1
Q
stroke
- correct name
- caused by
A
CVA - cerebrovasc. accident
caused by:
decreased blood flow to brain
* caused by bleeding or blockage
2
Q
epidemiology of stroke
A
- 3rd leading cause of death
- most common cause of disability
- 1.25 greater for males
- african-american 2x more likely
- mexican americans also high
3
Q
atherosclerosis
A
leads to incomplete or absent blood supply
4
Q
ischemic strokes
A
- thrombi : blood clot
- emboli : something in blood that blocks artery; air, plaque, clump of bacteria
5
Q
hemorrhagic strokes
A
bleeding due to aneurysm, weak blood vessels; assoc. w/ hypertension
6
Q
risk factors for stroke
A
- hypertension : 4-6x more likely
- heart disease : increase embolic stroke
- diabetes : increased chance of having HTN + heart disease
7
Q
early warnings of stroke
A
- weakness or numbness on one side of body
- sudden confusion or trouble understanding
- trouble talking
- dizziness, loss of balance, trouble walking
- trouble seeing out of one or both eyes
- double vision
- severe headache
8
Q
diabetes mellitus - exercise
A
- aerobic submaximal exercises are best
9
Q
exercise for type 2 will help
A
make tissue less insulin resistant + help control problem
10
Q
exercise when is better
A
in morning, better for glucose control
11
Q
exercise benefits for diabetes
A
- increase insulin sensitivity
- improve glucose tolerance
- combat obesity
- reduce risk factors for arteriosclerosis
- help lower BP
- enhance QOL
12
Q
COPD includes
A
- asthma
- emphysema
- chronic bronchitis
13
Q
asthma more common
A
- in males than females
- in NY city, Cook County IL, Fresno County CA
14
Q
causes of asthma
A
- allergens
- chemical irritants
- psychological stimuli (laughing, crying)
- temperature
- infection
- exercise
15
Q
symptoms of asthma
A
- shortness of breath
- excessive mucus production
- wheezing
- coughing
16
Q
medications for asthma
A
- sympathomimetic drugs
- corticosteroids
*drug decreases inflamm. effect
17
Q
chronic bronchitis
A
- increased mucus production
- narrow airway due to chronic inflamm.
- common in smokers
18
Q
emphysema
A
chronic inflamm. w/ thickening and destruction of respiratory bronchioles
- results in irreversible destruction of alveolar walls
- terminal bronchioles lose their elasticity + collapse causing severe difficulty on expiration
19
Q
obesity is assoc. w/
A
- hypertension
- hypercholesterolemia
- diabetes
20
Q
obesity is based on
A
the % of fat in the body
- males > 25%
- females > 30%
21
Q
obesity causes
A
- eat too much
- set point : too high or low
- genetics
- eating habits
- food addiction
22
Q
if intensity of exercise is too high
A
will preferentially burn glucose and not fat
23
Q
calorie burning lifestyle changes:
A
- stairs
- parking far away
- walking when possible
24
Q
guidelines for obese
A
- keep calorie intake around 10 kcals per pound
- reduce saturated fat
- increase dietary fiber
- use lean meats
- avoid use of oil
- broil or bake foods instead of frying
- eliminate sugar in coffee + tea
- use unsweetend juice
- drink water
- discontinue sweets
- snack on fruit + veg
- avoid fast food
25
obesity suggestions
- increase physical activity
- keep exercise diary
- make regular exercise a habit
- find exercise partner
- eat less than 1200 calories each day
- limit fat to 25% of total cals
26
obese children
- higher morbidity + mortality when they turn into adults
- higher risk of respiratory impairments
- higher risk of diabetes
- higher risk of orthopedic impairments
- physiological dysfunction
27
elderly people often cannot walk across a room or climb stairs b/c
- lack of strength
- lack of endurance
- lack of flexibility
28
elderly people + CV
- diminished myocardial muscle size
- SA node changes in excitability + loss of nodal cells
- fibrosis + calcification of heart valves
- narrowing of coronary arteries
- loss of arterial elasticity
- decreased stroke volume + max heart rate
- decreased max oxygen uptake
- postural hypotension (orthostatic) may lead to increased number of falls
29
elderly + respiratory system
- decreased number of cilia
- decreased thoracic wall mobility
- decreased total lung capacity decreased by 50%
30
most of decreased lung capacity is related to
- weakness on muscles of inspiration + expiration
- decreased thoracic wall mobility
31
elderly + nervous system
- cortical atrophy
- decline in neurotransmitter levels
- decreased brain weight by 20%
- decreased cerebral blood flow
- decreased nerve conduction velocity = decreased motor + sensory reaction time
32
decreased reaction time =
increased number of falls
33
what senses diminish with age
- sight
- hearing
- taste
34
elderly + vestibular
- vestibular function is impaired due to loss of hair cells in utricle + crista ampullaris
- vestibular dysfunction leads to falls
35
elderly + MSK
- slow twitch over fast fibers
- # of mitochondria decrease
- collagen becomes irregular in its structure = leads to decreased flexibility
- water loss in nucleus pulposus = less flexibility of spine + loss of height
36
elderly + bone loss
- progressive bone loss
- women over 35 : 1% of bone mass each year
- men over 60 ^
- related to fractures
37
elderly + gait
- poor posture
- forward head
- rounded shoulders
- externally rotated hips
- thoracic kyphosis + scoliosis
- weakness
- fear of falling
38
exercise + elderly
- maintain + improve CV
- slow decreases in oxygen uptake
- decrease LE edema
- increase collateral circulation + overall systemic circulation
- increases joint mobility, neuromusc. coordination, flexibility
39
osteoporosis slowed by
moderate exercise
- decrease # of fractures following fall
40
childrens BMI is
age + gender specific
41
development of alveoli is completed by
6 years
42
6 year old has ... the ventilation capacity of adult
1/3
43
children have .. hearts than adults
larger
44
resting heart rate is .. in children
higher
*inverse of body size
45
blood pressure is .. in children
lower
- peripheral resistance is lower
46
stroke volume is .. in children
lower
47
max HR is .. in children than adults
higher
* does not completely compensate for SV
48
cardiac output is ... for children + adult
lower for same activity
49
VO2max is greater for
boys than girls
- by puberty diff. becomes bigger
- mainly due to larger size
50
muscle output is greater in
adults
51
glycolytic enzyme capacity is lower in
children
52
lactate production is
lower in children
- as is ability to buffer lactate
53
breakdown of glycogen is
slower in children
54
toddlers should have .. of physical activity
30 mins
55
preschoolers should have .. of physical activity
60 mins
56
benefits of exercise during pregnancy
- stress relief
- weight control
- muscle tone
- decrease backache
- decrease incidence of varicose veins
- alleviate constipation
- increased energy level
- better sleep at night
- improved posture
- may facilitate labor
- faster recovery after labor
- fewer complications during labor
57
CV effects for preg. women
- resting HR is elevated
- resting cardiac output is elevated in first trimester, decreased by 3rd
- stroke volume decreases in 3rd trimester due to venous pooling decreasing venous return
58
BP in preg. women
- decreases in 1st and 2nd trimesters
- may rise in 3rd
- increases in BP may indicate problems
59
respiratory changes in preg. women
- 40% increase tidal volume
- rate is unchanged
- PCO2 decreases b/c of increased tidal volume
60
metabolic rate + preg. women
- oxygen consumption increases by 30% at rest
- exercise has lower VO2 max when corrected for body weight
- burn more cals in 3rd trimester about 250 more each day
61
MSK changes + preg. women
- protruding abdomen
- wide gait
- greater lordosis
- center of gravity moves forward
- uterus increases volume 150 times
- weight increases 20x
62
weight gain + preg. women
healthy weight is around 25lbs
- 8 for fetus
- 5 for amniotic fluid
- 2.5 for uterus
- 5 for maternal fluid retention
- 2.5 for additional fat deposition
63
diastasis recti
stretching of rectus abdominis muscles that pull away from their midline attachments
64
(preg. women) hormonal changes may cause
loose ligaments
- lead to weight bearing joint damage
65
pelvic floor muscles
- may stretch + weaken by weight of uterus
- may lead to urinary incontinence
66
(preg. women) low back pain
- due to ligament laxity
- changes in center of gravity
- increased pelvic tilt anterior
67
apgar scores
- heart rate
- respiratory effort
- muscle tone
- reflex irritability
- color
68
Brain Derived Neurotrophic Factor (BDNF) is important for
survival of a variety of neuronal populations
- protects areas of brain against ischemic damage
- enhances synaptic trasmission
69
deficiency in BDNF did what in mice
learning deficits
70
anti BDNF antibodies do what
impair memory + learning in rats
71
BDNF levels .. in response to exercise
increase
* more exercise = more BDNF
72
hippocampus
involved with short-term memory moving to long term
73
primary memory area is dependent on
physical activity
74
what decreases BDNF levels in hippocampus
corticosteroids
(released during stress)
75
3 weeks of exercise led to
- increases in gene expression of synaptic growth
- vesicle recycling
- nerve plasticity (remodeling)
- increases the # of new neurons
76
voluntary wheel running in rats led to
improved spatial learning + memory
77
forced treadmill running in middle aged rates :
- increased # of neural stem cells
- facilitated maturation of immature neurons
- restored age-related decline in BDNF
78
what counteracts the mental decline that comes with age
exercise
79
older adults who performed self paced walking for 60 mins 3x a week for 6 months :
- increases in volume of grey matter in frontal + temporal cortices
- increases in volume of anterior white matter
80
3 months of aerobic training produced ... in middle aged
- increases in cerebral blood volume
- improvements in cardiorespiratory fitness
- higher score on verbal learning + memory
- increases in neurogenesis
81
exercising rats led to
- better performance on maze testing
- higher brain concentrations of BDNF
- increased brain concentrations of insulin-like growth factor = produces new blood vessels + neurons
82
IGF-1 (insulin-like growth factor)
causes secretion of vascular endothelial growth factor (VEGF)
83
IGF may increase the potential for
cancer
84
exercise reverses the diminished
neurogenesis of aging in rats
85
what activity tend to:
- increase IGF
resistance eccentric
86
consistent physical activity was associated with
- slowing of age-related cognitive decline
improves cognitive function in:
- ADHD
- schizophrenia
- MS
- parkinsons
- stroke
87
male vs female show greater improvement in cognition w/ exercise
females
88
exercise may not be in integral part of daily living for people with SC injuries b/c
these people often die of CV or respiratory diseases
89
etiology of SC injuries
- traumatic
- congenital
- degenerative
90
congenital SC injury example
spina bifida
91
traumatic SC injury example
- MVA (46%)
- Fall (16%)
- Gunshot or stab (12%)
- Diving accident (10%
92
degenerative SC injury example
- MS
- ALS
- spinal stenosis
93
etiology of SC injuries
- most common : traumatic
- most young males
- most sport related are diving
94
when the SC is damaged what is also damaged
both grey + white matter
95
movement below level of injury is impaired because
info from higher centers cannot get to motoneurons
96
sensation below level of injury is impaired because
sensory info cannot get to higher centers to be appreciated + brought to consciousness
97
damage to cervical spine leads to
damage below cervical spine
- quadriplegia
- paraplegia
98
spina bifida
embryonic neural tube defect in which vertebral arches do not fuse
- non-fusion leads to incomplete development of soft tissue posterior to vertebral column
99
meningocele
spinal cord remains in spinal canal but dura moves into soft tissue defect
- does not usually have nervous system damage
100
myelomeningocele
spinal cord + meninges are carried to soft tissue
- usually have severe nervous system damage assoc. with it
101
hemimyelomeningocele
split cord malformation along with spina bifida
- only has 1/2 spinal cord damaged
102
Multiple Sclerosis
demyelinating disease that affects the spinal cord + other nervous tissues
- if spinal cord is demyelinated, patient functions like a spinal cord patient
103
MS starts in people
20-40 years old
104
SC patients usually lose
bowel + bladder function
105
(spasticity) muscles lacking input from higher centers
have increased muscle tone + hyperactive tendon reflexes
- muscles still connected to SC
- increased muscle tone resists passive ROM
106
autonomic hyperreflexia
spinal cord injury above T6 level
- higher centers are not controlling sympathetic nervous system, may lose control
107
if spinal cord is injured above C4 level
patient will need to be on ventilator
- b/c phrenic nerve is not innervating diaphragm
108
without passive moment for SC patients,
contractures will form
- due to shortened muscles
- leads to bony contractures which are permanent
109
level of function of SC - C4
- have scapular elevators + diaphragm
- no use of extremities
- need sip + puff wheel chair
- not a good candidate for active exercise
- need passive ROM + possibly cervical spine stretching
110
level of function of SC - C5
- some function of biceps, deltoid, scapular adductors
- no hand function, need active exercise for maintaining strength of functioning muscles
111
level of function of SC - C6
- brachioradialis, wrist extensors, pectoralis major, latissimus dorsi
- very functional people
- may be able to drive modified motor vehicle
- will benefit from active exercise + passive ROM
112
level of function of SC - T spine 1-5
- most or all UE function
- may be independent in wheel chair + transfers
- will not have complete innervation of muscles of inspiration + expiration (intercostals + abdominals)
113
level of function of SC - L spine 1-3
- will have hip flexion + adduction
- full function for muscle of inspiration + expiration
- usually good temp control
114
exercise for SC
- arm ergometer for aerobic training
- weight training with hand/wrist weights
- water exercise
- pulmonary function exercise
- slow deep breathing exercise
- spirometer to measure force of expiration
115
functional electrical stimulation for SC
- move paralyzed muscles
- increase circulation
- reverse osteoporosis
- improve cardiovascular endurance
- improve self image
UTHSC Applied Exercise Phys
flashcards
Decks in class (13)
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