S-SUPRASPINATUS-abduction at glenohumeral joint

I-INFRASPINATUS-external rotation at glenohumeral joint

T-TERES MINOR-external rotation at the glenohumeral joint

S-SUBSCAPULARIS-internal rotation glenohumeral joint

1) radial-wrist

2) brachial-medial side of elbow

3) carotid-neck; along border of sternocleidomastoid in lower neck

Underweight: <18.5

Normal: 18.5-24.9

Overweight: 25.0-29.9

Obese 1: 30.0-34.9

Obese 2: 35.0-39.9

Obese 3: >40

• Right atrium contracts
• Tricuspid valve
• Right ventricle contracts
• Pulmonary valve
• arteries and branches of respitatory system
• blood to capillaries to arteries, gas exchange
• 02 absorbed, CO2 removed
• Left atrium contracts
• through pulmonary veins
• mitral (bicuspid) valve
• into left ventricle

volume of blood pumped by the heart per min (Q)

calculated by Heart Rate x Stroke Volume

Q is approx. .4-.5L per minute

Amount of blood ejected from the left ventricle in a single contraction

STROKE VOLUME=END DIASTOLIC VOLUME-END SYSTOLIC VOLUME

What is blood pressure?

What is avg. bp?

What is considered hypertension?

Systolic (contraction) & Diastolic (relaxtion)

Average blood pressure is 120/80

Hypertension is 140/90

Fick Equation

VO2= HR (bpm) x SV (mL x beatˆ-1) x (a-venous 02 difference)

*single best index of physical work capacity or cardiorespitatory fitness*

Expiration-respitatory muscles relax, air flows from lungs into atmosphere b/c of positive pressure generated by elastic recoil of lungs

Muscles-internal intercostals, rectus abdominis, external and internal obliques, transverse abdominis

Obstructed airway. hypervenilation of lungs stretches the lung tisse and leads to additional elastic recoil, forcing crural portion of diagphragm down and shortening vertical muscle fibers.

Muscles can not contract.

1. Skeletal Muscle-primarily attached to bone, voluntary control, moves & stablize body, anchored by tendons
2. Cardaic muscle-contracts w/out an external nervous system (heart muscle)
3. Smooth Muscle-involuntary movement, not controlled by the brain (digestive tract)

24 vertebrae

7 cervial vertebrae

12 thoracic vertebrae

5 lumbar vertebrae

What is kyphosis?

What is lordosis?

What is scoliosis?

Kyphosis-cervical and lumbar posterior spinal curve

Lordosis-thoracic and sacral anterior spinal curve

Scoliosis-lateral deviation from midline of spine

What are type 1 muscle fibers?

Type 2? Type 2a, 2b, 2c?

Type 1 Muscle Fibers-slow twitch, selected for low activity of low intensity and long duration

Type 2 Muscle Fibers-fast twitch, shorten & develop tension sooner than type1, greater success in power & high intensity speed tasks, greater portion of type 2

Type 2a-endurance

Type 2b-"classic" fast twitch

Type 2c-innervation of skeletal muscle

What is Heart Rate Reserve?

(HRR)

Target HR (low end) =[ (0.40) x HRmax - HRrest)]+HRrest

Target HR (high end)=[(0.85+HRmax-HRrest)]+HRrest

Target VO2 (lower end)= [(0.40) x (VO2max-VO2rest)] + V02rest

Target VO2 (high end)= [(0.85x(VO2max-VO2rest)]+VO2rest

What is the inch to cm conversion?

Inch to m?

LBS to Kg?

inch x 2.54=CENTIMETER

inch x 0.0254=METER

lbs ÷ 2.2 = KG

Warm-up-body is better prepared to meet challenge that will be presented, improve performance and decrease injury, should include similiar movements to what stimuli will contain

Cool-down-improve performance and decrease injury, help clear metabolic waste from skeletal muscle, prevent exercise induced hypotension

Should be performed at 50% of stimuli

1. Hypertrophy
2. Strength/Power
3. Peak
4. Recovery

DOMS-delayed onset muscle soreness, shows individual has done TOO much TOO soon

Rhabdomylosis-promotes rapid breakdown of musc. tissue resulting in high amount of break down products entering into blood stream (harmful to kidneys & can cause kidney failure and death)

1) Static stretch-hold position, slow movements, passive

2) Dynamic-incoporates movement with muscle tension development, only as active stretches

3) Proprioceptive Neuromuscular Facilitation (PNF)-active and passive, improve joint range of motion

The principle of progression states an increase in workload is needed to maintain overload.

The principle of regression states that if you don't USE it you LOSE it.

Bilateral-most evident at night and is a characterstic sign of heart failure

Unilateral-venous thrombosis or lymphatic blockage

General edema (anasacra)-nephrotic syndrome (group of symptoms that include protein in the urine, low blood protein levels, high cholesterol levels, high triglyceride levels, and swelling), severe heart failure of hepatic cirrhosis

What is the waist to hip ratio? (WHR)

What WHR determines health risks in men and women?

WHR-comparison between the circumference of the waist and circumference of the hip

men= ≥ 0.95 or 102cm

women =≥ 0.86 or 88cm

What does more weight at trunk imply?

How is waist to hip ratio measured?

More weight at trunk, higher risk for type 2 diabtes, hyperlipedemia, CAD

Waist-smallest circumference measure 1inch above umbilicus or navel

Hip-largest circumference around buttocks, above gluteal folds

1. Precontemplation-I CAN'T, I WON'T
2. Contemplation-I MIGHT
3. Preparation-I WILL
4. Action-I AM
5. MAINTENANCE-I STILL AM

(maintenance-must be in the stage for 6 months and there after to be considered in the maintenance stage)

1. S-SPECIFIC-well-defined, clear actions, details, of how and when client will accomplish specific behavior
2. M-MEASURABLE-objective and measure (body fat comp, WHR), clear to trainer and client
3. A-ACTION-BASED-things client will actually do
4. R-REALISTIC-possible to achieve given time and resource (NOT REALISTIC-lose 30lbs in one week)
5. T-TIMELY-have a deadline to hit goal

• CHO-4 grams per cal
• PRO-4 grams per cal
• FAT-9 grams per cal

Drink water on a fixed time interval rather than use thrist as a signal

(thristy is already dehydrated)

Drink to match sweat losses,

.4-.8L during exercise

If weight drops below after exercise drink 20oz. for each lbs. lost

Body weight at least 15% below lowest value for excepted height

BMI <17.5 kg·m²

• intense fear of weight gain and fat
• body dysmorphia (can't see what their body really looks like)
• osteoporsis
• electrolyte imbalances
• menstrual irregularites or loss of menstrual cycle
• cardaic arrthymia
• loss of muscle mass

Healthy adults age 18-65, moderate aerobic activity 30 min 5x a week

OR vigorous activity 20 min 3x a week

Muscular endurance & strength training

2x a week

• F-FREQUENCY
• I-INTENSITY
• T-TIME
• T-TYPE
• E-ENJOYMENT

F-3-4x a week, daily

I- moderate & vigorous

T-30 min moderate & 30 min vigorous

T-Something they will ENJOY doing

**may safely participate in strength training with SUPERVISION performing only 8 to 15 reps**

F-5x moderate OR 3x vigorous per week

I- Moderate RPE 5-6, Vigorous RPE-7-8

T-30-60min (may be broken up into 10min intervals)

T-usually walking or swimming

• low intensity and duration for older adults w/chronic conditions, highly deconditioned or functionally limited
• progression of activities must be individualized
• weight training supervised
• if they have a chronic disease it must be an activity that they can tolerate
• incoporation of behavioral strategies
• postive reinforcement

Risk category according to risk stratification.

Neccesity of medical clearance, necessity of exercise test, neccesity for physicans supervision when participating in exercise test

Strength-1RM, estimate 1RM, handgrip dynamometry

Endurance-Push-up, Curl-up, YMCA Bench Press

In order to improve muscular strength what range of reps and sets should one perform?

To improve muscular ENDURANCE what should one do?

Muscular strength-4 sets, 8 to 12 reps to FATIGUE NOT FAILURE!!

60-80% of 1RM

Muscular endurance-50% of 1RM

Absolute contranindication-should not perform until conditions are stabilized or adequately treated

Relative contraindicition-may be tested only after careful evaulation of risk to benefit ratio

Bench Press- Alternate grip on bar

Barbell squat-

Behind lifter with arms around upperchest and push torso to elbows

**DO NOT** spot at elbows during dumbbell lifts

**DO** spot at wrists during dumbbell lifts

Osteopenia refers to bone mineral density (BMD) that is lower than normal peak BMD but not low enough to be classified as osteoporosis; Women are far more likely to develop osteopenia and osteoporosis than men

 Osteoporosis weakens bones and increases the risk of unexpected fractures. Serious consequences can occur with some fractures

Avg. person 10-15% or .8g

Endurance 1.2-1.4g

Strength 1.6-1.7g

Men 8-11mg/day

Women 8-18mg/day

Menstrual cycle causes women to lose more iron through menstratution.

Anemia can result from iron deficency.

Dehydroepioandnosterone

Chromium

Creatine

Androstenedoine

I-Identify the problem

D-Develop a solution

E-Evaulate the solution

A-Anaylze how well the plan worked

Suture-tight union unique to skull

Syndesomis-interosseous membrane between bone, the union alng the shafts of the radius, ulna, tibia and fibula

Gomphosis-unique joint at tooth socket

Primary (synchondroses; hylaine cartilage)-usually temporary to permit bone growth and typically fus (epiphyseal plate); some do not (sternum and rib)

Secondary(symphyses;fibrocatilaginous)-strong, slightly movable joints (interverterbral discs, pubic symphysis)

plane (arthrodial)-gliding and sliding movements (ac joint)

hinge (ginglymus)-uniaxial movements (elbow, knee extension and flexion)

ellipspdial (condyloid)-biaxial joint (radiocarpal extension, flexion at wrist)

Saddle (sellar)-unique joint that permits movement in all planes, including opposition (carpometacarpal joint of the thumb)

ball and socket-multiaxial joint the permit movements in all directions (hips and shoulder joints)

pivot (trochoidal)-uniaxial joints that permit rotation (proxmial humeroradial and altantoaxial joints)

1. sagitial-right and left

2. frontal (coronal)-anterior and posterior

3. transverse (axial/horiziontal)-

superior and inferior

What do tendons do?

What do ligaments do?

Tendons anchor muscle to bone.

Ligaments attach bone to bone.

RISK STRATIFICATION!

CHADFPOS

C-Cigarette smoking, currently smokes or has quit within the previous 6 months, is exposed to enviormental tobacco

H-Hypertension-SBP > 140, DBP >90, on meds for bp & measured on 2 seprate occasions

A-Age Women ≥ 45

Men ≥55

D-Dyslipedemia- Total serum cholestrol is ≥ 200mg·dL^-1

LDL ≥ 130 mg·dL^-1

HDL ≤ 40mg ·dL^-1

F-Family History- 1st degree male relative MI, CAD before age 55

1st degree female relative before age 65

Prediabetes-Fasting Blood Glucose over 100

Obesity-BMI > 30.0, Waist circumeference >102 cm men, >88cm women

Sedentary Lifestyle-30 MIN, 3X a week, 3 months

Negative risk factor HDL > 60

• Muscle maintains a constant length as resistance is applied.
• Force is sufficent to overcome resistance and muscle shortens.
• contraction = concentric.

1. Abdominal-vertical fold 2 cm to right of umbilicus

2. Tricep-posterior midline of upper arm, halfway between acromion and olecranon process w/ arm held by side

3. Biceps-anterior aspect of arm over the belly of the bicep muscle, 1 cm above triceps site

4. Chest/Pectoral-diagonal fold 1/2 the distance btw ant. axillary line (armpit) & nipple (men), 1/3 the distance btw ant. axillary line & nipple (women)

5. Medial Calf-vertical fold max. circumference of calf of midline of its medial border

6. Midaxillary-vertical fold mid axillary line at level of xiphoid process of the sternum

7. Subscap.-diagonal fold, 45º angle, 1-2 cm below inferior angle of scap.

8. Thigh-vertical on ant. midline of thigh, midway btw proximal border of patella, inginual crease

9. Suprailiac-diagonal fold, in line w/ natural angle of iliac crest taken in anterior exillary line immediately superior to iliac crest

a. cool, moist pale, ashen, or flushed skin

b. headache, nausea, dizziness

c. weakness, exhaustion

d. heavy sweating

e. body temp will be near normal

1. red, hot dry skin

2. rapid weak pulse, shallow breathing

3. changes in the level of consciousness

 4. vomiting

5. body temp will be very high as high as 105

1. Isotonic-same tension but length changes, either concetric shortening or eccentric lengthening, Ex. concetric- dumbbell curls, machine leg press, bench press, ex. eccentric-dumbbell curl then slowly lower curl
2. Isometric-same length muscles don't shorten or legthen but remain contracted, Ex. wall squat, lying bridge hold, static lunge hold
3. Isokinetic-same speed lifts, diffcult b/c you need special equipment for exercise

• Prescreen (PAR-Q, Informed Consent, Risk stratifaction)
• Resting HR, BP, BMI, IN., LBS., EKG
• Body Comp-Waist circumeference, Skinfold
• Cardio Testing-Submax YMCA cycle ergometer test, treadmill test
• Musculuar Testing- Muscular Strength:1RM. bench press & leg press, Muscular endurance:push-up test, curl-up test
• Flexibility testing-goniometer, sit-and-reach

Men-

chest, abdomen, thigh 

OR chest, triceps, subscap

Women-triceps, suprailiac, thigh

OR triceps, suprailiac, abdominal

Overweight is increased body weight, in relation to height when compared to some standard of acceptable or desirable weight

Obesity is defined as having a very high amount of body fat in relation to overall lean body mass or having a bmi over 30.

Physical activity is bodily musculoskeletal movement leading to caloric expenditure.

Exercise is a movement done to improve one of the five componenets of physical fitness.

1. Body comp.

2. Cardio

3. Muscular Strength

4. Muscular Endurance

5. Flexibility

 (RICES) rest (prevents further injury)

ice (reduces pain, swelling, and initiates inflammatory response)

compression (reduces swelling and bleeding)

elevation (controls edema and decreases blood flow)

stabilization (assists in muscle relaxation, diminishing spasm)

Ice-swelling and decreases blood flow

Heat-increases blood circulation and relaxes tight muscles

65% total cals from carbs or 6-10gm CHO/kg body weight

15% of total calories from protein or 1.2-1.7 gm PRO/kg body weight

20-35% of total cals

Women-32%

Men-22%

What does an AED do &

 when should it be used?

Flexion and extension?

Abduction and adduction?

Horiziontal abduction?

Horiziontal adduction?

Flexion- movement resulting in a decrease of the joint angle, usually moving anteriorly in sagitial plane

Extension: movement resulting in an increase of the joint angle, usually moving posterior in sagitial plane

Abduction:movement away from the midline of body, frontal plane

Adduction: movement towards midline of body, frontal plane

Horiziontal abduction: movement away from midline of body in transverse plane, horiziontal humerus movement when shoulder is flexed at 90°

Horiziontal adduction:movement toward midline of body, transverse plane, horiziontal humerus movements shoulder flexed at 90º

Internal rotation?

External rotation?

Lateral flexion?

Rotation?

Internal rotation-rotation in the transverse plane toward midline of body

External rotation-rotation in transverse plane away from midline of body

lateral flexion-movement away from midline of body in frontal planem used to describe neck and trunk movement

rotation-right or left rotation in the transverse plane, used to describe neck and trunk movement

Elevation? Depression?

Retraction? Protraction?

Elevation-movement of scap. superiorly in frontal plane

Depression-movement of scap. inferiorly in frontal plane

Retraction-movement of scap. toward spine in the transverse plane

Protraction-movement of the scapula away from spine in the transverse plane

Upward rotation? Downward rotation?

Circumduction? Opposition?

Upward rot.-superior & lateral movment of inferior angle of scap in frontal plane

Downward rot.-inferior & medial movement of the inferior angle of scap in frontal plane

Circumduction-circular mov. involving flex., ext., abd., add., circumscribing a cone shape

Opposition-diagonal mov. of thumb across palmar surface of hand to make contact with fifth digit

Radial deviation? Ulnar deviation?

Eversion? Inversion?

Radial deviation-abduction of wrist in frontal plane

Ulnar deviation-adduction of the wrist in frontal plane

Eversion-abducting the ankle

Inversion-adducting the ankle

Inversion

Dorsiflexion? Plantar flexion?

Pronation? Supination?

Dorsiflexion-flexing the ankle so that the foot moves anteriorly in sagitial plane

Plantarflexion-extending the ankle so that the foot moves posteriorly in sagitial plane

Pronation-combined movements of abduction and eversion resulting in lowering of medial margin of foot

Supination-combined movements of adduction and inversion resulting in raising of medial margin of foot

Agonist-prime mover, muscle or group of muscles responsible for action of movement

 Antagonist-opposing group of muscles, relax to permit primary movement and contract act as a barke in completion of

movement

Synergist-prevent unwanted movement, which helps prime movers perform more efficently

 Stabilizer-muscle stabilize a portion of body against force

What is center of gravity?

What is base of support?

An object's center of gravity is a theoretical point where the weight force of the object can be considered to act. Center of gravity changes with movement & depends on position of body.

Base of support where center of gravity is shifted over when there is a transition in body alignment.

Altered resting heart rate (HR), blood pressure and respiration patterns
•Decreased body fat and post-exercise body weight
•Increased VO2, VE , and HR during submaximal work
•Decreased lactate response
•Increased basal metabolic rate
•Chronic fatigue
•Sleep and eating disorders
•Menstrual disruptions
•Headaches, gastrointestinal distress
•Muscle soreness and damage
•Joint aches and pains

&

•Depression and apathy
•Decreased self-esteem
•Decreased ability to concentrate
•Decreased self-efficacy
•Sensitive to stress

What is muscular atrophy?

What is muscular hyperplasia?

1. wasting away of muscle or a muscle because of reduction in cross sectional area of muscle fibers; may be due to disease of the muscle or its nerve supply, or to disuse or nutritional inadequacy. See also hereditary spinal muscular atrophy (below).
2. an increase in the size of a muscle mass due to an increase in the number of muscle cells

• signs of cardaic pain
• dizziness, chest pain, turning pale, lack of sweating
• BP increase in diastolic (drop of more 20mm) and decrease in systolic
• temp. increase or decrease
• edema
• shortness of breath/rasping not from exercise