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Active Care > Test 2 > Flashcards

Test 2 Flashcards

1
Q

Exercise and response in cardiac output

A

Direct relationship

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2
Q

Exercise and response in Vo2 (Oxygen uptake)

A

Direct correlation

Increase with exercise

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3
Q

Vo2 max does what with training

A

Increases

The amount of oxygen that can be taken in and utilized per kg/min

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4
Q

EPOC

A

Excess post-exercise oxygen consumption

Due to initial depletion when starting the exercise

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5
Q

RQ

A

Volume of CO2 expired: volume of oxygen consumed

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6
Q

What is RQ an indicator of

A

Metabolic fuel use in the tissues

Carb 1
Lipid 0.7
Protein 0.8

Usually only fat and carbs are used to calculate

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7
Q

Exercise and response in RQ

A

Increases with exercise

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8
Q

Changes in BP with dynamic, low force exercise

A

Increase in systolic
No change in diastolic BP

***good predictor of CAD if diastole increases

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9
Q

Increase in diastole BP during dynamic, low force exercise is a good predictor of what? How much of a change is significant?

A

CAD

> 15mmHG or above 110mmHG

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10
Q

Weight lifting and BP

A

Systolic and diastolic pressure increase.

Systolic of 450mmHg have been reported

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11
Q

total peripheral resistance and local factors (CO2/lactate)

A

CO2/lactate cause dilation in the working muscles and decrease TPR

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12
Q

Lactate threshold

A

Point during exercise where lactic acid begins to accumulate in the blood

Max level of sustained activity

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13
Q

How do you know you’re at the lactate threshold

A

Can carry on a conversation but cannot sing

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14
Q

Vo2 max level and lactate threshold start

A

Around 60% vo2 max is when lactate starts to increase in the body

Untrained people: 55%
Endurance athletes: 70%

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15
Q

What other changes occur when lactate threshold is met?

A

Increase in mitochondria and capillary density

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16
Q

Ways to monitor the patient and rate their perceived level of exertion

A

Borg Scale

Talk test

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17
Q

What its the talk test and what is it used to measure

A

Determining patients ability to respond in conversation

Reflects:

HR
Vo2
Lactate threshold

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18
Q

Anaerobic threshold

A

Point where shift toward anaerobic metabolism where excess CO2 is expired

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19
Q

Endocrine changes with exercise. What increases and decreases?

A

Increase: cortisol, catecholamines, endorphins, growth hormone, testosterone

Decrease: insulin

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20
Q

Physiologic changes with training

A
  • decreased resting HR
  • increased SV at rest
  • max CO increase
  • increase in BV
  • static lung volumes UNCHANGED
  • HDL increase
  • cholesterol decrease
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21
Q

What is the PAR-Q form?

A

Physical activity readiness questionnaire

Screen for exercise contra-indications

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22
Q

What is the minimum requirement before starting an exercise program. Screening wise

A

PAR-Q form

Ages 15-69

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23
Q

What are the 7 ACSM risk factors?

A
  1. Family history of atherosclerotic disease
  2. Smoker
  3. HTN (>140, 90 or antiHTN meds)
  4. Dyslipidemia (LDL>140, HDL<40, cholesterol> 200)
  5. Prediabetes >100
  6. Obesity >30BMI
  7. Sedentary lifestyle

If HDL> 60 take away one risk factor

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24
Q

Major S/S of CVD, Pulmonary or metabolic disease

A
  • pain/discomfort in UE
  • shortness of breath
  • dizzy
  • orthopnea
  • ankle edema
  • palpitations/tachycardia
  • intermittent claudication
  • heart murmur
  • unusual fatigue/shortness of breath
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25
Q

ACSM risk stratification

Low risk

A

Men< 45
Women <55

With no more than one risk factor

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26
Q

ACSM risk stratification

Moderate risk

A

Men>45
Women >55

With two or more risk factors

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27
Q

ACSM risk stratification

High risk

A

Have a major risk factor

(Pain in UE, shortness of breath, dizzy, orthopnea, ankle edema, palpitations, intermittent claudication, heart murmur, unusual fatigue)

Or CVD, pulmonary or metabolic disease

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28
Q

Is an exam/exercise testing required? For low, moderate and high risk patients with moderate intensity and vigorous intensity

A

Moderate intensity/low risk: no
Moderate intensity/moderate risk: no
Moderate intensity/high risk: yes

Vigorous/low risk: no
Vigorous/moderate risk: yes
Vigorous/high risk: yes

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29
Q

Is physician supervision recommended during the exercise test for low, moderate and high risk patients for both submax testing and max testing

A

Submax testing:

Low risk: no
Moderate: no
High: yes

Max testing:
Low risk: no
Moderate: yes
High: yes

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30
Q

What is VO2 for moderate intensity

A

40-59%

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31
Q

What is Vo2 for vigorous intensity

A

60%+

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32
Q

What are examples of submaximal tests?

A 
Run/walk (1.5 mile run) (rockport 1 mile walk)
Step tests (Queens college step test—steps for 3 min...men 24/min, women 22)
Bike tests (Blake treadmill test)
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33
Q

What is the submaximal walking test called?

A

Blake treadmill test

3.3 mPH @0% grade and increase incline 1% each minute

Measure time till exhaustion

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34
Q

What is the Karvonen?

A

Heart rate reserve formula

Take into account available heart range due to varying resting heart rate baselines

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35
Q

Heart rate and VO2 have a _____correlation

A

Direct

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36
Q

What is the Karvonen formula

A

220-age=max HR

Max HR - Resting HR= Heart rate reserve

HHR x moderate/vigorous %’s to get HR range target

Mod: 40-59
Vig: 60-80

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37
Q

S/s of concussion

A 
HA
Fog feeling
Changes in personality
LOC/amnesia
Gait changes
Irritable
Slow reaction times
Sleep disturbance
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38
Q

Red flags of concussion

A 
Neck pain/tender
Double vision
Weak/tingling/burning in extremities
HA (severe/increasing)
Seizure
LOC
Vomit
Increased restlessness/combative
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39
Q

SCAT-5 cognitive screening sections

A

Immediate memory
Digits backwards
Months in reverse

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40
Q

SCAT 5 neurological screen

A
  • read outloud directions and follow instructions
  • full range of pain free passive C-movement
  • without moving head can they follow your finger without vision changes
  • finger to nose
  • tandem gait
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41
Q

SCAT 5 balance testing

A

Aka modified Bess

20 second trials
Double, single and tandem stance

Errors: hands on crest
Open eyes
Step/stumble
Moving hip further into flexion
Lifting forefoot/heel
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42
Q

Return to play protocol after concussion

A
  1. Symptom-limited activity
  2. Light aerobic
  3. Sport specific exercises
  4. Non-contact training drills
  5. Full contact practice
  6. Return
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43
Q

Symptom limited activity post concussion (1)

A

24-48 hours

Gradual reintroduction of work/school activities

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44
Q

Light aerobic exercise post concussion stage

A

When no concussion related symptoms present and can perform at or above pre-injury levels of motor and neurological function

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45
Q

What activities are allowed during light aerobic exercise stage post concussion

A

Walking, swimming, running, stationary bike

<70% max HR

No resistance training

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46
Q

Sport specific exercicse stage post concussion

A

When no concussion symptoms, performing normally and no return of symptoms with any prior activity

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47
Q

What is done during sport specific exercise post concussion

A

Movement drills, simple without much decision making

NO head impact activities

Add movement to increase HR

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48
Q

Non-contact training drill stage post concussions

A

No related symptoms, performing normally, no return of symptoms

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49
Q

What is done during non-contact training drills post concussion (4)

A

Tasks requiring complex physical/cognitive demand

MAY start resistance training
Exercise,cognition, coordination

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50
Q

Full contact practice activities post concussion

A

Normal team training activities while monitored my coach

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51
Q

Return to school strategy post concussion

A
  1. Daily activities that do not recreate symptoms
  2. School activities
  3. Return part-time
  4. Return full-time
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52
Q

Daily activities that do not recreate symptoms-return to school

A

Allow gradually:

Screen, reading, texting

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53
Q

School activities-return to school

A

Homework
Reading
Other cognitive activities PUTSIDE classroom

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54
Q

Minimal screening exam for concussion

A 
Mental status (alert/memory/behavior)
Cranial nerves (2-12)
Motor
Strength
Reflexes 
Sensory
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55
Q

Do LOC, amnesia, or seizures predict outcome of concussion?

A

No

56
Q

Possible predictors of delayed recover (14+ days)

A 
Migraine
Reaction time
Visual memory
Verbal memory
Dizziness
57
Q

Other management options for concussions

A

Vestibular rehabilitation techniques

  1. Gaze stabilization exercises
  2. Standing balance exercises + progression
  3. Walking balance challenges
  4. EPLEY MANEUVER
  5. Subsystem threshold exercise -Increasing PSNS, decrease SNS
  6. Blake maximal aerobic treadmill test
  7. Cervicovestubular rehabilitation (adjustments plus gaze stabilization)
58
Q

EPLEY maneuver

A 
Turn head towards involved ear
Quickly lie back
Turn 90 degrees opposite direction
Turn head&amp;body another 90
Side upright on opposite side
59
Q

Who is most likely to get c-spine pain

A
  • females
  • middle aged
  • sleep disorders
  • smoking
  • sedentary lifestyle
  • catastrophization
60
Q

Diffuse neck pain increased with movement

A

Mechanical neck pain
Facet syndrome
Sprain/strain

61
Q

Pain in certain postures alleviated by positional change

A

Upper cross

62
Q

Traumatic mechanism of injury or non-specific symptoms exacerbated by upright position and relieved when head and neck are supported

A

Cervical instability

63
Q

Nonspecific with radiating symptoms to one arm

A

Cervical radiculopathy

64
Q

Neck pain with bilateral UE symptoms and potential balance issues

A

Cervical myelopathy

65
Q

Evaluating for disc derangement and management

A

End range loading
Antalgia based criteria

End range loading

66
Q

Evaluating and management joint dysfunction

A

Palpation, extension-rotation, flexion-rotation

Adjust, traction.mobilize, end range loading

67
Q

Evaluate and manage radiculopathy

A

Brachial plexus tension, <60 cervical rotation, distraction, foraminal compression

ERL, traction, nerve flossing

68
Q

Evaluate and manage myofasical trigger point

A

Palpation

Ischemic compression, dry needling, IASTM

69
Q

ROM of C-spine

A

Flex: 60
Extend: 75
Rotate: 80
Lat flex: 45

70
Q

Where does most rotation come from in C spine

A

45 from C1-C2 (of the 80)

71
Q

Rotation under what degree is considered dysfunctional

A

60

72
Q

Where does most lateral flexion come from

A

Low C spine

35 of total 45

73
Q

Non-neural contributors to C spine stability

A

20% osseoligamentous

80% musculature

74
Q

Deep muscles control what

A

Segments

75
Q

Superficial muscles produce

A

Movement

76
Q

Deep muscles aka

A

Local or intrinsic

77
Q

Superficial muscles aka

A

Global or extrinsic

78
Q

Global vs local muscles in upper cross

Extrinsic vs intrinsic

A

Local/intrinsic are weakened/inhibited in UC

Global/superficial are tight/facilitated in UC

79
Q

Global/superficial muscle are what in upper cross

A

Tight/facilitated

Ex: SCM, scalene, suboccipitals

80
Q

Local/intrinsic muscles are what in upper cross

A

Weak/inhibited

Ex: longus colli/capitals

81
Q

What are the deep neck flexor muscles

A

Longus capitis
Longus coli
Rictus capitis anterior

82
Q

What do the deep neck flexors do/main function

A

Postural and provide dynamic stability

Along with ALL

83
Q

Reduced neck strength correlated with

A

Neck pain

84
Q

Stability triangle

A

NS (control subsystem)
Muscles (active subsystem)
Spinal column (passive subsystem)

85
Q

Local/intrinsic muscles of the C spine

Anterior

A

Longus capitis
Longus colli
Rectify capitis lateralis/anterior

86
Q

Local/intrinsic c spine muscles

Posterior

A 
Rictus capitis posterior major/minor
Oblique capitis inf/sup
Semispinalus capitis/Cervicals
Splenius capitis/cervis
Longissimus capitis/Cervicis
87
Q

Longus coli

A

Retraction of the C-spine

Deep to the cervical viscera/trach/esophagus

Act as a dynamic ALL

C1-T3

Counteract buckling forces of lordotic curve

88
Q

Global/extrinsic C-spine muscles

Anterior

A

SCM

Ant/med scalene

89
Q

Global/extrinsic muscles of C spine

Posterior

A

Upper trap

Lavatory scapulae

90
Q

Exercises to relieve neck/shoulder pain in office workers

A

Isometric holds unilaterally

Eccentric lowering from a shoulder shrug (increases proprioception)

91
Q

Common joint dysfunction with upper cross

A

sternoclavicular
AV
C and T facets

92
Q

Potential injuries with upper cross

A 
Rotator cuff
Shoulder instability
Bicep tendonitis
TOS
HA
93
Q

Method of movement evaluation

A 
Functional patterning (flex-rotate test &amp; ext-rotate test)
Motor control (C-flex pattern, quadruped rocking, flexor endurance test)
Passive ROM (passive and active ROM)
94
Q

Method of management of motor control

A 
Mobility (A/PROM)
Motor control (C-flexion pattern, quadruped rocking, flexor endurance(
Functional patterning (flex/ext-rotate)
95
Q

Posterolateral assessment observation. What are you typically looking for pattern wise in weak patient

A
  1. Rounded shoulders (facilitated-tight pecs)
  2. Anterior head carriage (F-SCM)
  3. Head extension (F-suboccipitals)
  4. Elevated shoulders (F-trap/levators
  5. Winging scap (I-serratus ant)
96
Q

Cervical flexion motor pattern-part of what step and explain

A

Motor control

Have patient look at the feet

Fail: chin protrudes 1st, overactive SCM, shaking

97
Q

Neck flexion motor evaluation

A

Dysfunction is chin lying flat on the chest and excessing forward translation without coupled Sagittarius rotation

Leads to approximation of facets
Usually means hypomobile upper and lower C spine and hyper middle

98
Q

Quadruped rockback—motor control

Head extends back—mean what

A

Poor anterior stability and tight posterior chain—lavatory and upper trap

99
Q

Craniocervical flexion test.

A

Put BP cuff behind occiput/neck and inflate to 20 mmhg

Nod head “yes” while maintaining hold

Test of precision not strength

100
Q

Flexor endurance test

A

Hold flexed position as long as possible

Men: 40
Women: 30

101
Q

Cervical extension rotation test—what part and what is it?

A

Functional patterning

increased pain= +

Identifies facet joint involvement in pain on ipsilateral side

102
Q

Cervical flexion rotation test. Part of what and what is it?

A

Functional motor patterns

Isolated for c1-c2

Range should be 40-44 degrees
Under 32= +
Connects to patient with cervicogenic headache

If patient has overall increased ROM, but is low ROM on this, tells you the ROM is coming from other areas that it shouldn’t

103
Q

Corrective exercise continuum

A 
Inhibit techniques (myofascial release)
Lengthen techniques (stretching)
Activate techniques (positional isometrics/strengthen)
Integration techniques
104
Q

Phases of healing and corrective exercises that go with

Acute inflammatory

A

Inhibit and lengthen techniques

0-3 days

105
Q

Phases of healing and corrective exercises that go with

Subacute/proliferative

A

Lengthen and activate

3days-3weeks

106
Q

Phases of healing and corrective exercises that go with

Chronic remodeling

A

Activate and integration techniques

3+ weeks

107
Q

Corrections for anterior head carriage

A

Posterior glide

Facilitates upper C flexion and lower C extension

108
Q

When making corrections make sure the patient is engaging what muscles

A

Intrinsic/local muscles

109
Q

Characteristics of C-extension syndrome

A 
Forward head
Pain with extension
Translation greater than Sagittarius rotation
Weak intrinsic flexors
Pain with prolonged posturing
HA in suboccipital
110
Q

Characteristics of cervical flexion syndrome

A

Decrease in cervical lordosis
Decreased thoracic kyphosis
Loss of flexion in T spine (may cause increased flexion in C spine)

111
Q

What joints are prone to mobility restrictions

A 
Ankle
Hip
Thoracic
Gleno-humeral
Upper cervical
112
Q

What joints are prone to stability restrictions

A

Knee
Scapula
L
Lower cervicals

113
Q

Shoulder pain and ROM improvement with?

A

Rib manipulation

114
Q

Primary muscles for inhalation

A

Diaphragm
Pasta sternal internal intercostal
Scalenes
Levatores costarum

115
Q

Primary muscles for exhalation

A

Elastic recoil
Diaphragm
Pleura/costal cartilage

116
Q

Diaphragmatic/abdominal/belly breathing

A

Diaphragm down
Lower rib cage moves down laterally, ventral and dorsal
Sternum moves ventral while intercostal spaces expand minimally at end of inhalation

117
Q

Paradoxical breathing

A

Abdomen draws in during inhalation and out during exhalation

118
Q

Chest/apical breathing

A

Excessive upward movement of sternum and shoulder girdle. Minimal abdominal movement

Pts will have very developed paraspinals and little rib expansion. Just extending through lumbars

119
Q

Secondary issues due to faulty breathing patterns

A

Asymmetrical motion
Shallow breathing
Tension in face/jaw
Sighs/yawns frequently

120
Q

Exercises to improve breathing

A

Blowing up ballon
Clamshell
Crocodile breathing

121
Q

Blowing up a balloon

A

Help to diaphragm breathe
Right arm above head, inhale through nose, exhale through mouth.

Posterior pelvic tilt with flat back

Hold air in balloon 3 seconds and repeate 4x

122
Q

Clamshell

A

Help with breathing

Post exhale patient holds breath and then abducts top knee keeping heels together. Found 3 open, 3 closed.

Then inhale.

123
Q

Crocodile breathing

A

In sphinx inhale and exhale through nose making sure abdomen expands into ground

124
Q

Evaluating shoulder mobility

A

Apley’s scratch

(Grab hands behind back)
Fists should be within hands length

To do this, should retract neck and extend T-spine. People compensating will flex forward

125
Q

Thoracic rotation

A

50 degrees

126
Q

Wall angel—for what and how

A

Thoracic mobility

Against wall with arms abducted 90 degrees and elbows bent at 90.

Have patient tuck chin.
FAIL=T-L junction does NOT flatten

127
Q

Wall slide for and what

A

Thoracic mobility

Squatting down while raising arms

Lat and pec stretch felt. Tight lats may cause hyperextension/shoulder to elevate
=inhibited/weak ant stabilization and facilitated/tight posterior chain

128
Q

Arm elevation. What adn when

A

Against a all should raise arm up and keep pelvis on wall and maintain normal lumbar curve.

Increased hyperlordotic curve= facilitated lat and pec

129
Q

Thoracic extension mobilization

A

Cat-camel

Foam roller

130
Q

Trunk stability push-up

What and how

A

Motor control

Everything should elevate as a unit. Recall straight line. This tests stability/control not strength.

131
Q

Quadruped for t-spine. What and how

A

Motor control

Extension of head means levator scap

132
Q

Brugger

A

Posture focused exercises

“Posture breaks”
“Cog wheel”

How poor posture in one can have affect on other areas

133
Q

What is brugger posture break

A

Sit at edge of chair with feet out slightly and wider than hips

Tuck chin
Deep belly breath
Slowly exhale and rotate arms out, spread fingers wide and “tall spine”

134
Q

Poor posture can lead to

A

Decreased cervical motion
Increased lumbar motion
Poor breathing capacity
Extremity involvement

135
Q

Scoliosis management

A

Triplanar involvement
VB rotates to concavity in C/L

VB rotates to convexity in T

Do rotation, lateral flexion and progressive flex/extension

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