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2/16-2/20 notes

by: Alec Greenspoon

2/16-2/20 notes KIN 545

Alec Greenspoon
GPA 3.65
Special sport populations
Dr. Smith

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About this Document

All notes from lecture and class discussion
Special sport populations
Dr. Smith
Class Notes
25 ?




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This 8 page Class Notes was uploaded by Alec Greenspoon on Sunday February 22, 2015. The Class Notes belongs to KIN 545 at University of Miami taught by Dr. Smith in Spring2015. Since its upload, it has received 111 views. For similar materials see Special sport populations in Kinesiology at University of Miami.

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Date Created: 02/22/15
KIN 545 216220 21615 Know MTOR not part of protection against IR injury Stress testing exercise and heart disease Systolic vs diastolic HF APOB APOA CRP A1c SRB LPL ABCA1 LCAT CETP Heart murmur Dilated vs hypertrophic cardiomyopathy 022 32015 0 Hypertrophic thickening of walls smaller chambers o Dilated heart becomes frail and overstretched Can be caused form high EDV Vagal vs sympathetic tone and inotropic vs chronotropic Stress test EKG is only 40 predictive Preload force generated by the heart Afterload pressure in the aorta LV or pulmonary artery RV that the heart has to overcome Increases with hypertension 0 Can lead to hypertrophic cardiomyopathy Pulmonary disease can lead to RV hypertrophy Systemic circulation low 02 dilates low C02 constricts Pulmonary circulation low 02 causes constriction low C02 causes dilation COPD patients increase right side hypertrophy Resistance training increases left side hypertrophy 21815 CVD Atrial systole Early vent systole Late vent systole Early vent diastole Late vent diastole 0 EKG o QRS complex indicates ventricular depolarization Sodium moved into heart potassium out 0 Signi cant Q wave indicates heart attack Red line across screen is aorta pressure Yellow line is atrial pressure Blue line is ventricular pressure Green is EKG 1 and 52 are heartbeats Murmur results from AV valves not closing in sync T wave is ventricular repoarization potassium coming out ST depression signi es ischemia Pressure differences drive openingclosing of valves Sodium channels open wave of depolarization Papillary muscle prevents vave from relapsing o Mitral valve on left Not optimal lling diastolic heart failure Preload gt afterload rapid ejection Ef ux of potassium causes repoarization 0 High potassium eve outside the heart heart won t repoarize o Sodiumpotassium ATPase recycles the potassium o lschemic heart cannot generate enough ATP No energy to drive sodiumpotassium pump 0 Premature ventricular contraction PVC is very large on EKG 5060 of ventricular blood volume shoud eject OOOOOO SA node generates its own action potential 0 100bpm if not innervated at all Greater vagal innervation parasympathetic AV node automaticity is 4060 bpm o P wave would be missing if AV node is pacing heart Athletes with increased vagal tone increase the delay to allow further lling of the ventricle Mechanism of slowing down heart is increased permeability of potassium 0 Greater repolarization so further from threshold Plateau is caused by equal conentrations of sodium and potassium lnotropic increased contractility Cronotropic increases heart rate Atropene is parasympathetic blocker o Inhibits ACH Slow response vs fast response cells 0 Slow response have automaticity Vasodilators 0 Systemic C02 is vasodilator 02 is vasoconstrictor 0 Pulmonary C02 is vasoconstrictor 02 is vasodilator o COPD will lead to right ventricular hypertrophy 0 High C02 in lungs causes vasoconstriction 22015 Heart failure main points to study Bainbridge re ex and tachycardia Reactive oxygen species and its effect on nitric oxide PVD and bradycardia Problem with aerobic exercise Treppe phenomenon w regard to arrhythmia 0 True sensitivity of cardiovascular testing Abnormal chronotropic response to aerobic exercise 0 HR response to ventilatory threshold 0 Post testing BP and HR DBP changes related to ischemia Thallium stress test nonexercise V02 peak instead of V02 max 0 Why is upper body ergometry used often in cardiorehab patients Vagas nerve PNS increases potassium permeability o Takes it further away from threshold 0 Athletes have greater vagal tone Sympathetic NS increases permeability to sodium Increases HR Postitive chronotropic and inotropic effects Heart failure patients have high resting HR and low max HR 0 Limited capacity for exercise Central command 0 Greatest control over HR during exercise 0 On way down the spinal cord stimulates HR receptors to raise HR Abnormal chronotropic response because central command is in charge of that o Weakened heart doesn t have enough output to supply brain along with working muscles which are vasodilating o Shunts blood to brain thus taking blood away from working muscles and causing ischemic pain Carotid artery palpation o Baroreceptors are over sensitive from peripheral vascular disease 0 End up with bradycardia Slow HR Sign of conductance blockage in heart or signi cant PVD Magnesium is cofactor for ATPase 0 Important for energy production Vasodilation from low oxygen increased C02 0 High level of free radicals and in ammation 0 NO inhibits calcium release thus preventing vasocontriction o Reacts with radicals to form peroxy nitrate Less NO available to cause vasodilation o Anthocyanins from blue and purple fruits are great for vasodilation o Nitric oxide supplements can cause decreased sensitivity to NO not good EKG 0 Lateral leads I AVL V5 and V6 0 Inferior II III and AVF o AVR right Septal V1 and V1 0 Anterior V3 0 Elevated ST segment is probably acute myocardial infarction Premature atrial beat 0 Early P waves not signi cant 0 Right ventricular hypertrophy 0 Big QRS across V1 decreases from V1V4 height 0 Common in COPD patients Irritable focus 0 Muscle ce not getting enough oxygen Not enough energy for NaK ATPase pump Fires early less dopolarization heart is now being paced by nonpacemaker Entire heart depolarizes from PVC premature ventricular contraction n Several in a row are dangerous I More calcium left over from early firing stronger ensuing contraction Treppe phenomenon O O O 0 High heart rate greater contractility More calcium left over from previous beat stronger contractions PVCs are strong Results in less end diastolic volume faster HR Dangerous heart quivering and not pumping properly 0 Signi cant Q wave would indicate infart somewhere in the heart ECG testing 0 True sensitivity is only 4050 0 0 Limited exercise capacity heart disease patients 1 MET discrepancy becomes a big deal Sub max testing not used in these patients Unable to achieve 80 of max HR expected 0 Abnormal chronotropic responseweakened heart and sign of O O O O O 0 advanced heart failure Inability to reassert vagal tone Talkless point during exercise Healthy people have negative de ection in HR Heart disease patients have positive de ection in HR Absolute stop test indicator Systolic BP fails to rise during exercise or decreases Diastolic increase greater than 10 compared to resting level Sign of ischemia 3 minutes post exercise BP should be less than it was at 1 min suggests ischemic abnormality if not lack of vagal tone


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