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Exercise science oral questions

Terms in this set (17)

When should we take Vitals and Why?
HR BP, RR at the beginning of the session, after any body position changes and after any exercise. At the beginning we can get a baseline for vitals, monitor any changes that occur though the session as well as any abnormalities. BP is first taken when there is a change of position to determine if pt is hyper- or hypo- tensive. (BP drops so HR can increase and venous tone increases to maintain homeostasis.) HR is taken first after exercise to measure the heart's response to exercise and stress. RR is usually only taken at rest at the beginning of the session.
ORDER:
SUPINE/ SITTING = BP, HR, RR
STANDING = BP, HR
AFTER EXERCISE = HR, BP
Resting BP Measurement - What information does BP provide? What are the two numbers we consider? JNC-7 Categorization?
BP is the pressure of the blood against the arterial wall of the heart. Systolic Pressure is the higher number, it is the pressure in the artery during ventricular contraction. It is the estimate of the work of the heart & the strain on arterial walls during ventricular contraction. Diastole Pressure is the lower number, it is the pressure in artery during ventricular relaxation. It indicates the peripheral resistance/ease that the blood flows from arteriole → capillaries.
What clinical signs and symptoms would you see when a patient changes from a supine or sitting position to upright standing that would alert you that Orthostatic Hypotension was present? Why does this occur? What can we do to manage this clinical scenario?
Orthostatic hypotension is a form of low blood pressure that occurs when standing up from sitting or lying down.
SIGNS → Common symptoms include dizziness, lightheadedness, blurred vision, weakness, fatigue,
WHY →more blood is in the heart in supine and more in the distal extremities in upright position (postural hypotension)
- BP drops so HR may increase and venous tone increases to maintain homeostasis
MANAGE→
- Allow more time to attain homeostasis & monitor/guard
- deep breathing & add exercise to activate muscle pump. can work them back from standing to sitting. if necessary, sitting to supine (feet elevated).
Describe the HR Response to Acute Exercise & Recovery - What is a normal response of the heart in terms of rate, rhythm, ECG waveform changes? What values of HR affect the decision to continue or stop exercise?
HR 60-80 bpm Normal Sinus Rhythm (NSR)
HR increases in direct proportion to exercise intensity until Max HR reached
HR Recovery:
HR measured at a fixed period after cessation of activity, measured in 1 minute increments
*Best predictor of Cardiovascular Fitness *
A greater reduction in HR after Ex during this period indicates a better conditioned heart
HR that does not decrease 12 bpm or more within 1 minute of stopping Ex is associated with increased risk of cardiac death
Do not want to see: STOP Exercise!
•Failure of HR to increase
•Interruption of regular heart rate pattern (NSR)
Describe the BP/Circulatory Response to Acute Exercise - What is a normal response of the circulatory system both centrally and peripherally? What values of BP affect the decision to continue or stop exercise?
- Stop exercise when SBP > 250 mmHg DBP > 115 mmhg
- Normal response: dilation of the active muscles blood vessels increase the vascular area for blood flow
- activation of sympathetic NS
- Heart Rate increase
- Stroke Volume increases
- Cardiac Output (Q) increases
- Blood Flow to exercising muscles (cardiac and skeletal) increases. reduced TPR
- Blood Plasma Volume decreases
Why is there an increase in Stroke Volume during Exercise?
Frank starling mechanism
1. Enhanced diastolic filling
- increase blood volume
- increase venous return
- increased cardiac filling so increased volume of blood in the heart
2. greater systolic emptying due to :
-Increased preload - Increased cardiac filling in diastole leads to more forceful contraction in systole
- Decreased afterload due to decreased TPR from vasodilation of blood vessels
- Increased stretch to ventricles from increased blood volume creates increased force of contraction
3. Training Adaptations
- Increased blood volume and reduced resistance to blood flow in peripheral tissues
What are Signs of Exercise/Physical Activity Intolerance?
Overtraining syndrome symptoms :
unexplained/ persistent decline in physical performance
Decreased appetite / loss of body weight
Susceptibility to upper respiratory infections
Painful muscles
Insomnia
Overuse injuries
Occasional nausea
Elevated resting HR & BP
Disturbed mood states
Why is a Pre-Participation Screening Questionnaire important? What is the risk of PA/Ex?
- Pre-Participation Screening for presence of Risk Factors for cardiovascular, pulmonary, and metabolic conditions as well as other health conditions (pregnancy, orthopedic injuries) that would affect exercise prescription.
- Risk of sudden cardiac death or acute MI is greatest in those performing unaccustomed PA, and with vigorous activity PA. CVD risk of light to moderate intensity PA is similar to the risk at rest. Absolute risk of exercise-related CVD event is low for the initiation of light to moderate intensity exercise, and with gradual progression.
Why is postural and body segment alignment important?
- It is important because it takes the stress off other structures that are not made to withstand those forces. If you are in ideal posture the joints are in a neutral zone, the muscles are at optimal length-tension relationships and there is no excessive muscle muscle work needed to maintain position. In ideal posture & alignment the body can perform the greatest variety of movement options without pain & with greater mobility. You can improve breathing with good posture.
- Generally everyone has asymmetries within the body so that is normal but there are stretches and exercises that can be done to improve a person's level
- Ideal will have less pain, more movement, and tension length relationship is better with ideal posture
How would you explain Body Composition measurements and findings to your patient?
- Body composition is a way to compare & contrast the baseline of a patient's health to what it should for their height/weight/age.
- different types of tests include: BMI, BIA, waist to hip ratio and skin fold test
- If you are put in a certain category as a starting point you aren't - stuck there, you can make improvements and find yourself in a more normal range
When to terminate a test
- Patient says STOP
- Clinical Observation
- Onset of angina, SOB, wheezing
-Hemodynamic changes
- Failure of HR to increase with increase work load
- ECG responses
- Ataxia, Dizziness
P wave
atrial depolarization
QRS complex represents
ventricular depolarization
T wave represents
ventricular repolarization
PR interval
delay of AV node to allow filling of ventricles
QT interval
ventricular systole
U wave represents
repolarization of the purkinje fibers
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