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Presentation on theme: "SEHAT DITINJAU DARI ASPEK BIOPSIKOSOSIOSPIRITUAL"— Presentation transcript:

Life Support Dr. Zaenal M. Sofro, AIFM, Sports & Circulatory Med Fak.Kedokteran UGM




5 Physiologic Requirements to Perform Exercise

6 6

7 Gravity: role of baroreceptor reflex in orthostatic adjustment
Baroreceprots in aorta & carotid bodies Cardiovascular ctr in medulla oblongata Vaso-constriction Heart rate Symp. + Parasymp. - pressure

8 SCHELLONG TEST Tn. XXX Usia : 52 Tahun * Life Support
Keterangan : Reaksi Hypertonie a Hypotonie Asympatothone Hypotonie Sympatothone Reaksi Vasovagale Parameter Real Standart QT Interval , ,40 MAP , Pulse Pressure IMT ,59 Keterangan Obesitas Lebih 24,7 Kg E.C.G Sinus Normal ZONA



11 ERGOMETRI 1 Life Support 0 1 2 3 4 5 6 7 8 9 10 Pengukuran VO 2
No. Induk Instansi Periksa Ke Tgl. Periksa Nama Keluhan Pakai obat Umur Berat Badan Tinggi Badan L.P.B. DJ. Max pred. % DJP : (02635) : Atlet Sepak Bola : SATU : 13 Desember 2003 : Atlet 1 : - : 22 Tahun : 57 Kg : 165,5 Cm : 1,63 m² : 198 x per menit : 76,77 Life Support PWC Pred watt PWC Real ,09 % DJ Latiuhan – 170 /menit Kondisi DJ Sistolik Diastolik Istirahat 70 110 80 Beban Akhir 152 175 Pemulihan 107 145 VO2 Max 49.1 cc/kg/menit MET 14.0 MET IMT 20,81 KET. Ideal 0Kg E.K.G. Sinus Normal Pengukuran VO 2




15 Cardiac Physiology Electrocardiography Diagnosis

16 Electrocardiogram (ECG/EKG)
Note: Tissue fluids conduct electricity. EKG: Measure of the electrical activity of the heart.


urine flow osmolarity drink 1200 ml water urine flow osmolarity drink 1200 ml isotonic saline Two Very Different Experimental Observations

Spine V6 V5 Sternum V4 V3 V1 V2

20 Willem Einthoven ( )‏ Permission to use this slide (a matter of academic integrity)‏ *If you are Kevin Patton's current student, you may use any slide for your own personal educational purpose. **If you are a student not currently in Kevin's courses, you may use any slide for your own personal educational purpose and are also encouraged to feed the lions at ***If you are a teacher you may use any slide for your own nonprofit educational purpose and are also expected to feed the lions for each use of a slide. ****Commercial use is available only with Kevin's express written permission. © . All rights reserved. DO NOT REMOVE THIS COPYRIGHT NOTICE LINE. Feedback, suggestions, corrections are most welcome!

21 ST Elevation Infarction
Here’s a diagram depicting an evolving infarction: A. Normal ECG prior to MI B. Ischemia from coronary artery occlusion results in ST depression (not shown) and peaked T-waves C. Infarction from ongoing ischemia results in marked ST elevation D/E. Ongoing infarction with appearance of pathologic Q-waves and T-wave inversion F. Fibrosis (months later) with persistent Q- waves, but normal ST segment and T- waves


23 Carbohydrate and fat utilization during exercise
80 20 40 60 100 Intense Moderate Exercise Light 80 60 40 20 % Fat Carbohydrate and fat utilization during exercise 23


25 Effect of Training on Blood Lactate / Lactate Threshold
Untrained Trained LT LT 25% 50% 75% 100% Percent of VO 2 max


27 General Level of Physiologic Function
% 120 100 80 General Level of Physiologic Function 50 40 20 Active Person Age, year Sedentary Person

28 Atherosclerosis timeline Content Points:
The pathological effects of atherosclerosis occur over decades. A subtle injury to the endothelium initiates the atherosclerotic process.3 Endothelial dysfunction underlies many stages in the progression of atherosclerosis from earliest onset to the lesions that result in coronary heart disease (CHD).4 Foam cells may infiltrate the vessel, progressing to a fatty streak. As the lesion progresses, small pools of extracellular lipid form within the smooth muscle layers, disrupting the intimal lining of the vessel. Progression to an advanced lesion, or atheroma, occurs when accumulated lipid, cells, and other plaque components disrupt the arterial wall. Progression of atheroma involves accumulation of smooth muscle cells that elaborate extracellular matrix macromolecules. Once the plaque becomes fibrous, the danger of rupture increases. This type of advanced lesion can be found beginning in the fourth decade of life. The clinically important complication of atheroma usually involve thrombosis. Arterial stenoses by themselves seldom cause acute unstable angina or acute myocardial infarction. Indeed, sizable atheroma may remain silent for decades or produce only stable symptoms, such as angina, precipitated by increased demand. Thrombus formation usually occurs because of physical disruption of atherosclerotic plaque. The majority of coronary thromboses result from a rupture of the plaque’s protective fibrous cap, which permits contact between blood and the highly thrombogenic material located in the lesion’s lipid core. The endothelium participates in the atherosclerotic process and remodeling through secretion of specific compounds.1 These will be discussed in later slides.

29 Physical activity

30 Initiation and Maintenance of PA Behavior Change
Self efficacy beliefs critical in initiation Pleasure, satisfaction, and self regulatory skills (goal setting and monitoring) are most important in sustaining PA behavior


32 Touch

33 Social Sympathetic Parasympathetic “Love” Rest Alarm Orient Discharge
John Hughlings Jackson ( ) Father of English Neurology Quoted by Stephen Porges 11/01 Social Sympathetic Contact (Eyes) “Love” Transaction (Mouth) Parasympathetic Rest Alarm Orient Discharge Fight/Flight Alarm Catatonia Immobility Disassociation Sleep (4 Stage) “Voodoo Death” Freeze

34 Social Engagement Safe Fight, Flight, Freeze Danger Life Threatening
Immobility Safe Danger Life Threatening Ventral Vagal Sympathetic Nervous System Dorsal Vagal System 34

35 Ekman’s Emotional Faces

36 Diet and risk of NCD Up to 80 % of cases of CHD and up to 90 % of type 2 diabetes could be avoided through changing lifestyle factors. About one third of cancers could be prevented by eating healthily, maintaining normal weight and being physically active throughout the life span. 36



39 Maintaining a Healthy Weight is a Balancing Act
Calories In = Calories Out How long will you have to walk in order to burn those extra 305 calories?*   *Based on 130-pound person 39

40 40

41 Drink Water Immediately
Safe Zone Drink Water Immediately Mildly Dehidrated Drink More Water Not Dehydrated Extremely Dehydrated


43 A Healthy Environment Means Healthier Kids

44 Most People with Health Conditions Don’t Do What They Should
Oops… I Forgot I Don’t Care Understand I’m Too Busy I’m Confused I’m Afraid I Can’t Afford It



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