Test No. 2 Flashcards
Definition: Leptin
a protein, produced in fat cells, that circulates in blood and alerts the brain that there is enough stored energy
tells you you are full
MS: cutoff for triglycerides
≥1.7mmol/L
Definition: Beta cells
detect an increase in glucose, produce insulin to facilitate glucose transport into the blood for energy
Definition: Intermittent Claudication
a classic symptom of PAD where an aching or cramping feeling occurs in the legs, calves and buttocks induced by exercise
How is fibrinogen detected?
through blood tests
Which has an obvious cause: secondary or essential hypertension?
Secondary - kidney disease, adrenal gland disorder, medication or sleep apnea
OSA
Obstructive Sleep Apnea
CVD: Cardio
F: 4-7 days/week
I: 11 - 13 on Borg - fairly light to somewhat hard
T: Progress to 20 - 60m
Ty: walking, bicycling, stair climbing, elliptical trainers, rowing machines
PROGRESS SLOWLY
Definition: Hyperglycemia
high blood sugar
What hormone stimulates appetite and tells you you are hungry?
ghrelin
MS: cutoff for LDLs
<1.0mmol/L - men
<1.3mmol/L - women
Which side of the heart pumps oxygenated blood to the systemic/peripheral cirulation?
left
Function: Platelets
recruited as plugs to stop bleeding in wounds
RMR
Resting Metabolic Rate
Diabetes related comlications
ACRONYM
SLR HNN
- Heart disease
- Stroke
- Liver Damage
- Retinopathy - eyes
- Neuropathy - nervous system
- Nephropathy - kidney disease
What type of substance is important in reducing inflammation?
antioxidants
What ratio of Canadians had at least one risk factor for heart disease or stroke in 2009?
9/10
Definition: Dyslipidemia
abnormal blood lipoprotein concentrations and is a major risk factor for atherosclerosis, heart attack and stroke.
High levels of LDLs or abnormally low levels of HDLs
True or False: You should inject insulin into the exercising muscles.
False
Locomotor movement examples?
running, hopping, jumping
What are the risks associated with exercise and type l clients?
- Increased risk of CVD
- Increased risk of hypoglycemia
- Increased risk of dehydration
- Increased risk of injury to the extremeties bc of neuropathy
True or False: The gastric bypass surgery is reversible.
False.
How does exercise affect blood sugar?
it lowers it.
Why is there an increased risk for hyperthermia when an obese individual is exercising?
- can result from increased muscle contraction during exercise
- is promoted by greater amount of subcutaneous fat
What is associated with Essential Hypertension?
AA CHESS
- Cigarette use
- Excess weight
- Sedentary lifestyle
- Excess sodium
- Older age
- Excess alcohol use
- Heredity
Which test reflects on an individuals average blood glucose levels? Over what period of time?
A1C test. 3 months
What substance does adipose tissue produce?
adipokines
Definition: Hypoglycemia
low blood sugar
Medications for Hypertension
ACRONYM
AABCD
- Diuretics
- Beta Blockers
- Calcium channel blockers
- Angiotensin ll receptor blockers
- Angiotensin-converting enzyme inhibitors
Definition: Myocardial Infarction
heart attack - result of the formation of a thrombus or clot associated with an atherosclerotic lesion that has formed in a branch or branches of the coronary artery system
True or False: You should inject insulin into the exercising muscles.
Why are adiponectin levels low in obese individuals?
Because there is a dysfunction in the adipose cells
Who are 3 people who have type ll?
overweight, obese, older
How does obesity impact the cardiovascular system?
- there is a build up of fat around the heart muscle
- build up of plaque in the arteries and vessels can increase total peripheral resistance, which increases blood pressure and negatively affects proper circulation
What do ketones trigger?
dehydration
Definition: Stroke
results when part of the brain is deprived from oxygen due to a blockage in cerebral arteries
What respiratory disorder is more prevalent in obese individuals?
Sleep Apnea
How are ketones formed?
by the breakdown of fats
What are the 2 functions of the cardiovascular system?
- ensure adequate oxygen delivery to all organ systems in the body
- deliver wast byproducts to excretory organs - kidneys and skin, where they can be removed
Definition: squamous
thin layer of simple cells
Obese Cardio: FITT
Frequency - 5-7 days/week - low - mod
- 2-3 days/week - vig
Intensity: Mod - 40-60%
Time: 30-60m - low - mod
- 20-25m - vig
- 150m/week
Type: treadmill walking, stationary bike, depends on subsequent workout
Definition: Type l Diabetes
an autoimmune disorder in which immune cells attack beta cells in the pancreas
What organ produces insulin?
pancreas
What is another term for formed elements?
hematocrit
True or False: High levels of adiponectin are associated with lower risk of heart disease.
True.
What glucose cutoff should you have your client eat carbs at?
<100mg/dl
What are some medications for fat loss?
Sibutramine
Orlistat
Examples of adipokines?
- adiponectin
- leptin
True or False: Food restriction or increased physical activity, alone, will NOT produce significant long-term weight loss
True
What makes up the plaque in the vessel created by excess homocysteine?
cholesterol and platelets
Is sleep apnea easy or difficult to diagnose?
difficult
What are some surgeries for obesity?
Gastric Bypass
Gastric Lap Band
Stomach Stapling
Definition: c-protein
a protein that is created and released by the liver into the blood in response to trauma, inflammation and infection
True or False: FEV1 is higher in obese individuals
False. Significantly lower
Why is c-protein a risk factor for cardiovascular disease?
Although c-proteins are not a direct risk of CVD, a high level of them can indicate future risk of a heart attack. However chronic response of c-protein to inflammation can cause platelet clumping in the vessel, eventually decreasing the circumference of the vessel and leading to blood clots.
Definition: Obesity
excess adipose tissue
BMI Risk: Obese Class lll
Extremely High
What causes an increase in fibrinogen levels?
ACRONYM
DIBIS
- infection
- illness
- bleeding from wounds
- damage to blood vessels
- stress
Symptoms: Hyperglycemia
Hunger, frequent urination, increased thirst
What kind of food should you have available to type l clients?
carbs
Obesity Class l
30-34.9
MS: Level of blood sugar
≥ 5.6mmol/L
Obese Warmup: FITT
Frequency: Before and after every workout
Intensity: Light to moderate - match upcoming workout
Time: 5-10m
Type: treadmill walking, stationary bike - depends on subsequent workout routine as well as contraindications of the client
Describe the endocrine role of the pancreas. % of cells?
release hormones involved in blood glucose through a group of glands to their target. 1%
For CVD clients, should you use HR or RPE?
RPE
What can obesity cause in the “digestive” system?
- Acid reflux displacement
- Gastroesophageal reflux disease - GERD
- Fatty liver
- Intestinal Absorption - constipation
- Gallbladder - gallstones
BMI Risk: Obese Class ll
Very High
What are these diagrams called?

Flow Volume Loop
What are the 4 benefits of exercise for obese individuals?
- Improved cardiovascular functioning - V02max, dyspnea reduces, OSA reduces
- Decreased risk for type ll and MS - lowers BP, improves cholesterol, reduces fat, and improves insulin sensitivity
- Reduced overall discomfort - ADLs
- Improved mood and decreased anxiety - self esteem, self efficacy
What are some NON-modifiable risk factors?
- Age
- Sex
- Family History
What is a telltale sign of Sleep Apnea?
snoring
MS: cutoff for LDL’s
<1.0mmol
Definition: Myocardial Ischemia
reduced bloodflow to the myocardium
MS: cutoff for blood pressure
Definition: Active Transport
does require energy expenditure - worth it becaue the body gets a lot out of it
Definition: Neuropathy
losing sensation in the extremeties
Obesity Class lll
≥40
Which is more common? Secondary or Essential hypertension?
Essential. 90-95%
What other condition may sleep apnea contribute to?
Diabetes
True or False: veins have a larger lumen.
True.
Definition: venules
small branches of veins that carry blood towards the heart
Definition: FEV1
most amount of air you can exhale after you take a deep breath in
What does insulin do when energy requirements are low?
promote glycogenesis
What does hypertension increase the risk of?
kidney disease, peripheral vascular disease and congestive heart failure
What is the mmol/L cutoff for the OGT - oral glucose tolerance test?
≥ 11mmol/L
What are the two types of chronic heart failure?
Systolic heart failure and Diastolic heart failure
Why do women generally gain weight in a pear shape?
estrogen puts an emphasis on lower body fat distribution
Definition: capillaries
smallest vessels; site of gas and nutrient exchange
What are the 4 methods of diagnosing type ll and gestacional diabetes?
- Fasting Plasma Glucose Test
- Oral Glucose Tolerance Test
- Random Plasma Glucose Test
- A1C Test
What sorts of things can cause inflammation in the vessels?
- Chemicals - such as heavy metals - mercury and lead
- Dietary - such as wheat and gluten allergies
- Coronary heart disease
- cancer
How many Canadians suffer from MS?
19.1%
What is the mmol/L cutoff for the FPG - fasting plasma glucose test
≥ 7mmol/L
By how much does the chance of stroke increase at the onset of type ll diabetes?
doubles
What kind of stimulus would decrease glucose?
fast
BMI Risk: Obese Class l
High
EEpa
the thermic effect of activity
Which is more reliable: FPG or OGT?
OGT - oral glucose tolerance test
Benefits of exercise on the cardiovascular system?
ACRONYM
VALOR
- Increased maximal oxygen uptake
- Improved heart functioning and reduced angina
- Improved health of blood vessels
- Imroved blood lipid profile
- Improved recovery from heart attack
What physiological factors influence BP?
ACRONYM
CHEV RV
- strength of heart contraction
- blood volume
- arterial wall elasticity and recoil
- blood flow resistance
- blood viscosity
- overall health
True or False: the ghrelin hormone shuts off when leptin is being produced
false. they switch priority
What hormone suppresses appetite?
leptin
What are the 4 precautions to exercise in relation to cardiovascular disease?
- Side effects from medication - lowered HR or BP, blood thinners
- Shortness of breath - fluid in lungs could indicate congestive heart failure
- Chest pain and exercise induced ischemia - angina, stop immediately
- High BP - monitor breathing techniques
How is c-protein detected?
- through blood tests
- through saliva
Definition: GERD
gastroesophogeal reflux disease - one valve in the esophogus doesn’t close and creates a reflux pattern
How does obesity impact the musculoskeletal system?
- degredation of the joints
- arthritis and osteoarthritis risk, more pressure reduces synovial fluid
- locomotion limited
What are the symptoms of ketoacidosis?
ACRONYM
mmdd Faun
dry mouth
frequent urination
nausea and vomiting
abdominal pain
rapid breathing or dyspnea
fruity breath
muscle weakness
mental confusion
True or False: There are high levels of adiponectin in obese individuals.
False. Low.
CVD: Warmup
F: Prior and following all exercise sessions
I: <40%
T: 5-10m
Ty: treadmill walking, stationary cycle, depends on subsequent workout routine
What are the 6 risk factors for cardiovascular disease?
ACRONYM
CHEFSS
- Smoking
- Stress
- Exercise
- Homocysteine
- C-reactive protein
- Fibrinogen
PHAC
Public Health Agency of Canada
What ratio of Canadians have metabolic syndrome?
1 in 5
Diabetes: Resistance
F: 2 - 3 days/week
I: 60 - 80% of 1RM
T: 2 - 3 sets - 8 - 12 reps
Ty: 8 - 10 multijoint exercises
What is the “hormone of energy expenditure”?
leptin
2 people get type ll diabetes every HOW MANY seconds?
10
Why are ghrelin levels low in obese individuals? Why is this surprising.
ghrelin is supposed to increase appetite, so you would think obese individuals have a lot of this. Because the levels of ghrelin are low, this indicates that something else is going on to make them continue to eat. Psychological, comfort, etc.
What classifies as “underweight”?
>18
What kind of test is required when working with CVD clients, and who should supervise said tests?
a stress test; physician, nurse, exercise physiologist, physical therapist and medical technician
Describe the exocrine role of the pancrease.
digestive enzymes secrete substances delivering them by way of ducts, like sweat and saliva
Diabetes: Warm Up
F: before and after
I: limbering movements, light stretching
T: 5 - 10 of each above
What is the mmol/L cutoff for the random plasma glucose test?
≥ 11mmol/L
What are the 3 components of the metabolic syndrome?
- Overweight and Obesity
- Abnormal cholesterol levels
- Insulin Resistance and High Blood Pressure
Why don’t people wear the OSA device?
becaues it is claustrophobic
TEF
the thermic effect of the digestion and assimilation of food
Definition: Peripheral Arterial Disease
narrowing of noncardiac arteries that may result in reduction of blood flow
What are the 3 main precautions to exercise when working with obese individuals?
- Increased risk of a cardiac event or stroke
- Increased risk of debilitating joint injuries
- Increased risk of hyperthermia
What produces adiponectin?
adipocytes
BMI Risk: Normal Weight
Least
What is happening with glucose and insulin when someone with type l exercises?
glucose continues to rise, as insulin never changes past baseline
True or False: c-protein reduces the effectiveness of white blood cells
false
When should you monitor blood glucose in clients with type l?
before, during and after
Definition: veins
vessels that carry blood towards the heart
What kind of stimulus would increase glucose levels?
meal
Definition: Prehypertension
systolic pressure 120-139mmMg
diastolic pressure 80-89mmMg
Definition: Hypertension
a systolic pressure ≥ 140mmMg
a diastolic pressure ≥ 90mmMg
or both
Definition: Silent Ischemia
insufficient blood flow to the heart without clinical signs or symptoms, type ll
What are microvascular dysfunctions?
eyes, feet and kidneys
Blood glucose response will vary in type l clients based on the 4 following factors
ACRONYM
BIDI
- BG before exercise
- Intensity
- Duration
- Changes in insulin doses
What are the 3 layers of blood vessels?
- Tunica Intima - edothelium or squamous cells
- Tunica Media - smooth muscle
- Tunica Externa or Adventitia - mostly fibrous connective tissue
What is the “silent disease”?
Hypertension
In what two ways can you assess blood glucose when working with a type l client?
Blood Glucose analyzer - blood or urine - shows ketones
What are the components of blood?
- plasma
- formed elements
What are the 5 hormones of the endocrine system related to obesity?
ACRONYM
LAGIE
- Leptin
- Adiponectin
- Insulin
- Estrogen
- Ghrelin
What rating classifies as obese?
>30
What type of fat does the skinfold assessment measure?
Subcutaneous
Why is there an increased risk of a cardiac event or stroke when obese individuals are exercising?
- excess weight overstressed the heart even at rest, so exercise increases that stress
- BP can reach dangerous levels during activity
- weakened vessels are prone to aneurisms
Definition: Atherosclerosis
development of plaque in arteries
Function: white blood cells
provide specific and nonspecific resistance
When working with an obese client, when should you check for breathlessness?
Before, during, and after workout.
Where are women more likely to feel symptoms of angina?
BP Formula
Cardiac Output x Peripheral resistance
What organ creates the pressure that drives blood through the vessels?
heart
Why do you need to be especially careful when type l are exercising?
because hypoglycemia symptoms mimic those of exercise
What is the cutoff for hypoglycemia?
<70mg/dl
Why are obesity rates higher in some cold areas?
Because cold weather makes people want to exercise less
FEV1
Forced Expiratory Volume in 1 second
Why does homocystein rarely accumulate?
because it usually converts back into methionine or cysteine
What is associated with the development of cardiovascular disease and diabetes?
metabolic syndrome
Where is ghrelin produced?
stomach cells
What are some reasons an obese individual might not want to go to a gym and workout?
- Don’t feel welcome
- Feel judged
- Feel like they are being looked at
- Not confident in their abilities
What method do you use to diagnose type l?
Blood test for autoimmune antibodies - presence of antibodies that destroy cells responsible for making insulin
Definition: Stable Angina
associated with the onset of a specific level of stress, such as exercise
What hormone, which inhibits the thyroid, is associated with weight gain?
Estrogen
How much insulin is usually in the body?
0.41 - 1.5
True or False: helping clients with type l is a trial and error process.
True
Object Control examples?
throwing, catching
What are the types of surface fat? Are they the most/least dangerous type of fat?
Peripheral, Subcutaneous, Lower Body. Least.
What are the two reasons why “self-reported” obesity statistics are unreliable?
- Undereport weight
- Overeport physical activity
Definition: Sleep Apnea
recurrent episodes of upper airway obstruction during sleep, accompanied by oxyhemoglobin desaturation
How many classes of obesity are there?
3
Defintion: Unstable Angina
less predictable and often occurs at rest
Definition: Fibrinogen
a protein that is synthesize and released by the liver into the blood to aid in blood clotting, as well as initiating and exacerbating the inflammation response
PAD
peripheral arterial disease
Definition: Alpha cells
detect decreases in glucose, produce glucagona nd stimulate a downstream effect - hunger
Which side of the heart pumps DE-oxygenated blood through to pulmonary circulation?
righ side
Symptoms: Hypoglycemia
sweating, fatigue, dizziness
How much more likely are diabetes patients to have an MI?
What causes an atherosclerosis?
fatty deposits - LDLs - accumulate on the inner lining of the arterial walls. LDLs pass into the tunica intima where they undergo “oxidization”. These oxidized LDL’s are toxic and increase inflammation. White blood cells called “monocytes” absorb the toxic oxidized LDL’s and become foam cells. When these foam cells rupture or die, they release their lipid content, creating a “lipid core”. Fibrous caps form over these in the healing process, creating more plaque. At first the plaque eats into the wall of the artery to about 40%, weaking the artery wall. But after that point, the plaque starts narrowing the lumen, leading to reduced blood flow.
CHF
chronic or congestive heart failure
Obesity Class ll
35-39.9
Definition: risk factors
characteristics or behaviours that increase the likelihood of disease development
What type of diabetes can ketoacidosis be fatal in?
type l
MI
Myocardial Infarction
Fu
Benefits of exercise on diabetes?
ACRONYM
MMICW
- Improved insulin sensitivity and glucose tolerance
- Reduced need for meds
- Reduced risk of associated conditions - CVD
- Improved mood and well being
- Improved weight management
What are the three components of energy expenditure that regulate energy balance?
- RMR
- TEF
- EEpa
Overweight Classification
25-29.9
How is homocysteine detected?
through blood tests
What 3 factors, besides age, contribute to a higher risk of developing MS?
- high abdominal obesity
- low income
- low education
List and define the 2 types of strokes.
- Hemorrhagic stroke - caused by bursting of a major vessel supplying the brain
- Ischemic stroke - caused by atherosclerosis of major vessels supplying the brain
What are some modifiable risk factors?
ACRONYM
CHOCL
- cigarette smoking
- hypertension
- high blood cholesterol
- obesity and overweight
- high blood LDL levels
BMI Risk: Overweight
Increased Risk
Definition: Chronic Heart Failure
inability of the heart muscle to pump blood at a rate consistent with the metabolic needs, resulting in fatigue or dyspnea
BMI Risk: Underweight
Increased Risk
CVD clients benefit better from resistance or cardio training?
cardio
What are the types of abdominal fat? Are these the most/least dangerous type of fat?
Central, Visceral, Intra-abdominal
Most
What method is much more accurate when reading BG levels in type l clients?
continuous glucose monitoring
What is a tell tale sign of ketoacidosis?
bad breath - fruity odor
Which type of diabetes has the inability to produce insulin?
type l
CVD: Resistance
F: 2 - 3 days/week
I: 12 - 15 reps, 11 - 13 on Borg
T: 2 - 4 sets of 8 - 10 exercises - major muscle groups
Ty: elastic bands, 1 - 2 lb hand weights, 1 - 5 lb free weights, cables or resistance machines
What
Definition: Energy Flux
the total change in energy balance
Definition: Arteries
large vessels that carry blood away from the heart
Why is homocysteine a risk factor for cardiovascular disease?
an excess amount of homocysteine starts to break off little pieces of the tunica intima, killing the endothelial cells there. This creates the formation of scabs, which end up narrowing the passageway and affecting or limiting blood flow
Function: red blood cells
transport oxygen to the body’s cells
Definition: Angina
chest pain that occurs in response to myocardial ishemia
What hormone acts as an anti-inflammatory?
adiponectin
Normal weight classification
18.5-24.9
Relating to cardiovascular events, what are some signs and symptoms?
ACRONYM
Noisy Sounds Can Severely Whack Dan’s Head
- numbness or weakness of face, arm or leg
- loss of sensation
- confusion, trouble speaking, trouble understanding others
- difficulty seeing
- difficulty walking
- dizziness, loss of balance, loss of coordination
- severe headache suddenly
Why is there an increased risk of debilitating joint injuries when an obese individual is exercising?
- excess weight stresses weight bearing joints
- exercise compounds this stress
Formula for BMI
kg/m²
What are macrovascular dysfunctions
brain, heart - atherosclerosis
Definition: Coronary Heart Disease
affects the coronary arteries which supply blood to the heart
What should waist circumferance be for men and women?
Men >102cm
Women >88cm
MS: cutoff for BP
≥130/85 mmHg
What part of the NS controls the tunica media of vessels?
sympathetic nervous system
What is the underlying cause of PAD, Angina?
atherosclerosis
What is another term for the tunice externa?
adventitia
In what 2 type ll and gestacional diabetes tests do you have to fast? How long?
FPG - fasting plasma glucose test
OGT - Oral Glucose Tolerance Test
8 hours
Why is fibrinogen a risk factor for cardiovascular disease?
fibrinogen causes damage to the blood vessel, promoting clotting and plaue formation. Increased levels also increase the viscosity of blood, which increases the workload of the heart and the risk of thrombosis
What are the 3 types of diabetes?
- Type l
- Type ll
- Gestacional
In which diabetes test do you have to consume a concentrated glucose drink?
OGT - oral glucose tolerance test
True or False: there can be a genetic predisposition to have higher homocystein levels
true
Definition: Homocysteine
an amino acid byproduct created in the digestion of protein
What causes an increase in homocysteine?
- a lack of the enzyme needed to convert homocysteine back into methionine or cysteine.
- low levels of b-12 folic acid increases plasma homocysteine
Definition: Facilitated Diffusion
the glucose concentration in blood and cells is such that no ATP is required for energy
What hormone controls blood glucose?
insulin
Definition: Thrombosis
blood clot that is travelling through the vessel
How can exercise help when insulin is ineffective?
because insulin binds to the receptors on the target cells to open the glucose gates, when insulin is not working properly, exercise can naturally open those gates, allowing glucose to flow through for energy
With neuropathy, what types of things should you avoid?
walking, stair climbing, gait or balance exercises
Definition: adipocytes
little fat cells
What are some symptoms of type l?
hunger, severe systemic weakness, and weight loss
True or False: Respiratory Rate is higher in obese individuals?
True
True or False: Obese persons have low levels of leptin
False
True or False: Veins have a thinner tunica media.
True
How much more likely are diabetes patients to have an MI?
2 - 4x
What can a chronic increase in glucose damage?
diney filtration - leads to failure and needing dialysis
How would you desribe metabolic syndrome?
a cluster of biochemical and physiological abnormalities
Obese Resistance: FITT
Frequency: 2-3 days/week
Intensity: muscles fatigued in 8 - 12reps - hypertrophy and endurance
- 1-2 sets beginners
Time: 45m - 60m - client dependant
Type: machine weights - free weights - focus on large muscle groups
Definition: arterioles
small branch arteries that carry blood away from the heart
Diabetes: Cardio
F: 3 - 7 days/week
I: Moderate - 50 - 80% - 12 - 16 RPE
T: 20 - 60m
T: Anything, unless neuropathy, then nonimact - swimming - cycling
How does exercise affect adiponectin?
- adiponectin is very responsive to exercise
- losing weight can increase levels
What is the strongest predictor of MS?
age
True or false: low LDL levels can counteract high levels of c-protein.
false