PET 4551 Study Guide for Final Please know material from previous study guides Know how to use the metabolic equations Walking Running 1 2 3 VO2 mL kg min 3 5 mL kg min Speed m min x 0 1 grade x speed x 1 8 VO2 mL kg min 3 5 mL kg min Speed m min x 0 2 grade x speed x 0 9 Leg Ergometer cycle VO2 mL kg min 7 0 mL kg min kgm min x 1 8 body weight in kg Know terms for isometric eccentric concentric isokinetic isotonic muscular strength muscular endurance and flexibility Know the physiological mechanisms of how strength increases over time Isometric same length hand grip dyanometer Eccentric length of the muscle increases should last 3 4 s Concentric length of the muscle shortens should last 2 3 s Isokinetic same velocity speed control rehab machines biodex Isotonic same tension free weights Muscular Strength 1 RM the maximal amount weight that can be lifted one time through the full range of motion Muscular Endurance A submaximal amount of weight that can be lifted over a period of time push ups curls Flexibility ability to move the joint through a full range of motion Time Course of Strength Training Decrease in reflexive protective mechanism Increase in number of motor units recruited Increase in motor unit synchronization Increase in motor unit firing rate Hypertrophy in Type I II fibers Increase in size or myofibrils Increase in total amount of contractile proteins Increase in lean body mass Neural Adaptation 1st 1 2 weeks 4 Know conduction blocks First Degree Second Degree Mobitz Type I or Wenckebach Block Mobitz Type II Third Degree Heart Block Conduction Blocks Obstruction of the electrical conduction 1 Sinus Node Block indistinguishable from sinus arrest 2 AV Block block around the AV node 3 Bundle Branch Block block in the ventricular bundle branches AV Block 1st degree 2nd degree 3rd degree 1st degree prolonged delay of conduction at the AV Node PR Interval is 0 2 s every atrial impulse gets through to ventricle 2nd degree not every atrial impulse gets through Two Types of 2nd degree block 1 Mobitz Type I 2nd degree or Wenckebach Block PR interval gets longer until drop beat Wenckebach block w in the AV longer and longer delay until one does not go through usually over 3 or 4th one 2 Mobitz Type II Block below AV node progressive lengthening of the PR interval does not occur EKG shown norm PR interval and QRS complex then there will be a dropped beat no QRS complex 3rd degree No atrial impulses make it through to activate the ventricles Ventricles respond by generating an escape beat at a rate of 30 45 b min Atrial beat is normal around 60 100 b min QRS are wide because of the ventricles origin 5 Know what the right and left bundle branch blocks look like Know characteristics Diagnose by looking at the width and configuration of the QRS complex Bundle Branch Block Right Bundle Branch Block Conduction on the right side of the heart occurs after the left side has depolarized This causes two things to happen 1 QRS complexes 12 s 2 V1 V2 will have RSR pattern lateral left leads I AVL V5 and V6 will have deep S waves Left Bundle Branch Block Lateral left leads I AVL V5 V6 will have marked prolongation in the R waves which will have a broad or notched top Leads over the right ventricle will have a deep S wave Left axis deviation may also occur 6 Know all of the arrhythmias including the two preexcitation conditions and the stages of a myocardial infarction Know how to diagnose a Myocardial Infarction What tests do we do Pre excitation Syndromes When conduction is generated more quickly than usual Wolf Parkinson White Syndrome Bypass called Bundle of Kent PR Interval 0 12 s QRS Complex widened and sloped wave called the delta wave Lown Ganong Levine Syndrome Accessory pathway is intranodal James Fibers PR interval is shortened Can cause arrythmias such as paroxysmal supraventricular tachycardia Atrial Fibrillation which can go into Ventricular Tachicardia PR goes to isoelectric line QRS not widened No delta wave This syndrome is characterized by a short PR interval 0 12 seconds and a normal QRS complex due to rapid atrioventricular conduction Heart attacks myocardial infarction Occlusion of a coronary artery 3 ways to determine or diagnose a MI History and Physical Examination Cardiac Enzymes creatine kinase myocardial bands females 10 70 males 25 90 lactate dehydrogenase aminotransferase glutamicoxaloacetic transaminase SGOT EKG Troponin I During an acute infarction the EKG evolves thru 3 stages 1 T wave peaking then inversion indicates ischemia not infarction 2 ST segment elevation indicates injury 3 Appearance of new large Q waves irreversible myocardial cell death never found in AVR Large Q waves of 04 in duration and 1 3 of R wave never look in AvR indicative of old Myocardial Infarction 7 Why do we have pacemakers What do the different rhythms look like with the different pacemakers People who need pacemakers are patients with Third degree complete AV block A lesser degree of AV block or bradycardia e g sick sinus syndrome if the patient is symptomatic esp in atrial fibrillation The sudden development of various combos of AV block and bundle branch block in patients who are in the throes of an acute myocardial infarction this situation usually only requires a temporary pacemaker that can be removed after the acute incident has resolved Recurrent tachycardias that can be overdriven and thereby terminated by pacemaker activity Fixed Pacemakers have two modes resting and exercise mode Sequential Pacemakers have more modes Page 189 ECG Product EKG from a patient with a ventricular pacemaker has spike due to pacemaker fire and leads to a retro P wave sharp waves EKG from a patient with an atrial pacemaker will generate a spike followed by a P Wave and a Normal QRS complex With a sequential pacemaker 2 spikes will be seen one preceding a P wave and one preceeding a wide bizarre QRS complex 8 Know what happens to the cardiovascular and muscular system with aerobic and strength training in other words what are the mechanisms behind the physiological improvements Found in Other Study Guides 9 Know the components of physical fitness Components of Physical Fitness Body Composition Muscular Strength and Endurance Flexibility Cardiovascular 10 Know the components of an exercise program how long should you spend on each component Components of Exercise Program Warmup 5 10 mins Active Warmup Stretching Aerobic Strength Cool Down 20 30 mins 20 30 mins 5 mins Active cool Down Stretching
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