Domain 1: Heath And fitness assessment Flashcards
(277 cards)
1
Q
Which of the following is TRUE of training and its effect on heart rate?
A
Exercise training has little impact on maximal heart rate.
2
Q
What is produced when carbohydrates are broken down during anaerobic glycolysis?
A
Pyruvate
Explanation:
Anaerobic glycolysis is the next most immediate energy source, and consists of a metabolic pathway that breaks down carbohydrates (glucose or glycogen) into pyruvate.
3
Q
During the preparticipation screening, your client is determined to have four risk factors. This is considered to be:
A
Moderate risk.
Explanation:
Two or more risk factors indicate a moderate disease risk.
4
Q
How many risk factors are present for this 54-year-old female?
Family history: Mother had myocardial infarction at the age of 60 Nonsmoker Blood pressure: 134/85 mm Hg Total cholesterol: 230 mg · dL−1 HDL-C: 46 mg · dL−1 Fasting blood glucose: 82 mg · dL−1 BMI: 27.3 Sedentary lifestyle
A
3
Explanation:
Risk factors include family history, total and HDL cholesterol, and sedentary lifestyle.
5
Q
A manifestation of coronary artery disease is:
A
Pain that occurs with exertion or exercise.
6
Q
To reduce body weight, which of the following is the MOST important determinant?
A
Negative energy balance
Explanation:
To reduce body weight, energy expenditure must exceed energy intake, referred to as a negative energy balance.
7
Q
Self-administered questionnaires are less useful for the EP-C because:
A
EP-Cs typically desire a more extensive health profile for their clients.
Explanation:
while self-guided screening (e.g., PAR-Q) can and should be used by all, there are many individuals, especially those at medical risk, who should also consult an EP-C for a more thorough screening.
8
Q
A male client is 45 years old and has high-density lipoprotein of 35 mg · dL−1. He spends 30 minutes a day walking to and from work. Based on this profile, how many total risk factors does he have?
A
2
Explanation:
This client’s age and HDL-C are considered positive risk factors. Note that physical activity is NOT considered a negative risk factor.
9
Q
Which of the following profiles is considered a risk factor with respect to obesity?
A
Waist of 36 inches for females
Explanation:
The defining criteria for obesity risk is waist girth of 35 inches or greater for females.
10
Q
Which of the following is a recommended procedure for administering a 1-RM strength test?
A
Conduct a familiarization period of 3-4 practice sessions.
Explanation:
Procedures for administering 1-RM include a familiarization period. A proper familiarization period (e.g., two weeks of resistance training including three to four practice sessions for each exercise) will likely achieve appropriate familiarization and reliability for 1-RM strength testing.
11
Q
Which of the following movements occur in the transverse plane of motion?
A
Glenohumeral rotation
Explanation:
Glenohumeral rotation takes place in the transverse plane of motion, about the longitudinal or vertical axis.
12
Q
VO2 is lower than required to create adequate energy during exercise via the oxidative energy systems. This is known as:
A
Oxygen deficit.
Explanation:
Prior to steady state, VO2 is lower than required to create adequate energy for the given task via the oxidative energy systems. This period of inadequate oxygen consumption has been termed the oxygen deficit.
13
Q
An exercise test is recommended prior to exercise training but a physician is not available to supervise the test. Who among the following would also supervise an exercise test?
A
An allied health care professional certified in ACLS
Explanation:
When an exercise test is recommended prior to exercise training, a competent nonphysician health care professional may also supervise the exercise test. A competent nonphysician health care professional is one who has advanced training in clinical exercise testing and credentials such as the AHA Advanced Cardiac Life Support certification.
14
Q
The facet joints of the lumbar spine are oriented in the __________ which primarily allows ____________ motions.
A
Sagittal plane; flexion/extension
Explanation:
The lumbar zygapophyseal joints (facet joints) are angled to allow flexion and extension, and restrict axial rotation.
15
Q
For which of the following conditions are a medical release or a physician-supervised exercise test unncessary prior to beginning an exercise program?
A
Well-controlled exercise-induced asthma
Explanation:
A client with well-controlled exercise-induced asthma is often able to participate in activity without physician clearance, assuming he is otherwise healthy and does not meet the criteria for moderate or high risk.
16
Q
In reviewing your client’s medical history, you note that she is on lipid lowering medication and her high-density lipoprotein cholesterol is 62 mg · dL−1. Based on her profile, how many total risk factors does she have?
A
0
Explanation:
Although the client’s total cholesterol is considered a positive risk factor, this is negated as her HDL-C that is considered a negative risk factor. Thus, the sum total equals zero risk factors.
17
Q
Which blood vessel is the location of gas and nutrient exchange?
A
Capillary
Explanation:
The capillary is the smallest and most numerous of the blood vessels and is the location of gas and nutrient exchange.
18
Q
Which of the following indicates a client has diabetes?
A
Oral glucose tolerance test of 250 mg/dL on at least two separate occasions
Explanation:
Prediabetes, which is defined as having a fasting blood glucose (FBG) between 100 and 125 mg/dL or a 2-hour value in oral glucose tolerance ≥140 mg/dL but ≤200 mg/dL. A FBG of ≥126 mg/dL would indicate that the individual has diabetes, which would automatically place them in the high risk classification.
19
Q
Which of the following would be considered a positive risk factor for dyslipidemia?
A
HDL 35 mg/dL
Explanation:
Dyslipidemia, defined as elevated low-density lipoprotein cholesterol (LDL-C greater than or equal to 130 mg/dL), depressed high-density lipoprotein cholesterol (HDL-C less than 40 mg/dL), or currently taking a lipid-lowering medication. If total cholesterol is the only value available, the risk threshold is greater than or equal to 200 mg/dL.
20
Q
Which of the following is NOT considered a true joint?
A
Scapulothoracic
21
Q
A female client is 55 years old and has high-density lipoprotein of 70 mg · dL−1. Based on this profile, how many total risk factors does she have?
A
0
Explanation:
This client’s age is considered a positive risk factor. However, her HDL-C is considered a negative risk factor, so the sum total equals zero risk factors.
22
Q
Which of the following is MOST accurate as it relates to total energy expenditure?
A
Resting energy expenditure makes up the majority of calories expended regardless of activity levels.
Explanation:
Resting energy expenditure (sometimes referred to as BEE or basal energy expenditure) is the amount of calories a person uses if he was to do no activity throughout the day.
23
Q
Which of the following activities requires anaerobic glycolysis as an energy source?
A
200 meter sprint
Explanation:
Anaerobic glycolysis is the primary source of ATP during medium-duration, intense exercise, such as 200 meter and 400 meter sprint events or any exercise of an intensity that cannot be continued for more than approximately 90 seconds.
24
Q
During the preparticipation screening, your client is determined to have four risk factors. This is considered to be:
A
Moderate risk.
Explanation:
Two or more risk factors indicate a moderate disease risk.
25
Running is done predominately in what plane of movement?
Sagittal
26
A lateral lunge is performed in which plane of movement?
Frontal
Explanation:
The frontal plane divides the body between the front and back. Any movement that is parallel to this plane, such as a lateral lunge, occurs in the frontal plane.
27
A posterior pelvic tilt produces lumbar ________ and an anterior pelvic tilt produces lumbar ________.
Flexion; extension
Explanation:
A posterior pelvic tilt results in lumbar flexion, in which the pubic symphysis moves superiorly, the lumbar spine flexes, and the hips extend, resulting in a decreased lumbosacral angle. With anterior pelvic tilt, the pubic symphysis moves inferiorly, the lumbar spine extends, and the hips flex, resulting in an increased lumbosacral angle.
28
Which of the following common characteristics are reported by those experiencing symptoms consistent with coronary artery disease?
"Heaviness"
Explanation:
"Heaviness" is a common symptom that is reported and is consistent with an ischemic response to exercise or exertion.
29
To lessen the chance of injury, the EP-C should:
Be diligent in choosing exercise modes and prescribing exercises that are based on an individual's current fitness level and desires.
Explanation:
To minimize musculoskeletal injury from the outset, the EP-C should be diligent in choosing exercise modes and prescribing exercises that are based on an individual's current fitness level and desires, along with any past exercise experiences.
30
Your potential client has a history of swollen ankles and reports shortness of breath when walking up the stairs. You would classify this as:
High risk and require that the client obtain a physician's clearance.
Explanation:
Both swollen ankles (ankle edema) and shortness of breath are major signs of a disease state. Thus, the individual should be classified as high risk and would require medical clearance and testing prior to exercise.
31
Which of the following cholesterol levels requires referral to a physician for further evaluation?
Total = 200 mg/dL, TC/HDL = 6
Explanation:
Note that the ratio of TC/HDL is high, and this infers that the HDL-C is less than 40mg/dL.
32
A manifestation of coronary artery disease is:
Pain that occurs with exertion or exercise.
33
When oxygen is not available in the mitochondria of the cell, _______ is converted to __________.
Pyruvate, lactic acid
Explanation:
In the absence of adequate oxygen supply, pyruvate is converted to lactic acid, which gradually builds up in muscle cells and the blood.
34
Which energy system is primarily responsible for resynthesizing ATP during submaximal exercise lasting longer than 3 minutes?
Oxidative phosphorylation
Explanation:
Cells must continuously create ATP at a rate equal to ATP use through a combination of three primary metabolic systems: creatine phosphate (CP), anaerobic glycolysis, and the oxidative system.
35
Concentric contraction of the triceps brachii muscle causes ____________ in the _____________plane.
Extension; sagittal
Explanation:
Most flexion movements will usually occur in the sagittal plane. Note that extension also occurs in the sagittal plane.
36
Pronation of the radioulnar joint occurs in:
The transverse plane.
Explanation:
Any type of rotational movement will occur in the transverse plane.
37
Where does blood flow immediately after passing through the tricuspid valve?
Right ventricle
Explanation:
The tricuspid valve is also known as the right A-V valve which controls blood from the right atrium to the right ventricle.
38
During pregnancy, resistance and flexibility exercises in the supine position should be avoided to prevent which of the following?
Orthostatic hypotension
Explanation:
The supine position may obstruct venous blood flow return to the heart and may result in orthostatic hypotension, which may lead to lightheadedness and fainting.
39
Which of the following is a positive risk factor?
Walking to and from work 3 days a week, for 20 minutes, for the past 2 months
Explanation:
A risk factor for a sedentary lifestyle is defined as not participating in at least 30 minutes of moderate-intensity activity, for a least 3 days a week, for at least 3 months.
40
Which of the following is the gold standard for assessing cardiorespiratory fitness?
Open circuit spirometry during graded exercise to fatigue
Explanation:
The gold standard used to measure cardiorespiratory fitness is the assessment of VO2max via open circuit spirometry during maximal-intensity, aerobic exercise. However it requires expensive equipment, technical expertise, and maximal-intensity exercise performance by the client.
41
During graded exercise, which of the following occurs due to large muscle vasodilation?
Total peripheral resistance may drop slightly.
Explanation:
TPR may drop slightly because of the large muscle vasodilation. As a result of this and the contrasting increase in cardiac output, DBP remains relatively stable.
42
Which of the following is considered a normal hemodynamic response to exercise?
Diastolic blood pressure will remain the same or slightly decrease.
Explanation:
During graded exercise, total peripheral resistance may drop slightly because of the large muscle vasodilation. As a result of this and the contrasting increase in cardiac output, DBP remains relatively stable. SBP, however, will increase linearly with exercise intensity.
43
An immediate referral to a physician is indicated with a client exhibits signs or symptoms of which of the following?
Syncope during mild exertion
Explanation:
There are several outward signs or symptoms that may indicate a client has current CPM disease. She is considered high risk regardless of the number of CPM disease risk factors present, and the client should be immediately referred to a physician before proceeding any further with exercise testing or programming.
44
For high school and college athletes, preparticipation screening primarily functions to:
Detect potential cardiac issues.
Explanation:
High school and college athletes are typically required to have a preparticipation screening, which is one means of detecting potential cardiac issues and thus preventing sudden cardiac death.
45
Which of the following BEST describes shoulder impingement?
Compression of the tendons in the subacromial space with shoulder joint motion
Explanation:
Impingement usually refers to the entrapment of the supraspinatus tendon. This is typically caused by a narrowing of the subacromial space which is located between the acromion and head of the humerus.
46
Which of the following is an endurance exercise training adaptation that benefits those with coronary artery disease?
Provides relief of symptoms
Explanation:
Most individuals with CAD have a subnormal functional capacity and may be limited by symptoms at relatively low levels of exertion. Training improves myocardial oxygen supply, decreased oxygen demand, or both and may provide relief of angina pectoris (i.e., chest pain/discomfort).
47
Which of the following is a self-guided screening questionnaire that focuses on symptoms of heart disease and possible musculoskeletal problems needing evaluation before beginning an exercise program?
Physical Activity Readiness Questionnaire (PAR-Q+)
Explanation:
The PAR-Q+ is a less extensive self-guided questionnaire than the AHA/ACSM Health/Fitness Facility Preparticipation Screening Questionnaire.
48
Before any health and fitness assessment is administered, the MOST important first course of action is to:
Explain and demonstrate each assessment before the client is tested.
Explanation:
Familiarity with the assessment will minimize anxiety and confusion, and practice of the assessment movements will enhance assessment results.
49
Which of the following is recommended by the National Heart, Lung, and Blood Institute to improve overall health?
Reduce weight by at least 5%
Explanation:
The National Heart, Lung, and Blood Institute recommends that a 5% to 10% weight reduction results in improved overall health.
50
Your potential 37-year-old client is on medication to control her hypertension and wishes to start a moderate-intensity exercise program. She has no other risk factors. You should:
Design an exercise program that starts at a lower intensity.
Explanation:
Since the client only has one risk factor of being on antihypertensive medication, a moderate-intensity exercise program with gradual progression would be appropriate, provided that she is monitored for adverse signs and symptoms.
51
If difficulties are encountered in calculating a percentage VO2max for prescribing exercise intensity in cases of cardiac disease, the EP-C should instead consider:
Rating of perceived exertion.
Explanation:
Typically, exercise intensity is measured as a percentage of VO2 max, VO2reserve, or heart rate reserve (HRR); however, this may be difficult to calculate in many cases of cardiac disease. In these cases, rating of perceived exertion (RPE) as an alternative measurement of exercise intensity may be useful.
52
Which of the following movements occur in the sagittal plane of motion?
Glenohumeral flexion
Explanation:
Glenohumeral flexion takes place in the sagittal plane of motion, about the frontal or bilateral axis.
53
Which of the following is MOST accurate regarding exercise testing and pregnant women?
Submaximal exercise testing is more appropriate, however rarely indicated.
Explanation:
Although submaximal exercise testing is more appropriate for this population, there is usually little need to conduct fitness assessments in pregnant women.
54
Which of the following is a primary disadvantage of utilizing field tests to predict VO2max?
They are dependent on client effort.
Explanation:
Field tests can be more subjective in nature, largely because of the dependency on client effort, and therefore are not as reliable as laboratory tests for assessing CRF.
55
Before you design an abdominal exercise program for a client you should FIRST:
Determine and establish neutral pelvic position.
Explanation:
Proper posture and alignment must be promoted from the very beginning in activities of daily living as well as exercise.
56
The volume of blood pumped by the heart in liters per minute is defined as__________.
Cardiac output
Explanation:
Cardiac output is defined as the product of heart rate and stroke volume.
57
Where is the majority of ATP generated in the cell?
Mitochondria
Explanation:
Mitochondria are known as the "powerhouse of the cell", as that is where the majority of ATP is generated.
58
What joint action of the shoulder is performed during a reverse cable fly or a reverse dumbbell fly?
Horizontal abduction
Explanation:
A reverse cable fly and reverse dumbbell fly begins with the hands together at the shoulder level. The arms perform horizontal abduction by moving the arms back in the transverse plane.
59
A joint is the most stable when it is in which of the following positions?
Closed pack
Explanation:
A joint is in a closed pack position when there is both maximal congruency of the joint surfaces and maximal tautness of the joint capsule and ligaments. This offers the most stable position for a joint.
60
A 53-year-old female has family history of a heart attack (father at age 72). If she wishes to participate in moderate-intensity exercise, you should:
Design an exercise program that progresses gradually in intensity and duration.
Explanation:
Note that this client does not have any risk factors. Her father had a heart attack much later in life, so this is not considered a risk factor.
61
You discover the following information about Rosalyn, your new 54-year-old female client:
BMI = 24.3 (68 inches, 160 lbs)
Total cholesterol: 190 mg · dL−1
HDL cholesterol: 62 mg · dL−1
Blood pressure: 128/84 mm Hg with antihypertensive medication
Former smoker: quit 2 months ago
Family history: Father had a heart attack at age 54
Walks to work 8 minutes each way
3 positive and 1 negative risk factors.
Explanation:
Positive risk factors include hypertension, smoking, and family history. The only negative risk factor is HDL-C levels.
62
The three planes of motion are
Transverse
Frontal
Sagittal
63
Transverse plane is
Top and bottom
64
Frontal plane is
Front and back
65
Sagittal plane is
Left and right
66
CVD RISK FACTOR THRESHOLDS for positive are
```
Age
Family history
Cigarette smoking
Hypertension/ high blood pressure
Dyslipidemia / high cholesterol
Prediabetes / blood sugar
Obesity/ BMI
Sedentary lifestyle
Points ( +1)
```
67
CVD RISK FACTOR THRESHOLDS for negative risk factors
High serum HDL ( >60mg/dL)- good cholesterol
Points ( - 1)
The higher the better
68
If difficulties are encountered in calculating a percentage VO2max for prescribing exercise intensity in cases of cardiac disease, the EP-C should instead consider:
Rating of perceived exertion (RPE)
Explanation:
Typically, exercise intensity is measured as a percentage of VO2 max, VO2reserve, or heart rate reserve (HRR); however, this may be difficult to calculate in many cases of cardiac disease. In these cases, rating of perceived exertion (RPE) as an alternative measurement of exercise intensity may be useful.
69
To obtain the health benefits of aerobic exercise, individuals should accumulate at LEAST:
75 minutes per week of vigorous-intensity exercise.
Explanation:
For substantial health benefits, individuals should accrue at least 150 minutes per week of moderate-intensity exercise or 75 minutes per week of vigorous-intensity exercise or an equivalent combination of moderate and vigorous aerobic exercise.
70
Which of the following is utilized to obtain critical client contact information?
client intake form
Explanation:
The Client intake form should be completed when initial client contact is made.
71
The upper respiratory tract consists of ________.
Nasal cavity, nose, and pharynx
Explanation:
The upper respiratory tract consists of the nasal cavity, nose, and pharynx.
72
Which of the following includes characteristics of central obesity?
Male waist-hip ratio of 0.91
Explanation:
Central obesity (also referred to as abdominal or android obesity) is associated with a higher risk of cardiometabolic diseases.
73
Which of the following is associated with a higher risk of cardiometabolic disease?
Android obesity
Explanation:
Central obesity (also referred to as abdominal or android obesity) is associated with a higher risk of cardiometabolic diseases.
74
Which of the following body composition methods passes electrical current through the body in order to assess the impedance to that current?
Bioelectrical impedance analysis
Explanation:
Bioelectrical impedance analysis (BIA) is a rapid, noninvasive body composition assessment tool where a harmless electrical current is passed through the body and the impedance to that current is measured.
75
Per the latest ACSM position stand, the MINIMUM threshold of frequency for aerobic exercise is:
Moderate-intensity aerobic exercise, 5 days per week.
Explanation:
Moderate-intensity aerobic exercise should be done at least 5 days per week or vigorous-intensity aerobic exercise done at least 3 days per week or a combination of moderate- and vigorous-intensity aerobic exercise done at least 3 days per week.
76
During a moderate-intensity jog, which energy systems provide the most energy within the first 2–3 minutes?
Creatine phosphate and anaerobic glycolysis
Explanation:
The oxidative energy system does not contribute much energy at the onset of exercise, but is able to sustain energy production for a longer duration. As steady state is reached, or when exercise intensity decreases and allows for longer exercise duration, the relative contribution of the anaerobic energy systems decreases and the relative contribution of the aerobic energy systems increases.
77
Which of the following is an example of an enarthrodial joint?
Glenohumeral
Explanation:
An enarthrodial joint is a multiaxial joint that permits movements in all directions. This includes the hip joint as well as the glenohumeral joint (shoulder joint).
78
Which of the following muscles inserts on the humerus?
Pectoralis major
Explanation:
The pectoralis major is one of the larger muscles that produces movement about the shoulder joint and thus attaches to the humerus.
79
Which of the following best describes the scapular or scaption plane?
30 degrees anterior to the frontal plane
Explanation:
The scapula lies in the scapular plane (also known as scaption) that lies 30 degrees anteriorly, relative to the frontal plane.
80
During the contraction phase of a biceps curl, the palms are ___________.
Supinated
Explanation:
Supination refers to position of the radiounlar joint where the wrist joint is rotated so that the thumb is positioned on the lateral side of the arm.
81
Joints between bones, along with bones and ligaments, collectively make up what system?
The articular system
Explanation:
Joints are the articulations between bones, and along with bones and ligaments, they constitute the articular system.
82
The study of the mechanics of human movement is called:
Kinesiology.
Explanation:
This is a basic definition of kinesiology.
83
A weight loss of what percent is associated with a reduction in health risks?
10%
Explanation:
Traditional behavioral weight loss programs that encourage reduced calorie intake and increased caloric expenditure typically resulted in a loss of 10% of initial body weight, an amount associated with a reduction of related health risks.
84
Which of the following hemodynamic variables have an inverse relationship and are heavily influenced by one another during exercise?
Diastolic blood pressure and total peripheral resistance
Explanation:
Conversely, diastolic blood pressure is heavily influenced by TPR. During dynamic, large muscle mass exercise, vascular beds within active muscles vasodilate, decreasing resistance within these blood vessels.
85
How many ATP molecules are produced when glycogen is broken down into pyruvate?
3
Explanation:
The net energy yield for anaerobic glycolysis, without further oxidation through the subsequent oxidative systems, is two ATPs if glucose is the substrate and three ATPs if glycogen is the substrate.
86
Your client forgets to bring the service introduction packet but is dressed appropriately for exercise. You should:
Reschedule the appointment, and underscore the importance of having all forms completed and signed.
Explanation:
To protect you and the client, have up-to-date information on the client's health and medical history, a signed medical clearance form from his physician, and a signed informed consent BEFORE training commences.
87
What amount of weekly, moderate-to-vigorous physical activity is recommended for better weight maintenance following weight loss.
250 minutes per week.
Explanation:
To prevent general weight gain, engaging in MVPA for at least 150 minutes a week is typically sufficient; however, the ACSM position stand indicates that engaging in more than 250 minutes a week of MVPA would result in better weight maintenance.
88
At submaximal workloads, which training effects from regular exercise are typically seen in systolic blood pressure, diastolic blood pressure, and mean arterial pressure?
SBP, DBP, and MAP are decreased slightly.
Explanation:
As a result of training, SBP, DBP, and MAP are all reduced slightly at submaximal workloads.
89
The frequency of breathing multiplied by the volume of air moved per breath, per minute, is known as:
Pulmonary ventilation.
Explanation:
Pulmonary ventilation is the volume of air inhaled and exhaled per minute. It is calculated by multiplying the frequency of breathing by the volume of air moved per breath (tidal volume).
90
ACSM recommends a diagnostic exercise test for clients with:
Type 2 diabetes for at least 10 years.
Explanation:
ACSM recommends a diagnostic exercise test for clients with Type 2 diabetes greater than 10 years in duration.
91
For which of the following conditions are a medical release or a physician-supervised exercise test unncessary prior to beginning an exercise program?
Well-controlled exercise-induced asthma
Explanation:
A client with well-controlled exercise-induced asthma is often able to participate in activity without physician clearance, assuming he is otherwise healthy and does not meet the criteria for moderate or high risk.
92
Which of the following would be considered a negative risk factor for ACSM risk classification?
HDL-C of 60 mg · dL−1
Explanation:
HDL-C greater than or equal to 60 mg/dL is one negative risk factor used in the ACSM Risk Classification. If the client meets this one criterion, then subtract one from the total sum of the positive risk factors. HDL-C participates in reverse cholesterol transport and may thus lower the risk of CVD.
93
Most commercial exercise equipment has a "caution" that is MOST crucial for:
Men ≥45 years old.
Explanation:
A "caution" listed on most commercially available exercise equipment is MOST crucial for men 45 years of age or older, or women 55 years of age or older.
94
Which of the following is a rationale for an initial screening?
Provide baseline data as a motivational tool for progress
Explanation:
One reason to conduct an initial screening for clients interested in physical activity is to provide benchmark data as an effective motivational tool for client goal setting.
95
Which of the following is considered a gliding joint?
Sacroiliac
Explanation:
The sacroiliac joint connects the sacrum to the ilium on each side and is sometimes described as a gliding joint. It is capable of relatively little movement.
96
When looking at postural alignment from a lateral view, the vertical plumb line should be: ________.
Slightly anterior to the lateral malleolus.
Explanation:
The vertical line should fall slightly anterior to the lateral malleolus.
97
During the concentric phase of a hamstring curl, the hamstrings are __________.
Flexed
Explanation:
The hamstrings flex the knee joint when a concentric action occurs.
98
The shoulder girdle refers to which specific joint?
Scapulothoracic
Explanation:
The shoulder girdle is also known as the scapulothoracic joint. This is not a true joint, as the scapula has no true bony articulation with the thoracic spine, but is instead held in place by muscle attachments.
99
What type of blood pressure response to acute exercise is seen in children that is different when compared with adults?
BP decreases and DBP decreases.
Explanation:
The physiological response to acute exercise in children is comparable to that in their adult counterparts. An exception here is SBP decreases (usually increases with adults) and DBP decreases (usually no change or slight increase).
100
Following the initial client contact, what are the next steps after the client has completed and returned all forms to you?
Review paperwork and clarify goals.
Explanation:
A detailed health and fitness history is necessary for screening, appropriate follow-up if needed, and validation of preferences and goals.
101
Tom is a 65-year-old normal healthy male who has exercised consistently for the last 5 years. While having him perform a set of abdominal crunches (a new exercise for him), he reports a gradual onset of a "dull ache" and "slight burn" in his neck toward the end of the set. Upon set completion, these feelings subside.
Which of the following is the BEST course of action?
Continue the exercise as part of his regimen, and provide education.
Explanation:
The Certified Exercise Physiologist must be alert to any and all feedback to ensure that the program is appropriate. As part of the informed consent, the client should be informed of what can be expected with respect to normal sensations and regular responses during resistance training.
102
The most common dietary fats are:
Triglycerides
Explanation:
Triglycerides are the most common form of dietary fats and oils; short-chain fatty acids are uncommon, and polyunsaturated fats lower blood cholesterol.
103
So that clients do not call at the last minute to let you know they will not be able to make a session, the Certified Exercise Physiologist–Client Agreement must include clear language with respect to the:
Cancellation policy.
Explanation:
The cancellation policy makes clear to the client the financial ramifications of not making arrangements to reschedule an appointment per the agreement.
104
All of the following components make up total energy expenditure ( TEE) EXCEPT:
1) Thermic effect of food.
2) Physical activity expenditure.
3) Resting metabolic rate.
4) Adiabatic transfer
Adiabatic transfer
Explanation:
There are three components to determining TEE: resting energy expenditure (REE or resting metabolic rate [RMR] or basal metabolic rate) accounting for 60%-70% TEE, thermic effect of food accounting for 10% TEE, and physical activity expenditure accounting for 20%-30% TEE.
105
Which of the following refers to oxygen consumption in relative terms?
53 ml · kg · min
Explanation:
Oxygen consumption refers to the rate at which oxygen is consumed by the body. It can be expressed in absolute (L/min) or relative (mL/ kg/min) terms.
106
The functions of the cardiovascular and respiratory systems are to:
Supply oxygen and remove waste products from the body.
Explanation:
The cardiovascular and respiratory systems work in synchrony to provide oxygen and remove waste from the body.
107
Which of the following is a sign or symptom of pulmonary disease?
Shortness of breath at mild exertion
Explanation:
Dyspnea is expected in most individuals during moderate to severe exertion, such as stair climbing. However, shortness of breath at rest or at mild exertion may be an indication of underlying cardiac and/or pulmonary disease.
108
For individuals younger than 30 years of age, the most common cause/s of sudden cardiac death is/are:
congenital and hereditary abnormalities
Explanation:
For young individuals (younger than 30 years), the most common causes of sudden cardiac death are congenital and hereditary abnormalities.
109
Which of the following joints favors mobility over stability?
Glenohumeral
Explanation:
The shoulder has a high degree of mobility; as a result, the shoulder region is very unstable.
110
Which of the following is considered a hinge joint?
Elbow
Explanation:
The elbow joint is a hinge joint and also consists of two other articulations in the humeroulnar and humeroradial joints.
111
Which of the following is/are a resilient, semirigid form of connective tissue that reduces the friction and absorbs some of the shock in synovial joints?
Cartilage
Explanation:
Cartilage is an essential connective tissue that is typically found in a synovial joint.
112
Where does gas exchange occur in the respiratory system?
Alveoli
Explanation:
The alveoli is the functional unit of the lung.
113
Given the following complete health and medical history, which client has one risk factor?
1) A 46-year-old male with cholesterol of 208 mg/dL who desires to begin training for his first marathon
2) A 21-year-old female who has slight scoliosis with tightness on left hip abductors
3) A 32-year-old male with family history of heart disease and prediabetes
4) A physically active 55-year-old female
A physically active 55-year-old female
Explanation:
The age threshold for females is 55 years of age or older.
114
Before fitness testing and training, initial client assessment should include health issues, exercise history, and:
Intended time frame for achieving desired goals.
Explanation:
Certified Exercise Physiologists should carefully evaluate prior resistance exercise experience and discuss training goals and intended time frame for completion.
115
Which of the following is the MOST accurate definition of glycogen?
The storage form of glucose
Explanation:
The basic form of carbohydrate energy for human nutrition is the simple sugar glucose, and our bodies make a complex carbohydrate called glycogen, which is the storage form of glucose.
116
The negative risk factor for cardiovascular disease is:
High-density lipoprotein cholesterol.
Explanation:
HDL, or the good cholesterol, is an indicator of health, and therefore a negative risk factor for CVD.
117
Prior to the first training session scheduled next week, you should provide specific session instructions on:
Appropriate exercise attire.
Explanation:
Not all clients will be familiar with what is involved in an exercise session. Provide specific instructions with respect to attire, nutrition and hydration preparation, avoiding exertion, and what can be expected.
118
For an individual to induce adaptation and obtain further benefits of exercise, which of the following principles must be incorporated?
Progressive overload
Explanation:
To improve CRF, an individual must exercise at a level greater than accustomed to induce adaptation. The EP-C can implement the overload principle by manipulating the frequency, intensity, or time of the exercise prescription.
119
Which of the following guidelines are indicated for pregnant women who have been medically cleared for exercise?
Exercise at moderate intensity for at least 150 minutes weekly.
Explanation:
If exercise is not contraindicated, pregnant women can follow the ACSM and Surgeon General's recommendations to accumulate a minimum of 150 minutes of moderate-intensity exercise weekly.
120
Which of the following BEST describes a VO2 plateau that occurs during submaximal exercise where energy production is equal to energy requirements?
Steady state
Explanation:
Steady state is the point at which VO2 plateaus during submaximal aerobic exercise, and energy production via the aerobic energy systems is equal to the energy required to perform the set intensity of work.
121
The most immediate source of ATP is:
The creatine phosphate system.
Explanation:
The most immediate source of ATP is the CP system which provides ATP to fuel work only during short, intense bouts of exercise, owing to the limited storage capacity of CP within each cell.
122
Which of the following is an accurate statement regarding risk classification?
1) Not recommended reflects the notion that a medical examination, exercise test, and physician supervision is strictly prohibited.
2) "Vigorous-intensity" exercise refers to an intensity of ≥ 75% VO2reserve, ≥ 8 METs, or an intensity that causes substantial increases in HR and breathing. 3)"Moderate-intensity" exercise refers to an intensity of 40% to < 74% VO2reserve, 3 to < 7 METs, or an intensity that causes noticeable increases in HR and breathing.
4) Recommended reflects the notion that a medical examination, exercise test, and physician supervision is recommended in the preparticipation health screening process.
Recommended reflects the notion that a medical examination, exercise test, and physician supervision is recommended in the preparticipation health screening process.
Explanation:
When a medical exam, exercise test, or physician supervised exercise test is recommended, it suggests completion as part of the preparticipation health screening process.
123
Obesity is defined as:
Waist circumference of 40 inches in men.
Explanation:
Obesity is defined by body mass index greater than or equal to 30 kg/m2, or waist circumference greater than 102 cm or 40 inches in men and greater than 88 cm or 35 inches in women. If available, body fat percentage values could also be used with appropriate judgment.
124
At the minimum, the health history questionnaire should assess a client’s:
History of various diseases and illnesses.
Explanation:
In general, the HHQ should minimally assess a client's history of various diseases and illnesses, as well as specific history of various signs and symptoms suggested of cardiovascular and other chronic or metabolic disease.
125
Deviations in which plane are referred to as hyperlordosis?
Sagittal
Explanation:
Hyperlordosis is an exaggerated curvature of the lumbar spine that would be viewed in the sagittal plane.
126
In a sit-to-stand movement, where is the center of gravity?
Shifted over the base of support
Explanation:
The initial phase of the sit-to-stand movement involves trunk lean and horizontal weight shift to position the center of gravity over the new base of support (feet), placing the lower extremity in a mechanically advantageous position to stand via hip extension, knee extension, and ankle plantarflexion.
127
Individuals who are short in stature may not be good candidates for which type of testing?
Step tests
Explanation:
A shorter individual with a shorter leg length will have a more difficult time performing a step test when compared to a taller individual with longer leg length.
128
Which of the following changes takes place in arteriovenous oxygen difference in response to exercise?
1) There is an increase in a-VO2 difference with increasing exercise intensity.
2) Oxygen in venous blood increases by 5 ml · dL−1.
3) There in a decrease in a-VO2 difference with increasing exercise intensity.
4) Oxygen in arterial blood increases by 5 ml · dL−1.
There is an increase in a-VO2 difference with increasing exercise intensity.
Explanation:
During exercise, venous oxygen content decreases as a result of the increased consumption of oxygen by the working muscles, thus resulting in an increase in a-VO2 difference with increasing exercise intensity.
129
An individual has two positive risk factors and one negative risk factor. Based on ACMS risk stratification and this profile, this person is considered to be:
Low risk.
Explanation:
Two positive risk factors and one negative risk factor makes for a total of one positive risk factor. Having one or no risk factors indicates a low risk of future CVD.
130
Which of the following is a sign or symptom of cardiovascular disease?
Pain or discomfort in the neck, jaw, or arms while standing
Explanation:
Pain or discomfort in the chest, neck, jaw, arms, or other areas are symptoms suggestive of cardiovascular disease. These may be due to ischemia or lack of oxygenated blood flow.
131
When reviewing the AHA/ACSM Health/Fitness Facility Preparticipation Screening Questionnaire, the risk factor threshold for family history applies only to:
Siblings.
Explanation:
Family history of specific cardiovascular events, including myocardial infarction (heart attack), coronary revascularization (bypass surgery or angioplasty), or sudden cardiac death, applies only to first-degree relatives (biological parents, siblings, and children). The risk factor threshold is met when at least one male relative (less than 55 years) or one female relative (less than 65 years) has had one of these specific events.
132
Which of the following BEST describes the mechanism for the cause of sudden cardiac death?
Plaque buildup that dislodges from an artery and causes a blood clot
Explanation:
Although the exact mechanism of sudden cardiac death or MI remains elusive, there appears to be an acute arterial insult that dislodges already present plaque, resulting in platelet aggregation or thrombosis.
133
The elbow can perform movements in which plane?
Sagittal
Explanation:
Any movement that is parallel to the sagittal plane, such as an elbow joint flexion or extension, occurs in the sagittal plane.
134
The clavicle is _________ to the pelvis.
Superior
Explanation:
Superior is a basic descriptive term used to describe the position of a body part that is above another body part or refers to an upper surface of an organ or structure.
135
The ankle's most stable position is in __________ due to the overall shape of the __________.
Dorsiflexion; talus
Explanation:
An ankle joint is in a dorsiflexed position which is considered a closed pack position since there is maximal congruency of the joint surfaces (talus and calcaneus) and maximal tautness of the joint capsule and ligaments.
136
Your client is a 30-year-old male who has not been active in the last few months. He has completed all the forms, and you observe that he does not have any risk factors. He reports that he experienced some shortness of breath while playing a pickup basketball game this weekend, something he hasn't done in a year. You should:
Perform the appropriate assessments and plan on an exercise program that gradually increases in intensity.
Explanation:
The individual has no risk factors and most likely experienced shortness of breath from not playing basketball in a while. Thus, a moderate-intensity exercise program is appropriate.
137
Which is an appropriate food source for vitamin K?
Green leafy vegetables
Explanation:
Green leafy vegetables, as well as intestinal bacterial synthesis, are sources for vitamin K.
138
Ankle edema may be indicative of which of the following?
Congestive heart failure
Explanation:
Chronic venous insufficiency occurs when the veins of the lower leg cannot pump enough blood back to the heart.
139
The purpose of our cells breaking down food that we consume is to:
Produce ATP.
Explanation:
Cells break down the food we eat with the ultimate goal of producing ATP, which is the cellular form of energy used within the body to fuel work.
140
Which of the following is MOST accurate regarding submaximal exercise testing?
It is generally considered safe for most individuals.
Explanation:
While submaximal exercise testing is generally considered safe for most, maximal- or vigorous-intensity exercise testing does pose some risk.
141
Which joint movement occurs in the transverse plane?
Internal rotation
Explanation:
The transverse plane divides the body from the top and bottom. Any movement that is parallel to this plane, such as a rotation, occurs in this plane.
142
A muscle that produces a low force and has a high contractile rate is classified as a __________ muscle.
Longitudinal
Explanation:
Longitudinal muscles produce a low force in comparison to pennate muscles that produce higher forces.
143
Medications that affect heart rate and/or blood pressure response during exercise include:
Diuretics.
Explanation:
Medications such as beta-blockers, diuretics, and some calcium channel blockers affect HR and blood pressure response to exercise, altering the exercise prescription.
144
Defining criteria for the hypertension risk factor for cardiovascular disease is:
BP 140/90 mm Hg or higher
Explanation:
Hypertension is defined, for risk factor classification, as systolic blood pressure at or above 140 mm Hg and/or diastolic blood pressure at or above 90 mm Hg.
145
What is a potential outcome of maintaining a professional presence and disposition when training clients?
Maintaining a professional presence may also help generate clients, as this is also a form of advertising.
Explanation:
Being approachable by clients and other staff may lead to more interest as it relates to training inquiries.
146
Which of the following individuals are often at risk for other chronic diseases and may need additional medical screening?
BMI rating of 35
Explanation:
Obese individuals are often at risk for other chronic deseases and can need additional medical screening and appropriate supervision for exercise testing and programming.
147
Which of the following commonly refers to the physiologic state where exercise has stopped but VO2 levels remain elevated?
Excess postexericse oxygen consumption
Explanation:
After cessation of exercise, VO2 remains elevated because of the increased work associated with the resynthesis of ATP and CP within muscle cells, lactate removal, and elevated body temperature, hormones, heart rate (HR), and respiratory rate. It is commonly referred to as excess postexercise oxygen consumption.
148
Which of the following activities requires the CP system to be utilized?
The long jump
Explanation:
The CP system can provide ATP to fuel work only during short, intense bouts of exercise, owing to the limited storage capacity of CP within each cell.
149
The function of the right ventricle is to:
Pump deoxygenated blood to the lungs for oxygen loading and carbon dioxide unloading.
Explanation:
The right ventricle is responsible for pumping deoxygenated blood to the lungs for oxygen loading and carbon dioxide unloading.
150
For which of the following conditions are a medical release or a physician-supervised exercise test unncessary prior to beginning an exercise program?
Well-controlled exercise-induced asthma
Explanation:
A client with well-controlled exercise-induced asthma is often able to participate in activity without physician clearance, assuming he is otherwise healthy and does not meet the criteria for moderate or high risk.
151
The risk factor for smoking no longer applies for which of the following?
Quit smoking for 9 months
Explanation:
The risk threshold for a current cigarette smoker is having quit smoking in the past 6 months or regular exposure to secondhand smoke.
152
Which plane of movement divides the body between the left and right?
Sagittal
Explanation:
The sagittal plane divides the body between the left and right sides. Any movement that is parallel to this plane occurs in the sagittal plane.
153
When looking at postural alignment from a posterior view, the vertical line should pass through the ________.
Midline of the body
Explanation:
The vertical line or plumb line is a reference used to assess alignment of the spine from the anterior, posterior, and sagittal views.
154
Which of the following assessments are MOST important for gathering information for designing a resistace training program?
Posture, functional movement, muscular strength, and endurance
Explanation:
Many people have muscular imbalances of the body, which may create postural alignment issues and injury. Thus, posture, functional movement, muscular strength, and endurance are critical assessments to identify indications for strengthening, stretching, and proper movement.
155
Which of the following BEST assesses lower-body muscular strength?
1-RM squat
Explanation:
Muscular strength is one-time maximal force that may be assessed in the lower extremity via the 1-RM squat.
156
A heart murmur that is clinically significant may be indicative of:
Valvular heart disease.
Explanation:
Most heart murmurs are harmless; however, significant murmurs can be a sign of heart valve issues, such as not opening or closing properly.
157
Which of the following is the MOST powerful method of marketing to potential clients?
Word of mouth
Explanation:
The most cost-effective method of marketing continues to be word of mouth.
158
During the initial client-contact process, you find that your potential client would rather work with a trainer of another gender. You should:
Refer the client to another Certified Exercise Physiologist who would be more compatible.
Explanation:
Trainers must assess compatibility with potential clients, and the client's preferences should be taken into account. This assessment also helps with developing rapport and exercise adherence.
159
What is the primary disadvantage for assessing VO2max?
Expensive equipment and technical expertise is required.
Explanation:
To maximize accuracy, it requires expensive equipment, technical expertise, and maximal-intensity exercise performance by the client. These requirements limit testing to primarily clinical laboratory and research settings.
160
Which of the following fasting blood glucose levels are indicative of prediabetes?
124 mg/dL
Explanation:
Prediabetes is defined as fasting blood glucose that is between 100 and 126 mg/dL.
161
The ulna bone is ________ to the humerus bone.
Distal
Explanation:
The term distal refers to a point away from the midline or further from the point of origin.
162
Intermittent claudication refers to:
Pain that occurs in the lower extremities during walking and disappears after stopping.
Explanation:
Pain occurs typically in the calf because of exercise-induced ischemia due to atherosclerosis in the lower extremity.
163
Health and fitness benefits occur with at least ______ minutes a week of moderate-intensity physical activity.
150
Explanation:
Moderate-intensity exercise is recommended at least 30 minutes per day, at least 5 days per week, for a total of at least 150 minutes.
164
Which of the following is a sign or symptom suggestive of cardiovascular disease?
Discomfort in the neck and jaw after carrying a heavy suitcase for a several minutes
Explanation:
Carrying heavy loads such as suitcases may provoke ischemia and result in discomfort in various areas of the upper extremities.
165
The facet joints of the lumbar spine are oriented in the __________ which primarily allows ____________ motions.
Sagittal plane; flexion/extension
Explanation:
The lumbar zygapophyseal joints (facet joints) are angled to allow flexion and extension, and restrict axial rotation.
166
To demonstrate outstanding customer service during your initial client contact, you should:
arrive to the appointment on time.
Explanation:
An important behavior that communicates your interest and concern for the client is to arrive early and on time.
167
Most commercial exercise equipment has a "caution" that is MOST crucial for:
Men ≥45 years old.
Explanation:
A "caution" listed on most commercially available exercise equipment is MOST crucial for men 45 years of age or older, or women 55 years of age or older.
168
The frequency of breathing multiplied by the volume of air moved per breath, per minute, is known as:
Pulmonary ventilation.
Explanation:
Pulmonary ventilation is the volume of air inhaled and exhaled per minute. It is calculated by multiplying the frequency of breathing by the volume of air moved per breath (tidal volume).
169
The gastrocnemius, soleus, and plantaris are located in which lower leg area?
Posterior tibial compartment
Explanation:
These muscles that are responsible for ankle joint plantarflexion are located in the posterior tibial area.
170
The shoulder girdle refers to which specific joint?
Scapulothoracic
Explanation:
The shoulder girdle is also known as the scapulothoracic joint. This is not a true joint, as the scapula has no true bony articulation with the thoracic spine, but is instead held in place by muscle attachments.
171
Which document acknowledges an "assumption of risk" with regard to participation in physical activity?
Informed consent
Explanation:
An assumption of risk, also known as an informed consent, is a document that explains the risks of participation in physical activity and indicates that the participant acknowledges the inherent risks involved.
172
Which of the following is a symptom suggestive of pulmonary disease?
Shortness of breath after quickly crossing the street in a residential area
Explanation:
Shortness of breath that is abnormal may be indicative of pulmonary disease.
173
Which of the following changes takes place in arteriovenous oxygen difference in response to exercise?
There is an increase in a-VO2 difference with increasing exercise intensity.
Explanation:
During exercise, venous oxygen content decreases as a result of the increased consumption of oxygen by the working muscles, thus resulting in an increase in a-VO2 difference with increasing exercise intensity.
174
Movement toward the midline in the transverse plane describes which term?
Horizontal adduction
Explanation:
Movement toward the midline of the body in the transverse plane is usually used to describe horizontal humerus movement when the shoulder is flexed at 90 degrees.
175
Which of the following is MOST important before the EP-C conducts submaximal graded exercise testing?
Awareness of normal and abnormal responses to exercise
176
Which of the following is not a standardized skinfold site?
1) Triceps
2) Chest
3) Buttocks/hips
4) Abdominal
Buttocks/hips
Explanation:
Triceps, chest and abdominal are all areas where skin fold measurements can be taken. The buttocks/hips is a standard site for circumference measurements not skin fold measurements.
177
Which of the following make up cardiac output?
Stroke volume and heart rate
Explanation:
Cardiac output is the product of SV and HR, and is also a measure of blood pumped per minute.
178
Syncope is defined as:
Loss of consciousness.
Explanation:
Syncope is commonly caused by a reduced perfusion of blood flow to the brain.
179
Which of the following is NOT considered a true joint?
Scapulothoracic
Explanation:
The scapulothoracic joint is not a true joint, but a physiological (functional) joint.
180
Concentric contraction of the triceps brachii muscle causes ____________ in the _____________plane.
Extension; sagittal
Explanation:
Most flexion movements will usually occur in the sagittal plane. Note that extension also occurs in the sagittal plane
181
The elbow can perform movements in which plane?
Sagittal
Explanation:
Any movement that is parallel to the sagittal plane, such as an elbow joint flexion or extension, occurs in the sagittal plane.
182
What amount of weekly, moderate-to-vigorous physical activity is recommended for better weight maintenance following weight loss.
250 minutes per week.
Explanation:
To prevent general weight gain, engaging in MVPA for at least 150 minutes a week is typically sufficient; however, the ACSM position stand indicates that engaging in more than 250 minutes a week of MVPA would result in better weight maintenance.
183
In general, a contraindication is BEST defined as:
A reason or rationale NOT to perform exercise or testing.
Explanation:
Contraindications provide a guide that may be followed to ensure a safer exercise environment.
184
To minimize any emergent event during exercise testing or training, the EP-C must:
Conduct appropriate screening on each client as a first step.
Explanation:
To reduce the likelihood of any adverse or unwanted events during a fitness assessment or PA program, it is prudent to conduct some form of screening on each client as a first
185
To increase accuracy of submaximal graded exercise testing, the EP-C should:
Achieve a steady state heart rate within 3-4 minutes at each workload.
Explanation:
Precise assessment of HR is a critical factor in determining VO2max. To minimize the error of prediction, a steady state HR should must be achieved within 3-4 minutes at each workload.
186
The Physical Activity Readiness Questionnaire-Plus is more effective in identifying:
Those at high risk.
Explanation:
The PAR-Q+ may be effective in identifying clients at high risk, but not necessarily reliable in identifying those at little or no risk.
187
Joints between bones, along with bones and ligaments, collectively make up what system?
The articular system
Explanation:
Joints are the articulations between bones, and along with bones and ligaments, they constitute the articular system.
188
The elbow can perform movements in which plane?
Sagittal
Explanation:
Any movement that is parallel to the sagittal plane, such as an elbow joint flexion or extension, occurs in the sagittal plane.
189
What type of blood pressure response to acute exercise is seen in children that is different when compared with adults?
SBP decreases and DBP decreases.
Explanation:
The physiological response to acute exercise in children is comparable to that in their adult counterparts. An exception here is SBP decreases (usually increases with adults) and DBP decreases (usually no change or slight increase).
190
Which of the following muscles is superior to the latissimus dorsi?
Levator scapulae
Explanation:
Superior is a basic descriptive term used to describe the position of a body part that is above another body part or refers to an upper surface of an organ or structure. In this instance, the levator scapulae is located above the latissimus dorsi.
191
Which of the following is recommended by the National Heart, Lung, and Blood Institute to improve overall health?
Reduce weight by at least 5%
Explanation:
The National Heart, Lung, and Blood Institute recommends that a 5% to 10% weight reduction results in improved overall health.
192
During the preparticipation screening, your client is determined to have four risk factors. This is considered to be:
Moderate risk.
Explanation:
Two or more risk factors indicate a moderate disease risk.
193
Which organizations publish formal screening guidelines for those who plan to participate in physical activity?
ACSM and American Heart Association
Explanation:
The two most widely recognized sets of formal screening guidelines for apparently healthy individuals are published by the ACSM and the American Heart Association.
194
Which of the following is considered a gliding joint?
Sacroiliac
Explanation:
The sacroiliac joint connects the sacrum to the ilium on each side and is sometimes described as a gliding joint. It is capable of relatively little movement.
195
Which of the following BEST assesses lower-body muscular strength?
1 RM Squat
196
Which of the following acronyms provides a framework for exercise prescription in healthy individuals?
FITT
Explanation:
The acronym FITT (F=frequency, I=intensity, T=time or duration, and T=type or mode) provides the framework to establish an exercise prescription in healthy individuals.
197
A Certified Exercise Physiologist may begin immediately training which of the following clients?
1) A 49-year-old male client who has an abdominal hernia
2) A 42-year-old female client who has lumbar lordosis
3) A 56-year-old female client who takes a calcium channel blocker
4) A 45-year-old male client who has asthma
A 42-year-old female client who has lumbar lordosis
Explanation:
This client is not at any risk threshold for age or health condition. Thus, training may begin immediately without medical clearance.
198
Obesity is defined as:
Waist circumference of 40 inches in men.
Explanation:
Obesity is defined by body mass index greater than or equal to 30 kg/m2, or waist circumference greater than 102 cm or 40 inches in men and greater than 88 cm or 35 inches in women. If available, body fat percentage values could also be used with appropriate judgment.
199
The _________ is responsible for collecting blood from the lungs and pumping it to the body.
Left atrium and left ventricle
Explanation:
The left side of the heart functions to pump oxygenated blood to the rest of the body.
200
Which of the following is a risk factor for cardiovascular disease?
An individual who quit smoking 4 months ago
Explanation:
The risk of cigarette smoking is removed once the individual has quit smoking for 6 months or more.
201
Which joint movement occurs in the frontal plane?
Adduction
Explanation:
The frontal plane divides the body from the anterior to posterior. Any movement that is parallel to this plane, such as an adduction, occurs in this plane.
202
The shoulder girdle refers to which specific joint?
Scapulothoracic
Explanation:
The shoulder girdle is also known as the scapulothoracic joint. This is not a true joint, as the scapula has no true bony articulation with the thoracic spine, but is instead held in place by muscle attachments.
203
A weight loss of what percent is associated with a reduction in health risks?
10%
Explanation:
Traditional behavioral weight loss programs that encourage reduced calorie intake and increased caloric expenditure typically resulted in a loss of 10% of initial body weight, an amount associated with a reduction of related health risks.
204
Which of the following is a common risk factor that is associated with exercise?
Injuries at the knee or foot
Explanation:
There is also an increased risk of musculoskeletal injury associated with exercise. The most common musculoskeletal injuries, regardless of gender, occur in the lower body, particularly at the knee or foot.
205
Movement resulting in an increase of the joint angle, usually moving posteriorly in the sagittal plane is called __________.
Extension
Explanation:
Extension typically occurs in the sagittal plane but can also occur in other planes, provided that the joint angle is increasing.
206
Exchange of blood gases and other nutrients within various tissues occurs in the ____________.
Capillaries
Explanation:
All exchange of oxygen and carbon dioxide occurs in the capillaries at the microscopic level.
207
Palpitations are BEST defined as:
An uncomfortable rhythm of heart beats or forceful heart beats.
Explanation:
Palpitations can vary in sensation but are often described as pounding or racing heartbeats, or that the heart has skipped or stopped beating. This may cause anxious feelings for some individuals.
208
A low to high diagonal chop using a medicine ball takes place in:
Multiple planes.
Explanation:
A low to high diagonal chop takes place in all three planes.
209
During the concentric phase of extension at the knee joint, the ________ work as an agonist and the ________ work as the antagonist.
Quadriceps, hamstrings
Explanation:
The quadriceps function as an agonist to extend the knee joint, and the hamstrings function as an antagonist since it functions to flex the knee joint.
210
How to read the signs: stopping an exercise test
* Onset of angina like symptoms
* Drop in SBP of >10mm hg with an increase in work rate , or if SBP decreases below the value obtained in the same position before testing
* excessive rise in BP: SBP > 250mm hg and / or DBP> 115 mm hg
* shortness of breath , wheezing, leg cramps, Claudication
* signs of poor perfusion: light headed was, confusion, ataxia, cyanosis, nausea or cold / clammy hands
* failure of HR to increase with increased exercise intensity
* noticeable change in heart rhythm by palpating or auscultation
* participant requests to stop
* physical or verbal manifestation of severe fatigue
* failure of the testing equipment
211
Some reasons why it is important to first screen clients for participation in physical activity programs
To identify those with or who...
* medical contraindications ( exclusive criteria) for performing physical activity
* should receive a medical/ physical evaluation/ exam and clearance prior to performing a physical activity program
* should participate in a medically supervised physical activity program
* other health/ medical concerns ( orthopedic injuries, etc.)
212
Known cardiovascular , metabolic and/or renal disease ( CMR):
* heart attack
* heart surgery, cardiac catheterization, or coronary angioplasty
* pacemaker/ Implantable cardiac defibrillator/ rhythm disturbance
* heart valve disease
* heart failure
* heart transplantation
* congenital( birth) Heart disease
* diabetes, type 1 & type 2
* renal disease such as renal failure
213
What are the 8/9 signs and symptoms suggestive of CMR ( cardiac + metabolic + renal) disease:
1) pain or discomfort in the chest, neck, jaws, arms, or other areas that may be due to ischemia or lack of oxygenated blood flow to the tissue like the heart
* character: the pain is felt as constricting + squeezing + burning + “heaviness” , or heavy feeling
* Location: the pain is substernal, across the midthorax, anteriorly in one or both arms or shoulders, in neck, cheeks, or teeth, or in forearms, fingers, and /or in the inter scapular region
* provoking factors: the pain comes on with exercise or exertion, excitement, other forms of stress, cold weather, or after meals
2) Dyspnea: defined as an abnormally uncomfortable awareness of breathing , medical term for shortness of breath. Is one of the principle symptoms of cardiac and pulmonary disease
3) Syncope, or fainting and dizziness during exercise may indicate poor blood flow to the brain due to inadequate cardiac output from a number of cardiac disorders
4) orthopnea: refers to trouble breathing while lying down. Indicator of poor left ventricular function
5) ankle edema, or swelling that is not due to injury is suggestive of heart failure, a blood clot, insufficiency of the veins, or a lymph system blockage
6) palpitations ( unpleasant awareness of the forceful or rapid beating of the heart) and tachycardia both refer to rapid beating or fluttering of the heart.
7) Intermittent claudication refers to severe calf pain when walking. This pain indicates a lack of oxygenated blood flow to the working muscles similar in origin to chest pain. the pain does not occur when sitting or standing
8) heart murmurs are unusual sounds caused by blood flowing through the heart . Some murmurs are innocent but others may indicate valvular or other cardiovascular disease. All murmurs should be evaluated by a physician unless they have been diagnosed and deemed safe already
9) unusual fatigue or shortness of breath that occurs during light exertion or normal activity and not during strenuous activity
214
Absolute contraindications to exercise testing:
* absolute meaning those bio markers should not be allowed to participate in any form of physical activity program and /or exercise test
* acute myocardial infarction within 2 days
* ongoing unstable angina
* uncontrolled cardiac arrhythmia with hemodynamic compromise
* active endocarditis
* symptomatic severe aortic stenosis
* decompensated heart failure
* acute pulmonary embolism, pulmonary infarction, or deep venous thrombosis
* acute myocarditis or pericarditis
* acute aortic dissection
* physical disability that precludes safe and adequate testing
215
Relative contraindications for exercise testing:
Relative means these people can be accepted or allowed into a physical activity assessment and/ or program if it is deemed that the benefits for the individual outweigh the risks to the individual
* known obstructive left main coronary artery stenosis
* moderate to severe aortic stenosis with uncertain relationship to symptoms
* tachyarrhythmias with uncontrolled ventricular rates
* acquired advanced or complete heart block
* recent stroke or transient ischemia attack
* mental impairment with limited ability to cooperate
* resting hypertension with systolic > 200mm Hg or diastolic > 110mm hg
* uncorrected medical conditions such as significant anemia, important electrolyte imbalance , and hyperthyroidism
216
Define Pulse Palpation technique:
* Should be counted for a minimum of 15seconds multiplied by 4 to calculate HR in units of beats per minute (BPM)
* counting HR for less than 15seconds reduces accuracy and reliability of this technique
217
Define Rate Pressure Product (RPP):
* also called double product (RPP = HR * SBP)
* is the product of HR and SBP that occurs concomitantly and serves as an estimate of myocardial oxygen demand (MVO2)
* can be useful to the EPC when performing exercise testing or prescribed exercise to clients with cardiovascular disease who have been cleared for exercise
* at rest the heart consumes abt 70% of the oxygen delivered to the cardiac muscles
* during exercise the cardiac muscle performs more work because of increased HR and increased contractility, thus MVO2 increases during exercise in direct proportion to exercise intensity
* if HR & SBP are lower at a given submaximal exercise intensity, the MVO2 will be lower, indicating increased fitness
218
How to Assess Resting Blood Pressure:
* patients should be seated for at least 5 min in a chair with back support
* patients should not smoke cigarettes or ingest caffeine at least 30min prior to the measurement testing
* Wrap cuff around upper arm at heart level; align with brachial artery
* use appropriate cuff size and place stethoscope
* inflate cuff pressure 20mm Hg above first korotkoff sound
* slowly release pressure at a rate equal to 2-5 hg *s
* SBP = phase 1, DBP = phase 5
* 2 measurements should be taken min, 1 minute apart, then find average between the two
* 1st examination BP should be done in both arms, if #’s are inconsistent the higher pressure should be used
219
Define cardiorespiratory fitness assesment (CRF):
* is an umbrella term that is an indicator of the functional capacity of the heart, lungs, blood vessels, and muscles to work in synchrony to support dynamic larger muscle mass exercise
* regularly performed in both healthy and clinical populations, used to gain insight for both most appropriate frequency, intensity, duration and mode of exercise to prescribe when creating individualized exercise programs. Also used as a motivational tool to help track progress and set obtainable short term goals
* Clinical Populations: used for screening, diagnosis and prognosis of medical conditions
220
Types of cardiorespiratory fitness assessments:
* maximal oxygen uptake VO2max ( treadmill, cycle ergometer, arm ergometer, etc.):
- open circuit spirometry during graded exercise test to volitional fatigue
* sub maximal oxygen uptake ( cycle ergometer):
- astrand-rhyming cycle ergometer test
- YMCA cycle ergometer test
* step tests ( aerobic step or specific height bench, metronome): maximal or submaximal
- queens college/ mcardle step test
- harvard step test
- astrand - rhyming step test
* field tests ( level walking/ running surface): maximal or submaximal
- rockport walk
- 12 min walk/ run test
- 1.5 mile run test
221
What’s the gold standard?
* used to measure CRF ( cardiorespiratoy fitness) is the assessment of VO2max via open spirometry during maximal intensity, aerobic exercise
* open circuit spirometry requires the collection of expired air from the client during a graded intensity exercise test to maximal exertion. then the expired air is analyzed with a highly specific gas analyzer
* this requires expensive equipment, technical expertise and maximal exercise performance by client even though it is the gold standard of CRF assessment
* this limits use of VO2 testing using open circuit spirometry to primarily clinical labs and research settings
222
The volume of blood pumped by the heart in liters per minute is defined as__________.
Cardiac output
Explanation:
Cardiac output is defined as the product of heart rate and stroke volume.
223
Which energy system is primarily responsible for resynthesizing ATP during submaximal exercise lasting longer than 3 minutes?
Oxidative phosphorylation
Explanation:
Cells must continuously create ATP at a rate equal to ATP use through a combination of three primary metabolic systems: creatine phosphate (CP), anaerobic glycolysis, and the oxidative system.
224
The benefits of physical activity would outweigh the risk for which of the following?
Controlled Type 1 diabetes
Explanation:
An absolute contraindication refers to those criteria that are nonnegotiable and individuals with those biomarkers should not be allowed to participate in any form of PA program and/or assessment. Persons with relative contraindications, however, may be accepted or allowed into a fitness assessment and/or PA program if it is deemed that the individual benefits outweigh the potential risks.
225
1) Define oxygen consumption
2) define Absolute oxygen consumption
3) define Relative oxygen consumption
1) Refers to the rate at which oxygen is consumed by the body. It can be expressed in absolute or relative terms
2) is the raw volume of oxygen consumed by the body
3) is the volume of oxygen consumed relative to body weight
- Relative oxygen can serve as a useful measure of fitness between individuals
226
What is a MET?
* one MET is equal to the relative oxygen consumption at rest
* 1MET = 3.5ml x kg x minute
* can calculate energy expenditure overtime
227
Define kilocalorie:
* is an estimate of energy cost that can be related directly to physical activity and exercise
* 3,500kcal = 1lb of fat
228
How to read the signs: stopping an exercise test
* onset of angina or angina like symptoms
* drop in SBP of >10mmHg with an increase In work rate, or if SBP decreases below the value obtained in the same position before testing
* excessive rise in BP: SBP >250mmHg and / or DBP >115mmHg
* shortness of breath, wheezing, leg cramps, or claudication
* signs of poor perfusion: lightheadedness, confusion, ataxia( the loss of full control of bodily movements), pallor( an unhealthy pale appearance), cyanosis( bluish or grayish color of the skin + nails + lips or around the eyes), nausea, or cold & clammy skin
* failure of HR to increase with increased exercise intensity
* noticeable change in heart rhythm by palpation or auscultation
* participant requests to stop
* physical or verbal manifestations of severe fatigue
* failure of the testing equipment
229
Signs & symptoms of common musculoskeletal injuries associated with exercise:
* exquisite point tenderness
* pain the persists even when the body part is at rest
* joint pain
* pain that does not go away after warming up
* swelling or discoloration
* increased pain with weight bearing activities or with active movements
* changes in normal bodily functions
230
Common Intrinsic Risk Factors associated with cardiorespiratory exercise:
* history of previous injury
* inadequate fitness or conditioning
* body composition
* bony alignment abnormalities
* strength or flexibility imbalances
* joint or ligamentous laxity
* predisposing musculoskeletal disease
231
Common Extrinsic Risk Factors associated with cardiorespiratory exercise:
* excessive load on the body
* type of movement
* speed of movement
* number of reps
* footwear
* surface
* training errors
* excessive distance
* fast progression
* high intensity
* running on hills
* poor technique
* fatigue
* adverse environmental conditions
* air quality
* darkness
* heat or cold
* high humidity
* altitude
* wind
* worn or faulty equipment
232
Define Heat Stress:
* hot environments reduce to body’s ability to dissipate heat and promote an increase in core body temp
* to maintain a neutral body temp in these conditions, ones sweat rate and skin blood flow increase to promote heat loss
* Heat is a performance limiting factor
* * increased sweat rates:
- can cause a reduction in plasma volume
- increase risk of dehydration
- may lead to a decrease in SV; which then promotes an increase in HR to maintain cardiac output at submaximal workloads
* HR drift = elevated HR at submaximal loads
* Increased blood flow to the skin circulation causes reduced blood flow to the working muscles
* physiological changes that occur during exercise in heat:
- reduced performance capacity
- diminished central’s nervous system function
- increased muscle glycogen utilization
* HR values should be expected to be higher in the heat vs normal environment
* cardiovascular drift: HR climbs over time ; which can decrease ones overall performance, staying well hydrated may help attenuate this during exercise
233
Define Cold Stress:
* exercising in this environment facilitates heat loss produced during exercise
* long duration exercise events can increase risk of hypothermia
* If core temp is challenged the body attempts to:
- increase heat production
- limit heat loss via shivering and VASOCONSTRICTION of blood vessels in the skin
* greater subcutaneous fat mass can help limit ones heat loss in a cold environment; this layer acts as a form of insulation or barrier between the warm blood and the cold environment
** the HR and cardiac output responses to exercise are similar to those of a thermoneutral environment
* * respiratory rate is higher at a given submaximal intensity
- VO2max may be slightly lower
* the primary barrier to maximal performance is the extra work associated with wearing bulky clothing during exercise
- increases the energy cost of exercise because the clothing adds extra weight , alterations in movement resulting in augmented extraneous work, and increased friction as layers of clothing slide against each other during exercise
234
Define Altitude:
* barometric pressure decreases with ascent to altitude
* The partial pressure of oxygen is equal to the product of barometric pressure and the percentage of oxygen in the air
* it is the change in barometric pressure that causes the PO2 to decrease at altitude and reduces our ability to provide oxygen to working muscles
- in response pulmonary ventilation increases
* * During initial high altitude exposure:
- SV decreases
- HR increases
- causing an increase in cardiac output at a given submaximal exercise intensity
- typically no change in BP
- possible weight loss and sleep disturbance can affect performance
* unacclimatized individuals will have to reduce the absolute intensity of exercise at a higher altitude because of the greater difficulty of doing exercise at the higher altitude. The time it takes to become acclimatized to altitude varies greatly between individuals and also depends on the local altitude
235
acclimatization when exercising in a hot, cold or high altitude environment:
Definition: it is the process of physiological adaptations that occur in response to changes in the natural environment
1) heat acclimatization:
* can improve exercise performance such as;
- lower core body temp
- lower skin temp
- higher sweat rate
- higher plasma volume
- lower HR at a specific workload
- lower perception of effort
- improved conservation of sodium
These all improve heat dissipation from the body to the environment and limit cardiovascular strain
* requires gradual exposure + 10 consecutive days to become adapted to environment
2) Cold Acclimatization:
* causes the shivering threshold to be reset to a lower mean skin temp
* enhances the ability to maintain heat production through means besides shivering
* improves maintenance of hand and feet temps, potentially attenuating the loss of dexterity that normally accompanies cold extremities
3) Altitude Acclimatization:
* requires adjusting to the lower PO2; this will stimulate the production of additional red blood cells (erythropoiesis) to increase the oxygen carrying capacity of the blood
* The kidneys release the hormone erythropoietin to stimulate erythropoiesis but this process will take time, about 4 weeks or more, to gain the full benefits
* to improve athletic performance practice the “live high, train low” strategy
* after returning to sea level the benefits have been shown to last up to 3 weeks
236
Define Sarcomeres:
* the smallest contractile unit within a muscle
* made up of many proteins
* a myofibril consists of many sarcomeres
* groups of myofibrils make up a single muscle fiber or muscle cell
237
Define Fascia:
* types of connective tissue
* they surround structures and create a stable yet flexible environment
* the connective tissue is muscle is like a rubber band that stretches and recoils to provide added force to a muscle contraction
238
Define agonist:
The prime mover of a joint
239
Define Synergists:
The muscles that assist the prime mover in the movement
240
Define type 1 muscle fibers:
* slow twitch fibers
* have a high oxidative capacity and a lower contractile force capability
* better four endurance activities
241
Define type 2 muscle fibers (2a & 2x):
* fast twitch fibers
* have a high glycolytic capacity
* higher contractile force capability
* better for strength nonfiction power activities
242
Muscle fiber types & recruitment:
* the ratio of type 1 and type 2 fibers in the body varies for each person and depends on hereditary factors
* regular resistance training may cause a small change in fiber type composition
- from one subgroup of fiber to another sub group of fiber
* resistance training will not convert type 1 fibers to type 2 fibers
* different training loads and movement speeds can alter the involvement of different types of muscle fibers in a given movement
* muscle fibers that are not stimulated will not reap training benefits
* motor unit: is a neuromuscular gathering of muscle fibers that are innervated by a motor neuron
* the size principle of motor unit activation states:
- that motor units are recruited from the smallest to the largest
- depending on the force production demands
- recruited first are the smaller or low threshold motor units and they are mostly type 1 fibers
- recruited later are larger or high threshold motor units and they are mostly type 2 fibers
- depends on the demands of the exercise
* training periodization/ program variation is based on that diff training loads and power requirements recruit diff types and numbers of motor units
* training heavy loads:
- can be lifted only 4-6 times
- will activate higher threshold motor units
- low threshold motor units will be recruited first then high threshold motor units will be activated as needed to produce the necessary force
243
Define Concentric muscle contraction:
* a weight is lifted
| * the muscle is shorten
244
Define eccentric muscle action:
* a weight is lowered
* involved muscles lengthen
* the highest force production occurs during this movement
* potent stimulus for increases in muscle size and strength
* to reduce the risk of a muscle strain a gradual and progressive introduction to resistance training is recommended
** extended periods with very heavy loads cash result in serious complications such as rhabdomyolysis, which may harm kidney function
245
Define isometric ( or static):
* when a muscle is activated but no movement at the joint takes place
* maximal force production is greater than a concentric contraction
* this muscle action takes place during the standing phase of the squat exercise when the weight is held stationary and no visible movement occurs
* Occur when the weight is 2 heavy to lift any further
- happens during the “sticking point” of an exercise when the force produced by the muscle equals the resistance
246
ROM stands for:
Range of motion
247
Assessment protocols:
* when strength comparisons are made between 2 individuals the values should be expressed as relative values
* relative values = per kilogram of body weight
* Assessing muscular strength:
- done in fitness facilities with dynamic measures that involve the movement of an external load or body part
- 1 RM test ( standard muscular strength assessment): the heaviest weight that can be lifted only once using proper technique
- 10 RM test ( multiple RM): can be used to assess muscular strength and provide valuable info regarding an individuals training program; can provide an index of strength changes overtime
- isometric strength can be measured by using devices like a handgrip dynamometer. These are specific to the muscle group and joint angle therefore provide limited information regarding overall muscular strength
* Assessing muscular endurance:
- is the ability to perform repeated contractions over a period and is typically assessed with field measures
- screens for muscle weakness
- push up test
- during the pushup test overweight individuals may find it difficult to perform; poor results may be obtained and may discourage participation in an exercise program
248
How to assess one repetition maximum (1-RM) strength:
1) warm up for 5-10min with low intensity aerobic exercise and dynamic stretching
2) perform, a specific warmup with several reps with a light load
3) select an initial weight that is within the subjects perceived capacity ( 50-70% of capacity)
4) attempt a 1-RM lift; if successful, rest approximately 3-5min before the next trial
5) increase resistance progressively (eg, 2.5-20kg) until the subject cannot complete the lift
* * a 1-RM should be obtained within 4 SETS to avoid excessive fatigue
6) the 1-RM is recorded as the heaviest weight lifted successfully through the full ROM with proper technique
249
How to assess upper body strength and endurance with the pushup test:
1) explain the purpose of the test to the client
* * to determine how many pushups can be completed to reflect upper body muscular strength and endurance
2) inform clients of proper breathing technique ( to exhale with effort, which occurs when pushing away from the floor)
3) usually...
- for men the test is started in the standard “down” position
- for women the test is started in the modified knee pushup position
* some men will need to use the modified position and some women can use the full body position
4) the subject must raise the body by straightening the elbows and return to the “down” position, until the chin touches the mat. The stomach should not touch mat
5) the subjects back must be straight at all times and the subject must push up to a straight arm position
6) demonstrate the test and allow the client to practice is desired
7) remind the client that the maximal number of pushups performed consecutively without rest is counted as the score
8) begin the test when the client is ready, stop the test when the client strains forcibly or is unable to maintain the appropriate exercise technique within 2 reps
250
Define Flexibility:
* ROM of a joint or group of joints, as per the skeletal muscles and not many external forces
* static flexibility: is the full ROM of a given joint because of external forces
* dynamic flexibility: is the full ROM of a given joint achieved by the voluntary use of skeletal muscles in combination with external forces
251
The 4 Factors Affecting Flexibility:
1) muscle properties:
2) physical activity & exercise:
3) anatomical structure:
* synovial joints ( freely moveable joints)
4) age & gender:
* with aging their is a reduction in collagen solubility which can lead to tendon rigidity & reduction in a joint
* reasons for increased female flexibility include smaller muscles and wider hips and differences in hormonal levels
252
Modes of Flexibility training:
1) static ( slow and constant )
* passive stretching ( with a partner)
* “ self stretching” ( by yourself)
* isometric stretching ( against a stationary object )
2) ballistic ( involves rapid & bouncing like movements)
* no longer advocated as a common practice
* could lead to muscle and tendon injuries
3) proprioceptive neuromuscular facilitation (PNF)
* collection of stretching techniques combining passive stretch + isometric + concentric muscle actions designed to use the autogenic & reciprocal inhibition responses of the Golgi tendon organ
* a strengthening technique as well
* 3 types of PNF stretching techniques ( they all have 3 phases a passive prestretch, passive stretch, and contractions )
A) hold-relax
B) hold- relax with antagonist contraction
C) agonist contraction
4) dynamic
* sport specific movements that are designed to increase core temp and enhance activity related flexibility and balance
253
Muscle and tendon proprioceptors:
* their are 2 sensory organs that provide muscular dynamic & limb movement information to the central nervous system
1) muscle spindles ( sensors)
* collection of 3-10 intramural specialized muscle fibers that are innervated by gamma motor neurons and provide information about the rate of change in muscle length
2) Golgi tendon organs ( GTOs)
* located in the musculotendinous junction and respond to changes in muscle tension
* these organs are encapsulated in a series of 10-15 muscle fibers and can identify and provide a response to changes in the amount of tension ( static) and the rate of tension (dynamic) development
* important role in PNF stretching - promotes further lengthening of affected muscle
* help with stretching and flexibility
254
Define Goniometers:
* includes the body axis or fulcrum, a stabilized arm, and a movement arm
* it is a quantitative assessment of ROM that is necessary to identify deficiencies resulting from injury or the need for a flexibility training program relative to the individuals needs
* most useful method for determining individual joint flexibility
* it is similar looking to a protractor expressed in degrees
* joint specific = ROM
255
Define Ballistic methods or “bouncing stretches:
Use the momentum of the moving body segment to produce the stretch
256
Define dynamic or slow movement stretching:
Involves a gradual transition from one body position to another and a progressive increase in reach and range of motion as the movement is repeated several times
257
Define Static stretching:
Involves slowly stretching a muscle/ tendon group and holding the position for a period of time ( 10-30sec)
* static stretches can be active or passive
A) active static stretching:
- involves holding the stretched position using the strength of the agonist muscle as is common in many forms of yoga
B) passives static stretching:
- involves assuming a position while holding a limb or other part of the body with or without the assistance of a partner or device ( like a elastic band or ballet barre)
258
Define Metabolic equivalents (METs):
* An index of energy expenditure (EE)
* a MET is the ratio of the rate of energy expended during an activity to the rate of energy expended at rest
* one MET is the rate of EE while sitting at rest
* 1 MET = an oxygen uptake of 3.5ml*kg
259
Define MET-min:
* an index of EE that quantifies the total amount of physical activity performed in a standardized manner across individuals and types of activities
* METs X minutes
* measure of exercise volume
260
Define Kilocalorie (Kcal):
* the energy needed to increase the temp of 1kg of water by 1c
* to convert METs. To Kcal * min, it is necessary to known an individuals body weight
* [(METs X 3.5ml*kg *min X body wt in kg) /1,000] X 5
261
define leg press weight ratio:
Weight pushed in lbs / body weight in lbs
262
generalized men skin fold equations:
* seven site formula: ( chest, midaxillary, triceps, subscapular, abdomen, suprailliac, thigh)
- body density = 1.112-0.00043499 ( sum of skin folds)
* three site formula: (chest, abdomen, thigh)
- body density= 1.10938-0.0008267 ( sum...)
* three site formula: ( chest, triceps, subscapular)
- body density= 1.1125025-0.0013125( sum of skin folds)
263
generalized women skin fold equations:
* seven site formula: ( chest, midaxillary, triceps, subscapular, abdomen, suprailliac, thigh)
- body density = 1.097-0.00046971( sum of skin folds)
* three site formula: ( triceps, suprailliac, thigh)
- body density= 1.0994921( sum of ...)
* three site formula: (triceps, suprailliac, abdominal)
- body density= 1.089733-0.0009245( sum...)
264
Which of the following is recommended by the National Heart, Lung, and Blood Institute to improve overall health?
Reduce weight by at least 5%
Explanation:
The National Heart, Lung, and Blood Institute recommends that a 5% to 10% weight reduction results in improved overall health.
265
Which of the following joints favors mobility over stability?
Glenohumeral
Explanation:
The shoulder has a high degree of mobility; as a result, the shoulder region is very unstable.
266
During the concentric phase of a hamstring curl, the hamstrings are __________.
Flexed
Explanation:
The hamstrings flex the knee joint when a concentric action occurs.
267
Your potential client has a history of swollen ankles and reports shortness of breath when walking up the stairs. You would classify this as:
High risk and require that the client obtain a physician's clearance.
Explanation:
Both swollen ankles (ankle edema) and shortness of breath are major signs of a disease state. Thus, the individual should be classified as high risk and would require medical clearance and testing prior to exercise.
268
A heart murmur that is clinically significant may be indicative of:
Valvular heart disease.
Explanation:
Most heart murmurs are harmless; however, significant murmurs can be a sign of heart valve issues, such as not opening or closing properly.
269
Which of the following is the gold standard for assessing cardiorespiratory fitness?
Open circuit spirometry during graded exercise to fatigue
Explanation:
The gold standard used to measure cardiorespiratory fitness is the assessment of VO2max via open circuit spirometry during maximal-intensity, aerobic exercise. However it requires expensive equipment, technical expertise, and maximal-intensity exercise performance by the client.
270
Which joint movement occurs in the frontal plane?
Adduction
Explanation:
The frontal plane divides the body from the anterior to posterior. Any movement that is parallel to this plane, such as an adduction, occurs in this plane.
271
A joint is the most stable when it is in which of the following positions?
Closed pack
Explanation:
A joint is in a closed pack position when there is both maximal congruency of the joint surfaces and maximal tautness of the joint capsule and ligaments. This offers the most stable position for a joint.
272
Which of the following activities has the lowest risk of musculoskeletal injury?
Walking
Explanation:
Walking for exercise, which is performed by approximately 30% of adults, is the most popular exercise in the United States. The musculoskeletal risk associated with walking is considerably lower than that with jogging, with about 1.5% of people reporting an injury in the previous month.
273
Where does gas exchange occur in the respiratory system?
Alveoli
Explanation:
The alveoli is the functional unit of the lung.
274
Which movement occurs in the frontal plane?
Elevation of the scapula
Explanation:
With the exception of tilt, all other movements of the scapula occur in the frontal plane. Note that elbow flexion and hip flexion occur in the sagittal plane and supination occurs in the transverse plane.
275
Which of the following increases functional capacity and may relieve symptoms of coronary artery disease?
Endurance exercise training
Explanation:
Endurance exercise training typically increases myocardial oxygen supply, lowers the demand for oxygen, or both.
276
Which of the following hemodynamic variables have a linear relationship and are heavily influenced by one another during exercise?
Systolic blood pressure and cardiac output
Explanation:
Systolic blood pressure is heavily influenced by changes in cardiac output. As cardiac output increases linearly with increasing workload, so does SBP.
277
Upon reviewing a client's health history questionnaire, you notice that it has not been filled out completely. She states that she cannot remember but will look up the information at home and get back to you asap. You should:
Consider any missing information as relating to a risk factor as positive.
Explanation:
In general, when information regarding a specific risk factor is not available, the EP-C is encouraged to consider the missing risk factor as positive.
