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Physiol Asset and Prog Mang
Exam 1
41
Health Care
Undergraduate 4
11/17/2009

Additional Health Care Flashcards

 


 

Cards

Term
Body Composition Models
Definition
Level 1 = atomic (oxygen, carbon, hydrogen, other)
Level 2 = molecular (water, lipid, protein, other)
Level 3 = Cellular (cell mass, ECF, ECS)
Level 4 = Tissue-system (Skeletal muscle, adipose tissue, bone, blood, and other)
Term
BMI classifications
Definition
Men: normal (24-27), semi Obese (28-31), and severely obese (>31)

Women: Normal (23-26), semi obese (27-32), severely obese (>32)
Term
Body Mass Index facts
Definition
BMI (kg/m^2) = wt (kg)/Ht^2

BMI has limited ability to predict %BF and to accurately classify levels of body fatness.
-large muscle and bone mass in relation to the height can have high BMI
-people with small muscle and bone mass tend to have low BMI
Term
Waist to hip ratio
Definition
waist = narowest part of the torso. b/t the ribs and iliac crest . measure of both visceral and SC = abdominal

Hip= maximum posterior extension of buttocks. the widest point over the greater trochanters. influenced by SC fat only.
Term
HOw can waist to hip ratio be misled?
Definition
misleading info provided by changes in WHR over 20 year. simultaneous increases in W and H means WHR is stable despite increase in visceral fat. Thus, WHR provides crude index of absolute amount of abdominal fat, whereas WHR provides index or relative abdominal fat accumulation.
Term
Sex-specific cutoff points for waist cirmumference
Definition
Men: Lvl 1 >=94cm, Lvl 2 >= 102cm
Women: Lvl 1 >= 80cm, lvl 2 >= 88 cm
Term
Skinfold method
Definition
-Good measure of sucutaneous fat
-the distribution of SC and internal fat is similar for all individuals w/in each gender (old: less sc fat) (level of fatness: % of visceral fat decreases as total BF ^)

--The sum of several SKF's can be used to estimate total body fat (1/3 of total BF is sc)
--Biological variation in fat distribution is affected by age, gender, level of fatness
Term
BIA is based on....
Definition
the relation between the volume of a conductor and its electrical resistance
Term
A comprehensive pre-exercise test evaluation in the clinical setting generally includes:
Definition
a medical history, a physical examination, and laboratory tests
Term
What are four reasons to exercise test?
Definition
-exercise prescription, diagnosis, prognosis, and treatment evaluation
Term
Blood pressure
Definition
the average of two or more properly measured, seated BP readings recorded during each of two or more office visits
Term
Diagnostic purpose
Definition
0helpful for patients to discontinue prescribed cario medications
-currently prescribed anti anginal agents alter the hemodynamic response to exercise and significantly reduce the sensitivity of ECG changes for ischemia
-Patients taking intermediate or high dose beta blockign agents may be asked to taper their medication over a 2 to 4 day period to minimize withdrawal responses
Term
The cornerston of antihypertensive therapy
Definition
lifestyle modification, weight reduction, a DASH eatin plan, less Na in diet (no more than 2.4 g) , and moderate alcohol comsumption
Term
JNC7?
Definition
emphasizes that most patients w/ hypertension who require drug therapy in addition to lifestyle modification require two or more antihypertensive medications to achieve the goal BP

goal BP = <140/90 mmHg (<130/80mm Hg for people w/ diabetes or chronic kidney disease)
Term
Functional or prescription Purpose
Definition
-patients sould continue their medication regimen on their usual schedule
-Exercise responses will be consistent with response expected during ex training
-bring list of meds
-drink ample fluids over the 24 hour period before test
Term
end points for graded exercise test in health population
Definition
-plateau in oxygen consumption
-heart rate (age predicted max)
-lactate production (>8 mmol)
-rating of perceived exertion (RPE)
-RER > 1.15 respiratory exchange ratio
Term
Physiological and subject variables for GXT in clinical population
Definition
-highest oxygen consumption reached
-heart rate (age predicted maximum - 85%)
-RPE = 17
-signs and symptoms
Term
Test order
Definition
Resting measurements (HR, BP, height, weight, body composition)

Exercise measurements (CR endurance, muscular fitness, flexibility)
Term
Things to consider when interpreting test scores
Definition
-are the norms for a test specific to different ages and genders?
-do the norms represent the entire population for scores, from low to high?
-how do you interpret norms that use descriptors such as "excellent, average, poor"?
Term
Standard error of the estimate (SEE)
Definition
-variability is expressed as a standard error of the estimate (see)
-based on general distribution of scores n the population under a bell-shaped curve
-relates to the validity of a particular test item
-if fitness level is predicted from measurements mede in testin, there will be some degree of prediciton error
Term
Correlation coefficient (r)
Definition
MATHEMATICAL EXPRESSION OF HTE RELATIONSHIP B/T ITEMS OR VARIABLES
-relationship b/t a test score item that is predicted versus an actual measurement of hte same
-relationship may be positive or negative
-relates to validity of a test item as well as repeatability (reliability)
-the closer r is to 1.0, the greater the validity and reliability of hte score
Term
VO2 max!!!
Definition
the gold standard measure of cardiorespiratory fitness (very reproducible on same work instrument)
-depends on work instrument
highest on treadmill (walking ~6% lower than running)
lower (~5-11%) on cycle ergometer
-arm ergometer values 70% of leg ergo meater
Term
Criteria for Achieving VO2 Max
Definition
-Leveling off of VO2 with higher work rate (<150 ml*min-1 or <2.1 ml*kg-1*min-1)

-post ex blood lactate >8mmoles*L-1

-R>1.15

-HR w/in 10 beats*min-1 or age predicted maximal hr (usefulness has been questioned)

-Should not expect subjects to meet all criteria
Term
Is it necessary to reach VO2 max plateau?
Definition
-not all subject achieve a plateau in VO2 (this leads to development of secondary criteria)

-Several studies have demonstrated that a plateau is not needed for a "true" vo2 max

-highest vo2 measuredduring incremental exercise test not different from vo2 during subsequent test at higher work rate
Term
Estimation of VO2 max from last work rate
Definition
-direct measurement of vo2 max is often not practical and can be complex and costly

-can use equations to calculate estimated VO2 max from last stage of GXT (must allow time for subject to reach steady state in each stage)
Term
Error in estimating VO2 max
Definition
-equations developed by actually masuring VO2 max in large numbers of subjects
Term
Standard error (SE) in estimating vo2 max`
Definition
how far off the predicted vow max is from actual value (1 se describes 68% of estimates)

-vo2 max estimated from last stage of miximal tes (SE =3 ml*kg-1*min-1)
-vo2 max estimated from HR in submaximal test (se = 4-5 ml*kg-1*min -1 )
-vo2 max estimated from one mile walk or 12 minute run (SE =5ml*kg-1*min-1)
Term
Step Test facts
Definition
-simple, inexpensive equipment
-protocols differ in step height, and step rate
-Estimating vo2 max is based on extrapolating submaximal HR and can also use astrand and tyhming nomogram
Term
The heart rate is controlled by the _________ which is composed of the _____________ and the _____________.
Definition
Autonomic nervous system. sympathetic, and parasympathetic
Term
Regulators of the heart: reflex controls of rate
Definition
-range: about 50-near 200.
-typical resting: near 70
-AP conduction
-muscle contraction
-parasympathetic slows and sympathetic speeds
Term
Most common way to change cardiac output?
Definition
change heart rate
Term
What increases heart rate?
Definition
Sympathetic nervous system (crisis, low blood pressure)
-Hormones (epinephrine and thyroxine)
-exercise
-decreased blood volume
Term
What causes decreased heart rate?
Definition
-parasympathetic nervous system
-high blood pressure or blood volume
-decreased venous return
Term
Movement of blood through vessels
Definition
-most arterial blood is pumped by the heart
-veins use milking action to elp move blood
Term
pulse is a....
Definition
pressure wave of blood and is monitored at pressure points where pulse is easily palpated
Term
Factors that influence heart rate?
Definition
-central command
-baroreceptors
-chemoreceptors's
-hypothalamus
-muscle afferents
-hormonal
Term
RHR
Definition
-averages 60-80 beats per minute; can range from 28 bpm to above 100 bpm
-tends to decrease with age and with increased cardiovasscular fitness
-lower RHR=higher fitness level
-is affected by environmental conditions such as altitiude and temperature
Term
Resting heart rate and training
Definition
-decreases with endurance training due to more blood returning to heart
-in sedentary individuals can decrease by 1 beat per min per week during initial training
-highly trained athletes may have resting heart rates of 40 beats per min or less
-increased efficiency of hte circulatory system
-the heart will increase the volume of blood pumped per beat (stroke volume)
-peripheral muscle cells will become more e ffective at extracting oxygen from the blood passing through their capillary networkds
Term
measuring Resting heart rate
Definition
-immediately after awakening and before getting out of bed, measure your heart rate using your heart rate monitor or from the palpitating pulse from artery, counting the beats for 60 seconds.
-take these measurements for five consecutive days and find the average
-use the average as your resting heart rate
-RHR is dependent on numerous factors.

HRmax= 220-age(males)
Hrmax=226-age(bitches)
Term
Recovery heart rate
Definition
average amount of time it takes your pulse to go from its target heart rate zone back down to your resting heart rate zone at the end of an exercise.
-healthy recovery heart rate time: 3-5 min
Term
Heart rate training zones (5)
Definition
Zone 1 (<65% recovery runs), zone 2 (65-72% long runs), zone 3 (73-83% aerobic capacity), zone 4 (84-90% lactate threshold, race pace effort), and Zone 5 (91-100% speed work, anaerobic training)
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