Health Fitness Specialist

Three assessments for muscular endurance
1. Bench Press
2. Push up
3. Curl-up

Transtheoretical Model – Cognitive processes (5)
1. consciousness raising
2. dramatic relief
3. environmental re-evaluation
4. self-revolution
5. social liberation

Transtheoretical Model – Behavioral processes
1. counter conditioning
2. helping relationships
3. reinforcement management
4. self-liberation
5. stimulus control

Twitch
When a motor unit is stimulated by a single nerve impulse

Tetanus
Motor unit stimulated continuously

Summation
Motor unit has more than one stimulus

Work Rate = ?
Force x Velocity

Anaerobic Glycolysis is also known as…
Lactic Acid Cycle, uses only carbohydrate, end result is lactic acid, no oxygen required. Used for events from 30 seconds to three minutes

Symptoms of hypoglycemia
tachycardia, excessive sweating (diaphoresis), light-headedness, visual disturbances

Symptoms of hyperglycemia
acetone odor on breath, confusion, slurred speech

Failure to spot or assist a client may be considered…? (legal term)
Negligence by omission

Informed Consent
Enables clients to make informed decisions. Not a legal document. Provides detailed explanation of exercise program. Does not provide legal immunity. Negligence is not covered by informed consent.

Diagonal skinfolds
Chest, suprailiac, subscapular; all other skinfolds are vertical

Shaping
setting a series of intermediate goals that lead to a long-term goal

At what stage are people at most risk of relapse?
Action

What is cardiac output?
the amount of blood ejected from the heart per minute.

What happens at the alveoli?
exchange of gasses with the blood occurs.

Karvonen Formula
Target Heart Rate = ((max HR − resting HR) × %Intensity) + resting HR

Consequences of high temperature
Dehydration, dizziness, syncope, heat exhaustion, or heat stroke

Consequences of low temperature
dehydration, reduced coordination, chills, hypothermia, potentially frost-bite

Stroke Volume and concentric phase
Stroke volume is NOT significantly elevated to more than resting during the concentric phase of resistance training.

Stroke Volume and eccentric phase
Stroke volume is significantly increased during eccentric phase

What is muscle fatigue?
The loss of force or power output in response to voluntary effort leading to reduced performance.

What is central fatigue?
The progressive reduction in voluntary drive to motor neurons during exercise

What is peripheral fatigue?
The loss of force and power that is independent of neural drive.

Determining treadmill speed formula:
Belt length (inches) x number of revolutions per minute 1,056 (the conversion of inches per minute to miles per hour)

Circumferences are used for…?
Circumferences are used to estimate body composition and provide specific reference to the distribution of fat in the body.

Define “push-up”
Downward phase: eccentric, flexion
Upward phase: concentric, extension

Oxidative – Aerobic
carbs and fats used to synthesize ATP; for activities lasting longer than 3 minutes

Children and sweat
Children sweat less because sweat rate and rate of sweat production for each gland are lower in children. They have same number of glands.

Beta blockers
decrease/lower heart rate

Blood flow from periphery
superior and inferior venae cavae, right atrium, tricuspid valve, right ventricle, pulmonic semilunar valve, pulmonary arteries, and lungs

Arteries
carry blood away from heart, decrease to arterioles

Capillaries
where the exchange of nutrients occurs between blood and tissue

Veins
carry blood toward the heart

Venules
small veins, carry blood from capillaries to veins

Blood flow from lungs
Left pulmonary vein, left artrium, bicuspid valve, left ventricle, aortic semilunar valve, ascendina aorta, systemic circulation

Muscle fibers
Type I = slow twitch and high oxidative
Type IIB = fast twitch with low oxidative
Type IIA = intermediate, with twitch and oxidative property, bridge between I and II
Type IIx to Type IIA = from endurance and resistance training

Tidal volume
amount of air leaving or entering with each breath, ranges from .5 to 4L

Systolic
is contractile heart movement, blood is leaving the heart

Diastolic
is relaxation or blood filling the heart

Stroke volume
Volume of blood ejected per beat (at rest is usually around 70 ml). SV + HR = Cardiac Output

Q =
Q = HR x SV, the amount of blood ejected from the heart per minute

EDV
amount of blood in each ventricle at end of resting phase.

Frank Starling Law
Describes the relationship between end-diastolic volume and stroke volume. It states that the heart will pump out whatever volume is delivered to it. If the end-diastolic volume doubles then stroke volume will double.

ESV
is volume of blood remaining in each ventricle after contraction

Five A’s of counseling`
Address agenda, assess, advise, assist, arrange follow up

Neuromuscular junction
where communication between motor neuron and skeletal muscle occurs

Motor neuron
ends at synaptic knob containing Ach

Actin and Myosin
contractile proteins; form crossbridges and slide past one another during contraction

tropomyosin and troponin
regulate bridging of actin and myosin

Pronation
rotational movement at the radioulnar joint in a transverse plane about a longitudinal axis that results in the palm facing downward.

Supination
rotational movement at the radioulnar joint in a transverse plane around a longitudinal axis that results in the palm facing upward.

Children
Lower stroke volume due to higher heart rate; resting HR and exercise HR are higher in children; are less efficient than adults at temperature regulation; poorer tolerance for exercise in heat

Systolic Blood Pressure
is the amount of pressure exerted on arterial walls; normal is <120; over 140 is hypertension

Diastolic Blood Pressure
the pressure exerted during resting phase; healthy is <80; over 90 is hypertension

Systolic during exercise
is dependent on exercise intensity; may exceed 200; terminate if over or equal to 260 or significant drop

Diastolic during exercise
should remain unchanged

Myosin
thick filament; part of contractile muscle

Actin
Thin filament; part of contractile muscle

Tropomyosin and troponin
regulatory filaments; with calcium are stored in sarcoplasmic reticulum; binds to troponin

Absolute contraindications for exercise
testing should NOT be performed until situation or condition is stable

Relative contraindications for exercise
the benefit of exercise outweighs the risk of testing

Informed consent
does not provide legal immunity

Negligence
breaks the duty owed to someone

Tort
Wrong that involves a breach of civil duty owed to someone else.

RICES
Rest, Ice, Compression, Elevation, Stabilization

Hypertension exercise guides
aerobic: 3-7 days/week; Intensity: 40 -70%; Time: 30-60 minutes; possible multiple bouts throughout the day. Avoid isometric, valsalva, and max efforts; high reps/low intensity is better; RPE = 13-15

Diabetes exercise guides
contraindicated if fasting glucose is greater than 250 mg/dL with ketones or greater than 300 mg/dL w/o ketones

Obesity
BMI greater than 30; waist circumference (m) > 102 cm; (f) > 88 cm; body fat: (m) >25%; (f) > 32%

Pregnant exercise guides
avoid supine position after first tri-mester; avoid risk of abdominal trauma; consume 30-50 g of carbs before exercise; consume extra 300 kcals/day

Carbs
45 – 65% of daily energy intake; 70% for athletes; 4 cal/gram

Protein
10-15% of daily intake; .8 g/kg of body wt.; athletes may need 1.2 – 1.4 for endurance and 1.6-1.7 for strength; 4 cal/gram

Capital expense
Large and extraordinary purches of durable items with an extended useful life, like exercise equipment

Non-capital expense
day-to-day operational expenses (i.e., medical and exercise supplies, stationary)

Fixed expense
are unchanged day to day, month to month

Variable expense
based on utilization like per diem, contract labor, etc.

Revenue
income that a company receives from its normal business

Net revenue
income minus commission, taxes, or other expenses related to income

Gross revenue
total revenue received before any deductions

Break-even analysis
designed around function of program, such that revenue generated is sufficient to pay for expenses incurred

Profitability analysis
Attempt to forecast future profits for program based on potential revenue generation as well as predicted fixed and variable expenses

Tort
a civil wrongdoing; negligence is failure to perform in a generally accepted standard

Malpractice
specific type of negligence; involves claims against defined professional; usually claim a breach of professional duties and responsibilites toward a client; usually an injury has occurred and breach of duty came before injury

Eversion
turning the sole of the foot away from the midline (outward)

Inversion
turning the sole of the foot toward the midline

Axial Skeleton
includes the bones of the skull, vertebral column, ribs, and sternum. Protects organ systems

Skull
has 29 bones

Spine
has 33 vertebrae: 7 cervical, 12 thoracis, 5 lumbar, 5 sacral and 4 coccygeal (fused into the coccyx)

The rear foot motion called pronation results from:
Abduction, eversion, and dorsiflexion

Sites of skinfolds test:
Chest/pec; midaxillary; abdominal; suprailiac; subscapular; triceps brachii; biceps brachii; thigh; calf

Capillary
blood vessel that is composed of one cell layer and functions to exchange nutrients and waste materials between blood and tissues

Which type of musculoskeletal lever is most common?
Third-class

During long duration exercise of submaximal intensity (marathon running), which type of muscle fibers are primarily recruited?
Type I

A single motor neuron and all the muscle fibers it innervates comprise a
Motor unit

Within the pulmonary system, the actual exchange of gasses with the blood occurs at the ?
Alveoli

Under resting conditions, stroke volume in a typical male (70 kg) is about ?
70 mL

The amount of blood ejected from the heart per minute is referred to as ?
Cardiac Output

The Frank Starling mechanism plays a vital role in determining ?
Stroke volume

In terms of chronological age, early childhood is usually described as ?
1 to 6 years

What is dyspnea?
Shortness of breath

Name four lung compartments affected by COPD.
central airways, peripheral airways, lung parenchyma, and the pulmonary vasculature

What is emphysema?
destruction of the parenchyma

What is asthma?
Common complex chronic disorder of the airways, characterized by variable and recurring symptoms, airflow obstruction, hyperresponsiveness of the bronchioles, and underlying inflammation

What is Restrictive Lung Disease?
A large group of disorders that restrict or reduce lung volume and tidal volume. Include loss of functioning of the alveoli-capillary unit (impairment in gas exchange), altered mechanical function of the thorax and pulmonary system, and secondary cardiovascular dysfunction.

What is Bruce Protocol?
treadmill test where grade and speed are increased at 3 minute intervals.

What is axial skeleton?
bones of the skull, vertebral column, ribs, and sternum

Whis is appendicular skeleton?
arms, legs, pectoral and pelvic girdles. most long bones are here.

Convert inches to meters by
multiplying by 0.0254

Convert inches to centimeters by
multiplying by 2.54

Convert kg . m . min(-1) to Watts by
dividing by 6.0

Convert mph to meters/minute by
multiplying by 26.8

What muscles of the heart contract to tighten the chordae tendinea, and are connected on the inner surface of the ventricle?
Papillary muscles

At what level is HDL considered a risk factor in the development of CVD?
<40% mg/dL

The smallest, narrowest passage within the bronchial system is called the
Bronchiole

Muscle fibers that can produce a large amount of tension in a very short period of time but fatigue quickly are referred to as
Fash-twitch glycolytic

When using the Borg scale for the general public, intensity should be maintained between?
12 and 16

Rotation of the anterior surface of a bone toward the midline of the body is called?
Medial rotation

Calcium, phosphorus, magnesium, potassium, sulfur, sodium, and chloride are examples of?
Macrominerals

Sagittal plane makes a division into?
right and left portions

Frontal plane makes a division into?
Anterior (front) and posterior (back)

Transverse plane makes a division into?
Upper (superior) and lower (inferior)

Kyphosis
curves of the thoracic and sacral regions. Considered primary curves

Lordosis
curves of the cervical and lumbar regions. Considered secondary curves

Commonly found abnormal curve in the frontal plane?
scoliosis

Commonly found abnormal curves in the sagittal plane?
hyperkyphosis (exaggerated posterior thoracic curvature) and hyperlordosis (exaggerated anterior lumbar curvature).

Angina pectoris that occurs at rest without a precipitating event?
Variant

A group of pulmonary disorders characterized by limitations in airflow tha are not fully reversible?
COPD

The loss of elasticity of the arteries is known as?
arteriosclerosis

A transient deficiency of blood flow to the myocardium resulting from an imbalance between oxygen demand and oxygen supply is known as?
Ischemia

A drug used during acute MI to dissolve blood clots, restore blood flow, and limit myocardial necrosis?
Thrombolytic agent’s therapy

What is the correct term and definition to describe a potential complication that may occur after an MI?
Aneurysm – bulging of the ventricular wall

A classic sign of subendocardial ischemia is?
St segment depression

A possible mechanism by which chronic exercise training may reduce resting blood pressure in a person with hypertension is:
A reduced heart rate

What is asthma?
Narrowing of the bronchial airways

Considered to be the ‘gold standard’ diagnostic technique for CHD
Coronary Angiography

Waist-to-hip ratio
Index of upper versus lower body fat dristribution. Waist circumference and hip circumference are measured then WHR is calculated using a standard nomogram.

The definition of Cardiorespiratory fitness is:
The coordinated capacity of the heart, blood vessels, respiratory system, and tissue metabolic systems to take in, deliver, and use oxygen.

Underwater testing assumes….
….standard densities for bone, muscle, and fat.

What is OSHA?
A federal agency that sets standards for staff and patient safety.

What are class 1A drugs?
Antiarrhythmic agents: Disopyramide, Moricizine, Procainamide, Quinidine

Path of electrical depolarization originates where?
Originates in the sinoatrial (SA) node.

Path of electrical depolarization ends where?
terminates in Purkinje fibers

The SA node is responsible for?
Initiating depolarization of the myocardium.

What is atrial flutter?
Results from a re-entrant circuit in the atria that generates flutter waves, usually at a rate of 250 – 350 per minute.

When do Premature Ventricular Complexes occur?`
When a site in the ventricle fires before the next wave of depolarization from the sinus node reaches the ventricle

What is Torsade de Pointes?
A type of ventricular tachycardia in which the appearance of the complexes are somewhat ‘twisted’ – thus the name ‘torsade.’

What is syncope?
Partial or complete loss of consciousness with interruption of awareness of oneself and ones surroundings.

What is cardiac output?
The volume of blood pumped by the heart per minute (mL blood/min).

The increase in blood flow to skeletal muscles during exercise is mediated by three factors:
(1) an increase in cardiac output, (2) vasodilation of skeletal muscle arterioles, (3) vasoconstriction of arterioles in the viscera and skin.

A P-Wave represents:
Atrial depolarization

A QRS-complex represents:
Ventricular muscle depolarization

A T-Wave represents:
Ventricular muscle repolarization

The PR-Interval represents:
Atrioventricular node, His bundle, Purkinje fibers

What is perfusion?
pumping a liquid into an organ or tissue (especially by way of blood vessels).

What is ataxia?
The loss of full control of bodily movements

What is ischemia?
An inadequate blood supply to an organ or part of the body, esp. the heart muscles

What is the most accurate measurement of functional capacity?
Peak VO2

The normal BP response to dynamic upright exercise is:
Progressive increase in SBP, no change or slight decrease in DBP, and a widening of the pulse pressure.

What are Class 1B drugs?
Lidocaine, Mexiletine, Phenytoin, Tocainide

What are Class 1C drugs?
Flecainide (Taborcor); Propafenone (Rythmol)

What is an insertion?
The point of attachment of a tendon to bone

What is Emphysema?
A pathologic or anatomic description marked by abnormal permanent enlargement of the respiratory bronchioles and alveoli accompanied by destruction of the lung parenchyma.

What is Hypercapnia?
Excess carbon dioxide in the blood

What is Hypoxemia?
Deficient oxygenation of the blood

What is Polycythemia?
Excess red blood cells often secondary to hypoxemia

What is Static Stretching?
Involves slow controlled sustained ROM

What is Ballistic/Dynamic Stretching?
Involves performing rapid dynamic, bouncing, or jerking movements often done to simulate athletic movements. Not recommended for non-athletes.

What is PNF Stretching?
Proprioceptive Neuromuscular Facilitation: Tense/Relax method, often referred to as partner stretching.

What is End Systolic Volume?
The amount of blood left in the ventricle right after ventricular contraction.