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ACSM Certification Review
Chapter 1
216
Physiology
Graduate
05/17/2010

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Term
What is the difference between regional and systemic anatomy? What does the book use?
Definition
Regional is organized according to regions, parts, or divisions of the body. Systemic is organized according to organ systems (i.e. respiratory and nervous). This book uses the systemic approach and discusses only skeletal, muscular, cardiovascular, and respiratory. (the chapter does that)
Term
What is biomechanics?
Definition
It is the field of study concerned with the principles of physics related to energy and force as they apply to the human body.
Term
Orientation: Proximal
Definition
nearest to the body center, joint center, or reference point.
Term
Orientation: Distal
Definition
away from the body center, joint center, or reference point.
Term
Orientation: Superior
Definition
above, toward the head.
Term
Orientation: Inferior
Definition
lower than, toward the feet.
Term
Orientation: Anterior
Definition
Toward the front.
Term
Orientation: Posterior
Definition
Toward the back.
Term
Orientation: Medial
Definition
Closer to the midline.
Term
Orientation: Lateral
Definition
away from the midline.
Term
What are the three cardinal planes in the body?
Definition
Transverse, Sagittal, and Frontal.
Term
What is the sagittal plane?
Definition
It makes a division into right and left portions.
Term
What is the frontal plane?
Definition
It makes a division into anterior and posterior portions.
Term
What is the transverse plane?
Definition
it makes a division into upper and lower portions.
Term
The body has three axes, what are they?
Definition
mediolateral, anteroposterior, and longitudinal.
Term
What is the mediolateral axis?
Definition
It lies perpendicular to the sagittal plane.
Term
What is the anteroposterior axis?
Definition
It lies perpendicular to the frontal plane.
Term
What is the longitudinal axis?
Definition
It lies perpendicular to the transverse plane.
Term
Movement: Flexion
Definition
a movement that decreases the joint angle. It occurs in a sagittal plane around a mediolateral axis.
Term
Movement: Extension
Definition
a movement that increases the joint angle. It occurs on the sagittal plane around a mediolateral axis.
Term
Movement: Addcution
Definition
a movement toward the midline of the body in the frontal plane around an anteroposterior axis.
Term
Movement: Abduction
Definition
movement away from the midline of the body in a frontal plane around an anteroposterior axis.
Term
Movement: Rotation
Definition
movement around a longitudinal axis and in the transverse plane, either toward the midline or away from the midline.
Term
Movement: Circumduction
Definition
a combination of flexion, extension, abduction, and adduction. The segment moving in circumduction describes a cone.
Term
Movement: Pronation
Definition
A rotational movement at the radiounlar joint in a transverse plane about a longitudinal axis that results in the palm facing downward.
Term
Movement: Supination
Definition
a rotational movement at the radioulnar joint in a transverse plane around a longitudinal axis that results in the palm facing upward.
Term
Movement: Plantarflexion
Definition
extension at the ankle joint.
Term
Movement: Dorsiflexion
Definition
flexion at the ankle joint.
Term
Movement: Eversion
Definition
turning the SOLE of the foot away from the midline.
Term
Movement: Inversion
Definition
turning the SOLE of the foot toward the midline.
Term
What is the axial skeleton?
Definition
it is the part of the skeleton that includes the bones of the skull, vertebral column, ribs, and sternum.
Term
How many bones are in the skull and which one is the most important in terms exercise testing?
Definition
29 bones. The mandible (lower jaw) is most significant because it may serve as an orienting landmark for palpating the carotid artery to assess pulse.
Term
What is the spine also called?
Definition
The vertebral column.
Term
How many vertebrae does the human spine commonly have? How many of each kind are there?
Definition
33. 7 cervical, 12 thoracic, 5 lumbar, 5 sacral (fused into one bone, the sacrum), and 4 coccygeal (fused into the coccyx).
Term
What are intevertebral disks?
Definition
round, flat, or platelike structures composed of fibrocarilaginous tissue.
Term
What is the outer, fibrocartilaginous portion of the disk?
Definition
the annulus fibrosus.
Term
What is the inner gelatinous portion of the disk?
Definition
the nucleus pulposus.
Term
What is the purpose of intervertebral disks?
Definition
they unite vertebral bodies and serve to absorb shock and bear weight.
Term
What are the four major vertebral curvatures in the sagittal plane?
Definition
Primary: Curves of the thoracic and sacral regions, which are defined as kyphosis.
Secondary: Curves of the cervical and lumbar regions, which are defined as lordosis.
Term
What are commonly found abnormal curves in the sagittal plane?
Definition
Hyperkyphosis (exaggerated posterior thoracic curvature) and hyperlordosis (exaggerated anterior lumbar curvature).
Term
What is the commonly found abnormal curve in the frontal plane?
Definition
scoliosis.
Term
How many pairs of ribs does the body have? How many of those pairs are true ribs?
Definition
12 pairs, and 7 pairs of true ribs.
Term
What are the spaces between the ribs called?
Definition
Intercostal spaces.
Term
Why is palpation of the intercostal spaces of the true ribs important?
Definition
For correct placement of ECG electrodes.
Term
What are the three parts of the sternum?
Definition
The manubrium (superior), the body (middle), and the xiphoid process (inferior).
Term
What is the sternal angel?
Definition
A slightly raised surface landmark where the manubrium meets the body of the sternum.
Term
Palpitation of the xiphoid process is necessary for what?
Definition
CPR.
Term
What does palpation of the manubrium help to determine?
Definition
Proper paddle placement in defribrillation.
Term
What does the appendicular skeleton include?
Definition
the bones of the arms and legs and pectoral and pelvic girdles.
Term
What are functions of the appendicular skeleton?
Definition
1) To attach the limbs to the trunk.
Term
What are the two important landmarks of the scapula.
Definition
The inferior angle at the bottom of the scapulae, forming the junction between the medial and lateral borders.
The acromion process, the bony process at the most lateral part of the shoulder.
Term
With what does the humerus articulate?
Definition
proximally with the glenoid fossa of the scapula, and distally with the ulna and radius.
Term
What are the most easily palpable aspects of the humerus?
Definition
The medial and lateral epicondyles.
Term
What are the two bones of the forearm?
Definition
The ulna and radius.
Term
Which one is the ulna and which one is the radius?
Definition
radius is the thumb side bone, ulna is opposite.
Term
What is the most prominent bony landmark of the proximal forearm?
Definition
The olecranon process on the posterior ulna.
Term
At the distal end of the forearm are the ______ _______ _______ laterally, and the _____ _______ _______ medially. These areas help to identify the proper location for assessing radial pulse.
Definition
radial styloid process, ulnar styloid process.
Term
Of what does the appendicular skeleton comprise?
Definition
Bones of the pelvic girdle, thigh, leg, and foot.
Term
Of what is the pelvic girdle composed?
Definition
The hip bones (ilium, ischium, and pubis), sacrum, and coccyx.
Term
What are the superiormost and anteriormost aspects of the ilium?
Definition
the iliac crest, and the aterosuperior iliac spine.
Term
What is the thigh formed by, and what is its most easily palpable landmark?
Definition
the femur, and the greater trochanter on the proximal lateral side.
Term
What is located anterior to the knee joint?
Definition
The patella. It serves as a landmark for locating the thigh skinfold.
Term
What is bone?
Definition
an osseous tissue.
Term
By what is the bone covered?
Definition
The periosteum.
Term
What types of bone are there?
Definition
Compact (dense) and cancellous (spongy)
Term
What are the five functions of bone?
Definition
1) Structural support for the entire body.
2) Protect organs and tissues of the body.
3) Serve as levers that can change the magnitude and direction of forces generated by skeletal muscles.
4) Provide storage for calcium salts to maintain concentrations of calcium and phosphate ions in body fluids.
5) Produce blood cells.
Term
What are the four general bone shapes?
Definition
Long bones, Short bones, flat bones, and irregular bones.
Term
Where are long bones found?
Definition
In the appendicular skeleton.
Term
Of what are long bones consisted?
Definition
Diaphysis, and epiphysis.
Term
What types of bone marrow are in the diaphysis and epipysis?
Definition
Yellow in the D, Red in the E.
Term
What is hematopoiesis?
Definition
production of red blood cells, white blood cells, and platelets.
Term
what are epiphyses covered with?
Definition
articular (hyaline) cartilage, which facilitates joint movement.
Term
Where is the location of the epiphyseal plate?
Definition
The junction between the epiphysis and the diaphysis.
Term
What happens at the location of the epiphyseal plate?
Definition
growth of the long bone occurs in immature long bones.
Term
What are characteristics of short bones?
Definition
they are almost cuboidal in shape and they are often covered with articular surfaces that interface with joints.
Term
What are characteristics of flat bones?
Definition
They are thin and relatively broad (e.g. bones of the skull, ribs, and scapulae)
Term
What are characteristics of irregular bones?
Definition
They have mixed shapes that do not fit easily into other categories (e.g. vertebrae)
Term
What are basic components of connective tissues?
Definition
specialized cells (e.g. in blood, bone, cartilage), extracellular protein fibers (e.g. elastin, collagen, fibrin), and ground substance.
Term
What are functions of connective tissues?
Definition
Provide support and protection, transport materials, store mechanical energy reserves, and perform regulatory functions.
Term
What are the structural classes of the joints?
Definition
Fibrous (sutures of the skull)
Cartilaginous (disk between vertebrae)
Synovial (hip, elbow, etc.)
Term
What are the functional classes of the joints?
Definition
Immovable (synarthroses)
Slightly movable (amphiarthroses)
Freely movable (diarthroses)
Term
What are the types of synovial joints? (6)
Definition
Ball and socket, condyloid, gliding, hinge, pivot, and saddle.
Term
What are examples and movements of ball and socket joints?
Definition
Hip and shoulder, circumduction, rotation, and angular in all planes.
Term
What are examples and movements of condyloid joints?
Definition
Wrist, circumduction, abduction, adduction, flexion, and extension.
Term
What are examples and movements of gliding joints?
Definition
Ankle, inversion and eversion.
Term
What are examples and movements of hinge joints?
Definition
Knee and elbow, flexion and extension in one plane.
Term
What are examples and movements of pivot joints?
Definition
Atlas/axis, rotation around central axis.
Term
What are examples and movements of saddle joints?
Definition
Thumb, flexion, entension, abduction, adduction, circumduction, and opposition.
Term
Bony surfaces are covered with what? (synovial joints)
Definition
articular cartilage
Term
What surrounds a synovial joint?
Definition
A fibrous capsule.
Term
What joins bone to bone.
Definition
ligaments.
Term
Inner surfaces of the joint cavity are lined with what?
Definition
synovial membranes.
Term
What is the function of synovial fluid?
Definition
to provide lubrication to the joint.
Term
Some synovial joints, such as the knee, contain what?
Definition
fibrocartilaginous disks (i.e. menisci)
Term
What reduce friction and act as shock absorbers?
Definition
Bursae.
Term
What is the epimysium?
Definition
The outer layer that separates the muscle from surrounding tissues and organs.
Term
What is the perimysium?
Definition
The central layer that divides the muscle into compartments called fascicles.
Term
What is the endomysium?
Definition
The inner layer that surrounds each muscle fiber.
Term
What controls each skeletal muscle fiber?
Definition
A motor neuron
Term
What comprises a motor unit?
Definition
A motor neuron and all the muscle fibers that it innervates.
Term
Where does communication between a motor neuron and a skeletal muscle fiber occur?
Definition
At the neuromuscular junction.
Term
Where does each axon of the motor neuron end?
Definition
at a synaptic knob containing the neurotransmitter acetylcholine (ACh)
Term
What separates the synaptic knob from the sarcolemma of the skeletal muscle fiber?
Definition
The synaptic cleft.
Term
What is the sarcolemma?
Definition
It is the part of the motor end plate that contains chemically gated sodium channels and membrane receptors that bind ACh.
Term
What is sarcoplasm?
Definition
The cytoplasm of the muscle cell. (look up "cytoplasm")
Term
What are transverse tubules? (or T-tubules)
Definition
A network of extensions of the sarcolemma.
Term
With what do the T-tubules communicate?
Definition
the sarcoplasmic reticulum.
Term
What does the sarcoplasmic reticulum do?
Definition
stores calcium in special sacs called terminal cisternae.
Term
What are myofilaments?
Definition
They are contained in myofibrils, and the consist of the contractile proteins actin and myosin.
Term
What are sarcomeres?
Definition
They are repeating functional units of the myofilaments.
Term
What are crossbridges?
Definition
They are the intersections of actin and myosin during muscle contraction, which results in a shortening of the sarcomeres.
Term
What does tropomyosin do?
Definition
It covers the actin bridging site during resting condition. It is attached to troponin.
Term
What else do tropomyosin and troponin do?
Definition
They regulate bridging of actin and myosin for muscle contraction and relaxation.
Term
How are muscles classified?
Definition
Agonist (prime mover)
Antagonist (prime mover that opposes the agonist)
Synergist ( assists the prime mover, but is not the primary muscle in the movement)
Term
In the upper body, identification and palpation of what four muscles are of particular importance to exercise testing?
Definition
The sternocleidomastoid (look up), pectoralis major, biceps brachii, and triceps brachii.
Term
In the lower body, identification and palpation of what three muscles are of particular importance to exercise testing?
Definition
The gluteus maximus, quadriceps femoris, and gastrocnemius.
Term
What is the inguinal crease?
Definition
The natural diagonal crease in the skin formed where the musculature of the thigh meets the pelvic girdle.
Term
Where are the atria in the heart?
Definition
Superior to the ventricles.
Term
Where is the coronary sulcus?
Definition
It marks the border between the atria and ventricles.
Term
When the atria are not filled with blood, what are they called?
Definition
Auricles.
Term
Do ventricles have thicker muscular walls than atria?
Definition
yes
Term
Where is the interventricular sulcus?
Definition
It marks the boundary between the left and right ventricles.
Term
Where is the apex?
Definition
It lies inferiorly at the tip of the heart.
Term
Where does the right atrium receive blood from?
Definition
The systemic circulation through the superior and inferior venae cavae.
Term
________ _____ return venous blood from the myocardium to the ________ _____, which opens into the right atrium.
Definition
Coronary veins, coronary sinus.
Term
How does each atrium communicate with the ventricle on its own side?
Definition
Through an atrioventricular (AV) valve.
Term
What is the right AV valve?
Definition
A tricuspid valve.
Term
What is the left AV valve?
Definition
a bicuspid valve.
Term
By what is each cusp braced?
Definition
chordae tendinae, which are connected to papillary muscles.
Term
What are the differences between the pulmonic and aortic valves?
Definition
unoxygenated blood leave the right ventricle and flows through the pulmonic. oxygenated blood leaves the left ventricle and flows through the aortic valve.
Term
Blood from the periphery flows through the heart according to the following sequence:
Definition
superior and inferior venae cavae, right atrium, tricuspid valve, right ventricle, pulmonic semilunar valve, pulmonary arteries, and lungs.
Term
Blood from the lungs flows through the heart according to the following sequence:
Definition
left pulmonary vein, left atrium, bicuspid valve, left ventricle, aortic semilunar valve, ascending aorta, and systemic circulation.
Term
What are arteries?
Definition
muscular-walled vessels that carry blood away from the heart, decrease progressively in size to become arterioles, and then connect to capillaries.
Term
What are capillaries?
Definition
vessels composed of one cell layer that functions to exchange nutrients and wast materials between the blood and tissues.
Term
What are veins?
Definition
Vessels that carry blood toward the heart, and they are classified according to size.
Term
What are venules?
Definition
Small veins that carry blood toward the heart, and are classified according to size.
Term
What does the heart use to circulate oxygenated blood?
Definition
arteries, arterioles, and capillaries.
Term
What does the upper respiratory tract consist of?
Definition
The nose, pharynx, and larynx
Term
What does the lower respiratory tract consist of?
Definition
the trachea and lungs, which include the bronchi, bronchioles, and alveoli.
Term
What do the lungs occupy, and what are they covered by?
Definition
Pleural cavities, pleural membrane.
Term
What three distinct lobes does the right lung have?
Definition
superior, middle, and inferior.
Term
What two distinct lobes does the left lung have?
Definition
superior and inferior
Term
Where does to apex of each lung extend?
Definition
into the base of the neck above the first rib.
Term
Where does the base of each lung rest?
Definition
On the diaphragm.
Term
What is the diaphragm?
Definition
The respiratory muscle that separates the thoracic from the abdominopelvic cavities.
Term
How does air enter the respiratory system?
Definition
Through two external nares (I'm assuming the nose and the mouth), and proceeds through the nasal cavity and sinuses.
Term
What happens to air before it enters the nasopharynx at the internal nares?
Definition
It is warmed, filtered, and moistened.
Term
What do cilia do?
Definition
They line the nasal cavity and function to sweep mucus and to trap microorganisms.
Term
What happens to air before it enters the nasopharynx at the internal nares?
Definition
It is warmed, filtered, and moistened.
Term
What do cilia do?
Definition
They line the nasal cavity and function to sweep mucus and to trap microorganisms.
Term
After air enters the nasopharynx, where does it proceed?
Definition
through the pharynx.
Term
Where does the pharynx extend?
Definition
between the internal nares, and to the larynx and esophagus.
Term
Where does air leaving the pharynx pass through?
Definition
a narrow opening in the larynx called the glottis.
Term
From the larynx, where does incoming air enter?
Definition
The trachea.
Term
What functions do C-shaped cartilages perform?
Definition
The protect, support, and maintain an open airway, to prevent overexpansion of the respiratory system, and to allow large masses of food to pass along the esophagus.
Term
Air enters the lungs via the...
Definition
tracheobronchial tree, which consists of the bronchi, bronchioles, and alveoli.
Term
The trachea branches to form what?
Definition
The right and left primary bronchi.
Term
each primary brochus enters a lung and branches into what?
Definition
secondary bronchi.
Term
What's next?
Definition
Bronchioles.
Term
What supply air to the lobules of the lung?
Definition
terminal bronchioles, which are the smallest branches.
Term
Of what do the lobules consist?
Definition
Alveolar ducts and alveoli, where actual gas exchange occurs.
Term
How thick are alveoli?
Definition
One cell layer.
Term
Why is knowledge of basic surface anatomy essential?
Definition
For the assessment of pulse rate and blood pressure, obtaining anthropometric measurements, determining ECG lead placements, and performing CPR and emergency defibrillation.
Term
What is pulse?
Definition
A measurement of heart rate.
Term
What are the three most common places to measure the pulse?
Definition
cartoid artery, brachial artery, and radial artery.
Term
of what is the assessment of systemic arterial blood pressure and indirect measurement?
Definition
the pressure inside an artery.
Term
Where and with what is blood pressure usually measured?
Definition
in the arm over the brachial artery, medial to the biceps tendon, using a sphygmomanometer and a stethoscope.
Term
where are the nine places to measure skinfolds?
Definition
Chest, midaxillary, abdominal, suprailiac, subscapular, triceps, biceps, thigh, and medial calf.
Term
where is midaxillary skinfold measurement done?
Definition
underneath the armpit at the level of the xiphoid process.
Term
where is the subscapular skinfold measurement done?
Definition
diagonally 1 to 2 inches inferior to the scapula
Term
where is the suprailiac skinfold measurement done?
Definition
the love handles.
Term
How are body width measurements done?
Definition
using spreading calipers, sliding calipers, or an anthropometer.
Term
What are common sites for body width measurement?
Definition
elbow, biacromial (distance between the acromion process), knee, and bi-iliac (distance between the iliac crests).
Term
How many electrodes does the standard 12-lead system use?
Definition
10, 4 limb and 6 precordial
Term
Where are the limb electrodes placed?
Definition
Right arm, and left arm, right leg and left leg.
Term
What is biomechanics?
Definition
The study of the forces and torques affecting movement and the description of the resulting movement.
Term
What is a force?
Definition
It can be thought of as a push or a pull that either produces or has the capacity to produce a change in motion of a body.
Term
What is a net force?
Definition
When multiple forces from multiple directions act on a body, the sum of these forces is the net force which determines the resulting change in motion.
Term
What is the law of inertia?
Definition
A body will maintain its state of rest or uniform motion in a straight line unless acted on by an external force.
Term
What is the law of acceleration?
Definition
It states that the acceleration of a body resulting from an applied force will be proportional to the magnitude of the applied force, in thedirection of the applied force, and inversely proportional to the moss of the body. a=F/m.
Term
What is the low of reaction?
Definition
For every action, there is an equal and opposite reaction.
Term
How are the forces influencing movement classified?
Definition
reaction, friction, and muscular.
Term
What is ground reaction force?
Definition
It is in accordance with Newton's law of reaction. The ground applies an equal and opposite force to the body as the body applies a force to the ground.
Term
What are the three directions that ground reaction forces are measured in?
Definition
Vertical, anteroposterior, and mediolateral.
Term
What is frictional force influenced by?
Definition
The nature and interaction of the contacting surfaces and the force pressing the surfaces together.

Ff=mN (m=the coefficent of friction, N=the normal force)
Term
What is torque?
Definition
The rotary effect of force produced by a muscle or group of muscles.
Term
What is the Center of Gravity?
Definition
the point of exact center around which the body freely rotates, the point around which body weight is equal on all sides, and the point of intersection of the three cardinal body planes.
Term
What is the base of support?
Definition
the area of contact between the body and the supporting surface.
Term
How is balance maintained?
Definition
when the COG remains over the BOS.
Term
How is stability maintained?
Definition
When the COG falls within the BOS
Term
What is rotation of a segment of the body dependent on?
Definition
The magnitude of force exerted by the effort force and the resistance force, and the distance these two forces are from the axis of rotation.
Term
What kinds of motion are there?
Definition
translatory motion, rotary motion, velocity, and momentum
Term
What is momentum?
Definition
The mathematical product of the mass and velocity of a moving object.
Term
What is a lever?
Definition
A rigid bar that revolves around a fixed point or axis (fulcrum). Levers are used with force to overcome a resistance.
Term
What are the three parts of a lever?
Definition
The axis, force arm, and resistance arm?
Term
What is a first-class lever?
Definition
Axis is between force and resistance.
Term
What is a second-class lever?
Definition
resistance is between force and axis and the force is greater than the resistance.
Term
What is a third-class lever?
Definition
the effort force lies closer to the axis of the lever than the resistance, and the force arm is smaller than the resistance arm.
Term
What is the gait cycle?
Definition
The time between successive ground contacts of the same foot.
Term
What is a stride?
Definition
two steps.
Term
How much of the gait cycle is in stance, and how much is in swing?
Definition
60% in stance, 40% in swing.
Term
What is the typical walking speed in adults?
Definition
1.5m/s. Decreases in walking speed occur with aging, injury, and disease.
Term
How much pelvic movement is done when walking?
Definition
approximately 5cm on each side.
Term
What are the subdivisions of the stance phase?
Definition
1) Heel Strike 2) Foot Flat 3) Midstance 4) Heel off 5) Toe Off
Term
What are the subdivisions of the swing phase?
Definition
1) Initial swing (acceleration). 2) Midswing 3) Terminal Swing (deceleration)
Term
What are common causes of gait abnormalities?
Definition
Muscular weakness and neurologic disorders.
Term
What examples of muscular weakness are mentioned in the chapter?
Definition
1) Weakness in the gluteus maximus.
2) Weakness in the gluteus minimus and medius.
3) Severe weakness in the plantarflexors.
4) Dorsiflexor insufficiency.
5) Weakness of the quadriceps femoris.
Term
What examples of neurologic disorders are mentioned?
Definition
hemiplegia, and parkinsonism.
Term
Why does running require greater balance?
Definition
because of the absence of a double support period.
Term
Why does running require greater muscle strength?
Definition
Because of many muscles contracting more rapidly and with greater force.
Term
Why does running require greater range of motion?
Definition
because of greater joint angles at the extremes of the movement.
Term
What else is true about running?
Definition
1) The direction of the driving force is more horizontal and the stride is longer.
2) The body has a greater forward incline.
3) Rotary actions of the spine and pelvic regions are increased.
4) Arm actions are higher and more vigorous.
5) Stride length and frequency are increased.
6) There is a flight phase.
Term
At running speeds up to 6 m/s, vertical ground reaction forces are what?
Definition
between two and threefold the body weight.
Term
What is buoyancy dependent on?
Definition
the percentage of weight composed of bone and muscle.
Term
What is true according to Archimede's principle?
Definition
A body immersed in fluid is buoyed up with a force equal to the weight of the displaced fluid.
Term
What is the "power position" in lifting?
Definition
1) Knees slightly bent
2) Body bent forward from the hips.
3) Back straight.
4) Chest and head upright.
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