CSEP-CEP Practical Exam Questions with accurate answers, rated A+

CSEP-CEP Practical Exam Questions with accurate answers, rated A+ What are the 5 circumference points? - -- Arm (midpoint between acromian and olecranon) - Waist (midpoint of iliac crest and ribs) - Hip (furthest protrusion of glutes) - Thigh (midpoint of inguinal crease and patella) - Calf (furthest protrusion) Describe the pros and cons of skinfold measurements - -Pros: accurate for leaner subjects, multiple equations for different populations Cons: high rate of user error, taking repeated measurements can increase error, can be impacted by physical activity (level of water in muscles)/ environment (cold/hot weather), shouldn't be used for obese clients Describe skinfold protocol - -Explain the purpose of the test Explain the test procedures Measure skinfolds on right side of body at eye level Lift fold 1 cm above desired site, place calipers directly over desired site Position calipers perpendicular to site of measurement Administer 2 trials within 1mm Measure skinfolds in rotational order DO NOT REMOVE FINGERS PINCHING WHILE MEASURING What are the 7 skinfold sites? - -- Tricep (midpoint of acromian and olecranon) - Bicep (belly of bicep) - Scapula (3cm inferior) - Waist (3cm superior of iliac crest) - Stomach (3cm lateral and 1cm inferior of belly) - Thigh (midpoint of inguinal crease and prox patella) - Calf (widest medial point) Describe the pros and cons of bioelectrical impedance - -Pros: easy to use, fairly reliable, quick results Cons: can be impacted by client age, water level, cannot be used with people with pacemakers Describe the pros and cons of DEXA - -Pros: very reliable, can highlight fat distribution Cons: movement may disrupt image, expensive, exposure to radiation Describe the process of taking BP - -1. Locate and palpate radial pulse 2. Close valve and increase pressure to 70 mmHg 3. Slowly increase pressure further until pulse disappears 4. Position earpieces of stethoscope in line with auditory canals 5. Place diaphragm of stethoscope over brachial pulse 6. Close valve and increase pressure to 20-30 mmHg above systolic estimate 7. Release pressure slowly 8. Note pressure of first Korotkoff sound (systolic) 9. Note measurement of Phase V diastolic pressure 10. Continue deflating cuff for at least 10 mmHg. 11. Continue listening for further sounds 12. Record Systolic and Diastolic values 13. Repeat and compare to 1st trial 14. Correctly classify resting blood pressure What are the stages of BP? - -Normal - 120/80 Prehypertension - 120-139/80-89 Stage 1- 140-159/90-99 Stage 2 - 160/100 Hypertensive crisis 180/110 Describe the normal and abnormal HR response to exercise - -Normal: increase in HR depending on what type of exercise Abnormal: sudden increase in HR, increase in HR with no increase in CO Describe the normal and abnormal BP response to exercise - -Normal: increase in systolic BP and a slight increase in diastolic BP Abnormal: no increase in BP, severe hypotension post exercise, large increase in DBP What is mean arterial pressure? - -Average pressure in arteries during one cardiac cycle (65-110) 5 lead EKG - -Green - right lower ribs White - right inferior to clavicle Black - left inferior to clavicle Red - left lower ribs Brown - 4th intercostal space Signs of an MI on a ECG? - -Downsloping ST segment and pathologic Q waves What are the segments of the EKG? - -QRS complex - ventricular depolarization P - atrial depolarization T - ventricular repolarization ST segment - time between ventricular depolarization and repolarization Length of: QRS complex, PR interval, QT interval, RR interval - -PR - 0.12-0.2 QRS - 0.08-0.1 QT - 0.4-0.43 RR - 0.6-1 What are some normal ECG changes during exercise? - -Decreased R-R interval P wave magnitude increase Decreased PR interval What are the time frames of the boxes on an ECG? - -Small box is 0.04 seconds Big box is 0.2 seconds Describe the process of Spirometry - -1. Breathe normally 2. Inspire completely and rapidly with a pause of ≤2 s at TLC 3. Expire with max effort until no air can be expelled while maintaining upright posture 4. Inspire with maximal effort until completely full 5. Repeat instructions as necessary, coaching vigorously 6. Repeat for a minimum of 3 maneuvers, usually no more than 8 for adults Contraindications for Spirometry - -- MI/eye/sinus/ear surgery within 1-week - Uncontrolled hypertension - Significant arrhythmia - Recent concussion - Late term pregnancy - Syncope related to expiration/coughing - Avoid vaping/smoking/exercise within 1 hour - Avoid intoxicants 8 hours prior What is FVC? - -Forced vital capacity, total volume the patient can force ably exhale in one breath What is FEV1? - -Forced expiratory volume in 1 second What is the difference between the 2 largest values in Spirometry testing? - -FVC - 0.150L FEV1 - 0.150L What can the client not do during Spirometry testing? - -Cannot cough during expiration Normal breaths per minute - -12-16 What are the cut points for: TLC, RV, ERV, IRV, TV? - -TLC: 6L RV: 1.2L ERV: 0.7-1.2L IRV: 1.9-3.3L TV: 0.5L Tidal volume and size - -Amount of air moving in and out of lungs in a normal breath (500mL) Inspiratory reserve volume and size - -Amount of air that can be inhaled following a normal inhalation (mL) Expiratory reserve volume and size - -Amount of air that can be forcefully exhaled after a normal breath (700-1000mL) Residual volume and size - -Air remaining in lungs that prevents collapse (1200mL) Forced vital capacity - -Volume of gas that can be exhaled as forcefully and rapidly as possible after a maximal inspiration Vital capacity - -TV + IRV + ERV Inspiratory capacity - -TV + IRV Functional Residual Capacity - -RV + ERV What is the order of fitness tests that should be used? - -Non-fatiguing tests Agility tests Max power tests Sprint tests Local muscular endurance tests Anaerobic tests Aerobic tests What are some common functional fitness tests? - -8 foot up and go 30 second arm curl Grip strength 10 m walk test 1 foot balance 6 minute walk test What are some contraindications of performing an exercise stress test? - -Acute MI (4 days) Unstable angina Brady/tachycardia or other abnormal rhythms Acute myo/pericarditis What are some reasons for stopping an exercise test? - -HR exceeds 85% of age predicted max Abnormal heart rhythms or response to exercise Tester feels the need to stop Patient feels the need to stop Patient feels dizzy, lightheaded, faint Hypertensive crisis (220/115) or abnormal response to exercise What is the anaerobic threshhold? - -Point where the body switches from aerobic to anaerobic metabolism How to identify the anaerobic threshhold? - -Blood lactate levels (will suddenly spike) RER level (1.1 is maximal effort) Ventilatory threshhold (increases rapidly compared to O2 consumption) Give examples of anaerobic capacity tests - -Wingate test 300 yard shuttle RAST 60 yard shuttle What is the ventilatory threshold? - -Point where ventilation rises rapidly compared to O2 consumed VCO2/VO2 - -- ventilation of CO2 and O2, can be used to estimate anaerobic threshold - CO2 will peak past O2 at threshold What is O2 saturation? - -Comparison of O2 saturated hemoglobin vs total hemoglobin in blood 95-99% What is the VO2 reserve method? - -Similar to the heart rate reserve method Correlates well with HRR VO2 reserve = ((VO max - resting VO2) x % of target) + resting VO2 What is the HRR method? - -Karvonen method HRR = ((MHR - RHR) x training %) + RHR Used to determine intensity Describe the Bruce Protocol - -- 3 minute stages that increase in grade and speed; goal is to achieve steady state HR - Completed when stopping criteria is met Measure - HR / RPE every minute BP at end of each stage Scored - minutes of completion Describe the Balke Protocol - -- 1-minute stages of constant speed that increase in grade (3mph F / 3.3mph M) - Completed when stopping criteria is met Measure - HR / RPE every minute BP at end of each stage Scored - minutes of completion Describe the Ebbling Treadmill test - -- 4 min warm up at 0% / 3-4 mph - 4 min walk at 5% and self-selected speed - 4 min cool down at 0%, should reach SSHR in last min Measure - HR and Speed every minute Scoring - Speed, age, SSHR in equation for VO2 max Describe the YMCA test - -1st set - 0.5kp (25W) 3 min 2nd, 3rd, 4th sets of 3 min are determined from HR from 1st set Should be within 10bpm of 85% max at 4th stage (if not, add 0.5kp for 3 min) Cool down at 0.5kp 3 min Measure - HR during every minute Scoring - Uses weight / HR / load to estimate VO2 max Describe the mCAFT - -- Starting stage determined using client's age - Step up and down steps using audio cadence - Stopped when client can no longer keep cadence or criteria are met Measure - HR at end of stage Scoring - Uses last level completed to predict VO2 max Describe the 1 mile walk - -- 3 min warm up at moderate pace - Walk 1 mile as quickly as possible Measure - HR at end of test, time taken to complete test Scoring - Uses weight, age and time completed to estimate VO2 What is a MET? - -Oxygen cost of an activity 3.5 mL/kg/min What is RPE? - -Rate of perceived exertion Used to quantify how many reps are left in the tank Describe 1RM, when it's used and why it's used - -How much weight can be lifted for 1 rep Commonly used for compound lifts (squat, bench) Helps with load and rep prescription Requires high technique and experienced lifters What does a muscular strength test assess - -Amount of force that can be produced Provide examples of muscular strength tests - -1RM squat, bench Grip strength What does a muscular power test assess? - -Assesses how quickly high force can be produced Give examples of power tests - -Vertical jump 1RM power clean Standing long jump What does a muscular endurance test assess - -Amount of force that can be maintained over a period of time Provide examples of muscular endurance tests - -Push ups Chin ups Plank Single leg stance Grip strength protocol - -Grip taken between fingers and palm of hand Hold dynamometer in line with forearm at level of the thigh, away from body Exhale while squeezing 2 trials per hand Scoring - max combined value of each hand Sit and reach protocol - -Feet flat against flexometer; must not extend beyond crossboards Inner edge of soles 6" apart Knees fully extended Hold position for two seconds Lower head to max distance Repeat test twice Scoring - Highest value reached on flexometer 1/3RM protocol - -Warm up at 50%; add weight and lift 1/3 reps If it can be done; add 10-120lbs until client can no longer lift Scoring - Highest weight lifted * Not to be done with novice lifters Push-up protocol - -M: lie on stomach, legs together, hands forward, positioned under shoulders Fully straighten elbows, use toes as pivot point, upper body kept in straight line, exhale on effort F: To push up: fully straighten elbows, use knees as pivot point, ankles extended, lower legs, ankles, and feet in contact with mat, upper body kept in straight line Test stops when unable to keep technique over 2 reps Scoring - Total number of push-ups 1 leg stance protocol - -Stand on 1 leg, barefoot beside chair, hands crossed in front of chest Hold position for up to 45 seconds Time ends when: Arms move, foot moves away from standing limb or touches floor, weight-bearing foot is moved, max 45 secs elapsed Scoring - Time completed up to 45 sec max * 2 trials for each leg: 1 with eyes open and eyes closed Vertical jump protocol - -Stand with feet flat on floor, stand and measure reach Place elbow on hip, ensure safe distance from wall Balance in semi-squat position and jump; no run up, step up, or pre-jump Scoring - Peak power calculated Power (W) = [60.7*jump height] + [45.3*body mass] -2055 * 3 trials with 10-15 sec rest What is the functional movement screen? - -Used to assess full body mobility and motor control, can be used to focus on areas of improvement and measure improvement What are the 7 tests and 3 clearance tests used in FMS? - -Overhead squat Inline lunge Hurdle step Shoulder mobility (shoulder clearance) Trunk stability push up (Press up clearance) Straight leg raise Rotatory stability (Posterior rocking clearance) Hip Flexion - -120 degrees Fulcrum - greater trochanter Prox arm - parallel to ground Distal arm - femur to lat epicondyle Hip Extension - -20 degrees Fulcrum - greater trochanter Prox arm - parallel to ground Distal arm - femur to lat epicondyle Hip Abduction - -40 degrees Fulcrum - ASIS Prox arm - horizontal line from ASIS to ASIS Distal arm - midpoint of patella Hip Adduction - -40 degrees Fulcrum - ASIS Prox arm - horizontal line from ASIS to ASIS Distal arm - midpoint of patella Hip INT rotation - -45 degrees Fulcrum - patella Prox arm - perpendicular to floor Distal arm - tibia to midpoint of malleoli Hip EXT rotation - -45 degrees Fulcrum - patella Prox arm - perpendicular to floor Distal arm - tibia to midpoint of malleoli Knee Flexion - -135 degrees Fulcrum - lat epicondyle Prox arm - femur towards greater trochanter Distal arm - fibula towards lateral malleolus Knee Extension - -15 degrees Fulcrum - lat epicondyle Prox arm - femur towards greater trochanter Distal arm - fibula towards lateral malleolus Foot Dorsiflexion - -20 degrees Fulcrum - lat malleolus Prox arm - fibula towards fibular head Distal arm - parallel to 5th metatarsal Foot Plantarflexion - -50 degrees Fulcrum - lat malleolus Prox arm - fibula towards fibular head Distal arm - parallel to 5th metatarsal Ankle Inversion - -35 degrees Fulcrum - midpoint between malleoli Prox arm - Midline of lower leg towards tibial tuberosity Distal arm - 2nd metatarsal In what order should a workout be planned? - -1.Release - Foam rolling and SMR 2.Reset - Prehab and breathing exercises 3.Readiness - RAMP warm-up 4.Reactive - Speed and power work 5.Resistance - Strength work 6.Resiliency - Energy systems development 7.Recovery - Foam rolling, mobility, flexibility and breathing What are some methods to determine training intensity? - -RPE/BORG Scale, HR reserve method, VO reserve, MET's What are the 10 core movements in resistance training? - -Knee dominant Hip Dominant Vertical push Vertical pull Horizontal push Horizontal pull Anti-flexion Anti-extension Anti-rotation Anti-lateral flexion Resistance training adaptations - -Neural (increased firing rates, synchronization, neural drive, decreased inhibition) Muscular (hypertrophy) What are the set, rep, and rest schemes for training hypertrophy? - -6-12 reps 3-6 sets, 30-90 sec What are the set, rep, and rest schemes for training endurance? - -12 reps 2-3 sets, 30 sec What are the set, rep, and rest schemes for training strength? - -6 reps 2-6 sets, 2-5 min What are the set, rep, and rest schemes for training power? - -1-5 reps 3-5 sets, 2-5 min What are some methods of progressing resistance exercise? - -· Lifting same load/volume with better form, more control, and less effort (efficiency) · Lifting same load for more reps (volume) · Lifting heavier loads (intensity of load) · Lifting same load and volume with less rest · Lifting load with more speed and acceleration · More work in same amount of time (density) · Doing same work in less amount of time (density) · Doing more sets with same load and reps (volume) · Lifting same load and volume more often throughout the week (frequency) What is variable/accommodating resistance? - -Allows for varying resistance during movement to stress the muscle action Adding bands to a squat to increase resistance at top of the squat where there is typically the least resistance Adding chains, the higher off the ground (less resistance) more chain is pulled off the ground, (adding more resistance) What is the valsalva maneuver? - -- Exhalation against a closed airway, creates an increase in intra-abdominal pressure increase in pressure creates a lack of blood flow - HR and BP increase to compensate for lack of flow - expiration results in sudden increase in flow and dramatic drop in BP What is the stress/rest principle? - -Body needs certain amount of time to recover post workout; 48 hours between workouts that stress same muscle systems What is the work to rest principle? - -Relative density of exercise and relief intervals in a set; different exercises and goals (strength vs endurance) will have different requirements Factors that determine RE programs in youth - -Training age Overuse injuries Biological age What is DOMS? - -Delayed onset muscle soreness Caused by microscopic tears in tissue, causing Ca to leak and activate proteases to degrade tissues, also initiating inflammatory process What is static stretching? - -Slow and constant stretch, held for 15-30 seconds; improves ROM; typically done post exercise (muscles are warm and are more receptive to stretching) What is dynamic stretching? - -Functionally based that uses sport-generic/specific movements to prepare body for activity; places emphasis on movements of the activity; actively performed in a controlled ROM; not as effective for increasing ROM What is PNF stretching? - -Proprioceptive Neuromuscular Facilitation Involves both active and passive movements performed with a partner to increase ROM; increasing ROM through reciprocal and autogenic inhibition 10/6/30 What are the recommended percentage intakes for macros? - -Carbs 40-65% Protein 10-35% Fats 20-35% What are some of the recommendations from the new food guide? - -Lots of fruits and veggies Water as a drink of choice Whole grains Plant based protein sources Foods low in saturated fats and high in unsaturated fats Describe the role of sedentary behavior in disease - -Linked to higher rates of chronic disease Reduces glycemic control, insulin sensitivity, increases triglyceride levels, increasing risk of developing diabetes, obesity Name some ways of reducing sedentary time - -Taking frequency stretch breaks during working Standing while working Take the stairs instead of the elevator Walk/bike to work What is the range of blood sugar for a diabetic before exercising? - -Should be between 5.5-16.7 mmol/L How would exercise testing differ in elderly patients? - -Focus on functional fitness rather than performance Performance may be limited by psychological factors (fear of falling or injuring themselves) Patients with devices (pacemakers) may not respond well to quickly increasing intensity exercise tests due to response of pacemaker Elderly patients may be taking medications (beta-blockers, ACE inhibitors) that will impact BP/HR response to exercise Why may BORG and RPE be used in elderly patients vs HR/BP - -May be taking medications that can impact the response to exercise What are some considerations when working with cancer patients? - -Avoid dislodging PICC lines or catheters May experience muscle weakness Vestibular issues Limited ROM due to surgeries No exercise if chemo was received in past 24 hours Radiation may impact cardiac function (reduced diastolic volume) Radiation increases stiffness Increased risk of fracture with advanced disease Exercise tolerance will vary from session to session Name some contraindications when working with cancer patients - -Monitor hematologic abnormalities (low platelets, hemoglobin level) MSK disorders (recent bone/back/neck pain; muscular weakness; extreme fatigue) GI disorders (severe nausea, vomiting/diarrhea) CV disorders (chest pain, elevated resting HR, elevated BP, irregular heartbeat, lymphedema) Pulmonary disorders (severe difficulty breathing, coughing/wheezing) Neurological disorders (decline in cognitive status, dizziness, disorientation, blurred vision) What is a ventilatory impairment? - -Restrictive lung expansion, resulting in decreased lung volume, increased work of breathing, and inadequate ventilation What is a gas exchange impairment? - -Excess or deficit in oxygenation or CO2 elimination at alveolar-capillary membrane Abnormal arterial blood gasses, abnormal arterial pH, decreased CO2, dyspnea, elevated BP, hypoxia What is an obstructive lung disease? - -Airway obstruction causes increase in resistance; volume of each breath gets smaller (asthma, bronchitis), air is trapped in the lungs (results in hyperinflation) How are the volumes and capacities changed in an obstructive lung disease? - -Increase RV, TLC Decreased ERV What is restrictive lung disease? - -Compliance of lung is reduced, increases stiffness of lung and limits expansion; greater pressure than normal required to give the same increase in volume How are the volumes and capacities changed in a restrictive lung disease? - -All capacities are reduced due to reduced compliance of the lung What is FEV1 in restrictive and obstructive diseases? - -Obstructive: reduced Restrictive: slightly reduced What is FEV1 in a normal patient? - -0.8 What is FVC in obstructive and restrictive lung disease? - -Obstructive: slightly decreased or unchanged Restrictive: decreased What is FVC in a normal patient? - -0.8 What is the FEV1/FVC ratio? - -Comparison of volume of air exhaled in one second vs total volume Used to test for obstructive disease What is a normal FEV1/FVC ration? - -Anything over 0.7 What is diffusion capacity? - -Measures the diffusion of air in and out of the lungs What is expiratory flow limitation? - -Expiratory flow cannot increase despite increasing expiratory efforts Predisposes to hyperinflation due to air trapping Presents commonly in obstructive diseases (slope of expiration is decreased because of obstruction) What is dynamic hyperinflation? - -Increase in end-expiratory lung volume (EELV) that may occur in patients with airflow limitation when minute ventilation increases (exercise) Due to reduced elastic recoil of lungs How does obstructive disease shift the flow volume loop? - -Shifted to the left (RV is increased due to air trapping) Expiration is not as steep (FEV1 decreased due to obstruction) Expiration is decreased (Reduced ERV) How does restrictive disease shift the flow volume loop? - -Shifted to the right (reduced RV) Decreased expiration (Reduced ERV) Smaller figure (Reduced VC and TLC) Why is FEV1 used to assess obstructive lung diseases? - -Expiration is impaired due to obstruction, so expiration rates are decreased Ankle Eversion - -15 degrees Fulcrum - midpoint between malleoli Prox arm - Midline of lower leg towards tibial tuberosity Distal arm - 2nd metatarsal Wrist Flexion - -80 degrees Fulcrum - triquetrum Prox arm - ulna towards olecranon Distal arm - midline of 5th metacarpal Wrist Extension - -70 degrees Fulcrum - triquetrium Prox arm - ulna towards olecranon Distal arm - midline of 5th metacarpal Wrist Radial Deviation - -20 degrees Fulcrum - capitate Prox arm - Midline of the forearm towards lat epicondyl Distal arm - 3rd metacarpal Wrist Ulnar Deviation - -30 degrees Fulcrum - capitate Prox arm - Midline of the forearm towards lat epicondyl Distal arm - 3rd metacarpal Elbow Flexion - -150 degrees Fulcrum - lat epicondyle of humerus Prox arm - humerus towards centre of acromion Distal arm - radius towards radial styloid Elbow Extension - -0 degrees Fulcrum - lat epicondyle of humerus Prox arm - humerus towards centre of acromion Distal arm - radius towards radial styloid Elbow Pronation - -90 degrees Fulcrum - ulnar styloid process Prox arm - parallel to humerus Distal arm - parallel to styloid processes on posterior forearm Elbow Supination - -90 degrees Fulcrum - ulnar styloid process Prox arm - parallel to humerus Distal arm - parallel to styloid processes on posterior forearm Shoulder Flexion - -180 degrees Fulcrum - greater tubercle Prox arm - midaxillary line Distal arm - humerus towards lat epicondyle Shoulder Extension - -60 degrees Fulcrum - greater tubercle Prox arm - midaxillary line Distal arm - humerus towards lat epicondyle Shoulder Abduction - -180 degrees Fulcrum - acromion Prox arm - parallel to sternum Distal arm - humerus towards medial epicondyle Shoulder INT Rotation - -70