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KIN 471 > final > Flashcards

final Flashcards

1
Q

aspects that make journals good

A
  • published by professional organization
  • open source=less good (lower standards)
  • impact factor (based on how many articles, quality, citations, etc.)
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2
Q

why are long term events particularly challenging for the GI tract?

A

@ elite level, they have to deal with a large calorie input/hour with little to no GI blood flow

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3
Q

prevalence of GI symptoms in runners

A

30-90%

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4
Q

upper GI tract

A

mouth–>pharynx–>esophogus–>stomach–>duodenum–>jejunum–>ileum

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5
Q

lower GI tract

A

cecum–>ascending colon–>transverse colon–>descending colon–>sigmoid colon–>rectum–>anal canal–>anus

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6
Q

small intenstine length + function

A

7m long
water, bile, enzymes added to chyme
nutrient absorption

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7
Q

liver’s GI role

A
  • process nutrients absorbed from SI
  • produce bile
  • detoxifiction
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8
Q

Pancreas GI role

A
  • secretes digestive enzymes into duodenum that break down CHO, protein, and fat
  • secretes insulin to bloodsteam
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9
Q

gallbladder

A

stores and concentrates bile

releases bile for fat digestion

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10
Q

large intestine GI role

A

absorbing water

nutrients have been absorbed at this point

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11
Q

continence

A

=waste is held in rectum through sphincters and pelvic floor muscles

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12
Q

why does exercise cause GI distress?

A

possibly:
aggressive diaphragm movement
abdominal contractions
intenstinal jarring (especially running, rectum is straight)
and blood being redirected to working muscle

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13
Q

splachnic hypoperfusion

motility

A

reduced blood flow due to vasoconstriction
motility of esophagus and reduced pyloric sphinctor tone
-reduced gastric emptying
-possibly increased intestinal permeability w/exercise

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14
Q

different symptoms in runners and cyclists

A

runners: lower due to pounding
cyclists: upper dues to pressure on abdomen and horizontal esophagus

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15
Q

why is delayed gastric emptying an issue?

A
  • can lead to bacterial overgrowth
  • can increase fluid in the intestine
  • potential for toxins to cause symptoms
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16
Q

what is recommended CHO for minimal GI symptoms?

A

glucose/fructose mix or maltodextrin/fructose mix

reduce fiber

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17
Q

nutrition for GI issues in athletes

A

avoid trigger foods
stay hydrated
avoid fiber before events

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18
Q

morning food recommendations

A

low GI if there’s time for digestion

high GI just before racing

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19
Q

NSAIDs and GI issues

A

3-5x increased risk GI symptoms

  • advil increases risk of intestinal bleeding
  • if they cause issues, they shouldn’t be taken
    1. reflux, upper GI bleeding in esophagus (common)
    2. stomach and duodenum symptoms of gastritis, bleeding, perforation
    3. permeability of intestine increased rarely
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20
Q

upper GI issues

A 
heartburn
acid reflux
nausea
vomiting
bloating
epigastric pain
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21
Q

gastroesophageal reflux likely mechanisms

A
  • decreases in esophageal peristaltic activity
  • dec. lower sphinctor tone
  • inc. transient lower sphincter relaxation
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22
Q

GERD causes

A

smoking, obesity, pregnancy, overeating, exercise

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23
Q

what can GERD symptoms mimic?

A

asthma

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24
Q

stitch

A

likely spasm of diaphragm or gas trapped in colon

avoid solid food before exercise

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25
Q

runners diarrhea

A

more prevalent in competition-ie anxiety may be a factor
cause may be ischemia, increased motility, etc.
-reduce fiber and anti-diarrheals may be used occasionally (competition)

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26
Q

rectal bleeding

A

athletes may find blood in stool after events
mx unclear
recurrent bleeding=risk for anemia

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27
Q

traveler’s diarrhea causes

A
  1. bacteria=most common-salmonella, E Coli
  2. virus-norovirus, rotavirus
  3. parasites-giargia, cyclospora
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28
Q

imodium

A

anti-diarrheal med
slows gut motility (peristalsis) and reduces frequency of stools
only good for certain circumstances (eg when you don’t have access to a toilet)

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29
Q

protozoal diarrhea

A

5-10%
from unclean drinking water or person-to-person contact
-initially watery, then foul-smelling and fatty (steatorrhea)
-gradual onset, “relatively tolerable”
-malaise
cramps, bloating, flatulence, nausea, weight loss common
vomiting possible

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30
Q

protozoal diarrhea treatment

A 
hydration and rest
antiprotozoal medication (prescription)
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31
Q

bacterial diarrhea

A

sudden onset, uncomfortable

-boil, peel, cook, or forget

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32
Q

prevention of traveler’s diarrhea

A
  • boil water for 3 min or use 2 drops bleach or 5 drops iodine
  • ice is not safe
  • alcohol does not sterilize water or ice
  • look for carbonation to for reassurance of proper processing
  • salads are unwise choices
  • avoid condiments and steam tables
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33
Q

viral gastroenteritis

A
  • stomach and intestines become inflammed–>pain, nausea, diarrhea, vomiting
  • sometimes body aches, headaches, and fever, which are only usually w/viral infections
  • treatment=oral rehydration and quarentine, hand washing, disinfecting w/chlorine
34
Q

evaporation

A
  1. evaporation (from water to gas) requires heat-cooling effect
    - more evaporation when low humidity
    - garments play a role
35
Q

radiation

A

transmission of heat energy from a surface

36
Q

conduction

A

transfer of thermal energy from one region to another along a temperature gradient

  • mesh promotes cooling
  • cotton kills
37
Q

convection

A

two types

  • forced convection through blood flow (fluid is moving anyway)
  • free convection through the flow of air around the body (heat causes fluid motion)
38
Q

mild hypothermia

A 
cold extremities
shivering
tachycardia
tachypnoea
urinary urgency
mild incoordination
39
Q

moderate hypothermia

A

apathy, poor judgement, slurred speech, amnesia
reduced shivering
dehydration
incoordination and clumsiness

40
Q

severe hypothermia

A 
inappropriate behavior
loss of shivering
arrhythmias
pulmonary oedema
hypotension, bradycardia
reduced LOC, muscle rigidity
41
Q

on-site management of hypothermic condition

A
  • recognition!!! (monitor Tc if possible)
  • remove from cold, wind, and wet
  • insulation to prevent further loss
  • nutritional an fluid support
  • passive or active rewarming possible
  • transport to medical facility if moderate to severe
42
Q

passive rewarming

A

remove from cold environment + wet clothing

  • replace with dry blankets/clothing
  • in a pinch, plastic bag + insulation when no dry clothing is available
  • space blankets not super useful cause they’re good for radiant, not convective heat loss
43
Q

active rewarming

A

warm packs on key areas

  • groin, axillae, torso
  • heat torso to reduce afterdrop
44
Q

superficial frostbite

A

affecting subcutaneous tissue

45
Q

deep frostbite

A

affecting bone joint and tissue

46
Q

frostnip

A

transient numbness with no residual damage

47
Q

frostbite blisters

A

clear are better and can be drained
cloudy or bloody are worse and usually are not
-blisters contain harmful thromboxanes and prostaglandins

48
Q

frostbite care

A

ibu
rewarming bath
aloe vera, dry, bulky dressings
eventual surgical management

49
Q

why are elite XC skiers, swimmers, etc more susceptible to asthma?

A

high ventilatory rate

+long term training (inc. w/ inc. years of training and dec. after over time after retirement)

50
Q

cold acclimatization

A

is possible
ideal protocol not studied
some evidence of 4-7 1 hr, 5C cold-air exposures over 14 days having an effect

51
Q

why is exercise complicated in the heat?

A
  • blood is transported to the periphery for cooling
  • relative and actual central fluid deficit
  • ->smaller SV and larger HR for given intensity
  • also, splanchnic vasoconstriction to compensate for peripheral steal leads to GI and kidney adverse effects
52
Q

heat exhaustion sx

A
  • pale, cool, moist skin
  • sweating profusely
  • mm cramping, pain
  • faint or dizzy
  • headache, nausea
53
Q

heat stroke sx

A
  • abnormal mental status!
  • flushed and hot dry skin
  • BP may be elevated initially then reduced
  • hyperventilation
54
Q

heat illness risk factors

A 
age above 65
alcohol, dehydration
overweight
poor fitness/sedentary
poor acclimatization
recent fever
sunburn or other dry conditions
55
Q

what medications would increase heat illness risk?

A 
those that
reduce sweating
alter skin blood flow
increase heat prod (metabolism)
reduce cardiac contractility
56
Q

wet bulb globe temp

A

index of heat stress that takes humidity into account

57
Q

exertional heat stroke

A

mental status changes + Tc >40

-metabolic heat production contributes=difference b/t exertional and classic heat stroke

58
Q

heat stroke causes of death

A 
improperly measuring core temp
delayed treatment
-reduce temp below 40 w/in 30 min 
-use towels if ice bath unavailable
rapid return to play w/out full determination and elimination of cause
59
Q

hyponatremia

A

serum or plasma sodium below normal reference range (less than 135mmol/L)

60
Q

hyponatremia sx

A

early: bloating, puffiness, nausea, vomiting, headache
later: altered mental status, obtundation, coma, seizeres, respiratory distress from pulmonary edema
body weight gain in most cases

61
Q

how does hyponatremia happen?

A

excessive consumption of fluids in excess of total loses

  • eg insensible losses from transcutaneous, respiratory, and GI losses
  • and sweat and renal fluid losses
62
Q

hyponatremia risk factors

A 
excessive drinking
weight gain during exercise
low body weight
-event inexperience
-NSAIDs
-high availability of fluids
-events >4 hours
63
Q

hyponatremia treatment

A

recognition
ABC’s
IV access
100mL of 3% NaCl solution and EMS transfer immediately

64
Q

heat illness prevention

A

ample fluids, sal-containing solutions and salty foods
drink to thirst
replace fluids w/1liter per 2 pounds lost

65
Q

acclimatization to heat

A

is possible
greater affect in untrained individuals
90min duration in 40 C for 5 days
-60 relative humidity

66
Q

how does heat acclimatization occur?

A
  • improved cutaneous blood flow (from core to periphery)
  • lower sweating threshold and increased sweat output
  • decreased Na in sweat
  • lower skin, core temp, and HR for given intensity
  • less CHO metabolism
67
Q

what has the opposite effect to heat acclimatization?

A

age

68
Q

case: fatigue, poor appetite, hypertension, tachycardia, poor sleep

A

possible causes: anxiety, anemia, general caloric deficit, exercise induced bronchoconstriction
overtraining
mono or other virus
test for: iron (blood) thyroid hormones, asthma, white blood cells, glucose, look at training volume + nutrition

69
Q

overreaching

A

accumulation of training stress that leads to short term performance decrements with or without related psychological and physiological signs and symptoms of maladaption

70
Q

overtraining

A

accumulation of training resulting in long term decrement in performance capacity with or without related physiological and psychological signs and symptoms of maladaption in which restoration may take weeks to months

71
Q

overtraining prevalence

A

60% of elite runners
also happens in packs sometimes
-like teams with terrible coaches

72
Q

overtraining vs overreaching

A

spectrum
overreaching has rapid recovery w/rest
-w/in days but at least by 2-3 weeks

73
Q

spectrum of overreaching

A

functional-recovery in days weeks (training camp for eg)
non-functional-recovery in wks to months-stagnation or dec. in performance capacity
overtraining: months to…, performance decreases

74
Q

how is overtraining diagnosed?

A

by excluding all other possible causes

  • rule out all other phenomena + profile of mood states
  • also performance testing if there’s baseline data (time trial to exhaustion)
  • hormones not super good-variable by lots of other things
75
Q

name 10 other things overtraining symptoms could be due to

A 
anxiety
mono
insufficient sleep
dehydration
exercise-induced asthma
iron deficiency
eating disorders
hypothyroidism
upper respiratory infection
76
Q

general and physical overtraining symptoms

A

workouts more difficult

  • early fatigue
  • faster HR w/less effort
  • dec. strength
  • dec. coordination
  • persistent fatigue
  • ongoing mm soreness
  • loss of appetite
  • inc. aches and pains
  • inc. in overuse injuries
  • frequent colds or infections
77
Q

what is the subjective psychological evaluation?

A
  • fatigue ratings
  • mood states (dec. pos. and inc neg. feelings)
  • mm fatigue ratings and inc. recovery time
  • perceived exertion during constant exercise load (inc.)
78
Q

cardiovascular factors in OTS

A

resting moring HR not super useful: sometimes higher, sometimes lower
-HR variability may be useful down the road

79
Q

weight and nutrition in OTS

A

individual variation, inc. or dec. more than normal

80
Q

OTS risk factors

A 
general health
general nutrition
mood state
personality (type A) stressors
intensity of training
volume of training
social, economic, and psychological stressors
environmental conditions
infections travel
81
Q

OTS treatment

A

rest

proper early diagnosis

6-12 wks

possibly address other stress with counseling
*collaboration with athlete, coach, and team or patient’s physician

KIN 471 (2 decks)

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