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PET4551 SG Exam 2 5/27/12 9:16 PM EXAM 2 ***** (Exam 1- Pg 14, Final – Pg 27) 1.# Know#previous#study#guide.####3.# When#should#you#stop#a#stress#test?#• Drop in SBP of > 10 mmHg with increase in workload • Onset of angina or angina-like symptoms • Failure of heart rate to increase • Excessive rise in BP: SBP>250 mmHg or DBP > 15 mmHg • Shortness of breath, wheezing, leg cramps, claudication • Noticeable change in heart rhythm • Signs of poor perfusion: light-headiness confusion, pallor (pale), nausea, cold and clammy skin, cyanosis • Technical difficulties (can’t get BP or HR) • Subject’s desire to stop • ST segment elevation (+1.0 mm) – that can mean ischemia or lack of BF • Increasing nervous system symptoms (dizziness) or having a panic attack #4.# What#are#some#field#tests#that#we#use#to#measure#cardiorespiratory#fitness?# fixed distance tests, fixed time tests 5.# What#are#some#of#the#advantages#and#disadvantages#of#submaximal#testing?#• Advantages*o Inexpensive*o Personnel*require*minimal*amount*of*training*o Allow*for*mass*testing*o Test*itself*is*shorter*in*duration*(compared*to*Max*test)*o Safer*since*it*does*not*require*maximal*exertion*o No*physician*needed*if*low*risk*o VO2*max*can*be*estimated*o Heart*rate*and*BP*are*monitored*o Useful*in*documenting*changes*due*to*intervention*programs*• Disadvantages#o Maximal*HR,*BP,*RPP*are*not*measured*o VO2max*not*directly*measured*o Limited*diagnostic*va lu e*er ror s*ran ge *from *10O20% *o True*max*HR*is*not*obtained*for*exercise*prescription**6.# Identify#sources#of#errors#th at#ar e#invo lved #in#su bmaximal#testing.#• Errors*in*the*measurement*of**workload*or*HR#• Age*predicted*max*HR#o Variability*between*individuals#• Variability*in*mechanical*efficiency*#o Some*people*will*require*less*O2*to*perform*a*given*work*rate#• Variability*in*submaximal*HR*at*the*same*work*rate*on*diferent*days#7.# What#are#the#four#assumptions#we#make#when#doing#submaximal#testing?#• 1.*A*steady*state*HR*is*obtained*for*each*exercise*work*rate.*• 2.*A*linear*relationship*exists*between*HR*and*work*rate.*• 3.*The*maximal*HR*for*a*given*age*is*uniform.*(220*–*age)*• 4.*Mechanical*efficiency*is*similar*for*everyone.**(this*can*differ*among*people*as*far*as*efficiency..*o Ex.*Short*people*on*bench*test*need*to*expend*more*energy*than*someone*taller*to*step*up*and*dow n.**o Another*Ex.*Less*coordinated*people*expend*more*energy*to*do*the*same*thing*also).**8.# What#is#meant#by#steady#state?#• Steady*state*=*HR*Doesn’t*increase*more*than*+*or*–*5*bpm*#9.## What#is#the#Rating#of#Perceived#Exertion#Scale?#• A*valuable*indicator*for*monitoring*an*individual’s*exercise*tolerance#10.# Know#general#procedures#for#submaximal#testing#cycle#and#bench#step.#• Submax*Test(page*123)#• Bench*Step*Test*(page*113)#11.# Know#systolic,#diastolic,#and#mean#arterial#pressure.##Know#how#to#calculate#MAP,#PP,#a nd #RP P.##• Indirect*Measure*o f*M AP*o HR*<*100*b/min*§ MAP*=*(1/3(SBPODBP))*+*DBP*o HR*>*100*b/min*§ MAP*=*(1/2(SBPODBP))*+DBP*• Direct*measure*of*Mean*Arterial*Pressure*(MAP)*o MAP*=*CO*x*TPR***• Pulse*pressure:*(SBP*–*DBP) • Rate*Pressure*=*(HR*x*SBP)/100* #12.# Know#how#to#calculate#the#heart#rate#reserve#from#the#Karvonen#Formula.##Be#able#to#calculate#intensity#or#target#heart#rate.#• Target*HR*=*[(HRmax*–*HRrest)%]*+*HRrest*• Heart*Rate*Reserve=*HrmaxOHRrest#13.# Know#how#to#calculate#relative#or#absolute#VO2.#• Relative*VO2:*mL/kg/min#• Absolute*VO2:*L/min#14.# Know#the#different#ECG#leads#chest#leads,#limb#leads,#precordial,#extremity,#unipolar,#bipolar.#• Frontal / Extremity/ Limb Leads (6) o Bipolar: I, II, III o Unipolar: AVR, AVL, AVF § aVr=augmented voltage right arm, aVL=left arm and aVf=left side foot (not actually placed on the foot though) • Chest/ Precordial Leads (6)- measure the horizontal plane o V1, V2, V3, V4, V5, V6 (all Unipolar) § Lead V1 fourth intercostals space to R of sternum § Lead V2 fourth intercostals space left of the sternum § Lead V3 midway btwn leads V2 and V4§ Lead V4 midclavicular line 5th intercostals space § Lead V5 anterior axillary line same level as V4 § Lead V6 midaxillary line same level as V4 • Bipolar Leads are named because of the differences in electrical voltage between two unipolar extremities o Lead 1 = LA –RA (aVL – aVr) o Lead 2 = LL – RA (aVf – aVr) o Lead 3 = LL – LA (aVf – aVL) o Lead I + Lead III = Lead II o aVr + aVL + aVf = 0 • Small box vertically (amplitude) = 1 mm, large box = 5 mm • Small box horizontally (time) = 0.04 sec, large box = 0.2 sec #15.# Know#how#to#calculate#heart#rate.#• Methods*for*HR*o Small*box*method:*1500/#*of*small*boxes*o Large*box*method:*300/#*of*large*boxes*o 6Osecond*method :*coun t*num b er*of*peak s*in*a*6*secon d*interval*starting*with*0*• Small*box*vertically*(amplitude)*=*1*mm,*large*box*=*5*mm*• Small*box*horizontally*(time)*=*0.04*sec,*large*box*=*0.2*sec**16.# Know#how#to#calculate#work#load#in#kgm /m in#or#w a tts.###• Watts*=*((kg)(m)/min)/6.12*#17.# Know#equation#for#VO2max#and#cardiac#output.#• Fick*Equation:*VO2*=*CO*x*(aOv)O2*difference*• * CO=*HR*x*SV*#18.# Why#does#heart#rate#increase#when#one#goes#from#the#supine#position#to#standing?#• HR*is*lowest*in*supine*position.*This*is*because*blood*pools*in*the*chest*and*SV*is*highest.*HR*when*standing*is*highest*because*blood*pools*in*the*legs*and*SV*decreases*due*to*gravity.*CO*stays*the*same*in*upright*and*supin e*po sition s*du e*to *the *cha ng es*in*HR*and *SV.*• #19.# What#happens#to#systolic#BP,#diastolic#BP,#heart#rate,#RPP,#PP,#and#MAP#when#you#start#exercising?#• SBP*increases,*DBP*stays*the*same*or*decreases,*HR*increases*to*100*because*of*a*decrease*in*PNS*activity,*HR*increases*beyond*100*because*of*an*increase*in*SNS*activity,*Catecholam ine’s*bind *to*betaOreceptors*at*the*SA*node*of*the*heart,*making*it*fire*more*often.**RPP*increases,*PP*increases,*MAP*increases*because*CO*increases*more*than*T PR *d rop s,*CO *in cr ease s,*SV*in cr ea ses*u p*to*40O50%*VO2*max*due*to*an*increase*in*plasma,*VO2*increases**• SBP*increases*as*it*is*indirect*measure*of*CO;*DBP*decreases*or*stays*the*same*as*it*is*an** indirect*measure*of*T PR**• CO*=*HR*x*SV*o HR*during*exercise*increases*because*§


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FSU PET 4551 - EXAM 2

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