A.

The Human Heart

The human heart is an organ that pumps blood throughout the body via the circulatory system,
supplying oxygen and nutrients to the tissues and removing carbon dioxide and other wastes. Thus,
the heart may be considered one of the most important organs of the body, such that even small
dysfunctions or abnormalities may cause drastic changes or effects in the human organism. Its
working mechanism is made possible by the many parts that operate together. The organ is divided
into several chambers that take in and distribute oxygen-poor or oxygen-rich blood. These
chambers are accompanied by veins and arteries that facilitate the same function. With all of its
parts working together towards the same goal, the heart successfully pumps blood with ease.

Structure of the Heart

The heart can be found at the center of the chest, underneath the sternum in a thoracic compartment.
It is made up of four chambers and several valves that regulate the normal flow of blood within
the body.
Two chambers called atria are located in the upper portion of the heart and receive oxygen-free
blood. The valves that separate these chambers are called atrioventricular valves which is
composed of the tricuspid valve on the left and the mitral valve on the right.

On the other hand, ventricles are chambers found on the lower portion of the heart; they pump
oxygen-enriched blood into all organs of the body, reaching even the smallest cells. Similar to the
atria, the ventricular chambers are also separated by valves. Collectively-termed as semilunar
valves, these are comprised of the pulmonary and aortic valve.

A double-walled sac called the pericardium encases the heart, which serves to protect the heart
and anchor it inside the chest. The heart also has a wall that is composed of three layers:
epicardium(outer thin layer), myocardium (middle thick layer), and endocardium(inner thin
layer).

The structure of the heart is made more complex because of the mechanisms that allow blood to
be distributed throughout the body and to return into the heart. Facilitating this continuous process
are two types of blood vessels: veins and arteries. The vessels that bring oxygen-free blood back
into the heart are called veins; those that bring oxygen-rich blood away from the heart and to other
body parts are called arteries. Functioning in the left ventricle, the largest artery is called aorta.
The aorta is considered a main artery in the body.

With regular functioning, the heart is continuously able to supply sufficient amount of oxygen to
all parts of the body.
Human Heart Function

The heart is the main organ in the circulatory system, the structure primarily responsible for
delivering the circulation of blood and transportation of nutrients in all parts of the body. This
continuous task uplifts the role of the heart as a vital organ whose normal operation is constantly
required. The heart’s blood-pumping cycle, called cardiac cycle, ensures that blood is distributed
throughout the body. The heart circulates blood through two pathways: the pulmonary circuit and
the systemic circuit.
In the pulmonary circuit, deoxygenated blood leaves the right ventricle of the heart via the
pulmonary artery and travels to the lungs, then returns as oxygenated blood to the left atrium of
the heart via the pulmonary vein.

In the systemic circuit, oxygenated blood leaves the body via the left ventricle to the aorta, and
from there enters the arteries and capillaries where it supplies the body's tissues with oxygen.
Deoxygenated blood returns via veins to the venae cavae, re-entering the heart's right atrium.

Blockage of any of these arteries can cause a heart attack, or damage to the muscle of the heart.
The performance of the heart could now be easily monitored when any cardiovascular problem or
disorder is suspected. For instance, a regularly abnormal heartbeat or beats per minute are
characteristic of a heart-related illness. This is because a heartbeat is a manifestation of the oxygen-
reloading process in the heart that is made up of two phases.

A healthy heart contraction happens in five stages. In the first stage (early diastole), the heart is
relaxed. Then the atrium contracts (atrial systole) to push blood into the ventricle. Next, the
ventricles start contracting without changing volume. Then the ventricles continue contracting
while empty. Finally, the ventricles stop contracting and relax. Then the cycle repeats.

Valves prevent backflow, keeping the blood flowing in one direction through the heart.

Diastole refers to atria and ventricles at relaxation and expansion together—while refilling with
blood returning to the heart. Systole typically refers to ventricular systole, during which the
ventricles are pumping (or ejecting) blood out of the heart through the aorta and the pulmonary
veins. The systole-diastole relationship is the reference in measuring blood pressure.
 B. Flow of Blood through the Heart to the Lungs
Blood containing a high concentration of oxygen is pumped by the left ventricle through the
aorta (a major artery), where it is carried to the tissue. Blood flows through a sequence of arteries
to capillaries to veins. Veins carry the blood containing lesser amount of oxygen back to the right
side of the heart, first to the aorta and then back to the ventricle. The right ventricle pumps blood
to the lungs. In the lungs, the blood picks up oxygen and carbon dioxide is removed. From the
lungs, the oxygenated blood travels back to the heart, first to the left atrium and then to the left
ventricle
The process of taking up oxygen and delivering it to the lungs, where it is picked up by the
blood, is called external respiration. External respiration requires fit lungs as well as blood
with adequate hemoglobin in the red blood cells. Insufficient oxygen-carrying capacity of the
blood is called anemia, a condition caused by lack of hemoglobin.
Delivering oxygen to the tissues from the blood is called internal respiration. Internal
respiration requires an adequate number of healthy capillaries. In addition to delivering oxygen
to the tissues, these systems remove carbon dioxide. Good cardiovascular fitness requires fitness
of both external and internal respiratory systems.

C. Stroke Volume, Cardiac Output, Blood Pressure, Heart Rate, Irregular Heartbeat and
Heart Murmurs
Stroke volume is the volume of blood pumped from the left ventricle per beat. It can be apply to
both ventricles of the heart, although it usually refers to the left ventricle. The stroke volume for
each ventricle is generally equal. The stroke volume is an important determinant of cardiac
output.
 Cardiac output is the total volume of blood the heart pumps per minute. The normal range
for cardiac output is about 4 to 8 L/min, but it can vary depending on the body’s metabolic
needs.
Cardiac Output (Q) = Stroke Volume (SV) * Heart Rate (HR)
Heart rate is the speed of the heartbeat measured by the number of contractions of the heart
per minute. It can vary according to the body’s physical needs, including the need to absorb
oxygen and excrete carbon dioxide.
Heart rate is usually equal or close to the pulse measured at any peripheral point.
Blood pressure is the pressure of circulating blood on the walls of blood vessels. Most of
this pressure is due to work done by the heart by pumping blood through the circulatory system.
Blood pressure usually refers to the pressure in large arteries of the systemic circulation.
Irregular heartbeat doesn’t necessarily mean that your heart is beating too fast
(tachycardia) or too slow (bradycardia).
It just means that it is out of its normal rhythm. Some arrhythmias are “silent” so you might
not notice anything.
Heart murmurs is an unusual sound heard between heartbeats. It sometimes sounds like a
whooshing or swishing noise. Heart murmurs can be harmless or abnormal.

D. Describe factors affecting resting heart rate.

Learning to count heart rate at rest and after activity can help you monitor the intensity of your
activity to determine if it is adequate to promote cardiovascular fitness.
To determine the intensity of physical activity for building cardiovascular fitness, it is important
to know how to count your pulse. To count the pulse rate, simply place the fingertips (index and
middle finger) over the major arteries. Major arteries that are easy to locate and are frequently used
for pulse counts include the carotid on either side of the Adam’s Apple, and the radial just below
the base of the thumb on the wrist.
Once the pulse is located, the heart rate can be determined in beats per minute. At rest, this is done
simply by counting the number of beats in one minute. To determine the exercise heart rate, the
most practical method is to count the pulse immediately after exercise. During physical activity,
the heart rate increases but immediately after exercise, it begins to slow and return to normal That
is why it is advised to take your pulse rate immediately after exercising for 15 seconds and just
multiply it to 4 because the heart rate has already slowed considerably within one minute after
activity ceases.
The average heart rate of an adult ranges from 60 to 80 bpm. However, when you are an athlete, it
could be as low as 40 bpm.
Your resting heart rate is telling you something – so listen.
Progress is a huge motivator and paying attention to your resting heart rate is an excellent way to
gauge how your aerobic fitness is improving.
What affects my resting heart rate?
AGE - Resting heart rate usually increases with age. This is mainly due to the decline of physical
fitness.
STATE OF TRAINING - Your sympathetic nervous system is more active during recovery than
when you’re well recovered.
TRAINING BACKGROUND
When you do aerobic training long enough, your heart will become more efficient. The capacity
of your left ventricle will increase and your ventricular muscles will become stronger which leads
to an increased stroke volume. That is, your heart will pump more blood per beat than before.
This increased stroke volume can be observed as a lower resting heart rate as well as a lower
training heart rate. To pump the same amount of blood, your heart needs fewer beats because the
volume per beat has increased.
TEMPERATURE - As the temperature increases, so does the need to cool the body down.
DEHYDRATION
When you’re dehydrated, the amount of plasma in the blood decreases. Because there’s less blood
in your body, your heart has to pump faster than normally to maintain an adequate body
temperature and to provide enough oxygen and nutrients to muscles in peripheral parts of the body.
STRESS - Mental or physical stress increases the activity of the autonomic nervous system.
When under stress, the central nervous system orders the heart, as well as your brain and large
muscles, to prepare for a fight-or-flight situation.
STATE OF MIND - Different emotions affect the autonomic nervous systems through hormonal
activity. When you’re very calm, the activity of the autonomic nervous system lowers your heart
rate. When you’re very excited, your heart rate goes up.
GENETICS - Your genome is one of the most important factors affecting the resting heart rate.
The effect of genes on the resting heart rate can be seen as a difference of more than 20 beats per
minute in two persons of the same age and level of fitness.
MEDICATION - Depending upon the medication, heart rate can either decrease or increase. Be
certain to ask your physician about any medication you are taking and its effects on your exercise
heart rate.

E. Maximum Oxygen Uptake (VO2max) and the Training Effect Level for the Heart

How to evaluate cardiovascular fitness or endurance?

 We can evaluate cardiovascular endurance using an indicator known as VO2max.
What is VO2 max?
 VO2max (maximal oxygen uptake, maximal aerobic power) is the maximal rate at
which oxygen can be used by the body during maximal work; it is related directly to
the maximal capacity of the heart to deliver blood to the muscles.
 VO2 max is commonly referred to as aerobic capacity, is a laboratory measure held
to be the best measure of cardiovascular fitness. It is the volume of oxygen used when
a person reaches his or her maximum ability to supply it during exercise.
 VO2max is a good index of cardiorespiratory fitness and a good predictor of
performance capability in aerobic events such as distance running, cycling, cross-
country skiing, and swimming.
 VO2max can be expressed either as milliliters per minute (mL/min) or this value can
be divided by the person’s body weight in kilograms (mL/kg/min).

How can (VO2max) be measured?

 This test is usually done on a treadmill. The highest amount of oxygen used in one
minute of maximum intensity physical activity is your maximum oxygen uptake.

Formula in getting your VO2 max:

VO2 max = 15.3 x (HR max / HR min)
Where: HR max = 220 – age (0.7 x age)
HR min = beats / 15 sec (4)

Training Effect Level of the Heart

 Training Effect measures the impact of an activity on your aerobic fitness.
 Training Effect accumulates during the activity. As the activity progresses, the training
effect value increases, telling you how the activity has improved your fitness.
 Training Effect is determined by your user profile information, heart rate, duration, and
intensity of your activity.

METHODS IN DETERMINING THE TRAINING LEVEL OF THE HEART

Oxygen Uptake Reserve (VO2R)
The difference between maximum oxygen uptake and the resting oxygen uptake. A
percentage of this value is often used to determine appropriate intensities for physical activities.
VO2R = VO2 max – VO2 min
 (Cannot be calculated without using a special equipment. That’s why, other indicators are
used.)

Heart Rate Reserve (HRR)

The difference between maximum heart rate (highest heart rate in vigorous activity) and
resting heart rate (lowest heart rate at rest).
HRR = HR max – HR min

Ratings of Perceived Exertion (RPE)

The assessment of the intensity of exercise based on how the participant feels; a subjective
assessment of effort.

F. Differentiate Aerobic and Anaerobic Exercise

Aerobic Exercise – a type of exercise that promotes the circulation of oxygen through the
blood and is associated with an increase rate in breathing. It is a physical activity that makes you
sweat, causes you to breathe harder, and gets your heart beating than at rest. Examples are
walking, running, dancing, swimming, boxing, and other team sports.

Anaerobic Exercise – an exercise that comprises brief, strength-based activities wherein

the body’s demand for oxygen exceeds the oxygen supply available. This type of exercise relies
on energy sources that are stored in the muscles. Examples of anaerobic exercises are
weightlifting, sprinting (running or cycling), jumping, etc.

G. The 3 Human Energy Systems

Adenosine Triphosphate (ATP)

• Body stores energy through this
• Made of 1 Adenosine molecule and 3 phosphate molecule

Energy
• Our body requires energy, this energy comes from the breakdown of ATP in our cells.
• Breakdown of ATP=Energy=Movement
• All energy for cellular activity comes from ATP

How ATP is generated

• Our cells can’t get energy directly from food
• Needs to be stored as a useable form of energy ATP
 • The food we eat contains energy (kilojoules)
• This energy is used to produce ATP molecules
• Energy is stored in ATP like a battery
3 types of nutrients we can get energy from
• Carbohydrates  Glucose  ATP
• Protein  Amino Acids  ATP
• Fats  Fatty Acids  ATP
The 3 Human Energy Systems
The body uses 3 different systems to supply cells with the necessary ATP to fuel energy needs.
Most of the body's activities use a continuum of all three energy systems, working together to
ensure a constant supply of energy.
The energy system depends on the intensity and the duration of exercise being performed
• ATP PC system = very quick explosive exercise
• Lactic Acid System = Moderately intense exercise lasting several minutes
• Aerobic System = Long duration exercise
1. ATP-PC System
• Anaerobic energy system (does not require oxygen to generate ATP)
• Used for explosive exercises lasting 8-10 seconds
• Generates ATP very quickly but only limited supply (runs out quick)
• The most inefficient energy system
How it works
• ATP is stored in the muscles and liver for quick access
• Run out in 2-3 seconds
• When you move, ATP is broken down to ADP+P to generate energy for the body to use
• When the Phosphate split that’s where the energy comes from
• ATP stores in the muscle run out very quickly therefore we must generate more
• VERY useful for quick explosive exercises, generates ATP very quickly but also runs out
quickly
• Phospate creatine (PC) is another compound stored in the muscle
• Is broken down to P+C to release energy for ADP to combine with the extra Phospate
 • However PC stores also run out quickly and that is why ATP-PC system only lasts for 10
seconds
• PC stores back to 98% after 3 minutes of rest
When is the ATP-PC system used?
• Heavy Weight Lifting
• 100m sprint
2. Lactic Acid System
• Also known as anaerobic glycolysis system, produces energy from muscle glycogen --
the storage form of glucose.
• Breaks down glucose and glycogen to form ATP
• Generating ATP through this also produces lactic acid
• Causes our body to fatigue
• can only be used for exercises lasting 2-3 minutes
• Lactic build up makes muscle feel heavy and tired
• Glycolysis, or the breakdown of glycogen into glucose, can occur in the presence or
absence of oxygen.
How it works
• When the muscles run out of PC stores must generate ATP another way – lactic acid energy
system
• Body breaks down glucose or glycogen to generate ATP through a process called
Anaerobic glycolysis or just glycolysis
• If oxygen is not present the body will also produce lactic acid in the process
• 1 molecule of glucose will produce 2 molecules of ATP
• 1 molecule of glycogen will produce 3 molecules of ATP
• Glycogen is stored in the muscles and liver
When is Lactic Acid system used?
• Intense exercises lasting 2-3 minutes
• 400-800m run
• Many team sports- Netball, football ect
3. Aerobic System
 The most complex energy system is the aerobic or oxygen energy system, which provides
most of the body's ATP.
• This system produces ATP as energy is released from the breakdown of nutrients such as
glucose and fatty acids. In the presence of oxygen, ATP can be formed through glycolysis.
• This system also involves the Krebs or tricarboxylic acid cycle -- a series of chemical
reactions that generate energy in the mitochondria.
• The complexity of this system, along with the fact that it relies heavily on the circulatory
system to supply oxygen, makes it slower to act compared to the ATP-PC or lactic acid
systems.
How it works
• Begins the same way the lactic acid energy system does- breakdown of glucose and
glycogen (glycolysis)
• If oxygen IS present lactic acid will not be produced and instead more ATP is formed
through Aerobic glycolysis
• Generates ATP much slower than Anaerobic glycolysis and even more slower than ATP-
PC system therefore is used for low intensity/long duration exercise.
• With oxygen 1 glucose molecule generates 36 molecules of ATP
• 1 glycogen molecule generates 37 molecules of ATP
• Fatty acids are broken down to produce 129ATP
When is it used?
• Continuous exercise lasting longer than 5 minutes (Marathon, Long distance cycling)

H. When is the best time to exercise?

- Exercising early in the morning can be the best time to exercise for it is the best way to
burn stored fat especially if you’re exercising on an empty stomach. A morning sweat may also
lead to better mental health and productivity throughout the day. That’s because exercise is great
for reducing stress.

EXERCISE PRECAUTIONS
 Wear comfortable clothing
 Put on appropriate gears
 Always warm up before exercising and cool down after exercising
 Take appropriate breaks
 Replenish extra fluids during and after doing physical activities
  Beware of the weather and environmental conditions
Listen to the body. Do not exercise when you are not feeling we

I. During exercise
A. Body signals of over-exercise
Moderate exercise is key to a workout routine that makes you feel energized, clear-minded,
and fit.
But a culture with a “more is better” motto can make it difficult to remember that too much
exercise can actually make you less healthy over time. Overexercising marks something a bit more
serious. “When your body exercises, cellular damage occurs,” explains Dr. David A. Greuner. This
is because you are training to some degree past your comfort zone, which results in your body
adapting to become stronger.

Here are the 10 ways your body will let you know if you're headed for overexercise:

1. Decreased performance. A drop in your workout performance is one of the earliest signs of
overload.
2. Disinterest in exercise. A significant decrease in motivation or enjoyment of the activity can
be a major sign of overexercise.
3. Mood changes. Depression, anger, confusion, anxiety and irritability are common when your
body is overstressed physically.
4. Delayed recovery time. Persistent muscle soreness that lasts for hours or days after your
workout is a sure sign you need more rest.
5. Elevated resting heart rate. When you put more stress on the heart, it has to work a lot harder.
An increase in your normal resting heart rate, say, from 50 beats per minute to 65 beats per minute,
could indicate that you're placing excessive stress on your body.
6. Fatigue. Mental or physical grogginess is a hallmark sign of overexercising.
7. Insomnia. Being in a state of overload often comes with disrupted sleep patterns, so instead of
getting that much-needed rest, you become restless and can't fall asleep.
8. Diminished appetite. A decrease in appetite can occur in the middle to later stages of
overexercising, and goes hand in hand with feelings of fatigue and lack of motivation.
9. Fat gain. If you've lost weight but noticed an increase in body fat, you could be in the later
stages of exercise overload.
10. Weakened immune system. Don't try to push through that exercise funk or you'll keep sliding
down—to a weakened immune system, inflammation, and outright injury. Not a good thing.
Prolonged overexercising can take weeks, even months, to recover from, and can put your health
at risk.

What are good tips for recovering from a period of overexercising?

1. Consider a break from training\
2. Taper the program to help reduce symptoms.
3. Seek help to redesign the training program.
 4. Alter your diet.
5. Evaluate other stressors that may be producing symptoms.
6. Reset performance goals.
7. Talk to someone about problems.
8. Have a medical check-up to be sure there is no medical problem.
9. If you have a coach, consider to talk to him/her.
10. Add fluids to help prevent performance problems from dehydration.
What is a side stitch?
A side stitch is a pain felt on either side of your abdomen. It’s more commonly reported on the
right side. Symptoms may range from cramping or a dull ache to a pulling sensation or a sharp,
stabbing pain.
A side stitch is usually experienced during prolonged athletic activities, such as running, basketball,
or cycling.
What causes side stitches?
Other research shows that an irritation of the lining of the abdominal and pelvic cavity may be the
cause. This irritation can occur during physical activity when there’s a lot of movement and friction
in the torso.
Eating a large meal or drinking sugary sports drinks may also result in a side stitch. Younger
athletes may be more likely to get a side stitch than experienced athletes. But side stitches can
affect anyone who exercises for a prolonged period of time.
How to treat a side stitch
 If you’re running, take a break or slow down to a walk.
 Breathe deeply and exhale slowly.
 Stretch your abdominal muscles by reaching one hand overhead. Try bending gently into the
side where you feel the stitch.
 Stop moving and try pressing your fingers gently into the affected area while you bend your
torso slightly forward.
 Stay hydrated while exercising, but avoid sugary sports drinks if they irritate your stomach.
How to prevent side stitches
 Practice good posture. Athletes with a rounded spine may experience side stitches more often.
 Avoid high-fat and high-fiber foods before exercising.
 Decrease the length of your workout and up the intensity instead.
 Avoid sugary beverages or all beverages right before exercising.
 Increase your level of fitness gradually.
 Increase your mileage by a few miles a week if you’re a runner

Second Wind
A phenomenon in distance running, such as marathons or road running (as well as other sports) whereby an
athlete who is too out of breath and tried to continue suddenly finds the strength to press on a top performance
with less exertion. The increase in the temperature of the skin can be felt as the same time as the “second wind”
takes place.
Some scientists believe that the second wind is a result of the body finding the proper balance of oxygen to
counteract the buildup of lactic acid in the muscles.
The feeling may be similar to that of a “runner’s high”, the most obvious difference being that the runner’s high
occurs after the race is over.

J. Effects/Benefits of Cardio-Respiratory Endurance Exercise/Training

1. Reduces risk for heart disease, other hypokinetic conditions, and early death.
 Individuals classified in the least fit category were 3-6 times more likely to develop symptoms of
metabolic syndrome or diabetes than the most fit group.
 Moderately fit individuals live approximately 5-6 longer than low-fit individual.
 Clearly, having at least a basic level of cardiovascular fitness is important to disease prevention.

2. Provides protection against the health risks associated with obesity.

 Individuals with higher levels of activity have lower levels of abdominal body fatness.
3. Enhances the ability to perform various tasks, improves the ability to function, and is associated with a
feeling of well-being.
 Enjoys leisure activities as well as meet immediate response to emergency situations.
4. Improves cellular metabolism
 Doing cardiovascular exercise increases no. of capillaries that results into greater oxygen supply. Also,
it helps heal injuries and muscle ache.
5. Protects the cells from chemical damage
 If you are physically active, then your metabolism is in good condition to prevent free radical damage
to cell structure.

K. Cardiac hypertrophy is an increase in cardiac muscle mass when cardiac muscle fibers thicken, or cells
become enlarged, due to chronic and increased stress on the heart.