sehat ditinjau dari aspek biopsikososiospiritual dr. zaenal m. sofro, aifm, sports & circulatory...
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SEHAT DITINJAU DARI ASPEK BIOPSIKOSOSIOSPIRITUAL
Dr. Zaenal M. Sofro, AIFM, Sports & Circulatory Med
Fak.Kedokteran UGM
Physiologic Requirements to Perform Exercise
Gravity: role of baroreceptor reflex in orthostatic adjustment
Baroreceprotsin aorta & carotid bodies
Cardiovascular ctr in medulla oblongata
Vaso-constric
tion
Heart rate
Sym
p.
+
Para
sym
p.
-
pressure
Tn. XXXUsia : 52 Tahun *
-30
-28
-25
-23
-20
-18
-15
-13
-10
-8
-5
-3
0
3
5
8
10
13
15
18
20
23
25
28
30
-30 -28 -25 -23 -20 -18 -15 -13 -10 -8 -5 -3 0 3 5 8 10 13 15 18 20 23 25 28 30
Tekanan Darah & Denyut Jantung
30405060708090
100110120130140150160170180190200210220
1 2 3 4 5 6 7 8Waktu (Menit)
TD
(m
mH
g)
30405060708090100110120130140150160170180190200210220
DJ (
kali
/ m
en
it)
Sist. Diast D.J
0 1 2 3 4 5 6 7
Keterangan : 1. Reaksi Hypertonie 2a. Hypotonie Asympatothone
2. Hypotonie Sympatothone 3. Reaksi VasovagaleParameter Real Standart
QT Interval 0,40 0,40
MAP 104,99 100
Pulse Pressure 45 40
IMT 36,59
Keterangan Obesitas Lebih 24,7 Kg
E.C.G. Sinus Normal
ZONA 2
52
49,1
47
48
49
50
51
52
VO2 Max REAL
94,47%
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
PWC Pred 194 watt
PWC Real 103,09 %
DJ Latiuhan 150 – 170 /menit
Kondisi DJ Sistolik Diastolik
Istirahat 70 110 80
Beban Akhir 152 175 80
Pemulihan 107 145 80
E.K.G. Sinus Normal
VO2 Max 49.1 cc/kg/menit
MET 14.0 MET
IMT 20,81
KET. Ideal
0Kg
0 1 2 3 4 5 6 7 8 9 10
Kombinasi Tekanan Darah dan Denyut Jantung
155
135
110
125
145
165
175185 195
80808080 80 808080 80
127115
7096
103
140
158152
165
30405060708090
100110120130140150160170180190200210220
1 3 5 7 9 11 13
Kenaikan Beban 25 watt
TD
30405060708090100110120130140150160170180190200210220
DJ
0 1 2 3 4 5 6 7 8 9 10 11
Intensitas Latihan untuk Meningkatkan STAMINA
20 15150
100 110 120 130 140 150 160 170 180 190 200
Denyut Jantung
Aerobik
Dianjurkan
Anaerobik
194
200,0
190
192
194
196
198
200
PRED REAL
103,09%
ERGOMETRY TEST
Cardiac Physiology Electrocardiography Diagnosis
Electrocardiogram (ECG/EKG)
• Note: Tissue fluids conduct electricity.
• EKG:– Measure of the
electrical activity of the heart.
PENGARUH JENIS MINUMAN TERHADAP OSMOLARITAS TUBUH
Two Very Different Experimental Observations
urine flow
osmolarity
drink 1200 ml water
urine flow
osmolarity
drink 1200 ml isotonic saline
V1 V2V3
V4
V5
V6
6 PRECORDIAL (CHEST) LEADS
Spine
Sternum
Willem Einthoven(1860-1927)
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
020406080
80604020 100
% Carbohydrate
% Fat
Carbohydrate and fat utilization during exercise
ExerciseMo
derate
Light
Intense
Percent of VO 2 max
25% 50% 75% 100%
[Blood L
actate]
Untrained
Trained
Effect of Training on Blood Lactate / Lactate Threshold
LTLT
0 10 20 30 40 50 60 70 80 90
20
50
40
80
100
120
Gen
era
l L
eve
l o
f P
hys
iolo
gic
Fu
ncti
on
%
Age, yearSedentary Person
Active Person
Physical activity
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
TouchTouch
- John Hughlings Jackson (1835-1911)
Father of English Neurology
Quoted by Stephen Porges 11/01
SocialSympatheti
c Parasympathetic“Love
”Transa
ction
(Mouth
) Contact
(Eye
s)
AlarmOrie
nt
Fight/F
light
Discharg
eRest
Freeze Imm
obility
Disass
ocia
tion
Slee
p (4
Stag
e) Alarm
“Voo
doo
Death
”
Catat
onia
34
Social Engagement
Fight, Flight, Freeze
Immobility
Safe
Danger
Life Threatening
Ventral
Vagal
Sympathetic
Nervous System
DorsalVagal
System
Ekman’s Emotional Faces
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.
How long will you have to walk in order
to burn those extra 305 calories?*
*Based on 130-pound person
Maintaining a Healthy Weight is a Balancing ActCalories In = Calories Out
Mildly Dehidrated
Extremely Dehydrated
A Healthy Environment Means
Healthier Kids
Most People with Health Conditions
Don’t Do What They Should
Oops…I Forgot
I Don’tCare
I Don’tUnderstand
I’m TooBusy
I’m Confused
I’mAfraid I Can’t
Afford It
JAZAA KUMULLAH KHAIRAN KATSIRAN