Advanced Study in exercise science exam 1

Epidemiology (stroke)

Stroke is a leading cause of serious long term disability. Stroke costs the United States an estimated$34 billion each year. This total includes the cost of health care services, medications to treat stroke, and missed days of work.

dorsal root ganglion

contains cell bodies of sensory neurons

neuromusclar junction

the synapse where motor neurons and skeletal muscle fiber meet

Dorsal

toward the back

Hemiparesis

weakness on one side of the body

acute

within the first 24 hrs- 7 days

Flaccidity

loss of muscle tone, limp

thick filaments

myosin

hemorrhagic stroke

occurs when a blood vessel in the brain leaks or ruptures; also known as a bleed

Dysarthria

slurred speech

Right hemisphere stroke

- Paralysis on the left side of the body - Vision problems - Quick, inquisitive behavioral style - Memory loss

Subacute

1 wk- 3~4 months

Broca's aphasia

An aphasia associated with damage to the Broca's area of the brain, demonstrated by the impairment in producing understandable speech.

Autonomic system

Bidirectional communication between the brain and smooth muscles, cardiac muscle and gland cells

Circle of Willis

A structure at the base of the brain that is formed by the joining of the carotid and basilar arteries.

When prescribing strengthening exercise to people with post-polio syndrome, we should exercise all of the muscle groups no matter the muscles were affected by the poliovirus or not.

False

Lesions

Focal (local) • contusions (bruises) • hematomas (large blood collections) • ischemia (oxygen deficiency)

contusions

Focal brain injury where the brain tissue is bruised in a local area

risk factors of stroke

High blood pressure Cigarette smoking Diabetes mellitus Carotid or another artery disease Peripheral artery disease Atrial fibrillation Other heart disease Sickle cell anemia High blood cholesterol Poor diet Physical inactivity obesity CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy)-heridatary alcohol abuse socioeconomic factors drug abuse-less common

Cushing's response:

Increased systolic BP • Widening pulse pressure • Decreased heart rate

Benefits of Exercise for Stroke Survivors

Lack of aerobic exercise prescribed during stroke rehabilitation. Exacerbates the decline in cardiorespiratory fitness. Improvements in: • VO2 peak • Physical function (gait related) • Psychological well being • Cardiovascular • Respiratory • Neuromuscular

Transient Ischemic Attack (TIA)

Minor stroke; where neurological function is regained quickly with time

Prevalence (stroke)

More than 7 million people in the United States today have survived a stroke

arteriovenous malformations

Most common type of brain vascular malformation. Abnormal tangle of arteries directly connected to veins without intervening capillaries. Most present with hemorrhage or seizures. 2% to 3% annual risk of bleeding,

Types of TBI

Penetrating head injuries occur when an object, like shrapnel, enters the brain and causes damage in a specific area. • Closed head injuries occur when there's a blow to the head, which can happen during a fall, car accident, sporting event, or any number of different ways.

stroke (CVA)

Rapid loss of brain function due to disturbance in the blood supply to brain

Golgi tendon organs

Receptors sensitive to change in tension of the muscle and the rate of that change

length-tension curve

The curve shows that the active tension is maximal when the muscle is near its rest length.

Somatic motor system

Transmits information from the brain to skeletal muscles.

Cardiopulmonary endurance training is usually more effective for people with post-polio syndrome. If a polio survivor has weakness on both legs due to the polio infection, we can prescribe exercise using an arm ergometer.

True

white matter

Whitish nervous tissue of the CNS consisting of neurons and their myelin sheaths.

hemispatial neglect

a failure to attend to stimuli on the opposite side of space to a brain lesion

traumatic brain injury

a form of acquired brain injury, occurs when a sudden trauma (external force) causes damage to the brain

gray matter

a portion of the CNS consisting of cytons (cell bodies), their dendrites and synaptic connections

vascular dementia

form of dementia caused by a stroke or other restriction of the flow of blood to the brain

ventral

front

Apraxia

inability to perform particular purposive actions, as a result of brain damage.

Microglia

ingest and destroy bacteria and cells

stroke in brainstem

it can affect both sides of the body and may leave someone in a 'locked-in' state. When a locked-in state occurs, the patient is generally unable to speak or achieve any movement below the neck.

somatic sensory system

Convey information from the skin and musculoskeletal system to areas of brain

stroke and sleep

About two-thirds of stroke survivors have sleep-disordered breathing (SDB) SDB is caused by abnormal breathing patterns. SDB can increase blood pressure, heart stress and blood clotting. Obstructive sleep apnea (OSA) is the most common type of SDB Other sleep disorders: 20%-40% circadian disturbances (sleepwake cycle disorders (SWDs))

Late sign of ICP

Dilated and non-reactive pupil • Unresponsiveness to verbal or painful stimuli • Abnormal posturing (flexion, extension, flaccidity) • Respiratory rate and pattern

anterolateral system

a somatosensory system that carries most of the pain, temperature, and crude touch information from the body to the brain

Time to terminate the test according to ACSM guideline

Onset of angina Drop in systolic BP (20 mm Hg) or failure to rise when load is increased BP >260/115 mm Hg Signs of poor perfusion - cyanosis, dizziness, confusion, light-headedness, ataxia, etc. Failure of HR to rise with increased workload Noticeable change in heart rhythm Subject requests to stop Severe fatigue Equipment failure

left hemisphere stroke

Paralysis on the right side of the body Speech/language problems Slow, cautious behavioral style Memory loss

global aphasia

Severe deficits in all language processes, including speech production, auditory comprehension, reading and writing

Shwann cells

Specialized cells that myelinate the fibers of neurons found in the PNS.

ischemic stroke

a stroke where the blood loss is caused by a blockage

People with Guillian-Barre Syndrome might be bed-ridden for a long time, therefore, muscle atrophy, postural hypotension, and reduced joint range of motion are commonly seen in those people. An exercise program should begin with non-fatiguing activities (PROM, AROM) for a short period of time and then progress to light muscle strengthening after increased muscle strength due to remyelination. We should be vigilant to the signs of fatigue and decrease intensity and frequency when needed.

True

The most common symptoms of the post-polio syndrome include slowly progressive muscle weakness, muscular fatigue, muscle atrophy. Pain from joint degeneration and increasing skeletal deformities is common and may precede weakness and muscle atrophy.

True

Oligodendrocytes

Type of glial cell in the CNS that wrap axons in a myelin sheath.

Homoncolus

a map along the cerebral cortex of where each part of the body is processed. The sensations occur all along the body. The impulses from the body will be sent into the spinal cord and eventually back to the brain to be processed.

Congenital CP

a result of an injury or disease that occurs at or before birth.

Glasgow Coma Scale (GCS)

a scale used to assess the consciousness of a patient upon physical examination, typically in patients with neurological concerns or complaints

Hematoma

a solid swelling of clotted blood within the tissues.

Which of the following statements is TRUE about post-polio syndrome?

a. Although the virus attacked the nervous system, increasing skeletal deformities such as scoliosis are commonly seen in people with post-polio syndrome. b. A gradual weakening in muscles that were NOT previously affected by the polio infection. c. People with post-polio syndrome might experience respiratory muscle weakness. d. A condition that only affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus.

Which of the following statements is TRUE about Guillian-Barre Syndrome?

a. It is an acute inflammatory demyelinating polyneuropathy. b. It attacks the myelin in the peripheral nerves causing lower motor neuron symptoms including weakness, paralysis, or hyporeflexia. c. The initial symptoms are burning or prickling sensations in the toes and fingertips, followed by lower extremity weakness that may ascend over hours to days to involve the arms, cranial nerves, and in severe cases the muscles of respiration.

thin filaments

actin

action potential

are formed when a stimulus causes the cell membrane to depolarize past the threshold of excitation, causing all sodium ion flow inward which in turn produces a further rise in the membrane potential.

Chronic

beyond sub-acute (can be years post stroke)

brain stats

brain is about 2% of bodyweight but consumes 25% of the bodies oxygen and nutrients and burns up to 70% of the bodies glucose 100 billion neurons in brain 83% of neurons in cerebral cortex 24 oz of blood transverse through brain every minute

concussion

caused by a bump, blow or jolt to the head that can change the brain function • impact • impulse • whiplash, blast injuries

Wernicke's aphasia

condition resulting from damage to Wernicke's area, causing the affected person to be unable to understand or produce meaningful language

Aneurysms

congenital or acquired weakness of the arterial wall resulting in dilation and ballooning of the vessel

Spasticity

continuous resistance to stretching by a muscle due to abnormally increased tension, with increased deep tendon reflexes

cerebral palsy

describes a group of permanent movement disorder due to non-progressive lesions in the developing brain.

dysphonia

difficulty producing speech sounds, usually due to hoarseness

Dyspraxia

difficulty with planing movements, especially complex or new movements

aphonia

loss of voice

Hyperacute

onset- 6 hours

hemiplegia

paralysis of one side of the body

muscle spindles

receptors sensitive to change in length of the muscle and the rate of that change

Acquired CP

result of trauma, intracranial hemorrhage, CNS infections, near drowning, hypoxia, and metabolic disorders

satellite cells

surround neuron cell bodies in PNS

intracranial pressure

the amount of pressure inside the skull The brain can swell (edema) • Excess blood can accumulate due to hemorrhage • Cerebrospinal fluid can accumulate due to blockage of outflow

Early signs of Increased Cranial pressure

• Headache • Nausea and vomiting • Altered level of consciousness • Waxing and waning level of consciousness • Restlessness-> drowsiness->aphasia • Subtle vital sign changes