ACSM CPT Review UPDATED ACTUAL
Exam Questions and CORRECT Answers
Heart Contraction: Phases - CORRECT ANSWER -- Right atrium → right ventricle
through tricuspid valve (three flaps)
- Right ventricle → pulmonary valve → pulmonary artery
- Pulmonary artery → right and left pulmonary artery → right and left lung
- Lungs → pulmonary veins → left atrium
- Left atrium → left ventricle through mitral (bicuspid) valve
third class lever - CORRECT ANSWER -- effort force is between resistance and axis
- most commonly found in musculoskeletal system
second class lever - CORRECT ANSWER -- resistance is between effort force and axis
first class lever - CORRECT ANSWER -- axis is between effort force and resistance
Frank-Sterling Law - CORRECT ANSWER -- SV increases with higher EDV due to
stretching of the cardiac fibers
-more filled with blood = more stretched= more elasticity to use to push blood out
arteriosclerosis - CORRECT ANSWER -hardening of the arteries (loss of elasticity)
Atherosclerosis - CORRECT ANSWER -- Fatty Plaque buildup in the artery walls
- partial regression of fatty, soft lesions is possible with aggressive multifactorial risk reduciton
thrombosis - CORRECT ANSWER -- blood clot that forms in a blood vessel or heart
chamber and remains there
,acute coronary syndrome - CORRECT ANSWER -A group of symptoms caused by
myocardial ischemia; includes angina, myocardial infarction, and sudden cardiac death
myochardial ischemia - CORRECT ANSWER -- insufficient blood flow to the heart
muscle that occurs when myocardial oxygen demand exceeds the oxygen supply
- occurs when a coronary artery is partially or completed obstructed because of atherosclerosis,
coronary thrombosis, or coronary artery spasm
Angina pectoris - CORRECT ANSWER -- transient pain or discomfort in the chest area
caused by myocardial ischemia
- typical angina initiated by factors such as exercise/stress, excitement, cold/hot, food intake
- vasospastic (variant) angina usually occurs at rest without precipitating event
Cholesterol and Exercise - CORRECT ANSWER -exercise can influence TG and HDL but
LDL and TC are influenced primarily by dietary habits and body weight
Pathophysiology of CAD - CORRECT ANSWER -- atherosclerotic lesions are formed in
the intima
- injury to the artery wall begins in the endothelial layer with subsequent platelet and clot
formation
- monocytes adhere to the endothelium, move to the intima, and take up cholesterol
- adventitia, outer layer of artery wall is not involved in development of atherosclerosis
Acute MI complications - CORRECT ANSWER -1. extension of the zone of ischemia to
surrounding tissue, thus widening the necrosis
2. ventricular aneurysm
3. ventricular rapture
4. papillary necrosis and rupture
5. left ventircular dysfunction
, Ventricular Aneurysm - CORRECT ANSWER -- necrotic muscle fibers of the heart
degenerate and remodel the ventricular wall, and may cause a thinning of the myocardial wall
- during systole, the non functioning muslce fibers bulge outwards (aneurysm) instead of
contracting
- aneurysm increases risk of thrombus, ventricular arrhythmias, and heart failure
Ventricular Rupture - CORRECT ANSWER -- mechanism similar to aneurysm but the
wall ruptures
- rupture of the ventricular free wall of often fatal
- rupture of the ventricular septal wall is less fatal and may be associated with chronic congestive
heart failure
MI Ischemia - CORRECT ANSWER -- common sign is ST segment alteration
- ST segment represents the interval between ventricular depolarization and repolarization
- ST segment depression suggests subendocardial ischemia
- ST segment elevation indicates transmural ischemia or acute MI
Metabolic Syndrome - CORRECT ANSWER -- a cluster of lipid and nonlipid risk factors
of metabolic origin
- excess body fat (abdominal), raised BP, insulin resistance, and dyslipidemia
- enhances risk of heart disease exponentially
CAD Risk Factors - CORRECT ANSWER -- men at least 45, women at least 55
- heart attack, bypass surgery, or sudden death in males <55, females <65
- current cig smoker or quit within last six months
- < mod PA 3 days/week for 3 months
- BMI at least 30, waist girth in men >102 cm, women >88 cm
- BP 140/90 or higher, or taking medication
Exam Questions and CORRECT Answers
Heart Contraction: Phases - CORRECT ANSWER -- Right atrium → right ventricle
through tricuspid valve (three flaps)
- Right ventricle → pulmonary valve → pulmonary artery
- Pulmonary artery → right and left pulmonary artery → right and left lung
- Lungs → pulmonary veins → left atrium
- Left atrium → left ventricle through mitral (bicuspid) valve
third class lever - CORRECT ANSWER -- effort force is between resistance and axis
- most commonly found in musculoskeletal system
second class lever - CORRECT ANSWER -- resistance is between effort force and axis
first class lever - CORRECT ANSWER -- axis is between effort force and resistance
Frank-Sterling Law - CORRECT ANSWER -- SV increases with higher EDV due to
stretching of the cardiac fibers
-more filled with blood = more stretched= more elasticity to use to push blood out
arteriosclerosis - CORRECT ANSWER -hardening of the arteries (loss of elasticity)
Atherosclerosis - CORRECT ANSWER -- Fatty Plaque buildup in the artery walls
- partial regression of fatty, soft lesions is possible with aggressive multifactorial risk reduciton
thrombosis - CORRECT ANSWER -- blood clot that forms in a blood vessel or heart
chamber and remains there
,acute coronary syndrome - CORRECT ANSWER -A group of symptoms caused by
myocardial ischemia; includes angina, myocardial infarction, and sudden cardiac death
myochardial ischemia - CORRECT ANSWER -- insufficient blood flow to the heart
muscle that occurs when myocardial oxygen demand exceeds the oxygen supply
- occurs when a coronary artery is partially or completed obstructed because of atherosclerosis,
coronary thrombosis, or coronary artery spasm
Angina pectoris - CORRECT ANSWER -- transient pain or discomfort in the chest area
caused by myocardial ischemia
- typical angina initiated by factors such as exercise/stress, excitement, cold/hot, food intake
- vasospastic (variant) angina usually occurs at rest without precipitating event
Cholesterol and Exercise - CORRECT ANSWER -exercise can influence TG and HDL but
LDL and TC are influenced primarily by dietary habits and body weight
Pathophysiology of CAD - CORRECT ANSWER -- atherosclerotic lesions are formed in
the intima
- injury to the artery wall begins in the endothelial layer with subsequent platelet and clot
formation
- monocytes adhere to the endothelium, move to the intima, and take up cholesterol
- adventitia, outer layer of artery wall is not involved in development of atherosclerosis
Acute MI complications - CORRECT ANSWER -1. extension of the zone of ischemia to
surrounding tissue, thus widening the necrosis
2. ventricular aneurysm
3. ventricular rapture
4. papillary necrosis and rupture
5. left ventircular dysfunction
, Ventricular Aneurysm - CORRECT ANSWER -- necrotic muscle fibers of the heart
degenerate and remodel the ventricular wall, and may cause a thinning of the myocardial wall
- during systole, the non functioning muslce fibers bulge outwards (aneurysm) instead of
contracting
- aneurysm increases risk of thrombus, ventricular arrhythmias, and heart failure
Ventricular Rupture - CORRECT ANSWER -- mechanism similar to aneurysm but the
wall ruptures
- rupture of the ventricular free wall of often fatal
- rupture of the ventricular septal wall is less fatal and may be associated with chronic congestive
heart failure
MI Ischemia - CORRECT ANSWER -- common sign is ST segment alteration
- ST segment represents the interval between ventricular depolarization and repolarization
- ST segment depression suggests subendocardial ischemia
- ST segment elevation indicates transmural ischemia or acute MI
Metabolic Syndrome - CORRECT ANSWER -- a cluster of lipid and nonlipid risk factors
of metabolic origin
- excess body fat (abdominal), raised BP, insulin resistance, and dyslipidemia
- enhances risk of heart disease exponentially
CAD Risk Factors - CORRECT ANSWER -- men at least 45, women at least 55
- heart attack, bypass surgery, or sudden death in males <55, females <65
- current cig smoker or quit within last six months
- < mod PA 3 days/week for 3 months
- BMI at least 30, waist girth in men >102 cm, women >88 cm
- BP 140/90 or higher, or taking medication
