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Applied Exercise Science > Exam 1 > Flashcards

Exam 1 Flashcards

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1
Q

anaerobic metabolism

A 
no oxygen
utilizes only carbs (glucose)
occurs IN the cytoplasm of cell
by-product is lactic acid
yileds net 2 ATP per molecule of glucose
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2
Q

anaerobic metabolism

A 
no oxygen
utilizes only carbs (glucose)
occurs IN the cytoplasm of cell
by-product is lactic acid
yileds net 2 ATP per molecule of glucose
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3
Q

aerobic metabolism

A 
requires oxygen
utilizes carbs, fats, and proteins
occurs in mitochondria
byproducts: water and CO2
yields net 36 ATP per molecule glucose
done through glycolysis, krebs, and ETC
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4
Q

where are aerobic cells located?

A

heart, CNS, PNS, skeletal muscle

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5
Q

where are anaerobic cells located?

A

connective tissue cell (bone, cartilage, RBC’s), skeletal muscle

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6
Q

VO2 max

A

maximum capacity of an individual’s body to transport and use oxygen during incremental exercise, which reflects the physical fitness for eh individual. Measured by mL O2/kg min

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7
Q

What is the gold standard for aerobic capacity testing?

A

oxygen consumption (VO2)

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8
Q

Ways to measure VO2

A
  1. CO x a-vO2 difference

2. Vol. O2 entering lungs-volume O2 leaving lungs

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9
Q

anaerobic threshold

A

not capable of performing work solely aerobically (start to perform work anaeriobically, so build up of lactic acid)

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10
Q

what % of VO2 max is anaerobic threshold usually?

A

55%- with training, above, with detraining, below

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11
Q

what is the “clinical” anaerobic threshold?

A

when exercising and have difficulty talking to another. Point when metabolic acidosis trying to compensate w/ respiratory alkalosis

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12
Q

1 MET= X mLO2/Kg*min

A

3.5 mLO2/Kg*min

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13
Q

Definition 1 MET

A

requirement of O2 of tissue of the body at rest.

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14
Q

Moderate intensity physical activity (MET)

A

3-6 METS

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15
Q

Vigorous-intensity physical activity

A

> 6 METS

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16
Q

Factors affecting peak VO2

A 
age
gender
genetics
body composition
endurance training
various diseases that affect oxygen transport
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17
Q

Mortality impact w/ 1 MET increase in women

A

mortality decreased by 17%

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18
Q

VO2 considered dialed?

A
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19
Q

What is the threshold value of maximally voluntary performance need for independence in older adults?

A

20 mL/Kg*min

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20
Q

Karvonen formula

A

(Max HR-Rest HR)*% intensity+ Resting HR=

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21
Q

general HR max equation

A

220-age x % intensity

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22
Q

Tanaka HR

A

(208-.7age) intensity

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23
Q

Heart rate reserve

A

describes the difference between a person’s resting HR and maximum HR. HRR= HR max-HR rest

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24
Q

as person becomes more fit, what happens to HRR?

A

HRR increases (HR rest will drop)

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25
Q

CV contraindications for exercise

A 
recent MI (within3-6 weeks)
PE or pulmonary infarction
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26
Q

Recent DVT protocol for exercise

A

If patient is on anti-coagulation therapy, whit hold high-intensity training on that limb
appropriate on other limbs if: using heparin (2-3x normal PTT 24-48 hrs)
IVC filter placed
3-5 hrs after first LMWH (lovenox, etc)
Coumadin if PTT is 2-3x normal and INR is 2-3

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27
Q

resting HR contraindications for exercise

A

100

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28
Q

READ THROUGH

A

POSSIBLE CONTRAINDICATIONS CV- slide 6

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29
Q

s/s of uncontrolled CHF

A 
S3 heart sound at rest
jugular venous distension
pitting edema
dypnea w/ mild exertion
lack of endurance
fluid retention (weight gain)
crackles
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30
Q

pitting edema scale

A

1+ barely perceptible depression
2+ easily identified depression- skin rebounds in 15 sec
3+ skin rebounds in 15-30 sec
4+ skin rebounds >30 sec

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31
Q

uncontrolled hypertension

A

resting SBP >200 mmHg or 110 or

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32
Q

possible contraindications for exercise w/ cancer

A

bone metastasis sites: concern for pathological fx
tumors in strength training area
medication effects

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33
Q

possible MSK contraindications

A 
recent fx
unstable fx
osteomyelitis
avascular necrosis
wounds w/ exposed tendon/muscle
precaution w/ compression fx
marfan syndrome- connective tissue disorder
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34
Q

craniotomy precautions

A

10 lbs, no valsalve

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35
Q

abdominal precauseions

A

no sit-ups/crunches, no valsalve, no lifting >10 lbs

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36
Q

sternal precautions

A

10 lbs

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37
Q

side effects steroids

A

hypertension, immunosuppression, osteoporosis, muscle weakness, thin skin

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38
Q

side effects beta-blockers

A

hypotension (FALLS)
bradycardia
drowsiness

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39
Q

CASES

A

go through cases following precautions/contraindication review

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40
Q

Exercise max BP

A

max w/ monitoring: 250/115

clinical 200/100-220/110

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41
Q

resting RR

A

12-18

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42
Q

BMI and % body fat

A

40= extreme obesity class III

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43
Q

normal % body fat

A

men=15-18%

women=22-25%

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44
Q

VO2 max slide 29

A

REVIEW

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45
Q

Normal Forced vital capacity

A

3-5 L

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46
Q

Forced expiratory volume values

A

2.5-4 L

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47
Q

Forced expiratory volume

A

2.5-4 L

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48
Q

aerobic metabolism

A 
requires oxygen
utilizes carbs, fats, and proteins
occurs in mitochondria
byproducts: water and CO2
yields net 36 ATP per molecule glucose
done through glycolysis, krebs, and ETC
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49
Q

where are aerobic cells located?

A

heart, CNS, PNS, skeletal muscle

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50
Q

where are anaerobic cells located?

A

connective tissue cell (bone, cartilage, RBC’s), skeletal muscle

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51
Q

VO2 max

A

maximum capacity of an individual’s body to transport and use oxygen during incremental exercise, which reflects the physical fitness for eh individual. Measured by mL O2/kg min

How well did you know this?
1
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2
3
4
5
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52
Q

What is the gold standard for aerobic capacity testing?

A

oxygen consumption (VO2)

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53
Q

Ways to measure VO2

A
  1. CO x a-vO2 difference

2. Vol. O2 entering lungs-volume O2 leaving lungs

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54
Q

anaerobic threshold

A

not capable of performing work solely aerobically (start to perform work anaeriobically, so build up of lactic acid)

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55
Q

what % of VO2 max is anaerobic threshold usually?

A

55%- with training, above, with detraining, below

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56
Q

what is the “clinical” anaerobic threshold?

A

when exercising and have difficulty talking to another. Point when metabolic acidosis trying to compensate w/ respiratory alkalosis

How well did you know this?
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5
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57
Q

1 MET= X mLO2/Kg*min

A

3.5 mLO2/Kg*min

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58
Q

Definition 1 MET

A

requirement of O2 of tissue of the body at rest.

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59
Q

Moderate intensity physical activity (MET)

A

3-6 METS

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60
Q

Vigorous-intensity physical activity

A

> 6 METS

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61
Q

INR values

A

.9-1.1 normal
2-3 normal if on anticoagulation therapy
>5 evaluate mobility assess safety for discharge
>6 discuss w/ MD

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62
Q

Mortality impact w/ 1 MET increase in women

A

mortality decreased by 17%

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63
Q

VO2 considered dialed?

A
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64
Q

What is the threshold value of maximally voluntary performance need for independence in older adults?

A

20 mL/Kg*min

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65
Q

Karvonen formula

A

(Max HR-Rest HR)*% intensity+ Resting HR=

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66
Q

respiratory- reasons to stop exercise

A

mod-sev dyspnea (can’t say 5 words)
abnormal breathing pattern
drop in O2 sates>5% baseline or

67
Q

Tanaka HR

A

(208-.7age) intensity

68
Q

Heart rate reserve

A

describes the difference between a person’s resting HR and maximum HR. HRR= HR max-HR rest

69
Q

as person becomes more fit, what happens to HRR?

A

HRR increases (HR rest will drop)

70
Q

advantages/disadvantages max testing

A

advantages: accuracy
dis: health risk, time, expense, personnel

71
Q

Recent DVT protocol for exercise

A

If patient is on anti-coagulation therapy, whit hold high-intensity training on that limb
appropriate on other limbs if: using heparin (2-3x normal PTT 24-48 hrs)
IVC filter placed
3-5 hrs after first LMWH (lovenox, etc)
Coumadin if PTT is 2-3x normal and INR is 2-3

72
Q

resting HR contraindications for exercise

A

100

73
Q

READ THROUGH

A

POSSIBLE CONTRAINDICATIONS CV- slide 6

74
Q

s/s of uncontrolled CHF

A 
S3 heart sound at rest
jugular venous distension
pitting edema
dypnea w/ mild exertion
lack of endurance
fluid retention (weight gain)
crackles
75
Q

pitting edema scale

A

1+ barely perceptible depression
2+ easily identified depression- skin rebounds in 15 sec
3+ skin rebounds in 15-30 sec
4+ skin rebounds >30 sec

76
Q

uncontrolled hypertension

A

resting SBP >200 mmHg or 110 or

77
Q

possible contraindications for exercise w/ cancer

A

bone metastasis sites: concern for pathological fx
tumors in strength training area
medication effects

78
Q

possible MSK contraindications

A 
recent fx
unstable fx
osteomyelitis
avascular necrosis
wounds w/ exposed tendon/muscle
precaution w/ compression fx
marfan syndrome- connective tissue disorder
79
Q

craniotomy precautions

A

10 lbs, no valsalve

80
Q

abdominal precauseions

A

no sit-ups/crunches, no valsalve, no lifting >10 lbs

81
Q

sternal precautions

A

10 lbs

82
Q

side effects steroids

A

hypertension, immunosuppression, osteoporosis, muscle weakness, thin skin

83
Q

side effects beta-blockers

A

hypotension (FALLS)
bradycardia
drowsiness

84
Q

CASES

A

go through cases following precautions/contraindication review

85
Q

Exercise max BP

A

max w/ monitoring: 250/115

clinical 200/100-220/110

86
Q

resting RR

A

12-18

87
Q

BMI and % body fat

A

40= extreme obesity class III

88
Q

normal % body fat

A

men=15-18%

women=22-25%

89
Q

VO2 max slide 29

A

REVIEW

90
Q

Normal Forced vital capacity

A

3-5 L

91
Q

tidal volume

A

.5L at rest

92
Q

Forced expiratory volume

A

2.5-4 L

93
Q

normal FEV/FVC values

A

> 80%

94
Q

normal pH

A

7.4

95
Q

normal pCO2

A

35-45 mmHg

96
Q

normal pO2

A

80-100 mmHg

97
Q

O2 saturation

A

95-100%

98
Q

what would a PFT look like in a person w/ COPD?

A

decreased FEV1

longer time need to expel air from lungs

99
Q

fasting blood glucose levels

A

60-100 normal
100-125 pre-diabetic
126+ diabetic

100
Q

ideal blood glucose levels to be able to exercise

A

100-250

101
Q

oral glucose tolerance test values

A

200 diabetes

102
Q

normal platelet count

A

150.000-400,000

103
Q

platelet count contraindication for exercise

A
104
Q

normal WBC count

A

3900-11000 exercise as tolerated

105
Q

normal hemoglobin values

A

males 13-18

females 12-16

106
Q

normal hematocrit values

A

males 41-51%

females 36-47%

107
Q

values for ABI in diagnosing PAD

A

normal=.91+
mild obstruction=.70-.90
moderate obstruction .4-.69
severe obstruction

108
Q

CASE STUDIES

A

REVIEW CASE STUDIES

109
Q

Expected change in DBP w/ exercise?

A

none or

110
Q

Within how much time should BP and HR return to within 10 of resting value?

A

5 minutes

111
Q

contraindications of BP w/ exercise

A 
sudden drop in SBP >10
failure of SBP to rise
SBP>250, DBP>115 w/ monitoring
SBP>200, DBP>110 w/out EKG
decrease in HR below baseline
112
Q

respiratory- reasons to stop exercise

A

mod-sev dyspnea (can’t say 5 words)
abnormal breathing pattern
drop in O2 sates>5% baseline or

113
Q

submax test assumptions

A
  1. stead-state HR is obtained for each exercise work rate
  2. a maximal HR for a given age is uniform (220-age)
  3. mechanical efficiency is the same for everyone
  4. there is a linear relationship between HR and workload
  5. HR will vary depending on fitness level between subjects at any given workload
114
Q

advantages of submax testing

A
  1. safer
  2. controlled pace
  3. not population specific
  4. quick assessment
  5. cost effective
  6. do not need highly trained personnel
    7 can do mass testing
  7. no physician supervision required- if symptoms/disease free
115
Q

disadvantages of submax testing

A
  1. VO2 max is not directly measured

2. Not a measure of true maximal HR (220-age can vary by 15 BPM)

116
Q

advantages/disadvantages max testing

A

advantages: accuracy
dis: health risk, time, expense, personnel

117
Q

populations for which the cycle ergometer is indicated for

A

balance disorders
obese
musculoskeletal problems (non WB)

118
Q

protocol for cycle ergometer

A

1 watt= 6.12 kpm/min
start at 150 kpm/min and increase by 150 every 2-3 min
start at 50 wtts and increase by 25 watts every 2-3 min

119
Q

different for arm ergometry?

A

decrease incremental workloads to 10-25 watts for every 2-3 minute stage

120
Q

astrand cycle rhyming test

A

75 watts for 2 min, 50 RPM
progress workload to 100, 125, 150 watts dependent on characteristics
establish working submax HR 130-170 bpm
then maintain workload additional 5 min

121
Q

astrand male/female diff

A

females start at only 50 watts, move up by 15

122
Q

items included in SPPB

A

static balance, gait speed, sit to stand

123
Q

SPPB scoring

A 
0-3= severe limitations
4-6= moderate limitations
7-9= mild limitations
10-12= minimal limitations
124
Q

dose response definition

A

intensity adequate for overload to musculoskeletal systems to induce adaptations

125
Q

neuromuscular adaptations account for ____% strength gains per week

A

10-15% strength gains per week. Hypertrophy contributions pick up later in training program

126
Q

60% 1 RM

A

12 reps 11 RPE

127
Q

70% 1 RM

A

10 reps 13 RPE

128
Q

80% 1RM

A

8 reps 15 RPE

129
Q

failure

A

inability to complete final rep through full, available ROM w/out compensation

130
Q

HR, SV and CO w/ exercise

A

all increase. SV increases significantly initially and then levels out

131
Q

HR corresponds with…?

A

increasing VO2

132
Q

what should a PT do w/ a patient complaining of angina?

A

stop exercising, ask if typical, do they have NG

133
Q

unstable angina vs. chronic stable

A

unstable angina much more concerning

134
Q

angina scale

A

1+ light, barely noticeable
2+ moderate
3+ severe, uncomfortable
4+ most severe pain ever experienced

135
Q

uncontrolled vs controlled a-fib

A 
uncontrolled= >100 bpm
controlled= 100 bpm or less
136
Q

what is double product?

A

HR x SBP

137
Q

dyspnea levels

A 
able to count to 15 in 7.5-8 seconds
level 0= single breath
1= 2 breaths
2= 3 breaths
3= 4 breaths
4= unable to count
138
Q

ventilation=

A

TV x RR

139
Q

what happens to tidal volume with increasing ventilation

A

tidal volume increases with increasing ventilation

140
Q

chronic bronchitis

A

over production of mucus causes an occlusion of airways

141
Q

causes of emphysema

A

herditary alpha-1 antitrypsin deficiency

smoking 80-90%

142
Q

how do PT’s assess whether the lungs are doing their job?

A

O2 saturation
cyanosis
pulmonary function tests

143
Q

when someone w/ COPD is desaturating what might you consider

A

encourage patient to breathe out more

144
Q

what would a PFT look like in a person w/ COPD?

A

decreased FEV1

longer time need to expel air from lungs

145
Q

what happens to FEV1/FVC?

A

increases (sometimes stays the same)

146
Q

what is the percent saturation of O2 w/ hemoglobin?

A

97% (90-100)

147
Q

what happens to oxygen sats w/ hemoglobin dropping to 7.5g/100ml blood because of a GI bleed?

A

oxygen sats remain

148
Q

at what point is supplemental oxygen provided?

A
149
Q

what does blood flow provide for and remove from an exercising muscle?

A

brings: oxygen and nutrients
removes: CO2, lactic acid, and leads to heat dissipation

150
Q

what happens to a-vO2 difference w/ activity?

A

a-v O2 increases w/ exercise

151
Q

claudication scale

A

1- definite discomort, modest levels
2-moderate discomfort or pain from which the patient’s attention can be diverted
3. intense pain from which the patient’s attention cannot be diverted
4. excruciating and unbearable pain

152
Q

ABI measurement

A

pt supine for 5 min
SBP both limbs- higher value= denominator
SBP measured in dorsalis pedis and posterior tin by placing cuff above ankle

153
Q

values for ABI in diagnosing PAD

A

normal=.91+
mild obstruction=.70-.90
moderate obstruction .4-.69
severe obstruction

154
Q

what value should be used for patient goals for improvement in walking speed?

A

gain of .1 m/s- predictor for well-being

155
Q

MDC for gait speed?

A

.1-.2 m/s

156
Q

MCID for gait speed?

A

.1 m/s

157
Q

red/yellow/green flags for gait speed?

A

.6 ms/ or less= red flag
.6-1.0 ms/s= yellow flag
>1.0 m/s functional community ambulator

158
Q

amount of protein needed by older adult w/out kidney disease

A

1-1.5 grams/kg

159
Q

strength training for older adults

A

3 days/week

60-80% 1RM for 2-3 sets of 8-12 reps

160
Q

what contributes to the preception that climbing a flight of stairs is more difficult with increasing age?

A

weakness and decreased performance from CV system

161
Q

minimum aerobic capacity for men/women to live independently?

A

men= 18

women=15

162
Q

how much does VO2 max decrease each decade for men and women?

A

men= decrease 4-5.5 each decade for men
women= 2-3.5 each decade
BUT still have capacity to increase VO2 max w/ proper training intensity

163
Q

aerobic exercise for older adults

A

3-5 days/week
intensity: 60-75% HR max
11-14 RPE
20-60 minutes

Applied Exercise Science (1 decks)

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