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Practice Test
- how does the cardiovascular system respond to pregnancy?
- cardiac output
- stroke volume
- heart rate
- blood volume
- systemic vascular resistance
- BF to uterus
- how does the metabolic system respond to preg- nancy?
- protein content
- fat deposits
- blood lipids
- salt accumulation
- body weight water retention
- how does the respiratory system respond to preg- nancy?
- tidal volume
- VO2 upward movement of diaphragm up to 5cm at rest
- how does the musculoskeletal system respond to pregnancy?
- shift in
- joint laxity
- risk of strains or sprains
- how does the endocrine system respond to preg- nancy?
increases increases increases increases decreases increases
increases increases increases increases increases
increases increases
center or gravity increases increases
increases increases increases
Practice Test
- human growth factor
- human placenta lactogen
- estrogens
- progesterone
- how does the emotional system respond to preg- nancy?
- mood fluctuations
- emotional lability
- what are the physiological responses to pregnan- cy?
- body weight increases as much as
- increase in body
- increase in blood volume
- increase in cardiac
- stays constant or decreases
- decreases
- the actute physiologic responses to exercise are generally during pregnancy compared with nonpregnancy
- healthy, pregnany women without exercise con- traindications are encourage to throughout pregnancy
- regular exercise during pregnancy provides benefits to the mother and child
- exercise may also reduce the risk of develop- ing conditions associated with pregnancy such as pregnancy-induced , and
increases increases
increases increases
water 45- 50% output MAP TPR
increased
exercise
health/fitness
hypertension gestational diabetes urinary incontinence
Practice Test
- or extreme underweight
- mild/moderate
- relative contraindications for exercise during preg- orthopedic nancy (3)
- limitations
- poorly controlled
- recurrent
- unevaluated maternal cardiac
- other significant
- absolute contraindications for exercise during pregnancy (1)
- significant
- incompetent , cervical insufficiency, or cer- clage
- restriction
- persistent
- absolute contraindications for exercise during pregnancy (2)
- placenta previa after weeks of gestation
- or pregnancy induced-HPTN
- disease
- membranes
- absolute contraindications for exercise during pregnancy (3)
- severe
- poorly controlled
- uncontrolled
- uncontrolled
- other serious , , or disorder
seizures pregnancy loss arrythmia medical conditions
heart disease cervix intrauterine growth bleeding
preeclampsia lung ruptured
anemia HPTN type I diabetes thyrooid disease CV, respiratory, systemic
Practice Test
- walking, swimming, stationary cycling, low impact aerobics, and running have been shown to be during pregnancy
- training may also be performed, however, re- search on risks and safety is limited
safe
resistance
- muscle training during pregnancy pelvic floor
- warning signs to stop exercise during pregnancy (1)
- leakage or other vaginal fluid loss including of the membranes
- pain or swelling
- pain
- dizziness, , or faintness
- warning signs to stop exercise during pregnancy (2)
- muscle weakness affecting
- regular painful
- prior to exercise or that is persistent and excessive that does not resolve on rest
- vaginal
amniotic, rupture calf chest syncope headache
balance uterine contractions SOB bleeding
- exercises to avoid during pregnancy (9) collision sport/activity activities that increase the risk of falling jumping and quick changes in direction scuba diving
Practice Test
- children and adolescents are physiologically to aerobic, resistance, and bone loading exercise.
adaptative
- gains in with resistance training may be simi- relative muscular strength lar between children and adolescents.
- no is recommended for moderate intensity exercise for children and adolescents
medical screening
- intensity exercise may be initiated for children vigorous and adolescents after safely participating in mod- erate intensity exercise
- children have a anaerobic capacity than adults lower
- physiologic responses to acute exercise in children lower compared to adults (1)
- absolute oxygen uptake
- relative oxygen uptake
- heart rate
- cardiac output
- stroke volume
higher higher lower lower
- physiologic responses to acute exercise in children lower compared to adults (2)
- systolic blood pressure
- diastolic blood pressure
- respiratory rate
- tidal volume
- respiratory exchange ratio
- delivers exercise and other lifestyle interven- tions and consists of a coordinated, multifaceted
lower higher lower lower
cardiac rehabilitation
Practice Test
intervention designed to reduce risk, foster healthy behavior and adherence to these behaviors, re- duce disability, and promote an active lifestyle for individuals with several forms of CVD
- an in-hospital, multidisciplinary, systematic ap- proach to applying secondary therapies of known benefit through assessment, early mobilization, education regarding lifestyle behaviors in control- ling CVD risk factors, evaluation of the individual's level of readiness for physical activity, and compre- hensive discharge planning following hospitaliza- tion for an acute cardiac event, procedure, or other CV-related pathology
- components of inpatient cardiac rehab
- clinical assessment via and
- physical and
inpatient cardiac rehab
chart review, individual inter- view ambulation, mobilization
- identificantion and education regarding and modifiable risk factors self-care
- planning for transitional care and a home program for ADL/PA
- to outpatient cardiac rehab
- exercise during inpatient cardiac rehab
- supervised daily maybe initiated in the ab- sence of contraindications
- a daily individual assessment performed by a CEP along with recommendations can be used to guide initiation and progression of the dose of in- patient PA
discharge referral
ambulation FITT monitor
Practice Test
- current including frequency, dose, and route of administration
- with an emphasis on the cardiopulmonary and musculoskeletal systems
- what is the FITT recommendation for outpatient cardiac rehab programs for aerobic frequency?
- what is the FITT recommendation for outpatient cardiac rehab programs for aerobic intensity (with an exercise test)?
- what is the FITT recommendation for outpatient
minimally 3 d/wk preferably up to 5 d/wk
use 40%-80% of exercise ca- pacity using HRR, VO2R, or VO2peak
use seated or standing RHR + cardiac rehab programs for aerobic intensity (with- 20-30 bpm or an RPE of 12- out an exercise test)?
- what is the FITT recommendation for outpatient cardiac rehab programs for aerobic duration?
- what is the FITT recommendation for outpatient cardiac rehab programs for aerobic type?
- exercise training considerations for individuals with CVD
- warm-up and cool-down activities of
- the presence of that is induced by exercise training and relieved with rest or nitroglycerin is sufficient evidence for the presence of myocardial
on a scale of 6-
20-60 mins
arm eergometer, combination of upper and lower extrem- ity cycle ergometer, upright and recumbent cycle ergome- ter, recumbent stepper, rower, elliptical, stair climber, tread- mill
5-10 mins angina prescribed medications B-adrenergic, GXT diuretic therapy
Practice Test
ischemia
- individuals should take their at their usual time
- individuals on a agent may have an attenu- ated HR response to exercise. ( a new may be helpful for individuals whose B-blocker dose was altered)
- individuals on are at an elevated risk of volume depletion, hypokalemia, or orthostatic hy- potension following exercise. monitor HR, BP, signs and symptoms
- HIIT vs MICT vs Control in HF
- what was the intervention?
- HIIT vs MICT vs Control in HF
- what were the VO2peak results?
- HIIT vs MICT vs Control in HF
- what were the LVEF results?
- HIIT vs MICT vs Control in HF
- what were the FMD results?
- HIIT vs MICT vs Control in HF
- what were the mitochondrial function results?
- GXT in individuals with HF
training 3x/wk for 12 weeks
HIIT (+46%) vs MICT (+14%)
increase by 35% with HIIT
increase with HIIT
increase with HIIT
lower
- individuals with HFrEF exhibit HR peak, peak vasodilation SV, and peak Q
- of large vessels and resistance vasculature are attenuated, limiting blood flow
- abnormalities in skeletal muscle histochemistry
oxidative capacity lower work rate
Practice Test
- the rate of dehiscence is of all individuals with sternotomy
- coughing, osteoporosis, or infections may the risk of sternal dehiscence
- while in an outpatient cardiac rehab, rhythmic activities can be performed
- restore an optimal HR at rest and during exer- pacemakers cise, to synchronize atrial and ventricular filling and contraction in the setting of abnormal rhythms, and to sychronize right and left ventricular contrac- tion
- a device that monitors the heart rhythm and deliv- implantable cardioverter de- ers an electrical shock if life-threatening rhyth,s are fibrillator (ICD) detected
- when an ICD is present, HRpeak during the exer- cise test and exercise training program should be maintained at least below the programmed HR threshold for defibrillation.
- After 24h following ICD implantation, ROM activities can be performed to avoid subsequent joint complications.
- Vigorous upper extremity activities such as swim- ming, bowling, lifting weights, elliptical machines, and golfing should be avoided for at least after device implant. Lower extremity activities can be performed.
10- 15bpm
mild upper extremity
3-4 weeks
Practice Test
cardiac transplantation
- HF
- 3-yr post-transplant survival rate in the US
- are strongly recommended to improve ex-
end-stage 83.5% aerobic and resistance train- ing ercise capacity and QOL, restore BMD, reverse sar- 15-30% copenia, and modify CVD risk factors
- Exercise capacity improves in response to exercise programs lasting for 2 to 6 months.
- Improvements in response and of the skeletal muscle.
- exercise testing for individuals following cardiac transplant
- is often elevated
- increases in HR are dependent on (lack of sympathetic innervation)
chronotropic, oxidative capaci- ty
resting HR circulating catecholamines delayed after BP
- HR increases with increases in workload are gradual
- the highest HRs may occur the exercise test or training session
- is often elevated at rest, with slightly atten- uated response to peak exercise
- a more exercise testing protocol should be used, similar to those recommended for individu- als with HF
- diseases of arterial blood vessels outside the heart peripheral artery disease and brain
- leads to stenosis and limits vasodilation > reduced blood flow to rgions distal to the area of occlusion
atherosclerotic plaque
- narrowing or blockage
Practice Test
- what are 5 methods of clinical management of pe- ripheral artery disease?
- an occurs when a vessel supplying blood to the brain is obstructed
antiplatelet medicines statins ACE inhibitors angioplasty bypass surgery
ischemic stroke
- ischemic strokes account for how many stroke cas- 87% es?
- a occurs when a weakened vessel ruptures and bleed into the surrounding brain
- hemorrhagic strokes account for of all stroke cases
- occurs when a blood clot blocks an artery for a short time
- after a stroke...
- deteriorates quickly
- death
- motor, sensory, emotional, and cognitive
- severity of impairments is contingent upon the of the affected area and presence or absence of
- analysis of sensory information
- facial recognition
- understanding 3D concepts
hemorrhagic stroke
transient ischemic attack (TIA)
brain function neuronal cell impairments attected area, collateral blood flow
right hemisphere
- left hemisphere
Practice Test
- language-based skills
- analytical tasks
- the following describes a stroke in the hemi- sphere
- paralysis on the left side of the body
- vision problems
- memory loss
- spatial problems with depth perceptions or direc- tions
- spatial neglect
- impulsivity, inappropriateness, and depression
- the following describe a stroke in the hemi- sphere
- paralysis on te right side of the body
- speech language problems
- impaired ability to write and learn new informa- tion
- memory loss
- vision problems
- impaired ability to analyze items
- depression, cautiousness, hesitancy
- immeiately following a stroke:
- prevent complications of
- regain
- recover basic
- after a stroke, ...
- reduces Q
- impairs immune function
- increases HR
right
left
prolonged inactivity voluntary movement ADLs
bed rest
Practice Test
- intermittent
- activities
- activities
- a heterogenous chronic inflammatory disorder of the airways that is characterized by:
- history of episodic bronchial hyperresponsive- ness
- variable airflow limitation/obstruction
- recurring wheeze, dyspnea, chest tightness, and coughing that occur particularly at night or early morning
- asthma severity: mild or moderate for body posi- tion
seated range of motion
asthma
prefers sitting to lying not agi- tated
- asthma severity: severe for body position sits hunched forward agitated
- asthma severity: life threatening for body position sits hunched forward drowsy or confused
- asthma severity: mild or moderate for speech phrases
- asthma severity: severe for speech words
- asthma severity: life threatening for speech not able to talk
- asthma severity: mild or moderate for respiration rate
<30 breaths/min
- asthma severity: severe for respiration rate >30 breaths/min
- asthma severity: life threatening for respiration rate
30 breaths/min
Practice Test
- asthma severity: mild or moderate for HR 100-120 bpm children <= bpm
- asthma severity: severe for HR 120 bpm children >125 bpm
- asthma severity: life threatening for HR >120 bpm; hypotension chil- dren >125 bpm
- asthma severity: mild or moderate for O2 satura- tion
- asthma severity: severe for O2 saturation <90%
- asthma severity: life threatening for O2 saturation <90%; cyanosis
- asthma severity: mild or moderate for auscultation wheeze
- asthma severity: severe for auscultation wheeze
- asthma severity: life threatening for auscultation might have silent chest
- asthma severity: mild or moderate for PEF >50%
- asthma severity: severe for PEF 35-50% predicted or PB
- asthma severity: life threatening for PEF < 33% predicted or PB might be unable to perform PEF
- what are 10 risk factors for asthma? heredity exposure to tobacco smoke viral exposure air pollutioon obesity sex stress