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IMF-104-01-0001-en	Why can maximal oxygen uptake not explain every form of exercise performance?	It summarises important capacity, but the limiting process changes with intensity, duration, environment, training, health, and motivation, so no single measure captures every limit.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0002-en	Intramuscular ATP sustains maximal contraction for only seconds. How does phosphocreatine protect energy supply at the abrupt onset of intense work?	Through creatine kinase it rapidly donates phosphate to ADP, regenerating ATP and buffering energy during sudden demand.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0003-en	What does reducing pyruvate to lactate accomplish during anaerobic glycolysis?	It regenerates oxidised nicotinamide cofactor, allowing glycolysis to keep producing ATP rapidly from glucose or glycogen.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0004-en	Why is it misleading to describe the energy systems as switching on one after another during exercise?	They operate simultaneously with shifting contributions: a sprint has high phosphagen and glycolytic flux while oxidative metabolism rises rapidly, and prolonged moderate exercise still uses glycolysis.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0005-en	Why does lactate production during exercise not indicate that muscle lacks oxygen?	Lactate reflects glycolytic flux and redox balance, and it is a usable fuel that muscle and heart oxidise or the liver uses for glucose production.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0006-en	How does stroke volume change with rising dynamic exercise intensity, and how can endurance-trained people differ?	It rises through filling and contractility and often approaches a plateau, whereas endurance-trained people may keep increasing it at high intensity.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0007-en	How can active muscle receive more blood when sympathetic outflow is high during exercise?	Local mediators such as adenosine, potassium, carbon dioxide, and hydrogen ions oppose vasoconstriction in active muscle (functional sympatholysis), while less active beds still constrict.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0008-en	Systemic resistance falls during dynamic exercise. Why does mean arterial pressure still usually rise moderately?	Cardiac output rises more than systemic resistance falls.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0009-en	Why can heavy resistance exercise transiently produce very high blood pressure, and what does this not imply?	Contracting muscle compresses vessels and raises resistance, amplified by breath holding and the Valsalva manoeuvre; the acute rise does not mean resistance training inevitably causes chronic hypertension.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0010-en	Why does ventilation rise disproportionately beyond the ventilatory threshold?	Bicarbonate buffering of accumulating hydrogen ions generates additional carbon dioxide, and neural drive also rises.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0011-en	What drives the immediate rise in ventilation at exercise onset, and what happens to arterial gases during moderate steady exercise in healthy people?	Central command and sensory feedback raise ventilation at once; ventilation then tracks carbon dioxide production, so arterial oxygen and carbon dioxide pressures stay near normal despite much larger gas exchange.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0012-en	By what mechanisms can exercise-induced arterial desaturation occur despite the lung's usual reserve?	Red-cell transit through the capillaries becomes short, ventilation-perfusion matching is imperfect, or diffusion is limited, as exposed by elite endurance demand, altitude, or lung or heart disease.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0013-en	Why does anaemia require a higher cardiac output for the same oxygen delivery even when saturation is normal?	Arterial oxygen content depends mainly on haemoglobin concentration and saturation, with little dissolved in plasma, so low haemoglobin lowers content per unit of blood.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0014-en	How do conditions in active muscle help haemoglobin release oxygen where it is needed?	Increased temperature, carbon dioxide, and acidity lower haemoglobin affinity, facilitating unloading in active tissue, while conditions in the lung support reloading.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0015-en	Why can extra mitochondria not fully compensate for severely limited muscle blood flow?	Oxygen delivery and utilisation are interdependent: mitochondria cannot use oxygen that is not delivered, just as high flow cannot make oxidative ATP without functional mitochondria.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0016-en	In what order are motor units generally recruited as force rises, and what can alter that order?	Lower-threshold fatigue-resistant units come first, then larger faster units; rapid ballistic tasks, electrical stimulation, injury, and specialised movement can modify the order.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0017-en	Why does carbohydrate use generally increase as exercise intensity rises?	Carbohydrate supplies ATP faster and more efficiently per unit oxygen than fat, and rapid ATP demand plus recruitment of more fibres favour glycolysis.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0018-en	Insulin concentration often falls during exercise. How does muscle glucose uptake still rise, and what maintains blood glucose?	Contraction-dependent transporter movement increases muscle glucose uptake independently of insulin, while glucagon and catecholamines support hepatic glucose output.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0019-en	Why does the same absolute workload provoke a smaller hormonal stress response after training?	Hormonal responses are graded by relative intensity, and training raises capacity so the same workload becomes a lower relative demand.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0020-en	What causes cardiovascular drift during prolonged exercise?	Plasma volume falls, reducing stroke volume, so heart rate must rise to maintain the same cardiac output.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0021-en	How does exercise economy differ from maximal oxygen uptake, and how can it improve?	Economy is the oxygen or energy cost at a given submaximal speed or power; it can improve through technique and elastic energy storage without any change in maximal oxygen uptake.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0022-en	What does the effect of deception about time or distance on output show about how performance is regulated?	Performance is regulated by both physiological state and information, because pacing reflects learned predictions about remaining distance and capacity.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0023-en	What distinguishes peripheral from central fatigue within a single bout, and why is neither the whole explanation?	Peripheral fatigue involves metabolites, excitation-contraction coupling, ion shifts, substrate depletion, and damage; central fatigue is reduced effective neural drive. They interact as safety and performance processes.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending
IMF-104-01-0024-en	Why can submaximal thresholds in exercise testing be more informative than a single peak value?	A peak may be limited by symptoms or protocol before a physiological maximum is reached, whereas thresholds and response patterns help locate cardiac, pulmonary, vascular, muscular, or motivational constraints.	Integrated Medical Foundations; chapter 104, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: 937011da9e5805ee0fdaacb25850f6e00238de3efc8030826dcbb266d54486c4; editorial review pending	imf lang::en chapter::104 module::104-01 review::pending