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clinical phys > Clinical Exercise Physiology - Final Exam Review (2022).docx > Flashcards

Clinical Exercise Physiology - Final Exam Review (2022).docx Flashcards

1
Q

What are the different certifications for Clinical Exercise Physiology?

A

A minimum of a bachelor’s degree in exercise science (1700 hours of clinical experience) and a master’s in clinical exercise physiology (600 hours of clinical experience).

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2
Q

What are the differences within the certifications for Clinical Exercise Physiology?

A

Clinical Exercise Physiologists (CEPs) need a master’s degree and must pass the ACSM CEP test. Exercise Physiologists (EPs) need a minimum bachelor’s degree and must pass the certification exam from ACSM.

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3
Q

What are some diseases and conditions related to lack of exercise?

A

Cancer, cardiovascular disease (CVD), non-insulin dependent diabetes, mood and mental health.

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4
Q

How do diseases related to lack of exercise relate to exercise levels?

A

Use it or lose it.

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5
Q

What is expected from clinical exercise physiologists?

A

Retention and exercise.

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6
Q

What are the health and fitness benefits of physical activity?

A

Cardiorespiratory fitness, muscular strength & endurance, musculoskeletal flexibility, body weight, caloric expenditure.

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7
Q

What is self-efficacy?

A

The belief that an individual can perform a task.

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8
Q

What is social support in relation to exercise adherence?

A

Cheering people on.

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9
Q

What has been the traditional method for exercise prescription and promotion?

A

Lifestyle-based physical activity promotion focusing on home or community activities that include daily tasks.

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10
Q

Why does the traditional method for exercise prescription have a low adherence rate?

A

Perceived lack of time.

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11
Q

What is the ecological perspective in exercise behavior?

A

Everything in your surroundings influences your behavior, helping realize the barriers people face.

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12
Q

What are some factors involved in exercise adherence?

A

Lack of time, social influence, community, public policy.

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13
Q

What are some tips for overcoming barriers to physical activity?

A

Promote changes that can happen in the home.

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14
Q

What are the different routes of administration for drugs?

A

IV, through the mouth/GI tract, through the skin, intramuscular.

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15
Q

What are the 3 different phases of the drug effect?

A
  1. Pharmaceutical: how a drug is processed from administered state. 2. Pharmacokinetic: effect the body has on the drug. 3. Pharmacodynamic: effect of the drug molecule in the body.
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16
Q

What is the keyhole concept?

A

A concept related to drug action.

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17
Q

What is the therapeutic index?

A

Knowing what amount of a drug is therapeutic or toxic.

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18
Q

What are the factors that modify drug response?

A

Age, body mass, food in GI tract, gender.

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19
Q

Why is compliance important in drug therapy?

A

Finishing or taking drugs as prescribed allows the drug’s intended effects to perform properly.

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20
Q

What are common medications and their effects on heart rate and blood pressure?

A

Beta-blockers, calcium channel blockers, angiotensin II receptor blockers, vasodilators.

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21
Q

What are the essentials for a clinical evaluation?

A

General interview, exam, lab data, diagnostic tests, assessment, plan.

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22
Q

What does the HPI involve?

A

It establishes a baseline of health for the patient and involves an interview that begins with the chief complaint.

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23
Q

What is the OPQRSTA method?

A

O= onset, P= provocation/palliation, Q= quality, R= region/radiation, S= severity, T= timing, A= associated signs and symptoms.

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24
Q

What does a physical examination entail?

A

Looking for abnormalities, patient complaints, auscultation, blood pressure, weight, gait, BMI, and infection.

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25
Q

What are some red flag indicators of clinical status?

A

Indicators that suggest a serious underlying condition.

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26
Q

What does peripheral edema indicate?

A

Heart failure: the heart is unable to efficiently pump blood and inefficient venous return.

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27
Q

What is the purpose of a GXT?

A

To evaluate chest pain to diagnose CAD and identify future risk or prognosis.

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28
Q

What are the absolute contraindications to GXT?

A

Certain abnormalities on resting ECG, unstable angina, decompensated heart failure, severe aortic stenosis.

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29
Q

What are the signs and symptoms of maximal effort during GXT?

A

Plateau in VO2, RER value > 1.1, blood lactate exceeds 8-10 mmol, PRE > 17, 85% of predicted HR.

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30
Q

What are the 5 components of physical fitness?

A

Cardiovascular endurance, muscular endurance, flexibility, body composition, muscular strength.

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31
Q

What is HRR and how do you calculate it?

A

Calculate HR max (220-age), HRmax-HRrest, multiply by intensity, add that to HRrest.

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32
Q

What are the different forms of diabetes?

A

Type 1, Type 2, gestational diabetes.

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33
Q

What are the hormones of interest in diabetes?

A

Insulin: moves sugar from the blood into cells. Glucagon: stimulates liver to make glucose.

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34
Q

What are the complications and symptoms of hyperglycemia and hypoglycemia?

A

Hypoglycemia: hunger, nervousness, irritability, fatigue, confusion. Hyperglycemia: frequent urination, increased thirst, blurry vision, dry mouth, fruity breath.

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35
Q

What are the causes of hyperglycemia and hypoglycemia?

A

Hyperglycemia: body has too little insulin or insulin resistance. Hypoglycemia: too much insulin, diet, genetics.

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36
Q

What are the signs and symptoms for diabetes?

A

Frequent urination, fatigue, excessive thirst, itchy dry skin, hunger pangs.

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37
Q

How is obesity determined?

A

BMI > 30.

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38
Q

What is the difference between visceral fat and subcutaneous fat?

A

Visceral fat surrounds vital organs; subcutaneous fat is under the skin.

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39
Q

What are the roles of leptin, ghrelin, and neuropeptide Y?

A

Leptin: hormone that lets you feel full. Ghrelin: hormone that makes you feel hungry.

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40
Q

What is the set point theory?

A

The idea that the body has an ideal weight range it wants to be in.

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41
Q

What are the side effects of obesity?

A

CVD, type 2 diabetes.

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42
Q

What role does behavioral therapy play in weight loss?

A

Helps individuals utilize their state of mind to make changes and address emotional issues.

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43
Q

What are some examples of drugs prescribed to overweight individuals?

A

Phentermine (appetite suppressant), Qsymia (appetite suppression), Belviq (satiety enhancer).

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44
Q

What is the difference between idiopathic, essential, primary, and secondary hypertension?

A

Idiopathic: cause unknown. Essential: genetically based. Secondary: renal or endocrine.

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45
Q

What are the different stages of hypertension?

A

normal: 120/80
prehypertension: 120-139/80-89
stage 1: 140-159/90-99
stage 2: >=160/>=100

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46
Q

Why does hypertension occur as one gets older?

A

Vessels become rigid and stiff, making it difficult to adjust to changes in blood pressure.

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47
Q

How is blood pressure determined?

A

BP = CO x PR.

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48
Q

How does untreated hypertension lead to death?

A

Damages endothelium, which predisposes individuals to atherosclerosis, leading to heart attack or stroke.

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49
Q

What happens to blood vessels as one gets older?

A

Vessels become rigid and stiff, making it difficult to adjust to changes in blood pressure.

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50
Q

Which populations are at greater risk for hypertension?

A

Elderly and obese individuals.

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51
Q

How does untreated hypertension lead to death?

A

It damages the endothelium, which predisposes individuals to atherosclerosis, potentially leading to heart attack or stroke.

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52
Q

Why does hypertension cause endothelium damage?

A

High volume of blood causes imperfections in the wall, leading to atherosclerosis because plaque has places to catch on.

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53
Q

How is ventricular hypertrophy related to hypertension and heart failure?

A

Hypertension increases workload on the heart, leading to left ventricular hypertrophy, which could result in heart failure from excessive workload.

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54
Q

What are some signs and symptoms of hypertension?

A

Headache, dizziness, easy fatigue, palpitations.

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55
Q

What are some examples of drugs used to treat hypertension?

A

ACE inhibitors block aldosterone for excess sodium uptake; Ca channel blockers block cardiac muscle contraction; Beta blockers block epinephrine and norepinephrine.

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56
Q

What are some laboratory tests for hypertension besides blood pressure?

A

Blood pressure reading, two measurements over two or more visits, urinalysis, blood chemistry, ECG, hematocrit.

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57
Q

What are some anticipated responses during exercise for blood pressure?

A

Blood pressure will spike during exercise but then come back down.

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58
Q

What are lipoproteins and apolipoproteins?

A

Lipoproteins are complexes that transport lipids in the blood; apolipoproteins are the protein components of lipoproteins.

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59
Q

What is the difference between hypertriglyceridemia and postprandial lipemia?

A

Hypertriglyceridemia is excess triglycerides in the blood; postprandial lipemia refers to fat levels immediately after eating.

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60
Q

What is hyperlipoproteinemia?

A

A condition characterized by an excess of lipoproteins in the blood.

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61
Q

What are the functions of Lipoprotein Lipase and Hepatic Lipase?

A

Lipoprotein lipase breaks down triglycerides in lipoproteins; hepatic lipase is involved in the metabolism of lipoproteins.

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62
Q

Are there any different exercise responses in individuals with dyslipidemia?

A

No, there are no different exercise responses.

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63
Q

How much weight loss is recommended to help with dyslipidemia?

A

5-10% weight loss is recommended.

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64
Q

What are some lipid-lowering medications and their functions?

A

Statins reduce lipid synthesis in the liver; fibric acid decreases fatty acid size; nicotinic acids increase HDL and lower LDL.

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65
Q

How much exercise is needed to show changes in HDL levels?

A

One exercise bout can change HDL levels.

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66
Q

What are the risk factors associated with metabolic syndrome?

A

Obesity, hypertension, dyslipidemia, and insulin resistance.

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67
Q

What is normal weight obesity and why does it occur as you age?

A

High body mass or waist circumference with excellent cardiovascular health, leading to increased risk for osteoporosis and sarcopenia.

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68
Q

Why has pediatric metabolic syndrome become an area of importance?

A

It puts children at risk for type 2 diabetes and heart disease as adults.

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69
Q

What is the role of insulin resistance in metabolic syndrome?

A

It causes hyperinsulinemia, increased lipogenesis, hypertriglyceridemia, and hypertension.

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70
Q

Why does insulin resistance increase the risk for metabolic syndrome?

A

It can raise blood pressure and triglyceride levels, leading to inflammation and ectopic adiposity.

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71
Q

What is ectopic adiposity?

A

Ectopic fat stores triglycerides in tissues that don’t normally contain large amounts of fat, interfering with cellular functions.

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72
Q

What does it mean that adipose tissue is proinflammatory?

A

Adipose tissues cause inflammation due to elevated levels of inflammatory cytokines and hormones.

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73
Q

Why is metabolic syndrome under criticism?

A

It describes relative risk, differing predictive value, and includes individuals with established diabetes and cardiovascular disease.

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74
Q

What are some treatment goals for metabolic syndrome?

A

Weight loss (minimum of 10%), improvements in diet quality, participation in physical activity, and smoking cessation.

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75
Q

What are the different stages of renal disease?

A

Stage 1: GFR <= 90; Stage 2: GFR 60-88; Stage 3: GFR 30-59; Stage 4: GFR 15-29; Stage 5: GFR > 15.

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76
Q

What are the treatment plans for renal disease?

A

Hemodialysis, peritoneal dialysis, and kidney transplant.

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77
Q

What are some side effects or complications of dialysis?

A

Hemodialysis is time-consuming; peritoneal dialysis is more invasive; transplant lists are long, and patients must take anti-rejection medications.

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78
Q

What are some diagnostic tests for renal disease?

A

Elevated serum creatinine, blood urea nitrogen, reduced GFR, blood tests, urinalysis, and CAT scans.

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79
Q

What are key areas to pay attention to when prescribing exercise for renal disease?

A

Peak O2 uptake is low, graded exercise testing is not helpful, and exercise should be on non-dialysis days.

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80
Q

Why is CHD the most common cause of death in the US?

A

Due to rising obesity rates.

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81
Q

What is atherosclerosis?

A

A buildup of plaque in vessels caused by obesity, hypertension, and dyslipidemia.

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82
Q

What are the risk factors for increased atherogenesis?

A

Endothelial injury, inflammatory response, tobacco smoke, LDL, and hypertension.

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83
Q

What are the three causes of ischemia?

A

Stenosis, occlusion, and reduced blood flow.

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84
Q

What is angina/unstable angina?

A

It is likely a result of transient vessel occlusion followed by spontaneous thrombolysis and vasorelaxation.

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85
Q

What occurs in a myocardial infarction?

A

Chest pain lasting more than 30 minutes, with ECG showing ST-segment elevation or T wave changes.

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86
Q

What are the treatment mechanisms for coronary syndromes?

A

Anti-ischemic therapy, oral and intravenous antiplatelet therapy, and reperfusion therapy.

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87
Q

What are the complications of acute myocardial infarction?

A

Arrhythmias and conduction abnormalities.

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88
Q

What are some pharmaceutical drugs used to treat cardiac problems?

A

Nitroglycerin, beta blockers, ACE inhibitors, aspirin, and anticoagulants.

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89
Q

What is the ischemic cascade?

A

A series of interconnected events that occur within tissue when blood supply is significantly reduced, leading to cell death if not addressed.

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90
Q

What is the difference between infarction and ischemia?

A

Infarction is necrosis of cardiac myocytes from prolonged ischemia; ischemia is when a body part doesn’t receive enough blood, leading to tissue damage.

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91
Q

Does an occlusion equal immediate infarction?

A

Not necessarily; however, if occlusion persists for more than one hour, it is the hallmark of acute myocardial infarction.

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92
Q

What is revascularization surgery?

A

Surgery to provide new or additional blood supply to a body part or organ.

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93
Q

What are the differences between CABS and PTCA?

A

CABS is bypassing a blockage; PTCA involves placing a stent.

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94
Q

What is the difference between HFREF and HFPEF?

A

HFREF is trouble emptying (systolic), while HFPEF is trouble filling (normal ejection fraction, diastolic).

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95
Q

What are some clinical symptoms of heart failure?

A

Paroxysmal nocturnal dyspnea, dyspnea on exertion, change in fatigue level, and fluid retention.

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96
Q

What are some anticipated responses in those with heart failure?

A

Decreased ejection fraction, decreased cardiac output, decreased stroke volume, increased heart rate at rest, and decreased oxygen saturation at submax and peak exercise.

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97
Q

When is a cardiac transplant recommended?

A

When survival rates are high, but complications include loss of cardiac autonomic fibers.

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98
Q

What is meant by PAD?

A

Blockage of leg arteries by plaque, resulting in stenosis or occlusion.

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99
Q

What is intermittent claudication?

A

Muscle pain that occurs during activity and stops with rest due to PAD.

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100
Q

What is critical limb ischemia?

A

Severe blockage in the arteries of the lower extremities and reduced blood flow.

101
Q

What is the ABI test?

A

An office-based test that measures the ratio of ankle pressure to brachial pressure.

102
Q

What populations are at higher risk for PAD?

A

Obese individuals or smokers.

103
Q

What are the signs and symptoms of PAD?

A

Cramping, aching, tightening, and fatigue in the lower extremities.

104
Q

What is meant by hemodynamic testing with the ABI test?

A

Normal ABI is >1; <0.5 indicates severe PAD; >1.3 indicates abnormal calcification.

105
Q

What is the function of cilostazol?

A

It is used to treat intermittent claudication.

106
Q

What is the overall exercise recommendation for those with intermittent claudication?

A

Walking up to 50 minutes, combining rest and exercise followed by decreased workload.

107
Q

What is the purpose of a pacemaker?

A

To maintain a normal heart rate when the intrinsic electrical circuitry of the heart fails.

108
Q

What are common indications for a pacemaker?

A

A heart rate that is too slow due to SA node dysfunction or conduction block in the AV node.

109
Q

What occurs in an AV node or heart block?

A

The electrical signal is blocked, causing loss of AV synchrony.

110
Q

What are the different types of pacemakers?

A

Temporary, single chamber permanent, and dual chamber permanent.

111
Q

What is the importance of rate responsive pacing?

A

It senses the body’s need for increased cardiac output.

112
Q

How does rate responsive pacing work?

A

The pacemaker range allows for heart rate changes based on activity level.

113
Q

What might be some positives and negatives for pacemaker usage?

A

Defibrillators can be placed with pacemakers; graded exercise testing is encouraged to determine pacemaker suitability for exercise.

114
Q

What is classified as COPD?

A

A disease characterized by the presence of airflow obstruction attributable to chronic bronchitis or emphysema.

115
Q

What is chronic bronchitis?

A

The presence of a productive cough most days during three consecutive months for two successive years.

116
Q

What is emphysema?

A

Abnormal permanent enlargement of respiratory bronchioles and alveoli.

117
Q

How is spirometry used to help determine COPD?

A

A reduction in FEV1 is a strong predictor of mortality rate.

118
Q

What are the different stages of COPD based on the FEV1/FVC ratios?

A

1: FEV1 >= 50% of predicted (mild); 2: FEV1 between 35-49% (moderate); 3: FEV1 < 35% (severe).

119
Q

What is FEV1 and how does it relate to FVC?

A

FEV1 is forced expiratory volume in one second, and FVC is forced vital capacity. Their ratio is used to assess lung function.

120
Q

What are the different stages of COPD based on the FEV1/FVC ratios?

A

1: FEV1 >= 50% of predicted; mild. 2: FEV1 between 35-49%; moderate. 3: FEV1 <35% predicted.

121
Q

How does hyperinflation of the lungs relate to dyspnea?

A

Hyperinflation can lead to difficulty in breathing, causing dyspnea.

122
Q

How does COPD cause skeletal muscle dysfunction?

A

COPD leads to a reduction in type 1 fibers and an increase in type 2 fibers in the quadriceps, limiting aerobic exercise and causing atrophy of type 1 fibers.

123
Q

What are the exercise responses in COPD patients?

A

Refer to Table 19.2.

124
Q

What therapies have been used to help COPD?

A

Oxygen therapy and pharmacological therapy.

125
Q

What are the different pharmacological therapies used for COPD?

A

Steroids (dilators), beta 2 agonists (bronchodilators).

126
Q

How is asthma related to COPD?

A

Asthma is not chronic and is often caused by allergies or exercise.

127
Q

What is the physiology of asthma?

A

Asthma involves inflammation in medium-sized bronchi, structural changes, hypertrophy, hyperplasia, and mucus hypersecretion.

128
Q

What factors cause asthma?

A

Host factors: genetic, obesity, gender. Environmental factors: allergens, infections, smoke, air pollution, diet.

129
Q

What roles do CD4 lymphocytes, eosinophils, and mast cells play in asthma?

A

These cells are involved in the inflammatory response that characterizes asthma.

130
Q

How is spirometry used to diagnose asthma?

A

FEV1 (<80% of predicted), FEV1/FVC <65% predicted, flow volume loop.

131
Q

Is exercise testing required for individuals with asthma?

A

Typically reserved for unusual declines in exercise tolerance.

132
Q

What considerations need to be made for exercise training in asthma?

A

Individuals are sensitive to changes in air temperature and humidity.

133
Q

What medications are used for asthma?

A

Corticosteroids, immunomodulators, leukotriene modifiers, long-lasting beta agonists, methylxanthines.

134
Q

What is cystic fibrosis and what are its symptoms?

A

CF can be misdiagnosed as asthma, bronchitis, or pneumonia due to similar symptoms.

135
Q

What gene is CF located on and what change does it cause?

A

Chromosome 7; it produces CFTR, a protein that functions as a chloride channel.

136
Q

What is CFTR and what does it do?

A

CFTR is a protein that functions as a chloride channel, causing symptoms of CF.

137
Q

What diseases are related to CF?

A

Hemoptysis, nocturnal headaches or cyanosis, pulmonary hypertension, right heart failure.

138
Q

What are the effects of CF on various body systems?

A

Exocrine pancreatic insufficiency leads to malabsorption of nutrients, sinus infections, CF-related diabetes, bone disease, and salty sweat.

139
Q

What role do oxyhemoglobin saturation, hypoxemia, and scoliosis play in CF?

A

Saturation is lower due to impaired gas exchange from elevated mucus levels. Hypoxia leads to lung function decline and increased inflammation. Scoliosis affects lung filling.

140
Q

What diagnostic tests can be used to screen for CF?

A

Genetic testing, chest X-ray, sputum culture, chest CT, liver function tests.

141
Q

What exercise special considerations need to be noted for CF?

A

Monitor pulse oximetry and use ECG at baseline maximal aerobic exercise.

142
Q

What drugs help with CF?

A

Mucolytics, bronchodilators, anti-inflammatories, antibiotics.

143
Q

What are some anticipated responses to exercise in the CF population?

A

Pneumothorax.

144
Q

What is the term neoplasm?

A

Abnormal growth of tissue.

145
Q

What does the term metastasize mean?

A

The ability to spread to other body parts.

146
Q

What are some risk factors that affect cancer?

A

Cancer affects all genders, ages, and ethnicities equally.

147
Q

What role do stem cells have in causing cancer?

A

Stem cells can contribute to the development of cancerous cells.

148
Q

What are the five broad categories for causing cancer?

A

Environment, heredity, oncogenes, hormones, impaired immune system function.

149
Q

What are oncogenes and tumor suppressor genes?

A

Oncogenes promote cancer, while tumor suppressor genes inhibit it.

150
Q

What are the components of the immune system related to cancer?

A

Components include lymphocytes, macrophages, and dendritic cells, which can recognize and destroy cancer cells.

151
Q

What is the adaptive vs the acquired immune system?

A

The adaptive immune system develops a response to specific pathogens, while the acquired immune system is the body’s long-term defense.

152
Q

How does estrogen play a role in cancer?

A

Estrogen presence could potentially accelerate cancer cell growth.

153
Q

What are the four types of cancer?

A

Carcinoma (epithelial cells), sarcoma (connective tissues), leukemia (white blood cells), lymphoma (lymphatic system).

154
Q

What are the signs and symptoms of cancer?

A

Weight loss, fatigue, nausea, malaise.

155
Q

How can cancer be diagnosed?

A

Through biopsy of tissue or tumor.

156
Q

What are the different treatment plans for cancer?

A

Surgery to excise tumors, biotherapy to stimulate immune response, chemotherapy to minimize cancer cells, radiation to damage DNA in cells.

157
Q

What are the preferences for different treatment plans?

A

Based on the stage, type, and location of cancer.

158
Q

What is the difference between AIDS and HIV?

A

HIV is defined as having >= 200 CD4 cells; AIDS is the later stage with < 200 CD4 cells.

159
Q

What type of virus is HIV?

A

HIV is a retrovirus that takes over cells and duplicates itself, leading to the destruction of the immune system.

160
Q

What is HAART and how does it relate to HIV treatment?

A

HAART reduces RNA and DNA replication of the HIV virus.

161
Q

What are the different stages of HIV?

A

1: CD4 count >= 500 cells, 2: CD4 count 200-499, 3: AIDS, CD4 count <200.

162
Q

What are the primary routes of HIV infection?

A

Infection occurs through bodily fluids and IV drug use; it is not transferred by insects, saliva, or sweat.

163
Q

What are the signs and symptoms of HIV?

A

Sore throat, fever, fatigue.

164
Q

What is meant by wasting in individuals with HIV?

A

Wasting refers to significant weight loss.

165
Q

What complications can arise from HIV?

A

Changes in glucose, lipid levels, and insulin resistance.

166
Q

What is lipodystrophy?

A

Loss of subcutaneous fat deposits in arms, legs, and face, with an increase in visceral fat.

167
Q

What is cardiac dysfunction in HIV?

A

Cardiac dysfunction can lead to arrhythmias.

168
Q

What exercise precautions need to be taken for individuals with HIV?

A

High fatigue, assess for orthopedic complications, test early in the morning.

169
Q

What are the complications of HAART regimens?

A

Assess for HAART-related orthopedic complications, test early in the morning.

170
Q

How do the drugs that treat HIV work?

A

They inhibit viral replication and help manage symptoms.

171
Q

What is the general description of arthritis?

A

Arthritis is characterized by inflammation of the joints.

172
Q

What are the signs and symptoms of arthritis?

A

Joint pain, swelling, stiffness, and decreased range of motion.

173
Q

What are some common negative features affected by arthritis?

A

Joint damage and loss of function occur due to inflammation.

174
Q

What is crepitus, effusion, and bone spurs?

A

Crepitus is a crackling sound, effusion is swelling in the joint, and bone spurs are bony projections that develop along joint margins.

175
Q

What populations are most affected by rheumatoid arthritis?

A

Women are more commonly affected.

176
Q

How does rheumatoid arthritis occur?

A

It is a chronic autoimmune disorder that causes systemic inflammation affecting synovial joints.

177
Q

What is ankylosis?

A

Ankylosis is the fusion of bones in a joint.

178
Q

What are the three levels of arthritis?

A

Acute: reversible signs and symptoms. Chronic: stable but irreversible structural damage. Chronic with acute exacerbation: increased pain and decreased range of motion.

179
Q

What are the general exercise goals for those with arthritis?

A

Small workloads and increments; cycle ergometry is preferred.

180
Q

What are some site-specific recommendations for exercise for those with arthritis?

A

Consider joint protection and pain management strategies.

181
Q

What specific factors need to be considered for exercise?

A

Time of day, aquatic exercise, footwear, cardio/pulmonary health, spondylitis, corticosteroids, body composition, etc.

182
Q

What is the difference between osteoporosis and osteopenia?

A

Osteopenia is a less severe form of osteoporosis.

183
Q

How are osteoporosis and osteopenia determined?

A

Through bone density measurements.

184
Q

What stages does bone remodeling consist of?

A

Bone remodeling consists of resorption and formation stages.

185
Q

What is meant by trabecular, cortical, and peak bone mass/density?

A

Cortical refers to the outer bone covering; trabecular refers to the inner bone tissue.

186
Q

How are osteoblasts and osteoclasts related?

A

Osteoclasts break down bone (stimulated by PTH), while osteoblasts build bone (stimulated by calcitonin).

187
Q

What are the risk factors for osteoporosis?

A

Caucasian or Asian descent, female gender, height <67 inches, weight <127 lbs, early menopause, estrogen deficiency, amenorrhea, inactivity.

188
Q

How is bone mineral content determined?

A

Through DXA scans, measuring bone mineral content per unit area.

189
Q

What are nonpharmacological and pharmacological ways to slow the loss of bone mass?

A

Calcium and vitamin D supplementation, weight-bearing activities.

190
Q

What hormonal therapies alter osteoporosis?

A

Calcitonin, PTH, SERMs, estrogen therapy.

191
Q

Why do hormonal therapies work?

A

Estrogen plays a role in maintaining bone density.

192
Q

What is the prevalence of non-specific low back pain (NSLBP)?

A

Annual rates of 14-93%, peaking between ages 45 and 60.

193
Q

Why does NSLBP occur?

A

It is often a symptom without an identifiable cause, possibly due to nerve root compression.

194
Q

What is meant by herniation, ankylosing spondylitis, red flags, secondary prevention, and primary prevention?

A

These terms relate to conditions and strategies for managing low back pain.

195
Q

What steps can be taken to increase prevention rates for NSLBP?

A

Engaging in regular exercise and maintaining good posture.

196
Q

What is the difference between yellow and red flags?

A

Yellow flags indicate psychosocial factors that may affect recovery; red flags indicate serious underlying conditions.

197
Q

What methods help determine the cause of NSLBP?

A

MRI and X-rays.

198
Q

What are the treatment plans for NSLBP?

A

Medication, exercise, passive modalities, facet joint injections, surgery.

199
Q

What do terms like spinal traction and spinal discectomy mean?

A

Spinal traction relieves pressure on the spine; spinal discectomy involves removing a herniated disc.

200
Q

What are some primary and secondary prevention strategies for NSLBP?

A

Primary: education and lifestyle changes. Secondary: early intervention and rehabilitation.

201
Q

What is spinal cord injury (SCI)?

A

SCI affects the conduction of neural signals across the site of the injury or lesion.

202
Q

What is the difference between tetraplegia and quadriplegia?

A

Tetraplegia refers to dysfunction of the arms; quadriplegia refers to paralysis of all four limbs.

203
Q

How is paraplegia different from tetraplegia?

A

Paraplegia affects only the lower limbs.

204
Q

Why are men at higher risk for SCI?

A

Men often engage in riskier behaviors leading to injuries.

205
Q

What are the different degrees of impairment in SCI?

A

They are classified as complete or incomplete based on the preservation of sensory or motor function.

206
Q

What are the different segments of the spinal cord?

A

Cervical, thoracic, lumbar.

207
Q

What effect does an injury to the C4 section of the spine have?

A

It results in quadriplegia and complete paralysis below the neck.

208
Q

Why are orthostatic hypotension and autonomic dysreflexia important in SCI?

A

They relate to the body’s inability to send appropriate signals due to disrupted autonomic nervous system function.

209
Q

Why are pulmonary ventilation and other systems impaired in SCI individuals?

A

The autonomic nervous system is disrupted, affecting various bodily functions.

210
Q

What comorbid diseases are common in SCI patients?

A

Endocrine response issues, osteopenia, respiratory issues, CAD, PAD, type 2 diabetes.

211
Q

How might functional electrical stimulation (FES) help with exercise?

A

FES can stimulate muscle contractions to aid in rehabilitation.

212
Q

Why is temperature regulation important in exercise for those with SCI/tetraplegia?

A

Individuals may have impaired ability to regulate body temperature, increasing the risk of heat-related illnesses.

213
Q

What is the standard explanation of why multiple sclerosis (MS) occurs?

A

The cause is unknown, but it is characterized by nerve demyelination.

214
Q

Why is MS considered an autoimmune response?

A

The immune system mistakenly attacks the myelin sheath surrounding nerves.

215
Q

What types of cells are responsible for myelin destruction in MS?

A

T cells.

216
Q

What are the four stages of MS?

A

They are characterized by varying degrees of disability and symptom severity.

217
Q

What is meant by optic neuritis, nystagmus, and paresthesia?

A

These are symptoms related to MS affecting vision and sensation.

218
Q

What are the characteristics of muscle spasticity?

A

Muscle spasticity involves increased muscle tone and involuntary contractions.

219
Q

What are common symptoms of MS?

A

Optic neuritis, nystagmus, muscle weakness, muscle spasticity, fatigue, depression, numbness, tingling pain, muscle spasms.

220
Q

What scales and tests are used to rate MS symptoms?

A

Various clinical scales assess disability and symptom severity.

221
Q

What diagnostic tests are used to determine MS?

A

Medical history, neurological exam, MRI, cerebrospinal fluid analysis, blood tests.

222
Q

Why might exercise testing be beneficial for those with MS?

A

It provides baseline measures for future comparisons and helps assess individual responses.

223
Q

What are the treatment plans for MS?

A

Physical therapy, occupational therapy, speech pathology.

224
Q

What is the current drug that may help with MS?

A

Various disease-modifying therapies are available to manage symptoms.

225
Q

What is meant by diplegia, hemiplegia, quadriplegia, choreathetosis, and ataxia?

A

Ataxia refers to a lack of voluntary coordination of muscle movements.

226
Q

What are the most common risk factors for cerebral palsy (CP)?

A

Premature birth, low birth weight, maternal infections, drug abuse, birth anoxia.

227
Q

What are the signs and symptoms of CP?

A

Developmental delays, abnormal muscle tone, abnormal posture, movement issues, speech difficulties.

228
Q

What are the associated and secondary conditions common in CP?

A

Incontinence, intellectual disabilities, osteoporosis, hip dislocation, dysphagia, GERD, drooping.

229
Q

What changes occur to gait and postural movements in CP?

A

Gait may be affected by muscle tone and coordination issues.

230
Q

What tests/measurements assess gait and spasticity?

A

Clinical assessments and standardized tests are used.

231
Q

What is the ICF model and how does it help those with CP?

A

The ICF model provides a framework for understanding health and disability.

232
Q

What are the nonpharmacological treatments for CP?

A

Electrical stimulation and physical therapy.

233
Q

What are some higher risk diseases associated with certain conditions?

A

Incontinence, intellectual disabilities, osteoporosis, hip dislocation, dysphagia, GERD, drooping chemical or bacterial pneumonia.

Secondary conditions include cardiovascular and cardiopulmonary conditions, communication disorders.

234
Q

What changes occur to gait and postural movements?

A

Changes in gait and postural movements can vary based on the underlying condition.

235
Q

What are some tests/measurements to assess gait and spasticity?

A

Tests include various clinical assessments and measurements specific to gait and spasticity.

236
Q

What is the ICF model and how does it help those with CP?

A

The ICF model provides a framework for understanding the impact of health conditions on functioning and disability.

237
Q

What are the nonpharmacological treatments for CP?

A

E-stim, assistive technology devices (ATDs), neuromuscular electrical stimulation, orthotics, walkers, wheelchairs, physical therapy (PT), occupational therapy (OT), speech therapy.

238
Q

What are the pharmacological treatments for CP?

A

Pharmacological treatments may include various medications tailored to individual needs.

239
Q

How might surgical treatments help those with CP?

A

Surgical treatments can address specific physical impairments and improve function.

240
Q

What is the classical definition of a stroke?

A

A stroke is defined as a sudden loss of brain function due to a disturbance in the blood supply to the brain.

241
Q

Who is at greatest risk for strokes?

A

Men are generally at greater risk for strokes, along with factors like age and ethnicity.

242
Q

What are ischemic, thrombotic, embolic, and hemorrhagic strokes?

A

Thrombotic: occlusive thrombus develops in or outside an ulcerated plaque. Embolic: from the carotid or other arteries that travel to the brain and lodge into a smaller cerebral artery or arteriole. Hemorrhagic: excessive bleeding in a cerebral artery, often due to hypertension. Ischemic: blood clot seals off a narrowed artery.

243
Q

What are the signs and symptoms of a stroke?

A

Signs and symptoms include memory loss and paralysis.

244
Q

What is the hemiplegic gait and why is it important?

A

The hemiplegic gait is a walking pattern characterized by weakness or paralysis on one side of the body.

245
Q

What are the benefits of an MRI vs CT scan in stroke assessment?

A

MRI can assess occlusions that lead to ischemic stroke, while CT scans have been the primary test.

246
Q

What is an endarterectomy?

A

An endarterectomy is a surgical procedure to remove plaque buildup from arteries to restore normal blood flow.

247
Q

What types of drugs are given to stroke patients?

A

Drugs include anticoagulants, antiplatelets, calcium channel blockers, and diuretics, prescribed to manage stroke risk and recovery.

248
Q

What are the primary goals for physical therapy after a stroke?

A

Goals include improving flexibility, strength, balance, and coordination.

clinical phys (6 decks)

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