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NASM - 6th Edition (2019) > Domain 1 > Flashcards

Domain 1 Flashcards

1
Q

What is the nervous system?

A

A communication network within
the body.

A conglomeration of billions of cells specifically designed to provide a communication network within the human body.

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2
Q

What is the central nervous system?

A

Brain and spinal
cord; coordinates activity of the body.

The portion of the nervous system that consists of the brain and spinal cord. its primary function is to coordinate the activity of all parts of the body

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3
Q

What is the peripheral nervous system?

A

Nerves
connecting the CNS to the rest of the body and
environment.

Cranial and spinal nerves that spread throughout the body
Two functions-
1. They provide a connection for the nervous system to
activate different effector sites, such as muscles (motor function).
2. Relay information from the effector sites back to the brain via sensory receptors (sensory function), thus providing a constant update on the relation between the body and the environment

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4
Q

What are the subdivisions of the peripheral nervous system?

A

Somatic - serve the outer areas of the body and skeletal muscle, and are largely responsible for the voluntary control of movement.
Autonomic - supplies neural input to the involuntary systems of the body (e.g., heart, digestive systems, and endocrine glands)

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5
Q

What are the three functions of the nervous system?

A
  1. Sensory - the ability of the nervous system to sense changes in either the internal or external environment,
  2. Integrative - the ability of the nervous system to analyze and interpret the sensory information to allow for proper decision making, which produces an appropriate response.
  3. Motor - The neuromuscular (or nervous and muscular systems) response to the sensory information.
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6
Q

What are the two subdivisions of the autonomic systems?

A
  1. Sympathetic - serve to increase levels of activation in preparation for activity
  2. Parasympathetic - Serve to decrease levels of activation during rest and recovery
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7
Q

What is a neuron?

A

Functional unit of the nervous system.

They make up the complex structure of the nervous system and provide it with the ability to communicate internally with itself, as well as externally with the outside environment.
Processes and transmits information through both electrical and chemical signals.
Form the core of the nervous system, which includes the brain, spinal cord, and peripheral ganglia.
Many neurons together forms the nerves of the body.
Composed of three main parts: the cell body, axon, and dendrites.

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8
Q

What are the two main kinds of neurons?

A
  1. Sensory (Afferent) - Transmit nerve impulses from effector sites (such as muscles and organs) via receptors to the brain and spinal cord.
  2. Motor (Efferent) - Transmit nerve impulses from the brain and spinal cord to effector sites.
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9
Q

What are mechanoreceptors?

A

Sensory receptors responsible for sensing distortion in body tissues.

Respond to outside forces.
Located in muscles, tendons, ligaments, and joint capsules and include muscle spindles, Golgi tendon
organs, and joint receptors.

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10
Q

What are joint receptors?

A

Respond to pressure,
acceleration, and deceleration of joints.

Receptors surrounding a joint that respond to pressure, acceleration, and deceleration of the joint.
Act to signal extreme joint positions and thus help to prevent injury.
Also act to initiate a reflexive inhibitory response in the surrounding muscles if there is too much stress placed on that joint.
Joint receptor examples include Ruffini endings and Pacinian corpuscles.

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11
Q

What are Golgi Tendon Organs (GTO)?

A

Sense changes in muscular tension

Receptors sensitive to change in tension of the muscle and the rate of that change.
Activation of the Golgi tendon organ will cause the muscle to relax, which prevents the muscle from excessive stress or possibility of injury.

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12
Q

What are muscle spindles?

A

Sense changes in muscle length.

Receptors sensitive to change in length of the muscle and the rate of that change.
They are sensory receptors within muscles that run parallel to the muscle fibers and are sensitive to change in muscle length and rate of length
change.
When a specific muscle is stretched, the spindles within
that muscle are also stretched, which in turn conveys information about its length to the CNS via sensory neurons. Once information from muscle spindles reaches the brain it can then determine the position of various body parts.

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13
Q

What are tendons?

A

They connect muscle to bone
Provide anchor for muscles to produce force.
Poor blood flow
Slow to repair and adapt

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14
Q

What are fascia?

A

Outer layer of connective tissue surrounding a
muscle.

The first bundle is the actual muscle itself wrapped by an outer layer of connective tissue called fascia and an inner layer immediately surrounding the muscle called the epimysium . The fascia and epimysium are also connected to bone and help to form the muscle’s tendon

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15
Q

What are fascicles?

A

Bundle of individual muscle fibers

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16
Q

What are muscle fibers?

A

Cellular components and myofibrils encased

in a plasma membrane.

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17
Q

What are sarcomeres?

A

Produces muscular contraction; repeating
sections of actin and myosin.

The functional unit of muscle that produces muscular contraction and consists of repeating sections of actin and myosin. It lies in the space between two Z lines. Each Z line denotes another sarcomere along the myobril

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18
Q

What is the sliding filament theory?

A

Thick and thin filaments slide past one another, shortening the entire sarcomere.

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19
Q

What are the differences between Type I & Type II muscles?

A 
Type I
More capillaries, mitochondria, and myoglobin
Increased oxygen delivery
Smaller in size
Less force produced
Slow to fatigue
Long-term contractions (stabilization)
Type II
Fewer capillaries, mitochondria, and myoglobin
Decreased oxygen delivery
Larger in size
More force produced
Quick to fatigue
Short-term contractions (force and power)
Fast twitch
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20
Q

What is a motor unit?

A

One motor neuron and the muscle fibers it connects with.

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21
Q

What is neural activation?

A

The contraction of a muscle generated by neural stimulation.

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22
Q

What are neurotransmitters?

A

Chemical messengers that transport impulses from nerve to muscle.

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23
Q

What is the local stabilization system?

A

Attach directly to vertebrae. Consists of: transverse abdominis, internal oblique, multifidus, pelvic floor, diaphragm.

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24
Q

What is the global stabilization system?

A

Attach from pelvis to spine. Consists of: quadratus lumborum, psoas major, external oblique, rectus abdominis, gluteus medius, adductor complex, portions of internal oblique.

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25
Q

What is the movement system?

A

Attach spine and/or pelvis to extremities.

Consists of: latissimus dorsi, hip flexors, hamstring complex, quadriceps.

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26
Q

What is the axial skeleton?

A

Skull, rib cage, and vertebral column.

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27
Q

What is the appendicular skeleton?

A

Upper and lower extremities, shoulder and pelvic girdles.

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28
Q

What is the skeletal system functions?

A 
Support
Movement
Protection
Mineral Storage
Blood cell formation
Energy storage
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29
Q

What are depressions?

A

Flattened or indented portions of a bone; can be muscle attachment sites.

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30
Q

What is a process?

A

Projection protruding from a bone; muscles, tendons, and ligaments can attach.

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31
Q

What are ligaments?

A

Connects bone to bone; little blood supply; slow

to heal.

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32
Q

What is arthrokinematics?

A

Joint motion.

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33
Q

What are non-synovial joints?

A

No joint cavity, connective tissue, or

cartilage; little to no movement.

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34
Q

What are synovial joints?

A

Held together by joint capsule and

ligaments; associated with movement.

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35
Q

What are the major motion types?

A

Roll, slide, and spin.

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36
Q

What are two important hinge types?

A

Hinge—elbows, ankles; sagittal plane movement.
Ball-and-socket—shoulders, hips; most mobile, all
three planes of motion.

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37
Q

What are weight-bearing exercises?

A

The best method to strengthen bones.

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38
Q

What are weight-bearing exercises?

A

The best method to strengthen bones.

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39
Q

What is the endocrine system?

A

A system of glands; secretes hormones to regulate bodily function.

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40
Q

What is testosterone?

A

Responsible for male sex traits.

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41
Q

What is estrogen?

A

Influences fat deposition on hips, buttocks, and thighs; responsible for female sex traits.

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42
Q

What is growth hormone?

A

Anabolic hormone; responsible for bodily growth up until puberty.

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43
Q

What is insulin?

A

Regulates energy and glucose metabolism in the body.

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44
Q

What is the cardiorespiratory system?

A

Cardiovascular and respiratory systems.

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45
Q

What is the cardiovascular system?

A

Heart, blood, and blood vessels.

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46
Q

What is cardiac muscle?

A

Shorter, more tightly connected than skeletal muscle; involuntary.

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47
Q

What is the atria and what is it divided into?

A

Smaller, superior chambers of the heart; receive
blood from veins.
Right atrium—gathers deoxygenated blood returning to the heart.
Left atrium—gathers oxygenated blood from the
lungs

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48
Q

What is a sinoatrial node?

A

Located in right atrium; initiates impulse for heart rate; “pacemaker for the heart”.

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49
Q

What are ventricles?

A

Larger, inferior chambers of the heart; pump blood out.
Right ventricle—pumps deoxygenated blood to
lungs.
Left ventricle—pumps oxygenated blood to the
body

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50
Q

What are arteries?

A

Carry blood away from the heart

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51
Q

What are veins?

A

Transport blood back to the heart.

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52
Q

What are arterioles?

A

Small branches of arteries; end in capillaries.

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53
Q

What are capillaries?

A

Smallest blood vessels; site of gas, chemical, and water exchange.

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54
Q

What is the function of blood?

A
  1. Protection - clotting, immunity
  2. Regulation - Temperature, pH
  3. Transportation - Oxygen, nutrients, hormones
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55
Q

What are venules?

A

Very small veins; connect capillaries to larger veins.

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56
Q

What is stroke volume?

A

Amount of blood pumped with each contraction.

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57
Q

What is heart rate?

A

The rate at which the heart pumps; average untrained adult = 70-80 bpm

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58
Q

What is cardiac output?

A

Volume of blood pumped per minute; heart rate × stroke volume.

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59
Q

What is the respiratory system?

A

Lungs and respiratory passageways; brings in oxygen, removes CO2.

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60
Q

What is inspiration?

A

Contracting inspiratory muscles to move air into lungs.

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61
Q

What is expiration?

A

Relaxing inspiratory muscles (passive), contracting expiratory muscles (active) to move air out.

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62
Q

What is resting oxygen consumption?

A

3.5 ml × kg-1 × min-1 = 1 metabolic equivalent (MET)

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63
Q

What is maximal oxygen consumption?

A

highest rate of oxygen transport and utilization achieved at maximal physical exertion.

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64
Q

What are abnormal breathing patterns?

A

associated with stress and anxiety; may result in headaches, fatigue, poor circulation, and/or poor sleep patterns.

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65
Q

Which are inspiratory and expiratory muscles?

A

Inspiratory
Primary—diaphragm, external intercostals.
Secondary—scalenes, pectoralis minor, sternocleidomastoid.
Expiratory
internal intercostals, abdominals.

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66
Q

What are the benefits of cardiorespiratory exercise?

A

Increases—cardiac output, breathing efficiency, oxygen transport and use, use of fats for fuel, mental
alertness, ability to relax and sleep, tolerance to stress, lean body mass, metabolic rate.
Decreases—resting heart rate, cholesterol, blood pressure, and the risks of heart disease, blood clots,
depression, anxiety, obesity, and diabetes.

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67
Q

What are bioenergetics?

A

Study of energy in the human body.

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68
Q

What is metabolism?

A

Process in which nutrients are acquired, transported, used, and disposed of by the body.

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69
Q

What is aerobic?

A

Requires oxygen.

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70
Q

What is anaerobic?

A

Without oxygen.

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71
Q

What is adenosine triphosphate?

A

ATP, Energy storage and transfer unit within cells.

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72
Q

What is anaerobic threshold?

A

Where the body can no longer produce enough energy with normal oxygen intake.

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73
Q

What is excess post oxygen consumption?

A

EPOC, elevation of metabolism after exercise.

74
Q

What are the three energy systems?

A

ATP-PC - Anaerobic, high-intensity, lasts 10-15 seconds
Glycolysis - Anaerobic, moderate-to-high intensity, up to 30-50 seconds
Oxidative system - Aerobic glycolysis, krebs cycle, electron transport chain, long-term energy

75
Q

What is biomechanics?

A

Science concerned with internal and external forces acting on the body

76
Q

What is force?

A

Influence applied by one object to another, accelerates or decelerates the second object

77
Q

What is torque?

A

A force that produces rotation.
The closer the load to the point of rotation, the
less torque it creates (i.e., bent arm is easier than
straight arm).

78
Q

What is a lever?

A

Rigid “bar” that rotates around a

stationary fulcrum.

79
Q

What are the classes of levers and what are examples of each?

A

1st class—fulcrum in middle (nodding head).
2nd class—resistance in the middle (calf raise).
3rd class—effort in the middle (biceps curl);
most common in human limbs.

80
Q

What is the meaning is superior?

A

Above a point of reference.

81
Q

What is the meaning of inferior?

A

Below a point of reference.

82
Q

What is the meaning of proximal?

A

Nearest to a point of reference.

83
Q

What is the meaning of distal?

A

Farthest from a point of reference.

84
Q

What is the meaning of anterior?

A

Front of the body.

85
Q

What is the meaning of posterior?

A

Back of the body.

86
Q

What is the meaning of medial?

A

Closer to the middle of the body.

87
Q

What is the meaning of lateral?

A

Farther from the middle of the body.

88
Q

What is the meaning of contralateral?

A

On the opposite side of the body.

89
Q

What is the meaning of ipsilateral?

A

On the same side of the body.

90
Q

What are the three planes of motion?

A

Frontal, Sagittal, Transverse

91
Q

What are examples of motions and exercises in the frontal plane?

A

Adduction/Abduction, lateral flexion, eversion/inversion

Side lateral raise, side lunge, side shuffle

92
Q

What are examples of motions and exercises in the sagittal plane?

A

Flexion/extension

Biceps curl, triceps pushdown, squat

93
Q

What are examples of motions and exercises in the transverse plane?

A

Rotation, Horizontal adduction/abduction

Throwing, golfing, swinging a bat, trunk rotation

94
Q

What is flexion?

A

Bending movement; decreases relative angle between segments.

95
Q

What is extension?

A

Straightening movement; increases relative angle between segments.

96
Q

What is plantarflexion?

A

Extension at the ankle.

97
Q

What is dorsiflexion?

A

Flexion at the ankle

98
Q

What is abduction?

A

Movement in the frontal plane away from the middle.

99
Q

What is adduction?

A

Movement in the frontal plane toward the middle.

100
Q

What is horizontal abduction?

A

Transverse plane arm movement from anterior to lateral (e.g. chest flies).

101
Q

What is horizontal adduction?

A

Transverse plane arm movement from lateral to anterior.

102
Q

What is internal rotation?

A

Rotation toward the middle of the body.

103
Q

What is external rotation?

A

Rotation away from the middle of the body.

104
Q

What is the muscle action spectrum?

A
  1. Concentric - moving in opposite direction of force, accelerates or produces force; muscle shortens.
  2. Eccentric - muscle developes tension while lengthening; decelerates force.
  3. Isometric - muscular force equal to resistive force, stabilizes force; no change in muscle length.
105
Q

What is the length-tension relationship?

A

Resting length of a muscle and the tension it can produce at that length.

106
Q

What is a force-couple?

A

Muscles working together to produce movement

107
Q

What is the force-velocity curve?

A

As the velocity of a contraction increases, concentric force

decreases and eccentric force increases.

108
Q

What is neuromuscular efficiency?

A

Ability to produce and reduce force, and stabilize the kinetic chain in all three planes of motion.

109
Q

What is structural efficiency?

A

Alignment of the musculoskeletal system that allows center of gravity to be maintained over a base of support.

110
Q

What is Davis’ law?

A

Soft tissue models along the lines of stress.

111
Q

What is autogenic inhibition?

A

Neural impulses that sense tension are greater than the impulses that cause muscles to contract; provides inhibitory effect to muscle spindles.

112
Q

What is reciprocal inhibition?

A

Simultaneous contraction of one muscle, and relaxation of its antagonist to allow movement.

113
Q

What is relative flexibility?

A

Tendency of the body to seek the path of least resistance.

114
Q

What is pattern overload?

A

Consistently repeating the same motion; places abnormal stresses on the body.

115
Q

What are postural distortion patterns?

A

Predictable patterns of muscle imbalances.

116
Q

What is altered reciprocal inhibition?

A

Muscle inhibition caused by a tight agonist, which inhibits its functional antagonist.

117
Q

What is synergistic dominance?

A

Inappropriate muscle takes over function of a weak or inhibited prime mover.

118
Q

What is muscle imbalance?

A

Alteration of muscle length surrounding a joint.

119
Q

What are the stages of the OPT model?

A

Stabilization- ability to maintain postural equilibrium and support joints during movement.
Strength- ability of the neuromuscular system to produce internal tension to overcome an external force.
Power- ability to produce the greatest force in the shortest time.

120
Q

What are the phases within Strength?

A

Strength endurance- ability to repeatedly produce high levels of force for prolonged periods.
Maximal strength- maximal force a muscle can produce in a single voluntary effort.
Muscular hypertrophy- enlargement of skeletal muscle fibers from resistance training.

121
Q

What are the stages of the cumulative injury cycle?

A

Tissue trauma, inflammation, muscle spasm, adhesions, altered neuromuscular control, muscle imbalance

122
Q

What is motor behavior?

A

Motor response to internal and external stimuli.

123
Q

What is motor control?

A

How the CNS integrates sensory information with previous experiences.

124
Q

What is motor learning?

A

Integration of motor control processes through practice, leading to a relatively permanent change to produce skilled movement.

125
Q

What is motor development?

A

The change in motor skill behavior over time throughout the lifespan.

126
Q

What is sensorimotor integration?

A

Cooperation of the nervous and muscular systems in gathering and interpreting information and executing movement

127
Q

What are muscle synergies?

A

Groups of muscles that are recruited by the CNS to provide movement.

128
Q

What is proprioception?

A

Cumulative sensory input from all mechanoreceptors that sense position and limb movements.

129
Q

What is feedback and what are the two kinds?

A

Use of sensory information and sensorimotor integration to help the HMS in motor learning.
Internal feedback—sensory information is used by the body to reactively monitor movement and the environment.
External feedback—information provided by some external source (e.g., fitness professional, recording, mirror, etc.) to supplement the internal environment.

130
Q

What are carbohydrates?

A 
Provides nutrition that fat and protein
can’t.
• Keeps glycogen stores full.
• Helps maintain fluid balance.
• Spares protein for building muscle.
sugars, starches, celluloses, and fiber; chief source of energy.
131
Q

What is a monosaccharide?

A

—a single sugar unit (glucose, fructose, galactose).

132
Q

What is a disaccharide?

A

two sugar units (sucrose, lactose, maltose).

133
Q

What is a polysaccharide?

A

—long chains of monosaccharide units linked together (starch, fiber).

134
Q

What is fiber and what are the two kinds?

A

—complex carbohydrate; provides bulk in diet and intestinal health; regulates absorption of glucose.
Soluble fiber—dissolved by water; helps moderate blood glucose and lower cholesterol.
Insoluble fiber—does not dissolve in water.

135
Q

What is a glycemic index?

A

the rate carb sources raise blood sugar and
the effect on insulin release:
High = >70 Moderate = 56-69 Low = <55

136
Q

What are food sources of lipids?

A

Monounsaturated- Olive oil, Avocados, Peanuts
Polyunsaturated- Sunflower oil, Soy oil, Omega-3s (fish,
flax)
Saturated- Meat, Coconut oil, Dairy

137
Q

What are triglycerides?

A

Chemical form of most fat in food and in the body.

138
Q

What are the functions of lipids?

A 
Storage of energy
Hormonal roles (oestrogen &amp; testosterone)
Insulation - thermal and electrical
Protection of internal organs
Structural components of cells
139
Q

What are saturated fatty acids?

A

Raises “bad” LDL cholesterol.

140
Q

What are trans-fatty acids?

A

Used to increase shelf life in foods; raises bad and lowers good cholesterols.

141
Q

What are unsaturated fatty acids?

A

Increases “good” HDL cholesterol; decreases risk of heart disease.

142
Q

What are monounsaturated fatty acids?

A

Lipid missing one hydrogen; one double bond.

143
Q

What are polyunsaturated fatty acids?

A

Lipids with more than one point of unsaturation.

144
Q

What is protein?

A

Amino acids linked by peptide bonds

145
Q

What are essential amino acids?

A

Cannot be manufactured by the body; must be obtained from food;

146
Q

What are nonessential amino acids?

A

Can be manufactured by the body.

147
Q

What is a complete protein?

A

Supplies all essential amino acids in appropriate ratios.

148
Q

What is an incomplete protein?

A

Contains less than all 8 essential amino acids in appropriate ratios.

149
Q

How is protein used?

A

When energy needs are met with carbs and fats…protein is “spared” to build and repair body tissues and structures.

Amino acids are broken down and used for energy instead of carbs and fat (gluconeogenesis) during a negative energy balance

150
Q

What are micronutrients?

A

Vitamins and minerals needed for health.

151
Q

What is toxicity?

A

Degree to which a substance causes harm.

152
Q

How much of the body is water?

A

60%

153
Q

How much water should sedentary adults consume?

A

3L for men, 2.2L for women. Add extra 8 oz for every 25lbs overweight

154
Q

What is the recommendation for hydration replenishment with exercise?

A

If exercise exceeds 60 minutes, use a sports drink containing up to 8% carbs.

155
Q

What are the effects of hydration?

A

Adversely affects circulatory function and decreases performance.

156
Q

What is a calorie?

A

Amount of heat energy required to raise 1 gram of water by 1°C.

157
Q

What is resting metabolic rate?

A

Amount of energy expended at rest.

158
Q

What is the thermic effect of food?

A

Additional energy use for digestion; 6-10% of total energy expenditure.

159
Q

What percent of total energy expenditure happens during physical activity?

A

Around 20% of total energy expenditure.

160
Q

What are the macronutrient intake recommendations for protein?

A 
4 calories per gram
Sedentary adults: 0.4 g/lb/day
Strength: 1.2-1.7 g/lb/day
Endurance: 1.2-1.4 g/lb/day
10-35% of diet
161
Q

What are the macronutrient intake recommendations for

carbohydrates?

A

4 calories per gram
6-10 g/lb/day
25-38 g from fiber
45-65% of diet

162
Q

What are the macronutrient intake recommendations for fat?

A

9 calories per gram
20-35% of diet
High polyunsaturated to-saturated ratio is desirable.

163
Q

What are the recommendations for using carbs for performance?

A

1) Eat a high-carb meal 2-4 hours before exercise.
2) Eat 30-60g every hour during exercise lasting more than 60min.
3) Eat 1.5g/kg body weight 30min after exercise to maximize glycogen
replenishment.

164
Q

What is the dietary reference intakes?

A

Guidelines for adequate intake of a nutrient

165
Q

What is the recommended dietary allowance?

A

Average daily nutrient intake level to meet the requirement of nearly all healthy individuals.

166
Q

What is the tolerable upper intake?

A

Highest average daily intake level likely to pose no risk to health.

167
Q

What is adequate intake?

A

Recommended average daily nutrient intake level adequate for healthy individuals.

168
Q

What are the recommendations for fat loss?

A

Eat less than 10% of calories from saturated fat.
• Distribute carbs, protein, and fat throughout the day.
• 4-6 meals per day; helps control hunger, minimizes blood sugar fluctuation, and increases energy.
• Avoid “empty” calories and highly processed foods.
• Drink a minimum of 9-13 cups water daily.
• Weigh and measure food.
• Diets under 1200 calories per day need physician supervision.

169
Q

What are the recommendations for lean mass gain?

A

Eat 4-6 meals per day.
• Spread protein intake throughout the day
• Ingest carbs and protein within 90 minutes of exercise to increase recovery and protein synthesis.
• Do not neglect carbs and fat.

170
Q

What are the general health recommendations?

A

Select carb sources that are low-glycemic and high in fiber.

• Total calorie intake and burn in a 24-hour period dictates weight lost or gained.

171
Q

What is an Ergogenic aid?

A

Something that enhances athletic performance.

172
Q

What is Creatine?

A

Made in the body.

• Can increase muscle mass, strength, and anaerobic performance during exercise.

173
Q

What is caffeine?

A

3 – 6 mg/kg body weight 1 hour before exercise has the most effective ergogenic response.
• Effects will occur on an individual basis.

174
Q

What are prohormones and anabolic steroids?

A

Prohibited by the World Anti-Doping Agency.

175
Q

What is a high-protein deit commonly associated with?

A

A decrease in urea production

176
Q

When performing a squat, an overactive hip flexor complex can decrease neural drive to the gluteus maximus; what is this an example of?

A

Altered reciprocal inhibition

177
Q

Dysfunctional breathing results in an increase in the activity level of which of the following secondary respiratory muscles?

A

Scalenes

178
Q

What is occuring when a prolonged intolerable stressor produces fatigue and leads to a breakdown in the system or injury?

A

Exhaustion

179
Q

The active supine biceps femoris stretch uses which physiological principle to increase flexibility?

A

Reciprocal inhibition

180
Q

Resting metabolic rate accounts for what percentage of total energy expenditure?

A

0.7

181
Q

Which movements are the latissimus dorsi responsible for concentrically accelerating?

A

Shoulder extension, adduction, and internal rotation

182
Q

Scapular elevation refers to which of the following motions of the scapula?

A

Superior

NASM - 6th Edition (2019) (6 decks)

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