Specialist PSI Exercise Module
CARDIOVASCULAR SYSTEM
• Main transport system – Gases– Food– Waste– Hormones– Minerals– Medications
• Heart rate - controlled by autonomic nervous system
Specialist PSI Exercise Module
• Circulation
–Pulmonary (to lungs)
–Systemic (to body)
–Coronary (to heart muscle)
• Blood vessels -
“tubes”
–Arteries - from heart to body
–Veins - from the body to the heart
–Capillaries - interchange of gases, food and waste
Specialist PSI Exercise Module
CONTRACTION OF HEART MUSCLE
• Heart muscle contracts automatically – spontaneous discharge of pacemaker cells
• Sino-atrial node - heart’s pacemaker located in right atrium. Impulses travel through atria to ventricles via A-V node.
• Heart muscle cells are connected
Specialist PSI Exercise Module
CONTRACTION OF HEART
• Parasympathetic activity slows the heart
• vagus nerve releases Acetylcholine
• Sympathetic activity quickens the heart
• release of Adrenaline and neurotransmitters
• Blood Pressure• cardiac output flowing into vascular system influences systolic pressure • resistance of blood vessels influences diastolic blood pressure
Specialist PSI Exercise Module
VOLUMES
• Stroke Volume
• Blood per beat
• Cardiac Output
• Blood per minute
• Maximal O2 Uptake
• Amount of oxygen that can be used in one minute – ml/kg/min
Specialist PSI Exercise Module
Age
% VO2 max
Maxim
al O
xyg
en
Up
take (m
l/kg
.min
)
Dressing
Making the bed
Walking (3mph)
Stair Climbing (slowly)
50
75
25
0
75
50
25
20
40
030 80
% VO2 max
100
100
Men
Specialist PSI Exercise Module
EFFECTS OF AGEING
At rest no major changes to heart rate, stroke volume or cardiac output due to age alone BUT when the system is challenged then there are age-related deficits – compounded by sedentary behaviour
• stiffness of heart wall (collagen)
• Maximal H.R.
• Maximal stroke volume
• Maximal cardiac output
• Maximal aerobic power – 10% per decade
• systolic blood pressure
• incidence of postural hypotension (failure of venous return)
Specialist PSI Exercise Module
Fallers vs Non-fallers
• Cardiac symptoms can affect falls– Syncope– Arrythmias– TIAs– Postural Hypotension
• Cardiac medications not a major risk except in combination with other medications (>4)
Specialist PSI Exercise Module
FUNCTIONAL CONSEQUENCES
• Tasks will require % of maximum in older person
• Unable to sustain submaximal activities
• Postural hypotension can lead to blackout / drop
attack / injury
• Fartlek training approach
• Circulation re-booster on major postural
transitions
Specialist PSI Exercise Module
EFFECTS OF TRAINING
• Increased time in Diastole ( heart health)
• Maximal aerobic power can be by
– Muscle oxidative enzymes
– Muscle capillarisation
– Stroke volume and cardiac output
• Relative increases similar to young people
• Everyday tasks require % of VO2 max
• Everyday tasks can be performed for longer with greater
ease
Hypertension and Postural Hypotension in some
Specialist PSI Exercise Module
PULMONARY SYSTEM
• Main transport system for gases
– Oxygen
– Carbon Dioxide
• Ventilation controlled by Nervous
System
– normally automatic (respiratory
centres in brain stem)
– some voluntary control (cortex
overides respiratory centres)
Specialist PSI Exercise Module
• Nasal passages• Larynx• Trachea• Bronchi• Bronchioles
• Terminal Bronchioles• Alveolar Ducts• Alveoli
• Gas exchange takes place rapidly in alveoli - large surface area surrounded by dense capillaries
Structure
Specialist PSI Exercise Module
VENTILATION
Inspiration is active
volume of thoracic cavity by
contraction of intercostal muscles and diaphragm
Expiration (at rest) is passive
volume returned to resting values
Specialist PSI Exercise Module
LUNG VOLUMES
Specialist PSI Exercise Module
EFFECTS OF AGING
• Stiffness of chest wall
• Strength of respiratory muscles
• Elastic recoil in lung
• Residual dead space
• Functional area of lung
• Cartilaginous support
• Thickening of mucosal lining
• Sensitivity of respiratory centres
Specialist PSI Exercise Module
FUNCTIONAL CONSEQUENCES
System still adequate for sub-maximal activity
• Respiratory work
• Oxygen costs of many activities
• Breathlessness may reduce tolerance of
exercise
• maximal voluntary ventilation
• mechanical efficiency of movement
• posture
Specialist PSI Exercise Module
EFFECTS OF TRAINING
• maximal voluntary ventilation
• mechanical efficiency of movement
• posture