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Med Aspects of Exercise Exam 2
Terms in this set (66)
What helps develop the endometrium to prepare for delivery at the end of gustation by decreasing oxytocin receptors on the uterus? => less likely to have uteral contractions.
help the growth of breast ductal network & associates with fetal organ development during gustation.
Levels of this hormone rise at the start of labor and stimulate contractions of the uterine muscle.
Hormone that helps to establish the placenta. It stimulates growth of blood vessels that supply the womb and inhibits contraction of the uterus, so it grows as the baby does.
Aids in milk production
HCG peaks in what trimester?
Also maintains corpus luteum
Allows corpus luteum to produce estrogen and progesterone
human placental lactogen (hPL)
increases during the end of the first trimester and stays elevated throughout.
Increases lipolysis & insulin resistance in the mother after the first trimester. => fat in the blood and elevating blood glucose, advantageous to the fetus (feeding baby)
Human Chorionic Gonadotropin
This hormone is produced by the placenta after implantation. Known as the pregnancy hormone because this is what a pregnancy test detects to determine if you are pregnant or not.
This is the main hormone needed to produce breast milk.
Hormone that inhibits contraction to prevent premature birth. Works to relax the pelvic ligament and promotes smooth muscle relaxation.
works to increase our basal metabolic rate. It is also responsible for lipolysis. This hormone often increases during pregnancy. It's the increase in this hormone that can explain why pregnant women are usually warm. They have a larger core meaning that it is harder to dissipate weight.
Angiotensin I changes into Angiotensin II via a converting enzyme. The release of angiotensin II causes smooth muscle vasoconstriction along with the stimulation of aldosterone. Aldosterone works to increase blood pressure and blood volume via the reabsorption of sodium. (Where sodium goes, water follows) This whole process increases both preload and afterload.
physiological changes in pregnancy
- Increased tidal volume caused by an increase in metabolic activity
- Residual volume decreases
- Increased oxygen consumption
- Gait changes/altered center of gravity
- Heart enlargement/increase HR
- Weight gain (normal is 20-30lbs) compromised foot arch
- Increased frequency of urination
How does metabolism change
Because we have increased thyroid hormone, we can expect to see a pregnant women's basal metabolic rate increase 20-30%.
In the first trimester we can expect to see hyperinsulinemia caused by an increase in CHO metabolism and lipogenesis and in the 2nd and 3rd trimesters we see more insulin resistance
Also known as large gestational age (LGA) is a common condition in which a fetus or newborn weighs more than 4000 grams. When babies are large for their gestational ages, it causes the pregnancy to be considered high risk.
Risks factors that make a baby more likely to be macrosomic
- Obesity during pregnancy
- Maternal diabetes
- Overdue pregnancy
- Previous pregnancies
- Male baby
- Maternal age
~Something to note:
Stillbirths are greater for those born over 8.8lbs
Gestational Diabetes Mellitus
is a condition in which a hormone made by the placenta prevents the body from using insulin effectively, causing glucose build up in the blood instead of being absorbed by the cells.
risk factors associated with Gestational Diabetes Mellitus (GDM)
- Prenatal exposures
- Dietary patterns
- Physical/built environment
GDM & mother's delivery
She could experience a longer labor, the need of a c-section, maternal hemorrhage, and longer hospital stay.
Supine Hypotension Syndrome
a conditioned that a pregnant woman might experience while lying in the supine position. This specific position causes the uterus to place compression against the inferior vena cava and aorta, causing there to be a decrease in venous return, which can then lead to a drop in blood pressure.
a fall in SBP of at least 20 mmHg or DBP of at least 10 mmHg within 3 min of standing when compared with BP from sitting position.
Not considered unusual in the first weeks after birth. Women have said during this time they feel sad, not themselves, restless, irritable, and can at times cry for no reason.
Considered "Baby Blues that have gone too far" Women suffering with PPD are usually experiencing, guilt, low sex drive, insomnia, exhaustion, scary thoughts about baby, and feelings of hopelessness and or despair.
submaximal exercise responses for pregnancy
-Increased oxygen demand in weight bearing exercise
-increase use of CHO (except in 3rd trimester)
- Increased HR, SV, and Cardiac Output
-Dyspnea is common
-Decline in SV and CO during weight bearing exercise in late gestation
maximal exercise responses for pregnancy
-Absolute VO2 does not change but relative declines
-Later in gestation, we will see a decline in max HR and a decreased capacity to use glycolysis due to insulin resistance.
Cardiovascular changes during pregnancy
- An increase in resting heart rate by roughly 5-10 bpm
- Postural hypotension
Pulmonary changes during pregnancy
- A decrease in RV
- Increased work of breathing and ventilation
Exercise's affects on prenatal depression
Prenatal exercise can reduce the odds and severity of prenatal depression, however; prenatal exercise did not alter the odds of postpartum depression or the severity of depressive symptoms during or following pregnancy.
3 H's and a small d
refers to major mother and fetal risks that are associated with exercise.
-Hyperthermia: high core body temp (102 or greater)
-Hypoxia: low oxygen due to blood shunting
-Hypoglycemia: Low blood sugar
-Dehydration: low body water from excessive water loss (leads to hyperthermia)
guidelines to Exercise and Pregnancy
Women with uncomplicated pregnancies can exercise in moderation
Late pregnancy exercise may magnify maternal hypoglycemia
Exercise in the coolest part pf day or in water
Fetal HR should remain between 120-160 bpm
Do not start a new exercise program during first 15 weeks of pregnancy.
Avoid supine exercise
Low impact or non-weight bearing is suggested
3-5x/week 20-30 min session. 11-13 on the RPE scale
Diastasis recti & how to adapt an exercise program for it
as the partial or complete separation of the rectus abdominis caused by the uterus stretching and separating those muscles. When exercising post-partum, avoid exercises that increases that muscle separation (planks, oblique twists, crunches, leg raises)
contradictions to exercise during pregnancy
-Pregnancy induced hypertension
- Insufficient weight-gain (<1 kg/month in last 2 month)
-History of preterm labor
-Obesity, Diabetes, or Thyroid Disease
A severe complication of pre-eclampsia associated with extremely high blood pressure that can result in seizures. Most serious form of toxemia during pregnancy.
Android body shape
someone who carries more of their fat in the abdominal area. The "beer gut" = much greater risk for CAD
Gynoid body shape
those who carry more of their weight/fat in their hips.
many health consequences associated with obesity
- Low back pain
- Impaired fertility
- Pregnancy complications
refers to the increase in fat cell NUMBER
Refers to the increase in fat cell SIZE
the bigger culprit in terms of an individual being severely obesity, as it is associated with greater difficulty in losing weight.
critical periods in which we are most susceptible to an increase in the number of fat cells that we have
during our 3rd trimester, our first year of life, and in our adolescent years. This is when exceptional growth takes place
The reason we tend to see a significant weight loss in someone who has reduced their carb intake
When CHO leaves, water follows. So when we cut back on carbs, we tend to lose a great deal of water weight.
For each gram of CHO, there is an associated ______ grams of water.
There is a tendency for an individual to return to a certain weight following weight loss. This suggests that there might be some sort of biological "_________________" component for our body weight.
physiological signals related to set point theory
- glucose concentration
- body weight
The cognitive signals that are related to set point theory
- How do I look
- Size of clothing
- Perception of effort
Genetic factors account for about ________% of the transmissible variance for fat mass and percent body fat.
Cultural factors account for about ______% of the transmissible variance for fat mass and percent body fat.
- Southern cooking
- Modern food supply/availability
lifestyle and physical activity account for the other ____% of the transmissible variance for fat mass and percent body fat.
mechanisms related to Hypothalamic Obesity
- Hyperphagia, causing an increase in energy intake
- Impaired gut-brain satiety signaling
- Hormone deficiencies (GH, TSH, LH, FSH)
The Food Quotient (FQ)
the food you ate (mix of CHO and fat)
The Respiratory Quotient (RQ): represents the breakdown of the food/fuel your burning.
you're in nutrient balance and that weight is being maintained. Ratio is 1.0
RQ > FQ
not oxidizing (burning) as much fat as we consumed. Ratio is >1 and we are experiencing weight gain.
RQ < FQ
using/burning more fat than is being consumes. Ration is <1 and we are experiencing weight loss.
categories of energy expenditure
Thermic Effect of Food
Resting Metabolic Rate
Increasing our ____________- has the biggest impact on increasing our RMR and TEF
effect of exercise on appetite
Studies have shown that exercise decreases the levels of appetite by suppressing feelings of hunger
some behavioral modifications that can promote weight loss
- Planned PA
- Nutritional Education
- Accountability partner
- Record Keeping
- Cognizant of sitting/screen time
surgery that decreases our ability to absorb as much food by removing part of the small intestine to limit absorption (risk for deficiencies)
Surgeries that can decrease the stomach size
Decreasing the area that stomach has for food by inserting a small balloon into stomach.
Surgery that reduces the size of the upper stomach to a small pouch, this is performed by stapling of a section of the stomach. The surgeon then attaches this small pouch directly to the part of the small intestine. Overall, reducing amount of food you can eat.
Phenetamine and Sibutramine
inhibits intestinal lipase and causes 30% malabsorption
fad/ variant diets
Overall these do not promote lifelong weight control.
Why should you include exercise with diet restriction
-Exercise and diet restrictions promote a greater energy deficit
- Less reliant on diet
-Helps with long term control
Facilitate lipid mobilization and use
Programming recommendations for obese
150-300min/week or 50-60 min/day (3-5x/week), initial focus should be on aerobic exercise, once aerobic kcals met, then add resistance training, >2000 kcals week, gradual progression, WB exercise as tolerated.
exercise testing recommendations for obese
Closely monitor BP, expect low aerobic power, examine medical history, weight/exercise history
what percent of babies are born macrosonic?
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