to determine a Cardiovascular limitation?
-ECG
-Blood pressure response
-O2 pulse should be >10 ml O2/beat
What are 3 ways to determine a gas exchange limitation?
-SaO2 (decrease should be <4%)
-Pa O2 <10 mm Hg drop
-A-gradient <35 mm Hg O2