188 Questions
What is the primary function of acetazolamide in the context of altitude illness?
To lower the pH of the blood
Why should athletes who are part of an anti-doping program avoid taking acetazolamide?
It is a banned substance according to the World Anti Doping Agency
What is the recommended dosage of acetazolamide for the prevention of acute mountain sickness?
125 mg po bid
What is the primary function of dexamethasone in the prevention of altitude illness?
To reduce the risk of HAPE
How can athletes improve acclimatization to a new time zone?
By adjusting their time-keeping devices to the destination time zone
What is the theoretical risk associated with using sleeping medications while traveling to altitude?
Worsening of night-time oxygenation
How can exercise enhance sleep according to the text?
In the late afternoon or early evening
What should be done to manage jet lag?
Adjust the time-keeping devices after boarding the aircraft
What is the recommended duration of acclimatization for athletes at altitudes up to 2500 m?
14 days
What was found to be effective at inducing ventilatory adaptations and enhancing exercise performance at 4300 m for moderately trained individuals?
Staying at 2200 m for 14 days
Why is the use of natural altitude not always feasible for athletes?
Logistical, geographical, or financial reasons
What has led to the development of devices such as hypoxic tents and hypobaric chambers?
The desire to enhance exercise performance at high altitudes
Where is the cortical representation for the leg located?
Most medially
Which tract is described as the most clinically important pathway in the nervous system?
Lateral corticospinal tract
Where does the lateral corticospinal tract originate mainly?
Primary motor cortex of the brain
At which point does the lateral corticospinal tract cross to the opposite side?
Junction between the medulla and spinal cord
What are the motor neurons projecting from the motor cortex to the spinal cord called?
Corticospinal neurons
Which division of the nervous system controls 'fight-or-flight' functions such as increased heart rate and blood pressure?
Sympathetic division
Where do sympathetic efferents arise from in the spinal cord?
Thoracic and upper lumbar spinal cord
Which descending motor pathway is involved in controlling fine, skilled movements?
Lateral corticospinal tract
What neurotransmitter does the parasympathetic division use as its peripheral neurotransmitter on end organs?
Acetylcholine
What are the additional descending motor pathways organized into, apart from the lateral corticospinal tract?
Motor tracts
What characterizes an upper motor neuron (UMN) lesion?
Muscle weakness with increased reflexes and tone
Which neurotransmitter is most commonly associated with excitatory postsynaptic potentials (EPSP) in the nervous system?
Glutamate
In the nervous system, which fibers connect one hemisphere to an area in the opposite hemisphere?
Commissural fibers
What is the primary function of the tentorium cerebelli in the brain?
Separates the cerebellum from the cerebrum
Which structure serves as a carrying case for the brain, as mentioned in the text?
Dura
Where do ventral nerve roots convey signals from and to in the spinal cord?
From the ventral SC to the periphery
Which division of the nervous system controls 'fight-or-flight' responses such as increased heart rate and blood pressure?
Sympathetic nerves and ganglia
What characterizes a lower motor neuron (LMN) lesion?
Muscle atrophy and fasciculations
Which nerve roots innervate the knee extensors?
L4
What is the characteristic symptom of lower motor neuron (LMN) lesions?
Muscle weakness and loss of strength
What causes foot drop, leading to gait abnormality?
Lack of ankle dorsiflexion in swing
What is the scale used to test muscle strength, ranging from 0 to 5?
Muscle strength scale
Which nerve roots mediate elbow extension?
C5
What is clonus, as per the text?
Sustained clonus
In LMN injury, which type of damage occurs?
Efferent damage
What is the primary cause of muscle atrophy in infants, as per the text?
(Lack of input from motor neuron)
Which type of herniation involves the movement of brain tissue from one intracranial compartment to another?
Transtentorial herniation
In which space does a subarachnoid hematoma occur?
Subarachnoid space
Which feature is characteristic of a subdural hematoma?
Slow due to venomous bleed
What is the primary function of the spinal cord's filum terminale?
To anchor the spinal cord to the coccyx
At which spinal segments does the spinal cord terminate?
L1-L2
Which area of the spinal cord has more gray matter at the cervical and lumbosacral levels than thoracic levels?
Ventral horns
Which structures drain into the dural sinuses and are susceptible to injury leading to a specific type of hematoma?
Bridging veins
Which part of the nervous system is primarily responsible for innervating neck, head, arms, and hands?
Cervical segments
What is the primary function of the corticospinal tract?
Controls distal muscles of hands and feet
Which tract is responsible for unilateral facial weakness affecting the facial nerve?
Corticobulbar tract
Where is the pyramidal decussation located?
Between the medulla and spinal cord
What is the function of the rubrospinal tract?
Facilitates flexor muscle tone
Which cranial nerve is affected in Bell's palsy?
Cranial nerve 7
What are the key symptoms of a lesion in the corticobulbar face and corticospinal pathways originating in the right motor cortex?
Headaches and weakness affecting the left face, arm, leg
What is the function of the medial vestibulospinal tract?
Controls axial muscles like neck and trunk
What are the symptoms associated with upper motor neuron lesions?
Increased muscle tone, hyperactive tendon reflexes, and spastic paralysis
What is the clasp-knife phenomenon associated with?
Increased tone spasticity
Which disorder is often associated with rigidity that is velocity dependent?
Bradykinesia
What does a positive Babinski reflex involve?
Inward flexion of big toes
Where does a lesion need to be for the decerebrate posture to occur?
Below the midbrain
Which gait is typical of unilateral upper motor neuron (UMN) lesions?
Hemiplegic gait
What symptom may lead to altered gait in upper motor neuron (UPN) lesions in the corticospinal tract?
Tremors
Which region is affected by primary lateral sclerosis (PLS)?
Unknown region
Which nerve roots mediate elbow extension?
C7
What is the primary cause of muscle atrophy in infants, as per the text?
Werding Hoff Mann disease
What is the function of the rubrospinal tract?
Facilitates flexion of the upper limb at the elbow and shoulder
What symptom may lead to altered gait in lower motor neuron (LMN) lesions?
Inability to dorsiflex the foot
Where do sympathetic efferents arise from in the spinal cord?
Ventral nerve roots
What characterizes a lower motor neuron (LMN) lesion?
Development of local aspects due to lack of input from the motor neuron
What is clonus, as per the text?
Uncontrolled muscle twitching
Where does a lesion need to be for the decerebrate posture to occur?
Midbrain or upper pons
What distinguishes an upper motor neuron (UMN) lesion from a lower motor neuron (LMN) lesion?
Weakness with increased reflexes and tone
Which neurotransmitter is the most common excitatory postsynaptic potential (EPSP) in the nervous system?
Glutamate
What is the primary function of the corpus callosum?
Connects structures on the right to the left side of the CNS
Where does the tentorium cerebelli separate in the brain?
Cerebellum from cerebrum
What is the primary function of the thalamus in the nervous system?
Important relay center for sensory signals
Which structure mainly carries afferent sensory information in the dorsal spinal cord?
Dorsal roots
What are the characteristics of commissural fibers in the nervous system?
Relay impulses between different areas of CNS in opposite hemispheres
What distinguishes white matter from gray matter in the nervous system?
Gray matter mainly consists of myelinated axons
Which pathway controls movement of the extremities and may produce characteristic deficits?
Corticospinal tract
Where does the pyramidal decussation occur, causing 85% of the fibers to control the opposite side of the body?
Between the medulla and spinal cord
Which tract is responsible for facilitating extensor muscle tone and inhibiting extensor muscle tone?
Rubrospinal tract
Which condition is characterized by facial muscle weakness or paralysis of the 7th cranial nerve?
Bell's palsy
What does a unilateral lesion at the spinal cord level cause in terms of muscle weakness?
Contralateral muscle weakness
Where do upper motor neurons from the motor cortex synapse with lower motor neurons?
Anterior horns of the central gray matter of the spinal cord
Which tract is responsible for modulating reflexes and tone in the spinal levels?
Reticulospinal tract
What symptom is associated with upper motor neuron lesions in the corticospinal tract?
Increased muscle tone (hypertonicity)
What is the clasp-knife phenomenon associated with?
Rigidity
Where does a lesion need to be for the decerebrate posture to occur?
Below the midbrain
What is the characteristic symptom of lower motor neuron (LMN) lesions?
Positive Babinski reflex
What symptom may lead to altered gait in upper motor neuron (UPN) lesions in the corticospinal tract?
Hemiplegic gait
What has led to the development of devices such as hypoxic tents and hypobaric chambers?
Ventilatory adaptations and enhanced exercise performance at high altitudes
What is the theoretical risk associated with using sleeping medications while traveling to altitude?
Disruption of the body's natural acclimatization process
What is the primary cause of muscle atrophy in infants, as per the text?
Degeneration of UMN
Where does a subarachnoid hematoma occur?
Between the dura mater and arachnoid membrane
What is the primary cause of injury for a subdural hematoma?
High acceleration and deceleration causing shearing between layers and tearing of vessels
Which space does a subarachnoid hematoma occur in?
Subarachnoid space
What is the primary function of the filum terminale in the spinal cord?
To hold the spinal cord in place
What characterizes a subfalcine herniation?
Unilateral mass lesion causing brain structures to herniate under the falx cerebri from one side to the other
What causes a slow bleed and crescent shape in a hematoma?
Tearing of bridging veins passing through arachnoid and meningeal layer of dura
What is the primary function of the subarachnoid space?
To transmit cerebrospinal fluid (CSF)
What is characteristic of the white matter in sacral levels of the spinal cord?
Contains mostly descending fibers that have not yet terminated on their targets
Where does a subdural hematoma commonly develop symptoms?
In a different region from where it originated, leading to delayed symptoms
What prophylactic medication has been shown in one study to reduce the incidence of HAPE in susceptible individuals?
Salmeterol
Which prophylactic medication is currently a monitored substance by WADA?
Tadalafil
What type of effect do beta agonists have on exercise performance in healthy athletes based on extensive research?
No effect
Which prophylactic medication does not have convincing evidence of improving exercise performance at altitude?
Tadalafil
Why is there no ideal prophylactic medication recommended for athletes traveling to altitude according to the text?
Lack of efficacy
What is NOT recommended by the text as a counter-measure to decrease exercise-induced immunosuppression?
Taking zinc supplements
From a nutrition perspective, what type of beverages may be helpful according to the text?
Carbohydrate beverages
Which of the following is hypothesized in the text to be protective against UV-induced damage and immunosuppression?
Fish oil
What is recommended for athletes going to high-altitude venues in foreign countries according to the text?
Following travel medicine guidelines for vaccination
What should athletes NOT do to improve acclimatization according to the text?
Using sleeping medications
What is the primary purpose of using supplemental O2 for high-intensity training at altitude?
To enhance acclimatization
What is the main concern athletes should have related to nutrition when at altitude?
Ensuring sufficient fluid intake
In what scenario would the use of intermittent hypoxic strategies be particularly warranted?
In elite athletes with less than 0.5% performance changes
What physiological change occurs in plasma volume on exposure to altitude?
Plasma volume decreases
Why is long-term use of intermittent hypoxic strategies discouraged for most populations?
It may have negative health effects similar to sleep apnea
Which medication shows potential to reduce the incidence of high-altitude pulmonary edema based on the text?
Acetazolamide
What is the primary focus of the study by Siebenmann et al. (2011) based on the text?
High-altitude pulmonary edema prevention
In the context of high-altitude pulmonary edema, what was the outcome of using tadalafil according to the text?
Reduced incidence of edema
Which study evaluated the effects of salmeterol for the prevention of high-altitude pulmonary edema?
Sartori et al. (2002)
What did the trial conducted by Gertsch et al. (2010) compare in relation to altitude headaches?
Acetazolamide vs. ibuprofen
What is the concept introduced in the class notes that refers to the capacity of individuals to act independently and make free choices?
Agency
What term is used to refer to differences in the health of individuals or groups?
Health inequities
Which perspective involves examining how various biological, cultural, and social categories interact to lead to oppression and inequality?
Intersectionality
Referring to the text, what do health inequities specifically denote?
Differences in health based on social groups
In sociology, what is the key debate focused on regarding human behavior?
Agency vs. Structure
What is a key component of health promotion policy mentioned in the text?
Legislation and fiscal measures
How does health promotion aim to influence policy makers?
By fostering greater equity in policies
What type of conditions does health promotion seek to generate according to the text?
Safe, stimulating and satisfying conditions
What is the process of empowerment of communities within their own endeavors and destinies?
Effective community action
How is personal and social development supported in health promotion?
By providing information and education for health
What is the Ottawa charter primarily focused on?
Focusing on health as a resource
What does the text define as the prerequisites for health?
Income, education, and social justice
Why is health promotion not solely the responsibility of the health sector according to the text?
Because individuals need to take control of their health
What does the Ottawa charter propose as a means to reduce health inequities?
Achieving equity in health through action and advocacy
What is highlighted as a key aspect in achieving the best possible health given the context?
A constant negotiation of circumstances towards better health
What does the HP logo's outside red circle represent?
Building Healthy Public Policies
Which key action areas are encompassed by the three wings in the HP logo?
Personal Skills Development, Community Action Strength, Health Policy Building
What does the round spot within the HP logo's circle symbolize?
Basic HP Strategies: Enabling, Mediating, and Advocacy
What do the three wings originating from the inner spot in the HP logo stand for?
Five Key Action Areas of Health Promotion
What is the main function of the Ottawa Charter for Health Promotion logo?
Represent Five Key Action Areas and Three Basic Strategies of Health Promotion
What do the three wings of the Ottawa Charter logo represent?
Key action areas for health promotion
What is the significance of the upper wing breaking the circle in the Ottawa Charter logo?
Constantly changing society and communities
What is NOT a responsibility of the health sector?
Creating supportive environments
Which organizations were 'co-sponsors' of the Ottawa Charter along with the World Health Organization?
Health and Welfare Canada
What was the modification made to the Ottawa Charter logo for the Jakarta Conference in 1997?
Made more open and lively with wings reaching out of the circle
Which nerve provides sensation to the knee?
Obturator nerve
What type of information is carried by bare nerve endings?
Pain and temperature
Which nerve innervates the small toe and lateral foot?
Tibial nerve
What is the primary function of Meissner corpuscles and Merkel receptors?
Provide superficial touch
Which major dermatome corresponds to the top of the shoulder (collarbone)?
C5
Where do large diameter myelinated axons carrying proprioception information enter the spinal cord?
Medial portion of the dorsal root entry zone
What is the primary sensory region innervated by a nerve root?
Skin
'Ruffini endings' primarily provide information related to:
Deep touch and vibration
Where do axons in fasciculus cuneatus synapse?
On nucleus Cuneatus
Which structure is responsible for crossing midline in the caudal medulla?
Internal arcuate fibers
What type of information does the medial lemniscus tract carry?
Vibration, proprioception, fine touch
Where do third order sensory neurons project from after leaving the thalamus?
Somatosensory cortex
What is the function of the fasciculus gracilis and cuneatus?
Carrying upper or lower extremities information
Where do first order neurons decussate after ascending to the caudal medulla?
Internal arcuate fibers
What is the pathway through which vibration, proprioception, and fine touch information is transmitted?
Cervical spinal cord to thalamus
Which structure forms the medial lemniscus tract after decussation at internal arcuate fibers?
Rostral medulla
What is a characteristic feature of a transverse cord lesion?
All sensory and motor pathways are either partially or completely interrupted
In a Brown-Sequard syndrome, what is the characteristic pattern of sensory loss?
Contralateral loss of pain and temperature sensation, ipsilateral loss of vibration and joint position sense
What is a common cause of central cord syndrome?
All of the above
In a hemicord lesion, what is the characteristic motor deficit?
Ipsilateral upper motor neuron (UMN) type weakness
What is a common cause of a transverse cord lesion?
All of the above
In a central cord syndrome, what is the characteristic sensory deficit?
Bilateral loss of pain and temperature sensation
What is a common cause of a Brown-Sequard syndrome?
All of the above
In a transverse cord lesion, what is the relationship between the sensory level and the level of the lesion?
The sensory level is the same as the level of the lesion
What is a characteristic feature of a hemicord lesion?
Ipsilateral loss of vibration and joint position sense, contralateral loss of pain and temperature sensation
What is a characteristic feature of a central cord syndrome?
Bilateral regions of suspended sensory loss to pain and temperature
What is the function of the liver in the digestive system?
To process nutrients absorbed from the small intestine
What happens to the blood flow during exercise?
Blood flow is directed away from the GI tract and towards the working muscles
What is the function of the gallbladder in the digestive system?
To store and concentrate bile
What is the effect of exercise on the GI tract?
It leads to distress, abdominal contractions, and intestinal jarring
What is the primary function of the pancreas in the digestive system?
To secrete digestive enzymes and insulin
What is the length of the small intestine?
About 7 meters
What is the primary cause of gastrointestinal distress during exercise?
Splanchnic vasoconstriction
What is a common symptom of gastroesophageal reflux disease (GERD) in athletes?
Chest pain
What is the recommended dietary approach to manage runner's diarrhea?
Reduce fiber consumption
What is the primary mechanism of NSAID-induced gastrointestinal issues?
Increased risk of upper GI issues
What is the recommended treatment for protozoal diarrhea?
Antiprotozoal medication
What is the primary cause of traveler's diarrhea?
Bacteria
What is the recommended approach to manage foodborne illness during travel?
Boil or peel food
What is the primary symptom of lower GI issues during exercise?
Diarrhea
What is the recommended treatment for bacterial diarrhea?
Antibacterial medication
What is the primary cause of rectal bleeding during exercise?
Lack of blood flow and dehydration
Test your knowledge on nutrition and medication for high altitude visits. Explore the impact of high carbohydrate diets and medications like Acetazolamide on oxygenation and exercise performance at altitude.
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