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Med Aspects Exam 1
Terms in this set (165)
Evidence Based Practice
The integration of the best research evidence clinical expertise and patient/client needs that will result in the best patient or client outcomes
Observation/question, Research, Hypothesis, Experiment, Collect data, Analysis, Conclusion
Scientific method develops what?
Science and evidence
ACSM position stands are built on _____________________
The evidence we get from quantitative research is based on probability of getting the same _______________ (p-value)
Bias, Randomization, well developed methodology, experimental vs. control, independent vs. dependent variables, single or double blind and a large sample size.
How do you go from high variability to low variability in a research design?
Probability value that indicates how likely it is that a result occurred by chance alone.
Includes the purpose and 'why should I care?'
Includes 'what do we know about this?'
Includes 'how was the study designed?'
Includes 'what did you find?'
Includes how you research findings fit into the literature? Do the studies have similarities/differences? How might these findings add to what is known about the subject? What could be improved about the study?
Includes 'what are the main findings?'
the groups are about 98% the same
a p-value of .978 would tell us what?
mean difference/ SD of group=?
How different the sample means are
The probability sample means are the same
Meta Analysis and Effect size
How do I compare different studies results?
The _________________ group's SD is used in the Effect Size calculation because it is not affected by the treatment
A system that is used to synthesize good comparisons across studies
Something you are trying to measure
What the scientist changes or what changes on its own
What is being studied/measured
Digital Object Identifier (DOI)
A unique alphanumeric string assigned by a registration agency (The International DOI Foundation) to identify content and provide a persistent link to its location on the internet
P-values tell us about what?
What can be 'bought' with large sample sizes?
Effect size yields information on "How Important" or "How Clinically Effective" a _________ is
What can be significant, but may be unrelated to cause and effect?
Description of the tissue, organ, or system changed during a single bout of exercise (ex: HR went up)
Description of how the tissue, organ or system changed in response to exercise training (ex: resting HR decreases)
Only the tissues, organs or systems that are utilized during exercise will adapt. The adaptation is specific and not across all tissues, organs and systems
A condition experienced by athletes in most competitive sporting environments that leads to a decrease in performance or attitude
Alarm Reaction Phase, Resistance or acquired adaptation phase, Fatigue phase
Three phases of Selye's General Adaptation Syndrome
Tachycardia, Decrease muscle tone, Decreased BP and Decreased body temp
In the alarm Reaction Phase, 'shock' includes:
Mobilize physiological defense systems, Increase BP and muscle tone,Increase Catecholamines, and Increase serum Cortisol
In the alarm Reaction Phase, 'countershock' includes:
an elevated level of homeostasis
Chronic elevated serum cortisol takes its toll with protein catabolism, immunosuppression, illness and death
feelings of helplessness
increased catabolic activity in comparison to anabolism, excessive duration, intensity or frequency of exercise
causes of overtraining
Increases gluconeogenesis from an increase in protein catabolism
Cortisol can come form ANY protein
actions of cortisol
if you don't move it, you lose it
is like a code for humans
The Human Genome
a "whole genome" consists of ____________ gigabytes
Of the human genome, 3 billion base pairs of DNA are distributed _____________ amongst 46 chromosomes
what encodes for a specific protein, they are the basic component of making up genomes
To carry the genetic code for cell reproduction and for organism reproduction, codes for protein synthesis.
The purpose of DNA
3 base pair sequences
A codon is made up of what?
combine exons and splice out introns
What does mature mRNA do?
What unwinds the protein and allows RNA polymerase to make a copy of a portion?
Occurs in the nucleus. Encodes a sequence of a portion
What has the anticodon for the mRNA?
Is the genetic code enough?
Changes in DNA expression (proteins) due to transient internal and external factors. Stable with some heritable changes in gene expression NOT caused by changes in the DNA code.
Patterns of gene expression governed by the cellular material that sit on top of the genome (epi=above)
histones winding around and forming packs of DNA
what is chromatin made up of?
silences gene expression
relaxes chromatin to make for easy access while being less densly-packed
transcriptionally active and less compact
transcriptionally inactive and very compact
very small messenger RNA sequences. They go into the ribosome and alters it to increase or decrease the given gene sequences. DOES NOT ALTER THE DNA, just how much is produced.
What does physical inactivity promote?
Physical inactivity causes over ___________ of proteins leading to metabolic dysfunction
inflammation and immune response. Increases when inactive
A woman who smokes while pregnant induces _________________ changes in all three generations at once: in herself, her unborn daughter, and her daughters reproductive cells
what percent of the obese population is genetically obese?
When some of the epigenetic tags remain in place and therefore pass from generation to generation
'blank' cells that can divide and become mature cells of varying kinds
Mesenchymal Stem Cells (MSC)
stem cells found in bone marrow and blood
Physical inactivity stimulates regulatory protein synthesis via methylation/acetylation of DNA and histones to increase production of Yellow Marrow from __________________
do trained athletes have more or less hemoglobin?
Connecting DNA to a "misexpression of proteins" that cause underlying predispositions to disease/disorders
functional proteins have been made
functional proteins have not been made
generally a silencer
Generally a promoter
epigenetics could cause what?
What is the 'recipe' for proteins being built?
used as enzymes and building muscle, but also as regulators of metabolism and function
between a capillary and its adjacent alveolus
where does gas exchange occur?
it flows down its concentration gradient (never up)
how do you get gas to flow?
Arterial PO2 has to be lower than the _________ PO2
the amount of pressure exerted on a surface by the weight of the air above that surface
on Earth, what is the typical %O2 of the air?
What concentration remains the same throughout all air
% O2, CO2 and N remain constant
at different altitudes, pressure changes, but what stays the same?
CO2, O2, and H+ (especially!)
what are chemoreceptors sensitive to?
higher because you are hypoxic at altitudes, which means that your body will be using anaerobic fuel which produces lactate, making an acetic condition.
at altitude, is there a higher or lower RER?
do we lose water vapor in the air at high or low altitudes?
A person's adaptation to a NATURAL environment
An acclimation to control the environment to a LAB SETTING
we can treat AMS and HAH with what?
in treatment for AMS or HAH, acetazolamide is used as a _________ to decrease CSF production to allow for the secretion of bicarb
Descent 500m or more, rest and acclimatize, or speed acclimatization with acetazolamide
treatment for AMS
drugs are not as effective as descent from altitude and oxygen. Nifedipine, by reducing pulmonary arterial pressure may be effective.
treatment for HAPE
debilitating headache and severe fatigue, excessively rapid breathing and heart rates. Couch producing a pink frothy liquid and bluish skin tone
systemic arteriole hypoxia
What causes cerebral vasodilation and increased blood flow?
Initiate immediate descent or evacuation. If descent is not possible, use a portable hyperbaric chamber and administer oxygen. Dexamethasone 8 mg IM, nifedipine 10-20 mg sublingual, oxygen at 4 l/m, and hyperbaric treatment for 1 hour. This will stabilize the BBB by increasing blood glucose
Muscle capillary density increases
Q remains lower at max
what happens during acclimitization?
the higher the altitude, the ___________ the Hb
compete within 24 hours of arrival at altitude, avoid sickness and changes
Train Low and Compete High
Allow 2 weeks to train and adapt and compete within 24 hours of arrival at lower altitude
Train High and Compete Low
The __________________ limb is impermeable to sodium chloride
the _______________ limb is impermeable to water and electrolytes
Responsible for excreting waste, concentrating urine and conserving electrolytes
upper urinary tract
made up of the renal pelvis and kidneys
lower urinary tract
made up of the ureter, bladder and urethra
renal pelvis and bladder
what parts of the body are able to collect urine? "Collecting System"
is the efferent arteriole bigger or smaller?
is the afferent arteriole bigger or smaller?
cross the endothelium, basement membrane, then go through the visceral epithelium.
To get into the Bowman's capsule space you have to...
1. Filtration from blood into nephron
2. reabsorption from filtrate into blood
3. tubular secretion from blood into filtrate
reabsorption of water under effects of ADH
Tubular Processing of the Glomerular Filtrate
In the renin-angiotensin-aldosterone system, the hypothalamus and posterior pituitary sense osmolality and release ____________ to the urinary (Bowmans) space
how many liters of glomerular filtrate are formed in one day?
plasma is cleaned how many times a day?
how long does it take to filter the entire plasma volume?
fresh or refrigerated urine tested by dipstick method. This test shows us the health of the kidneys
a plant product that is filtered but now reabsorbed or secreted. It is used to determine GFR and therefore nephron function
what measures the amount of creatine in the blood?
If GFR is 25% of normal, this would mean that the patient has what?
If GFR is less than 25% of normal, this would mean that the patient has what?
End Stage Renal Disease
If GFR is 5-10% of normal, this would mean that the patient has what?
helps vein get larger for easier access for the health provider to needle
a machine that collects the dialysate (waste products) and disposes of them. 3x per week for 3-4 hours and a dialysis center.
draining of the cavity using the body's own membrane. This can be done at home, daily.
membrane to filter substances via osmosis
HTN and diabetes
What are the two main causes of renal failure?
End stage renal failure is increasing by what percentage every year in the US?
what is the best current treatment for ESRD?
within the first hour
When exercising during dialysis, during when is the most optimal?
This type of measuring device doesn't care how fast you breathe, it only cares about your volume.
the forced expiratory volume in one second
Mid Expillatory Power (MEP) test
average rate at 50% (middle of expiration)
the FEV1/RVC equals what?
The FEV1% is decreased in COPD but no change in ______
what measuring tool is used to differentiate COPD vs RID?
reactive airway "reversible" Chronic, yet intermittent. Inflammation of small bronchi (bronchioles). Increased smooth muscle, mucous glands and inflammatory cells. Episodic and reversible bronchospasm from an exaggerated response to a stimuli.
Chronic Obstructive Pulmonary Disease (COPD)
irreversible. Characterized by decreased airflow rate during expiration = hard to get air out.
Abnormal and permanent enlargement of the alveoli. This is accompanied by destruction of the airspace wall without obvious fibrosis. (Destroyed, merging alveoli. Decreased surface area of lung).
sputum producing cough and inflammation 3 months in only a 2 year period
permanently dilated and fluid or pus filled dilated bronchi due to infection/obstruction. Can be relieved with manual percussion and postural drainage therapy.
the third leading cause of death in the US
what phase of asthma includes IgE secretion by plasma cells and mast cells releasing mediators that contract the airway smooth muscle directly
What phase of asthma includes recruitment of inflammatory and immune cells (dendritic cells, eosinophils, basophils, helper t cells & memory t cells)
deeper, fewer breaths
chronic cough, chronic sputum production, dyspnea, acute bronchitis, history of exposure to risk factors
key indicators for COPD diagnosis
a deficiency in Alpha 1 Antitripsin leaves the lungs open to damage by __________________________
a deficiency in Alpha 1 Antitrypsin is seen in ____________ patients
Right ventricular hypertrophy and potential failure due to the pulmonary HTN from hypoxia
all COPD patients are at risk for chronic __________-
bronchial inflammation and alveolar destruction
most patients with COPD have a mixture of what two things?
chronic bronchitis (mucous plugging up bronchiole) is also known as...
COPD emphysema (high CO2 retention and abnormal air spaces) is also known as...
strong evidence suggests that __________ extremity aerobic exercise should be used as a therapeutic intervention for COPD patients 3-7x/week
lung volume (FVC)
"restriction in lung disorders ALWAYS means a decrease in ___________
idiopathic pulmonary fibrosis
unknown cause, immune involvement, collagen-vascular disease of slow onset
black lung from coal dust, also silicosis and asbestosis
idiopathic pulmonary fibrosis and pneumoconiosis are interstitial diseases _____________ granulomas
unknown cause, mostly african americans, macrophage and lymphocyte accumulation. Self-resolve or progressive fibrosis
T-calls, delayed hypersensitivity reaction, inhaled antigens like moldy hay, acute or chronic depending on renewed exposure
scaroidosis and hypersensitivity pneumonitis are interstitial diseases _____________ granulomas
acute low back pain
less than 3 months
chronic back pain
more than 3 months
vertebral degeneration of osteoporosis/arthiritis
vertebral slips over adjacent vertebrae
where does nerve impingement happen?
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