KHP 450 EXAM 1

A

administration of fitness tests and evaluation of results

Skill related physical fitness components

agility, coordination, speed, balance, power, reaction time

Exercise related adverse events

an increase in physical activity generally leads to more benefits than risks, however risks such as musculoskeletal injuries and cardiovascular events are possible. *progressive increase in training is best

Physical activity

any bodily movement produced by the contraction of skeletal muscles that results in a substantial increase in caloric requirements over resting energy expenditure

PAR-Q

appropriate only when you desire moderate exercise, if any yes answers you should see a physician

ACSM recommendation for muscular strength and endurance activities in heathy 18-65 yr

at least 2 days/week, more it better (to a point!)

P-R interval

atrial depolarization and the delay in electrical pulse at AV node, upper limit is 0.20 seconds or 2 small blocks on ECG

Health related physical fitness components

cardiovascular endurance, body comp, muscular strength and endurance, flexibility

Angina

chest pain or discomfort (resulting from a lack of oxygen rich blood to the heart) that is a symptom of coronary artery disease.

Administration of fitness tests and evaluation of results

common measurements obtained: RHR, BP, % body fat, waist circumference, low back flexibility, submaximal graded exercise test, muscular strength& endurance tests. Compare tests to normative data for age and gender

Level of physical activity

considering the present level of activity and the intensity of physical activity.

Cardiac vein

coronary sinus

Cardiac arteries

left main and right coronary arteries, circumflex branch, left anterior descending branch

V5

level with V4 at left anterior axillary line

V6

level with V5 at left midaxillary line (directly under the midpoint of the armpit)

Why is coronary artery narrowing important?

blood supplies oxygen to the heart cells, oxygen is required for the heart to function, even at rest the heart muscle extracts 75% of the O2 delivered to it, the myocardium relies on ATP for contraction (O2 is needed to produce ATP), in the heart 40% of the muscle cells are mitochondria

Sinoatrial SA node

located in right atrium, pacemaker of heart, depolarize without input from brain, depolarization spreads from SA node across atria resulting in a P wave on ECG

"R" continued

low risk=asymptomatic ppl with 1 or less risk factor moderate risk= asymptomatic with 2 or more risk factors high risk= ppl with known CV, pulmonary, or metabolic disease, or signs and symptoms suggestive of disease

M

medical history review

CVD risk factor: age

men 45 and older, women 55 and older

Absolute intensity

metabolic equivalents (METs): standardized way of describing energy cost of a particular activity (assumes a standard metabolic rate)

ACSM aerobic recommendation for healthy adults aged 18-65 years #1

moderate intensity aerobic physical activity for 30 min x 5 days/week minimum. *can achieve this through a min of 10 minutes exercise sessions

At rest the insides of heart muscle cells are

negatively changed

Systolic bp (contraction)

normal <120 pre-hypertension 120-139 hypertension >= 140

Diastolic (relaxation filling) BP

normal <80 pre-hypertension 80-89 hypertension >= 90

Exercise related cardiac events

not common in young individuals, higher in middle aged and older adults, prevalence is low but is higher when intensity is vigorous or sedentary individuals are performing infrequent/unaccustomed exercise

CVD risk factor: Sedentary lifestyle

not participating in at least 30 minutes of moderate intensity physical activity on at least 3 days a week for at least 3 months

Educated participants

participants with primary risk factors or borderline values should be provided with that info, fitness professionals should discuss lifestyles changes to alter these values. *info alone is NOT likely to cause change

Statement on risks vs. benefits by ACSM

physicians should not overestimate the risks of exercise because the benefits of habitual physical activity substantially outweigh the risks

When depolarized the insides of the cells come

positively charged

HSQ idenfies

presence of CV, pulmonary, and metabolic disease

E

Establishment of the necessity of physician consent

E (last one)

Evaluation of progress with follow up tests

Referral to phase III program

professionally qualified staff who have academic training in and clinical knowledge of monitoring special population classified as high risk. No universal guideline, but a facility should have guidelines for referral

Action potential

sequence of processes in which the membrane rapidly changes its electrical potential

Intercalated fibers/disks

small electrical junctions between adjacent cardiac muscle cells, allow electrical impulses to pass from cell to cell, allow for simultaneous contraction of the ventricular muscle fibers needed for effective pumping

Pre-activity screening should identify

symptoms or chronic diseases increasing the risk for cardiovascular events during exercise. not a standardized practice

Setup of Exercise prescription

the considerations for exercise prescription are health status, risk stratification, personal goals, fitness test results

R-R interval

time between successive R waves, if R-R is regular it can be used to determine HR

Q-T Interval

ventricular systole

ACSM aerobic recommendation for healthy adults aged 18-65 years #2 (OR)

vigorous intensity aerobic activity= 20 minutes x 3 days/week, OR a combination of this and #1

Exercise programming is determined by

who we are, what are our goals, what is our current fitness level

Risk factor assessment and stratification

"risk factor" is a primary risk factor for CVD, (sec 3 HSQ) if participant wants to pursue vigorous activity and 2 or more risk factors are present, physicians consent should be obtained

Medical history review

(sec 2 of HSQ) used primarily to identify CV, pulmonary, and metabolic disease (big 3), checks the signs and symptoms of big three, identifies pregnant women (if any yes consult physician)

Physical activities guidelines report (2008)

150min/week moderate intensity, or 75min/week vigorous, or a combination, recommends breaking these sessions up into different days, also points out dose-response relationship

V2

4th intercostal space to the left of the sternum

V1

4th intercostal space to the right of the sternum

V4

5th intercostal space a midclavicular line

CVD Negative risk factor: HDL

60 or greater

What do we know about exercise?

Dose- response relationship between physical activity and cardiovascular disease

CVD risk factor: dyslipidemia

LDL: 130 or higher HDL: < 40 On lipid lowering medication Total serum cholesterol: 200 or greater

L

Level of physical activity

Establishment of the necessity of physician consent

Low risk= no physician needed for moderate or vigorous, moderate risk= no physician needed for moderate but should have it for vigorous, high risk= physician consent should be obtained before any training

P

Prescribed medications

R

Risk factor assessment and stratification

S

Set up of exercise program

CVD risk factor: Hypertension

Systolic 140 or higher, diastolic 90 or higher, measured on 2 separate occasions, or on anithypertension medication

Exercise

a type of physical activity consisting of planned, structure, and repetitive bodily movement done to improve components of bodily/physical fitness

CVD risk factor: Obesity

a BMI > or equal to 30. In men a waist girth >102cm in women >88cm

ECG

a graphical recording of the heart's electrical activity obtained through skin electrodes

HSQ- Health screening questionnaire

a more thorough pre-activity screening tool, identifies low, medium, or high risk stratification based on ACSM/AHA specifications.

Physical fitness

a set of attributes or characteristics that individuals have or achieve that relates to their ability to person physical activity.

Pre-participation screening is used to:

determine current health status, determine whether physician's consent is needed prior to fitness testing or exercise programming

V3

directly between V2 and V4

Prescribed medicine

documentation of prescribed medication, could identify further risk, some people will unintentionally miss a risk factor

Relative intensity

expressed as a percentage of VO2 max or of maximal HR, more fit individuals have higher VO2 max

Evaluation of Progress

follow up tests should be performed to monitor changes over time and adjustments in exercise perscription should be made where necessary. Should be 3 months after initiation and biannual testing for continued monitoring.

What the dose-response relationship means is..

general recommendations are given for physical activity guidelines to produce health benefits, some exercise is better than no exercise, additional exercise is even better to a point

Benefits of physical activity and exercise

improved cardiovascular and respiratory function, reduction in CVD risk factors, decreased morbidity and mortality, other benefits

AV node

impulses travel from SA node through atrial muscle to AV node, conduction slows to allow atrial emptying into ventricles prior to ventricular contraction

Ischemia (coronary artery disease)

inadequate blood supply (especially to the heart)

During exercise an ECG (especially for high risk people)

is used to screen for irregular rhythms that may pose a danger to the exercising client. Some rhythms like atrial fibrillation are common if they are controlled (little risk)