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46 Cards in this Set
- Front
- Back
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Health Screening (Why) |
Identify people with diseases who should be medically supervised during exercise. Indentify & exclude people with medical contraindications. Detect people who should undergo medical/exercise test before exercise or increasing intensity/frequency. |
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Health Screening - Multi Stage Process |
1) Self Guided e.g. Par-Q or Acsm Questionnare. 2)CVD Risk factor assessment & classification. 3) Medical test (physical/mental) |
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CVD Risk Factors |
Age - (Men >45, Women >55). Fam Hist - MI, Coronary Revascularisation or Sudden Death (Men <55, women <65). Smoking - Current, within last 6 months or exposure. Sed Lifestyle - Less than 30 mins, 3 times a week for 3 months. Obesity - BMI over 30, waist over 40inch (men) or 35inch (women). Hypertension - SBP >140 and or, DBP >90 on two occassions. Dyslipidemia -TCL >5.18mmol, LDL >3.37 mmol, HDL <1.04 or medication. Prediabetes - IFG >5.55mmol <6.94 mmol two occassions. |
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Negative Risk Factors |
HDL - >1.55mmol. |
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Signs/Symptoms of CVD/Pulmonary Disease. |
- Pain of chest, neck, jaw or arms due to ischemia. - Shortness of breath at rest/mild exertion. - Diziness. - Ankle odema. - Palpitations/tachycardia. - Intermittent Claudication (blood flow). - Orthopnea (Supine shortness of breath). - Known heart mumour. Unsual fatigue or SOB usual activities |
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Risk Classification |
Low - <2 Risk Factors, No S/S and no known disease. Mod - 2 or less risk factors, no S/S, no disease. - Medical exam vig intensity. High - N/A risk factors, S/S and known disease. - medical exam, exercise test and supervison. |
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GXT |
- Assess the ability to tolerate increasing intensity. - limited by CV, heart, symtoms and lungs. - positive response - negative health - negative response - healthy performnace. |
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GXT Methods |
Treadmill - Easy to use and familiar. Attain high vo2 max and hr. Cycle Ergometer - Cheaper and less space. Easy obtain ECG and BP. Unfamilar and 5 - 25% less vo2 max. Arm Ergometer - less vo2 max 20 - 30% and reduced muscle mass used. |
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GXT - What to record. |
Heart Rate (ECG). BP Expired Gas RPE Chest Pain Dyspnea Before, During and After. |
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GXT - Vo2 max |
Cardiovascular Fitness/Prognosis Changes with training Encourage to give 100% effort Critea:- - vo2 max & Hr plateu at increased workload. - RER >1.15. - Blood Lactate >8mmol. - RPE > 17. |
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Vo2 Max Definition |
Maximal intergrated capacity of the pulmonary, cardiovascular and muscular systems to transport, uptake and utilize oxygen. |
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What limits vo2 max? |
1) Respiration 2) Central Circulation 3) Peripheral Circulation 4) Muscle Metabolism |
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Respiration |
O2 Diffusion Ventilation Alvelor ventilation perfusion rate Hb-O2 affinity rate |
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Central Circulation |
Q Arterial Blood Pressure HB concentration |
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Peripheral Circulation |
Muscle Blood Flow Capillary Density O2 diffusion Muscle Vascular Conductance Hb-O2 affinity rate |
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Muscle Metabolism |
Enzyme and oxidative potential Energy stores Myoglobin Mitochondira - size and volume Muscle mass and fibre type Substrate delivery |
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Mean Transit Time |
Rest - 750ms Exercise - 300 - 400ms. Increased capillary bed increases MTT and allows greater oxygen extraction from the arterial blood. |
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Respiration & Lung Disease - 4 Stages |
1) Pulomary Ventilation 2) external respiration 3) transport of gas 4) internal respiration |
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Obstructive Lung Disease |
Intrinsic - inflamtion or scaring of lung tissue or filling of air spaces with debris. Extrinsic - chest wall, pleura or intercostals. |
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COPD |
Chronic Bronchitis - Inflmation/excess mucus. Emphysema - breakdown of alveoli membranes. Asthma - bronchial hyper responsivness and variable bronchoconstriction. |
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Asthma |
Normal - clear airway - dilated airway - loose smooth muscle - thin walls Asthma - narrowed airway - tightened smooth muscle - imflamtion of walls - thick. - mucus build up. |
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EIB/EIA |
Thermal Theory - Muscosal Cooling - Vasconstriction - Rapid rewarming - Vascular leakage/edema Osmotic Theory - Muscosal Dehydration - Increased osolarity - cell volume changes - mediators released - smooth muscle contraction - vascular leakage/edema |
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Field Testing |
Positives - Ecologicall valid - sports specific - large sample sizes - cost effective - time effective Negatives -reliability - internal validity - uncontrollable environment. - accuracy of results. |
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Field Testing |
Aerobic Endurance Muscular Strength/Endurance Flexibility Body Comp Power Speed Agility Coordination Reaction Time Balance |
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Muscle Metabolism (Sprinting) - Demands |
High force production Quick muscle contraction Rapid ATP breakdown & resynthesis High rate of Pcr breakdown High rate of Glycogen breakdown High phosofructokinase activity |
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ATP |
ATP removes a Phosphate (Pi) to release energy and form ADP. Creatine Kinase removes (P) from Pcr to form another ATP for energy. |
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ATPase and Fibre Types |
1 - low activity = slow release 2a - moderate activity = fast release 2x - high activity = fast release |
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Pcr Content |
Type 1 = 80-90mmol.g.drymass Type 2a = 80-90mmol.g.drymass Type 2x = 100-120mmol.g.drymass |
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10 Second vs. 20 Second |
10 Second -uses 55% Pcr -uses 13% glycogen -50mmol.kg.drymass lactate -32% vo2max 20 second -uses 73% Pcr -uses 18% glycogen -80mmol.kg.drymass lactate -57% vo2max |
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Lactate Metabolism |
Aerobic Training increases mitochondria, greater fat usage and less use of glycogen. = reduced glycotic flux = reduced lactate formation |
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Lactate Metabolism - lowering |
Reduce production, increase clearance. |
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Carb and Fat metabolsim |
Lipolytic activity highest in adipose tissue and skeletal muscle. Glycerol is a metabolite that is used as a marker of lipolysis. |
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Hormones |
HSL & ATGL Breakdown of Triglycerides |
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Cardiovascular Responses |
Diastole -Relaxtion (62%). Systole - Contracton (38%). |
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Stroke Volume and Ejection Fraction |
SV = EDV - ESV e.g. 60ml=100-40 EF= SV - EDV e.g. 60% = 60/100 |
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Cardiac Output Factors |
Pre Load - Myocardium Stretches, increases blood volume and greater contraction. Contractility - strength of contraction at a given pre load. Afterload - pressure at which ventricles must contract to open aortic/semi lunar valves. |
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Vascular Adaptations |
Preload -Increases after training -increases plasma/blood volume -no change in RBC Afterload - less resistance = increased Q - increase capillary bed of muscle |
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Short Term De Training - Metabolic |
Metabolic Increase RER Increase Sub Max RER Decrease Insulin Glucose Uptake Decrease Muscle Glut 4 Protein Content. Decrease Lipoprotein Lipase Activity. Decrease HDL Increase LDL Increase Sub Max Lactate Decrease Lactate Threshold Decrease Bicarbonate Decrease Muscle Glycogen |
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Short Term De Training |
Muscular Decrease Capillary Density Decrease oxidative Decrease glycogen synthase activity. Decrease mitochondrial ATP production Decrease mean fibre cross sectional area. Decrease EMG activity. Decrease strength/power. |
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Hypertension |
A transitory or sustained elevation of systemic arterial blood pressure to a level likely to induce cardiovascular damage or result in other adverse consquences. |
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Hypertension |
Primary - 95% Secondary - 5%. |
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Major Contributors |
Cebebrovascular Disease Myocardial Infarcation Heart Failure Peripheral Vascular Disease Renal Failure |
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Control of Blood Pressure |
Cardiac Output Total Peripheral Resistance Autonomic Nervous System The Renin-Angiotensin System |
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Causes of Essential |
Defect of smooth muscle in arterioles increase resistance in vessels. Kidneys are unable to excrete enough salt, therefore sodium and fluid is retained increasing pressure. |
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Other Causes |
Age Fam History Environment Sodium Intake Alcohol Weight Birth Weight Race |
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Secondary Hypertension |
Indentifiable cause, however removal of the cause doesn't gaurantee restoration. Renal Disease Drugs Pregnancy Endocrine - conns syndrome and cushings disease. Vascular Sleep apneoa |
