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Transcript
Assistant Prof: Nermine Mounir Riad
Ain Shams University, Chest
Department



Oxygen is consumed in the production of
ATP and that co2 is produced as waste
product.
Respiratory quotient(RQ) this ratio of o2
consumption to co2 production.
 It equals 0.8

Takes place by means of diffusion of
substances.
External respiration:(within the lungs)
 Respiratory exchange ratio(R) is the ratio
of this exchange within the lungs
between oxygen and carbon dioxide.
R= 200/250=0.8
Internal respiration:(within the muscles)
Gas exchange and nutrients.

1- The fuel needed for ATP production must
be supplied.
2-waste products that result from ATP
production must be removed.
Metabolism parameters:
1-oxygen consumption:
-Normally at rest average 250 ml/min (3.5-4
ml/min/kg), with exercise it will increase
directly with the level of muscular work, VO2
increase until exhaustion occurs and
maximum level of O2consumption(VO2max)
is reached.
- VO2 max is a reproducible , well defined
physiologic end point so it is used as a
definitive indicator of an individual s
muscular work capacity. Normally range
from 1700-5800 ml/ min
2- CO2 production:
 Normally 200ml/min (2.8 ml/min/kg)
 During the initial phase of exercise it
increase at a rate similar to VO2, once
the anaerobic threshold has been
reached , VCO2 increases at a faster rate
than VO2. the faster rate is the result of
additional CO2 production from
HCO3/CO2 buffering mechanism.
3-Anaerobic threshold:
 In normal individuals occurs at
approximately 60% ± 10% of the
persons VO2 max.
 At the onset of the AT , there is marked
increase in CO2 production because of
lactic acid buffering and a compensatory
increase in ventilation.
 After the onset of the AT, a
breathlessness develops and a burning
sensations begins in working muscles.
4-Respiratory Quotient:
 CO2 production ↑ during exercise esp. after
the AT has been achieved →↑RQ from
resting levels of 0.8 to beyond 1.0
 The subject will be able to continue exercise
for a short period of time as much as 1.5
5-Blood PH:
 Remains relatively unchanged till the onset
of AT → the blood gradually becomes more
acidotic as the body is less able to buffer the
excessive acid (H)produced by anaerobic
metabolism.
1-Minute Ventilation:
 Normally = 5-6 l/min,100l/min in maximal
exercise.
 At the very start of an exercise → vent. ↑(d.t.
resp. centers stimulation by the brain motor
cortex and joint proprioceptors)
 Humeral factors (chemoreceptors) do the fine
tuning of vent.
 The level of vent. Continue increasing
correspondingly with the increase of the
workload till AT reached → vent. ↑ in a rate
greater than the rate of workload ↑to
compensate for the additional C02 produced
during anaerobic metabolism.
2-Tidal volume:
 Normally = 500 ml, 2.3-3 L during
exercise
 Increase early in exercise and are initially
responsible for the increase in vent.
3-Breathing Rate:
 Normally = 12-16bpm, up to 40-50 bpm
 Responsible for the increase in minute
ventilation that occur late in maximal
exercise, esp. after AT reached
4-Dead space/ Tidal volume Ratio:
 Normally= 0.20-0.40, ↓ during exercise
0.04-0.20
 ↓significantly during exercise d.t ↑in tidal
volume with constant dead space
5-Pulmonary capillary blood transit time:
 Normally= 0.75 second, ↓ 0.38 second
d.t ↑ C.O.
6-Alveolar-Arterial Oxygen Difference:
 Normally= 10 mmHg changes little until
a heavy workload is achieved . However,
it can increase to 20-30 mmHg.
7-Oxygen Transport:
 Local conditions of increased temp.,
PCO2 and a relative acidosis in the
muscle tissues → greater release of
oxygen by the blood for use by the
tissues for metabolism.
1-Cardiac Output:
 Normally = 4-6L/min up to 20L/min
 Increase linearly with increases in the
workload during exercise till the point of
exhaustion.
 At work levels of up 50%of an individuals
exercise capacity, the ↑ in C.O is d.t ↑ in
heart rate and stroke volume together.
After this point, it ll be d.t. in ↑ heart
rate.
2-Stroke Volume:
 Normally = 50-80 ml can double during
exercise.
 Increase linearly with increase in
workload until a maximum value is
achieved, ≈ 50% of an individuals
capacity for exercise.
 After a HR of about 120bpm , there is
little additional increase in SV → CO
increase based in HR.
3-Heart Rate:
 Can increase as much as 2.5-4 times the
resting HR.
 HR max is achieved just prior of total
exhaustion, considered as physiologic
end point for each individual.
 HRmax (±10bpm)= 210-(0.65X age)
 HRmax (±10bpm)=220- age
4-Oxygen pulse:
 In order to meet the demands of
increasing muscle work during exercise,
each heart contraction must deliver a
greater quantity of oxygen out to the
body.
 O2 pulse= VO2/HR
 Normally = 2.5-4 ml o2/ heart beat up to
10-15 ml in exercise.
5-Blood pressure:
 During exercise→↑systolic blood pressure (up to
200mmHg) while diastolic blood pressure remains
relatively stable( may ↑up to 90mmHg)
 Pulse pressure (difference between systolic and
diastolic pressure) ↑ during exercise.
6-Arterial- Venous Oxygen Content Difference:
 During maximal exercise the difference ↑2.5-3 times
the resting value. (N. 5 vol%)
 The ↑ is due to the greater amounts of O2 that are
extracted by the working muscle tissue during exercise.
7-Distribution of circulation:
 Circulation to the skeletal muscles
increases which in turn increase the
cardiac output.
 Circulation to the heart ↑.
 Skin perfusion ↑ as cooling mechanism for the
body but can ↓ at extreme exercise levels (as the
muscles demand ↑)
Thank you