KSS 467 MidTerm Review

What Percent of CHD are due to physical inactivity?

6%

CHD is worsened by physical inactivity and improved by physical activity

CHD (Myocardial Ischemia)

Lack of blood flow to heart muscle

Atherosclerosis

Buildup of plaque in the arteries

Myocardial Infarction

Heart attack; complete stoppage of blood

Coronary Heart Disease Risk Factors

Age, Family History, Cigarette Smoking, Hypertension, Dyslipidemia, Diabetes, Obesity, Physical Inactivity

What are the criteria for Family History CHD?

Myocardial infarction, coronary revascilarization, sudden death before 55 of first degree family in male, or 65 yrs female

What are the criteria for cigarette smoking in CHD?

Current smoker, exposure to environmental smoke, cessation within 6 months

What are the criteria for hypertension in CHD?

SBP 130 or above, DBP 80 or above, on hypertension medication

What are the criteria for Age in CHD?

Men 45yrs or above, Women 55yrs or above

What are the criteria for Dyslipidemia in CHD?

HDL 40 or below, LDL 130 or above, TC 200 or above, on lipid medication

What are criteria for Diabetes in CHD?

Fasting blood glucose 126 or above, HbA1C 6.5% or above

What are the criteria for Obesity in CHD?

BMI 30 or above, waist circumference 40in or above in men and 35in in women

What are the criteria for Physical Inactivity in CHD?

Not getting 30 mins MVPA at 3days/week for the last 3 months

View Blood Pressure Table for Adults

View Cholesterol Table for Adults

What are the risk factors of Metabolic Syndrome?

Hypertension, Dyslipidemia, Insulin Resistance, Abdominal Obesity (Must have at least 3)

What is the minimum health screening required for exercise perscription?

Administer ParQ+, Identify signs and symptoms of key diseases, analyze CHD risk factors, obtain signed consent

When do you need to refer a client to a physician for exercise?

If they answer yes on the ParQ extended, If they have a known disease (CHD, Metabolic, or Renal Disease)

What are the relative Contraindications?

Known obstruction in main coronary artery, Moderate to Severe Aortic stenosis, Tachydysrhythmias, Acquired heart attack, Hypertrophic obstructive cardiomyopathy, Recent stroke, Mental Impairment, Resting SBP 200 or above, DBP 110 or above, Uncorrected Medical conditions

What are absolute contraindications?

Acute myocardial infarction, Ongoing Unstable Angina, uncontrolled cardiac arrhythmias, Active endocarditis, Aortic stenosis, Heart failure, Pulmonary embolism/infarction, Myocarditis, Pericarditis, Aortic dissection, Physical disability

What are the 5 criteria of Infromed Consent?

Purpose, Risks, Benefits, Confidential, Questions

What is physical fitness?

The ability to perform without undue fatigue

What are the 5 aspects of physcial fitness?

Cardiorespiratory Endurance, Musculoskeletal fitness, Body Composition, Flexibility, Balance

What sequence do you test the aspects of fitness in?

Health History > Body Comp > VO2 max > 1-RM > Flexibility > Balance

What is Validity?

An assessment that is accurate (Direct and Indirect)

What is Reliability?

An assessment that is consistent and repeatable

Labeled ECG Diagram

What is the function of the Right Atrium?

Recieves doxygenated blood from superior and inferior vena cavae (the body), Passes blood the the tricuspid valve to the RV

What is the function of the Left Atrium?

Recieves oxygenated blood from the pulmonary veins (the lungs), passes blood through the mitral valve to the LV

What is the function of the Left Ventricle?

Recieves oxygenated blood from the LA, pumps blood through aortic valve in the aorta (the body)

What is the function of the RIght Ventricle?

Recieves deoxygenated blood from the RA, pumps blood thorugh pulmonary valve to pulmonary trunk (the lungs)

What is the duration, amplitude, and cardiac event of the P Wave?

D: < .11 sec

A: < 3mv

CE: Atrial Depolarization

What is the duration, amplitude, and cardiac event of the P-R Interval?

D: .12-.20 sec

A: isoelectric

CE: Atrial Activation, AV Node delay and conduction

What is the duration, amplitude, and cardiac event of the QRS Complex?

D: .05-.10 sec

A: 5-30 mv

CE: Ventricular Depolarization

What is the duration, amplitude, and cardiac event of the S-T Complex?

D: NA

A: -.05-1.0

CE: Ventricular Repolarization, slow phase

What is the duration, amplitude, and cardiac event of the T Wave?

D: NA

A: < 5 mv

CE: Ventricular Repolarization, fast phase

What is the main wave to calculate HR on an ECG graph?

Count the number of small boxes between two R waves and divide into 1500

What are the main leads to read an ECG?

II, AVF, V5, V6

What is the anatomical placement of the RL lead?

Just above iliac crest on the right dimple of the stomach for exercise

What is the anatomical placement of the LL lead?

Just above iliac crest on the left dimple of the stomach for exercise

What is the anatomical placement of the RA lead?

Just below the right clavicle medial to the deltoid

What is the anatomical placement of the LA lead?

Just below the left clavicle medial to the deltoid

What is the anatomical placement of the V1 lead?

Fourth interspace on the right sternal margin

What is the anatomical placement of the V2 lead?

Fourth interspace on the left sternal margin

What is the anatomical placement of the V3 lead?

Between V2 and V4

What is the anatomical placement of the V4 lead?

Fifth interspace at the midclavicular line just below the nipple

What is the anatomical placement of the V5 lead?

Midway between V4 and V6 on the anterior axillary line

What is the anatomical placement of the V6 lead?

Same transverse line as the V4 at the midaxillary line

What are the descriptors of Tachycardia?

HR 100 or above at rest, most commonly due to increased CO (Exercise)

What are the descriptors of Bradycardia

HR 60 or below at rest

What are the descriptors of Sinus Arrythmia?

Irregular HR rhythm

What are the descriptors of Premature Ventricular Contractions?

Skipping a beat, early or wide QRS, unrelated P wave

What are the descriptors of Ischemia?

Inverted or upside down T Waves

What are the descriptors of Injury or Infaction?

ST segment > 4mm

What are the reasons to do a VO2max Stress Test?

Screen for CV disease, follow progress known for CHD, Assessing exercise safety, Quantify CV fitness

What are the two categories of exercise testing?

Submax: less sensitive and stressful, at least 85% of HRmax

Graded Exercise Test: measure aerobic capacity with increased workloads

What are the criteria for a VO2max test?

O2 plateau with 150ml/min with increased workload

Within 10BPM of predicted HRmax

RER > 1.1

Lactacte > 8mM

RPE > 18

(Must have 3/5)

WHat are the two ways to quantify VO2max?

Direct: measure with a max test on a metabolic cart

Indirect: Estimate/Predict with equations and must be with 5 ml/kg/min to be valid

What are two ways to express VO2max?

Absolute: L/min or ml/min

Relative: ml/kg/min

What percent lower is females VO2 than males?

10-20% due to LBM

What happens with age to our VO2?

decreases 9%/decade after 25 yrs of age

What happens to VO2 with altitdue or pollutions?

Decreases

How much does VO2 decrease with bed rest?

20-40%

How much can you improve your VO2 with training?

5-40% depending on initial values

What is the range for active individuals VO2?

55-50 in males, 45-55 in females

What is the world record VO2?

80 ml/kg/min

What is a sedentary or obese individuals VO2?

Typically 18-22 ml/kg/min

What do resting HR, SBP, DBP need to be within before exercise testing?

HR needs 2 within 5

SBP needs 2 within 6

DBP needs 2 within 4

What do you need to collect every stage of exercise testing?

HR (last 10 sec)

BP (last 30 secs)

RPE (last 10 secs)

ECG

Appearance

RER, O2, VE, Lactate

What do recovery values need to be within after 1,3, & 5 mins post exercise testing?

HR (under 100)

SBP within 20 of rest

ECG

What are the ten termination signs of exercise testing?

Onset of angine

Drop of SBP

Shortness of breath

Excessive rise in BP

Failure for HR to increase

Poor appearance

Noticable change in ECG

Client requests to stop

Physical and verbal signs of severe fatigue

Equipment failure

What is the selection of the exercise testing dependent on?

Age, gender, health status, fitness

What are the modes of exercise testing?

TM-Walking, TM-Running, Cycling, Arm Crank, Field Tests

What is the formula to estimate VO2max when walking on a treadmill?

3.5 + spd(26.8)(0.1) + spd(26.8)(%grd)(1.8)

What is the formula to estimate VO2max when running on a treadmill?

3.5 + spd(26.8)(0.2) + spd(26.8)(%grd)(0.9)

What is the formula to estimate VO2max when cycling on a bike?

kgm/min = kpRPM6

VO2max = 3.5 + ((2(kgm/min))/BW in kg)

How do you calculate the VO2max of a multistage submaximal TM test?

SM= VO2 of the stage

(SM2-SM1)/(HR2-HR1)= b

VO2max = SM2 + b(HRmax - HR2)

What are some modes of field tests? Why are they useful?

Endurance Runs, Walking (Rockport), Step Test, Swimming

Inexpensive and good for large groups