International Personal Training (sample manual)

EQF LEVEL 

4 

Active IQ 

Personal 

Training 

MANUAL 

SAMPLE CONTENT 

SAMPLE VERSION

 

 


2 

SAMPLE VERSION | Copyright © 2022 AIQ International Qualifications. Not for resale

The cardiorespiratory system 

Section 3 

Section 3: The 

cardiorespiratory system 

The heart 

The heart is a muscular pump which transports blood to the tissues via the blood vessels. It is about the size of a 

man’s clenched fist, and it is located behind and to the left of the sternum. 

The walls of the heart consist of three layers: 

• The pericardium – this layer forms a protective 

sac around the heart and is also known as the 

epicardium. 

• The myocardium – this layer is the largest with the 

greatest mass, and is formed from cardiac muscle. 

The left layer of myocardium is much thicker than 

the right so that it is able to pump blood around the 

body. 

• The endocardium – this is the inner lining of the 

heart wall; it is formed of epithelial tissue resting on 

a connective tissue base. 

The heart is divided by the septum (the central wall) into separate left and right halves. 

• The right half receives blood from the body and pumps blood to the lungs. 

• The left half receives blood from the lungs and pumps blood to the body. 

POINT OF 

INTEREST 

Root words: 

Many anatomical terms are made up of 

root words which give away the function, 

location or structure of the subject. 

• peri = ‘around’ 

• myo = ‘muscle’ 

• endo = ‘inside’ 

• cardium = ‘heart’ 

Figure 3.1: Walls of the heart 


The left half of the heart has thicker, more muscular walls than the right, therefore enabling it to pump blood to a 

greater distance around the body. 

Anatomy and physiology for exercise and health 

There are four chambers in total: 

• The two upper chambers (atria) receive blood from the veins. 

• The left atrium receives oxygenated blood from the pulmonary vein. 

• The right atrium receives deoxygenated blood from the superior and inferior venae cavae. 

• The two lower chambers (ventricles) pump blood into the arteries. 

• The left ventricle pumps oxygenated blood around the body via the aorta. 

• The right ventricle pumps deoxygenated blood to the lungs via the pulmonary artery. 

SAMPLE VERSION | Copyright © 2022 AIQ International Qualifications. Not for resale 

3

Section 3 


The upper atria are smaller and less muscular than the lower ventricles. This is because the atria have a receptive 

function that does not require the muscular force of the ventricles, which are required to pump blood powerfully out 

to the lungs or to the body. 

Heart valves 

Figure 3.2: Anatomy of the heart 

Heart valves are formed from tough connective tissue; they are made up of cusps, or flaps, that cover the entrance 

or exit to a vessel or chamber. They open and close passively – either sucked into place or blown open, depending 

on the differential pressure in each chamber or vessel. 

• Semilunar valves lie between the ventricles 

and arteries and prevent backflow of 

blood from the chamber to the vessel. 

The aortic semilunar valve separates 

the left ventricle and the aorta, and the 

pulmonary semilunar valve separates the 

right ventricle and pulmonary artery. 

• Atrioventricular (AV) valves lie between 

the atria and ventricles and prevent 

backflow of blood from the lower to upper 

chambers. The left AV valve is also known 

as the bicuspid valve (two cusps) or the 

mitral valve. The right AV valve is also 

known as the tricuspid valve (three cusps). 


Figure 3.3: The valves of the heart 

4 



Section 3 

Circulation 

Pulmonary 

arteries 

Lungs 

Pulmonary 

veins 

Right 

ventricle 

Right 

atrium 

Venae 

cavae 

Figure 3.4 Blood flow around the body 

The right side of the heart receives blood from the upper and lower body via the superior vena cava and inferior vena 

cava. The blood is saturated in carbon dioxide (CO2) and is referred to as deoxygenated. The deoxygenated blood 

is ejected to the lungs by the right ventricle via the pulmonary artery. 

In the pulmonary capillaries, CO2 diffuses into the lungs to be expired, while oxygen (O2) enters the blood (gaseous 

exchange). The oxygenated blood travels to the left atrium of the heart via the merging venules and veins that finally 

become the pulmonary vein. The left ventricle then ejects the blood and O2 via the aorta to the tissues of the body. 

Once the oxygenated blood reaches the capillaries, gaseous exchange occurs – the oxygen diffuses into the tissues 

and CO2 diffuses into the bloodstream. 

Contraction of the heart 

SA node 

The stimulation starts in the sinoatrial 

(SA) node. 

Atria contract 

The interconnected cardiac muscle 

fibres pass the impulse across the atria. 

AV node 

The atrioventricular (AV) node 

is stimulated and allows the full 

contraction of the atria before 

stimulating the ventricular muscle to 

contract. 

Body 

Aorta 

Left 

atrium 

Left 

ventricle 

The heart is stimulated to contract by a complex series of integrated 

systems. The heart’s pacemaker – the sinoatrial (SA) node – initiates the 

cardiac muscle contraction. The SA node is located in the wall of the right 

atrium (see Figure 3.5). The heart muscle at rest is stimulated to contract 

at a regular, rhythmic rate. 



Ventricles contract 

The AV node stimulates the ventricular 

muscles to contract. 

Figure 3.5: The contraction of the heart 


5

Section 3 


Resting heart rate 

Traditionally it has been taught that average resting heart rate for males is 72 beats per minute (bpm) with the female 

average a little higher at 78 bpm. However, resting heart rates vary considerably between different individuals 

within Western populations, with research showing up to 70 bpm variations, depending on a range of different 

factors. A study of 92,457 people published in 2020 found the average heart rate for the whole population group 

was 65.5 bpm with a range of 40–108 bpm. However, 95% of males had a resting heart rate between 50–80 bpm 

and females between 53–82 bpm. 

Average Resting HR 

68 

66 

64 

62 

60 

Heart rate training zones 

Figure 3.6: Average resting heart rate versus age 

It is common practice to use the valid and reliable method of tracking heart rate data to gauge exercise intensity. To 

calculate heart rate training zones, it is necessary to calculate the maximum heart rate (MHR) and the target heart 

rate (THR). 

Calculating maximum heart rate (MHR) & target heart rate (THR) 

There is a very simple equation for calculating maximum heart rate (MHR): 

Age-predicted MHR = 220 – age 

58 20 30 40 50 60 70 80 

For example, a 26-year-old would have an MHR of 194 bpm (220 – 26 = 194 bpm). 

This theoretical calculation is known to have a level of inaccuracy equivalent to +/– 11 bpm, therefore the actual 

maximum heart rate could range from 183–205 bpm. 

Intensity 

Age 


% MHR 

Very light


Section 3 

Based on ACSM guidelines, most clients should exercise at a target heart rate (THR) between 57% and 100% of 

MHR. 

THR can be calculated by multiplying the individual’s MHR by the desired % MHR. 

Using the 26-year-old above as an example, with an intended training target of 80% MHR: 

THR = MHR x % MHR 

THR = 194 x 80% 

THR = 155 bpm 

If the inaccuracy of the MHR calculation is included, then the target heart rate will have a range. 

183 x 80% = 146 bpm 

205 x 80% = 164 bpm 

Therefore, 80% training intensity will be between 146–164 bpm. 

ACTIVITY 

Use the simple equation above to calculate your: 

• 60% MHR 

• 75% MHR 

• 90% MHR 




7

Section 3 


Structure and function of blood vessels 

As the name suggests, blood vessels are responsible for carrying blood around the body. There are various types of 

blood vessels, which are differentiated by their shape, size and function. 

Blood vessel Structure Function 

Arteries • Thick, muscular walls. 

• Subdivide into smaller blood vessels 

called arterioles. 

• The largest artery is the aorta, which 

leaves the left ventricle carrying blood 

under the highest pressure. 

Veins • Thinner walls than arteries with little 

muscle. 

• Subdivide into smaller blood vessels 

called venules. 

• Contain one-way valves to prevent blood 

from flowing in the wrong direction. 

Capillaries • Extremely thin walls (approximately one 

cell thick). 

• Link arteries to veins. 

• Significantly higher in number than 

arteries and veins. 

• Carry blood under high pressure away 

from the heart. 

• All carry oxygenated blood except the 

pulmonary artery. 

• Carry blood towards the heart under lowto-moderate 

pressure. 

• All carry deoxygenated blood except the 

pulmonary vein. 

• Allow for diffusion of gases and nutrients 

throughout the body, including muscle 

tissues. 

Table 3.2: Blood vessel properties 


Figure 3.7: Structure of the blood vessels 

8 



Section 3 

Atherosclerosis 

In a healthy blood vessel, blood flows smoothly to reach its target tissue or organ and supply it with the nutrients 

and oxygen it requires for optimal function. Vascular disease is the narrowing of the blood vessels, and it is one 

of the main causes of death in the developed world. It is triggered by inflammation within blood vessels and the 

subsequent accumulation of mineral, protein and fat deposits. This creates a build-up of plaque on vessel walls; this 

can ultimately lead to a blockage that can severely restrict, or completely prevent, blood flow. As a consequence of 

this, tissues and organs can be starved of vital nutrients and oxygen. 

Vascular disease is most commonly caused by the hardening of arteries – a condition called atherosclerosis (see 

Figure 3.8). Atherosclerosis is initiated by the inflammatory response to vessel damage that creates plaque, using 

cholesterol, protein and mineral deposits in an attempt to heal the area. 

As plaque builds up, the artery wall becomes thicker, harder and less elastic. The artery narrows as a consequence 

of the build-up and cannot effectively stretch to accommodate blood. 

A lack of blood flow as a result of atherosclerosis can cause target tissue death unless those tissues are supplied 

by blood from alternative arteries. 

1 – Inflammation 

Known as the ‘fatty streak’ stage because this is how 

the condition first becomes visible. 

Damage (e.g. caused by smoking or hypertension) 

initiates an inflammatory response. 

2 – Narrowing 

The body tries to repair the damaged area using 

cholesterol, proteins and minerals. 

These substances build up, creating a ‘plaque’ that 

thickens and hardens the artery walls. 

The artery is narrowed by the plaque build-up. 

3 – Blockage 

The plaques build up so much that they rupture and 

release cholesterol and connective tissue into the 

artery. 

The body’s protective mechanism creates a blood 

clot around the rupture which further scars, hardens 

and can block the entire artery. These are called 

‘complicated lesions’. 

Figure 3.8: Atherosclerosis 

Atherosclerosis commonly affects the arteries of the heart and brain and produces varying symptoms, depending 

on the tissues involved. Coronary atherosclerosis can be associated with chest pain on exertion that settles with 

rest. This is referred to as angina pectoris, which literally means ‘strangles chest’, and is the direct result of 

reduced blood flow to the heart muscle. 


If a coronary artery is completely blocked, the area of 

the heart which is deprived of blood will die, causing a 

heart attack (myocardial infarction). 

Blockages in small arteries in the brain deprive areas of 

the brain of blood, resulting in a stroke (cerebrovascular 

accident). 


A combination of genetic and lifestyle factors (such 

as family history, lack of exercise, stress, unhealthy 

diet, being overweight and smoking) play a role in the 

damage and gradual build-up of plaque within the 

vessel walls. 


9

Section 3 


Coronary heart disease 

Figure 3.9: Plaque build-up within the coronary artery 

The coronary arteries are the major blood vessels that supply the heart with blood. Due to a range of different 

factors, it is possible that they can begin to narrow because of arterial plaque build-up, resulting in a reduced blood 

supply to the heart. This can cause angina pectoris. Angina often feels like a heaviness or tightness in the chest, 

which may spread to the arms, neck, jaw, back or stomach as well. If a coronary artery becomes completely blocked, 

it can cause a heart attack. Heart attack symptoms vary from one person to another. The most common signs and 

symptoms are: 

• Chest pain: tightness, heaviness, pain or a burning feeling in the chest. 

• Varying levels of pain in arms, neck, jaw, back or stomach. 

• Sweating. 

• Light-headedness. 

• Shortness of breath. 

• Nausea or vomiting. 

Risk factors for coronary heart disease (CHD) 

The main risk factors for all cardiovascular disease, especially coronary heart disease (CHD) are identified in Table 

3.3 as non-modifiable (cannot change) and modifiable (can change) risk factors. 

Non-modifiable CHD risk factors 

• Family history of heart disease. 

• Ethnicity, e.g. Asian, Hispanic and Latino, African 

American. 

• Sex – males are at greater risk than females. 

• Age – older ages groups are at greater risk. 

Modifiable CHD risk factors 

• Smoking. 

• High blood pressure. 

• High blood cholesterol. 

• Type 2 diabetes mellitus. 

• Overweight or obesity. 

• Physical inactivity. 

• Poor dietary habits. 

• Chronic, high stress. 

• Excess alcohol consumption. 


Table 3.3: Heart disease risk factors 

The greater the number of risk factors present, the higher the possibility of developing CHD. The non-modifiable 

risk factors cannot be changed, but by themselves they are less likely to result in CHD without the impact of some 

of the modifiable risk factors. The modifiable risk factors are mostly related to lifestyle and behaviour choices, and 

are therefore subject to change to help reduce the risk of CHD. 

10 



Section 3 

Lifestyle interventions 

Addressing one risk factor, such as smoking cessation, will elicit health benefits. However, to significantly reduce the 

risk of developing CHD, a broader lifestyle change approach will be required. 

Important lifestyle changes that will improve health and also reduce CHD risk may include: 

• Smoking cessation. 

• Staying within recommended alcohol limits (1–2 units per day maximum). 

• Following a healthy diet, according to recommendations. 

• Maintaining a healthy body weight, according to BMI. 

• Engaging in regular physical activity and exercise, according to current guidelines. 

• Planning adequate rest and relaxation time, and reducing stress where possible. 




11

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info@activeiq.co.uk 

www.activeiq.co.uk 

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accuracy, the material contained within 

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Reproduction of this publication is 

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Copyright © 2022 AIQ International Qualifications. Not for resale

International Personal Training (sample manual)

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