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4 I(Blood pressure)4 1 4 2. (Systolic Blood Pressure; SBP) 4 3. (Diastolic Blood Pressure; DBP) 4 4. 5 II. 5 III6 16 2. 6 IV. 7 1. 7 2. 7 V. (Electrocardiogram; ECG) 8 1. 8 2. 8 1) 8 2) 8 3) 9 4) 9 5) 10 1
6) 11 VI. (Oxygen uptake: Vo 2 )11 1. 11 2. 12 1) (oxygen deficit) 12 2) (steady state) 12 3) (oxygen debt) 13 VII. (maximal oxygen uptake: Vo 2 max)13 VIII. (%Vo 2 max) 14 IX. 14 1. 14 1) (protocol) 14 2) (V o 2 measurement) 14 2. 14 1) (protocol) 14 2) (V o 2 measurement) 15 X. (Blood lactate) 15 1. (Lactate) 15 2. ATP (Adenosine Triphos Phate) 16 1) ATP- (Creatine Phosphate: CP) ()16 2) (Lactic)16 3) (Aerobic) 16 3. (Blood lactate) 16 XI.,, 17 1. 17 2. 17 3. 17 XII. 18 XIII. 18 XIV. 18 1. (Lactate Threshold: LT) 18 2. OBLA (Onset of Blood Lactate Accumulation 19 2
3. MaxLass (: Maximal Lactate Steady State) 19 XV. 20 1. 20 1) 20 2) 20 2. 20 3. LT OBLA 20 4. 40 21 3
I(Blood pressure) 1. 2.(Systolic Blood Pressure; SBP) -1 (dicrotic notch) 140mmHg 450mmHg 100mmHg 10cm, 136cm 250mmHg 3. (Diastolic Blood Pressure; DBP),(),,, (-1).,,., (),,. 140mmHg, 90mmHg.,,.,,., 4
,. 4. (Pulse pressure)(mean Blood Pressure),-2.,.,. = () (). DBP + 1/3!(SBP DBP) = DBP + ((SBP DBP)/ 3), 100mmHg, 80mmHg.. = 100 80 = 20mmHg = 80 + ((100 80)/3) =86.7,, (90mmHg>86.7mmHg). II.,., ()., (),,.,,.,, (aldosterone),,,.,,.,.,,.,.,,.,,.,.,,, (,,).,,., 5
.,.,, (-3).,,.,,,(-4).,(isometric),,,,. III. 1. 4000,,,.( 1500 ),.,, 1628 William Harvey, 1.,1733 Stephen Hales, 2.5m.,,. 1828, U,1847,., 1856. 1833 (Jules Herisson). 1880 (von Basch)., 1896 Scipione Riva Rocci. 1,.1901, Riva Rocci 5cm, (-5). 2. 1905, Nicollai Sergeivivh Korotkoff,. Korotkoff Riva Rocci,.,. ().,. (). Korotkoff 5 (-6),( 1 ), ( 5 )(-7). 6
IV. 1.,,.,.,,.,. ()(, ).. (),,(12 )(-8),,,, (-9)., Korotkoff, 20 ~ 30mmHg,,1 2mmHg. (Swan 1 )(-6). Korotkoff,,.,,,(Swan 2 ).,,(Swan 3 ).,(Swan 4 ),(Swan 5 )., 10mmHg. 30,.,(). 2.,,,.,(-10). (): 1 50 (50rpm) 3, 3 1 1.0kp, 2 1.5kp, 3 2.0kp 1 0.5kp, 2 1.0kp, 3 1.5kp 7
((kgm)., (kpm),1kp, 1kg,9.80665,1kpm 9.80665. kpm,.(watt),, 1 1 1.. 1 watt = 0.01433 kcal/min 1 kcal/min = 69.767 watt 1 kpm/min = 0.163 watt 3 1 (, 1, 2 3, 2, 5 6, 3, 8 9 V.(Electrocardiogram; ECG) 1.,.,,., 50 (-11), 50 (-12).,, 1/200 ( 65kg,65,000 g!1/200 = 325 g)., 1/13 ( 65kg,65,000 g1/13 = 5,000g: 1 5,000ml ). 2..()(-13).,,,.()( ). 1), 400.,,1850,,,. 1887, August us Desire Waller (1856 1922),,. 1894, Willem Einthoven (1860 1927), Waller,,,. 2) (-14) 1 P, Q, R, S, T 5 Q, R, S QRS P 8
QRS T R,Q S,P T,. T 3) 25mm/, 25mm 1., 1mm,0.04 mm,10mm 1mV, 1mm 0.1mV 1/2,1mm 0.2mV -15 P,0.06 0.01 ( 2-3mm ), 0.25mV P R (PR ) 0.20 QRS,0.10 QRS T (QT ) 0.30 0.45 (Heart Rate; HR),1 R II (,) (-16) 0.20 R 0 R 60/0.2=300( 300 0.2 1 2 R 60/0.4=150 150 0.4 1 16 100, 75, 60, 50 1mm,0.2 1/5=0.04 300 150 R, 300 1mm 150/5= 30 150 100 R, 150 1mm 50/5= 10 100 75 R, 100 1mm 25/5= 5 75 60 R, 75 1mm 15/5= 3 60 50 R, 60 1mm 10/5= 2 4) P,QRS,T 9
medical check, 5) 1 0N 2 12 Einthoven I II III 17-17 3 Einthoven 3 I,II,III 12 12 12 6 6 6 18 I II III avr a augmented) a 10
avv vector V avf R,(right) R R,(right) R; L,(left) L; F,(foot) F 6 (-19), V1 : 4 V2 4 V3 : V2 V4 V4 5 V5 V4 V6V4 6) 1 1-20 2 1/3 21 10cm 21 22 23 VI.(Oxygen uptake: Vo2) 1. (oxygen uptake; Vo 2 ),,., 1 (ml/min),,, 1kg (ml/kg/min).,.,, () 11
. = 2.,., (adenosine triphosphate; ATP)., ATP,(ATP-CP ), 3 (energy supply system).,,() (H 2 O)(Co 2 ) ATP.,,.,.,,(hemoglobin:) ().,.,,(oxygen deficiency), (steady state),(oxygen debt) ( oxygen intake curve). (-24). 1). (oxygen deficit) (-25),,(steady state)., (oxygen requirement).,, ( )(0 2 deficit).,,. 2). (steady state) (oxygen consumption),.,.,,,,atp,,.,,(-26).,, 12
,,,,., 3-5. 3). (oxygen debt),., (-24, -25). (), ATP (PCr),,.,,,().,,(excess post-exercise oxygen consumption: EPOC).,(; Vo 2 max), ATP-CP,.,,, ATP-CP (),().,(-26), ( maximal oxygen debt),.,,.,, 1,,. VII. (maximal oxygen uptake: Vo 2 max),,.,. (),.,,.,( ),,(), (V o 2 max)(maximal aerobic power)( -27).,, ATP. Vo 2 max, 6 10(all out)()., V o 2 max,, (respiratory exchange ratio: R) 1.10 1.15. 13
*: leveling off,, 2 2ml/kg/min *; respiratory exchange ratio, R:, Co 2 / O 2 ). Vo 2 max, 40-50ml/kg/min, 80ml/kg/min (-28).,, Vo 2 max Vo 2 max. VIII. (%Vo 2 max)., % Vo 2 max.,% Vo 2 max,(vo 2 )(Vo 2 max),., %.,, 8 ~ 10% Vo 2 max,, 50 60% Vo 2 max. LT(lactate threshold: ), 50 70% V o 2 max, 70% V o 2 max. IX. 1. 15,(),. 1). (protocol) (),, 160m/min(9.6km/h) 140m/ min(8.4km/h) 2.5%. 2) Vo 2 measurement, 1 15 15,15 16 20 5, ( -29). 2. 1). (protocol) Vo 2 max,(incremental loading)(constant loading).,,1 (exhaution).,1 V o 2 max,15,,., 14
, 15% Vo 2 max.,, 10,., 180m/min(10.8km/h) 160m/ min(9.6km/h), 2 2.5%(-30). Vo 2 max, leveling off (R) 1.10 1.15. 2). (Vo 2 measurement), 1 W-up, 2 2.5% 2.5%., 1 3.,,(respiratory exchange ratio: R) 1.10 1.15, 4, 5. X. (Blood lactate) 1. (Lactate) (lactate),, (C) 3,(H) 6,(O) 3 (C 3 H 6 0 3 )(-31).,,,,,( )(-32).,.,(90.08 g/mol),,, (-33). (:D) (: L-), L-(D-).,,,, 1 100g (-34).,,.,.,,.,,(glucose ), (pyruvic acid)(),,, (: mitochondria), H 2 O)(CO 2 )().,.,., ATP(adenosine triphosphate), 19.,(),,,., 15
.,,,,. 2. ATP(adenosine triphosphate) (-35) 1). ATP- (Creatine Phosphate: CP) () ATP, CP ATP... 2) (Lactic), ATP. 1 2,.,. 3) (Aerobic), ATP.., ATP,. 1) 2) ATP,3). 3. (Blood lactate), ATP ADP (-36). ATP,,., ATP.,( )()(-37).,,. (),() ().,,, ().,,., 1mM (),7 14mM. 16
mol (),, 0.012kg (12g) m (),10-3 (=1000 1) 1m mol = 1/1000 mol : mm () M: mol/l ; mm: m mol/l: 1mM = 1/1000M mm/l mg/dl, 9.01.,,,, (H + ). H + OH - H + H + 1proton ph7.357.45 ph7.35 acidosis XI.,,,,,.,.,,,. 1.,,,.,,.,,,. 2.,,.,,.,,, (-38). 3.,,,,,(-39)., 17
., (,),., (-40).,,. XII., 1mM ( 9mg/dl), all out () 10mM ( 90mg/dl).,,,(-41),.,, 1 2mM,,,., 2 3mM.,,,.,,,,,.,. XIII.,,,,.,,,,.,,,,,,,,,,., 1,.,, 1,., 1. XIV. 1. (Lactate Threshold: LT) (),. (Lactate Threshold: LT). 18
LT, 1), 2) ( Ivy et al., 1980)., LT,. ph LT LT LT LT LT LT,,. LT, 50-70%Vo 2 max, 120-140 /(-42).,,,, (-41)., LT, (Vo 2 max)., OBLA (Onset of Blood Lactate) MaxLass (Maximal Lactate Steady State). 2. OBLA (Onset of Blood Lactate Accumulation) LT,.,, LT,, LT. 4mM(36mg/dl)., 4mM,, OBLA. 3. MaxLass (Maximal Lactate Steady State) OBLA, LT, 4mM. LT, (MaxLass).LT, 1 3,LT (),,. 19
XV. 1.,,,,.,,().,,, ().,,.,,.,,,. 1) (-43)... (-44). 2)..,. 1, 2. 2., BIOSEN C line ( C ) Lactate SCOUT ().,,.,,,,. ().,.,,. (-45).. 3. LT OBLA C VII. 20
,,,,.,(). 3, 30 (2 30-3 ). 4mmol/l, kp. [] (-46). 1kp, 3 05 kp. 0.5kp, 3 0.5 kp. LT OBLA (-47) (kp),.., ()., OBLA, 4mmol. 4. 40 C (-48). VII (,kp=0.075)., 40.,,., (-49).., 0, 1, 2, 3, 5, 7, 9.,. (-50). 21
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