Therapeutic Interventions Week 1 - Intro, Energy, Review of Inflammation
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Questions and Answers

Which of the following physiological systems is NOT directly influenced by exercise?

  • Musculoskeletal
  • Digestive (correct)
  • Cardiovascular
  • Endocrine
  • During the inflammatory phase of tissue healing, which of the following is a primary goal of exercise prescription?

  • Improve range of motion and flexibility
  • Maximize muscle hypertrophy
  • Increase cardiovascular endurance
  • Minimize inflammation and promote blood flow (correct)
  • What is the primary role of the endocrine system during exercise?

  • Regulating blood flow to the muscles
  • Maintaining body temperature
  • Releasing hormones that influence metabolism and energy expenditure (correct)
  • Controlling the rate and depth of breathing
  • Which of the following tissue healing phases is characterized by the formation of new collagen fibers?

    <p>Proliferative (C)</p> Signup and view all the answers

    How does exercise impact the cardiovascular system during the remodeling phase of tissue healing?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the primary function of the Krebs Cycle?

    <p>To generate energy carriers such as NADH and FADH2 (A)</p> Signup and view all the answers

    What is the role of oxygen in aerobic ATP production?

    <p>It is required for the electron transport chain (C)</p> Signup and view all the answers

    How many molecules of ATP are produced directly in the Krebs Cycle?

    <p>None, it produces NADH and FADH2 which are used to produce ATP (A)</p> Signup and view all the answers

    Which of these statements is TRUE about the citric acid cycle?

    <p>It produces carbon dioxide as a byproduct (A)</p> Signup and view all the answers

    What is the net gain of NADH molecules produced in one complete turn of the Krebs Cycle?

    <p>3 (A)</p> Signup and view all the answers

    A client reports experiencing fatigue and muscle weakness, particularly during high-intensity activities, and notes difficulty recovering between exercise bouts. Which metabolic system is most likely compromised in this scenario?

    <p>Phosphagen system (B)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of impaired glycolysis?

    <p>Increased reliance on the phosphagen system (C)</p> Signup and view all the answers

    A client presents with severe fatigue, muscle weakness, exercise intolerance, and organ dysfunction. These symptoms strongly suggest a dysfunction in which energy system?

    <p>Oxidative system (A)</p> Signup and view all the answers

    Which of the following is a key characteristic that distinguishes the inflammatory phase of tissue healing from the proliferation phase?

    <p>Increased blood flow to the injured area (A)</p> Signup and view all the answers

    A client is engaging in a marathon run. Which of the following statements is ACCURATE regarding their energy system usage during the event?

    <p>The oxidative system will be the primary energy system for most of the race. (C)</p> Signup and view all the answers

    Which of these factors is NOT a direct contributor to impaired glycolysis?

    <p>Creatine kinase deficiency (D)</p> Signup and view all the answers

    A client reports that simple tasks feel exhausting. This symptom could be attributed to a dysfunction in which energy system?

    <p>Phosphagen system (D)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of the remodeling phase of tissue healing?

    <p>New tissue formation (A)</p> Signup and view all the answers

    What is the primary function of platelets during the hemostasis phase of tissue healing?

    <p>Forming a blood clot to stop bleeding (D)</p> Signup and view all the answers

    A client complains of exercise intolerance and reports experiencing early fatigue during training. This is likely associated with a disruption in which of the following?

    <p>Oxidative system (B), Glycolysis (C), Phosphagen system (D)</p> Signup and view all the answers

    What is the primary role of the Krebs cycle?

    <p>To oxidize substrates and produce NADH and FADH2. (C)</p> Signup and view all the answers

    What is the main source of energy for high-intensity exercise lasting 5-6 seconds?

    <p>Phosphagen system (A)</p> Signup and view all the answers

    Which of the following is NOT a substrate involved in bioenergetic reactions?

    <p>Insulin (A)</p> Signup and view all the answers

    What is the main function of the electron transport chain?

    <p>To generate ATP from NADH and FADH2. (A)</p> Signup and view all the answers

    What is the name of the process by which ATP is produced in the electron transport chain?

    <p>Oxidative phosphorylation (C)</p> Signup and view all the answers

    Which energy system contributes the most to a marathon runner's energy needs?

    <p>Oxidative system (A)</p> Signup and view all the answers

    What is the major function of neutrophils in acute inflammation?

    <p>Cleaning the wound of debris (B)</p> Signup and view all the answers

    How does exercise affect the concentration of glycogen in muscle and liver?

    <p>Exercise increases muscle glycogen and decreases liver glycogen. (B)</p> Signup and view all the answers

    Which of the following is NOT a factor that can impede healing?

    <p>Adequate blood supply (D)</p> Signup and view all the answers

    What is the primary goal of physical therapy during the acute stage of inflammation?

    <p>Maximum protection and control of inflammation. (C)</p> Signup and view all the answers

    What is the main difference between acute and chronic inflammation?

    <p>Cells involved and duration of inflammation. (D)</p> Signup and view all the answers

    What is the term used for the anaerobic contribution to energy production at the start of exercise?

    <p>Oxygen deficit (B)</p> Signup and view all the answers

    What is the significance of the oxygen uptake reaching a "steady state" during low-intensity exercise?

    <p>The body has achieved a balance between energy supply and demand. (D)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of the fibroblastic-repair phase?

    <p>Predominance of neutrophils. (B)</p> Signup and view all the answers

    Which of the following is a correct statement about the relationship between inflammation and healing?

    <p>Inflammation can occur without healing. (B)</p> Signup and view all the answers

    Which of the following is NOT a component of the phosphagen system?

    <p>Lactate (B)</p> Signup and view all the answers

    What is the primary function of the oxidative system?

    <p>To generate energy carriers like NADH and FADH2 through the oxidation of acetyl-CoA (C)</p> Signup and view all the answers

    Which of the following statements about lactate is FALSE?

    <p>Lactate accumulation is a direct cause of muscle fatigue (D)</p> Signup and view all the answers

    What is the primary energy source used during high-intensity, short-duration activities, like a 100-meter sprint?

    <p>Phosphagen system (C)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of the glycolytic system?

    <p>It involves the breakdown of fats into fatty acids (C)</p> Signup and view all the answers

    What is the role of ATPase in ATP hydrolysis?

    <p>ATPase converts ATP into ADP and inorganic phosphate (A)</p> Signup and view all the answers

    Which of the following accurately describes the relationship between the phosphagen system and glycogen stores?

    <p>The phosphagen system is the primary energy source for short-duration, high-intensity exercise, while glycogen stores serve as a longer-term energy source (C)</p> Signup and view all the answers

    The rate of glycolysis is influenced by several factors. Which of the following would DECREASE the rate of glycolysis?

    <p>Lower pH (A)</p> Signup and view all the answers

    Which of the following statements about the lactate threshold is TRUE?

    <p>It is a marker of the point at which the body relies primarily on anaerobic metabolism to meet energy demands (C)</p> Signup and view all the answers

    What is the primary energy source used during prolonged, submaximal exercise, such as a long distance run?

    <p>Oxidative system (A)</p> Signup and view all the answers

    Which enzyme is directly involved in the phosphagen system's rapid replenishment of ATP?

    <p>Creatine kinase (B)</p> Signup and view all the answers

    What is the primary function of the NADH and FADH2 molecules produced during the oxidative system?

    <p>To carry electrons to the electron transport chain (C)</p> Signup and view all the answers

    Which of the following is a primary energy source used at rest?

    <p>Fats (B)</p> Signup and view all the answers

    What is the difference between active and passive mobility?

    <p>Active mobility requires muscle activation, while passive mobility relies solely on soft tissue extensibility (A)</p> Signup and view all the answers

    Which of the following best describes the concept of neuromuscular control?

    <p>The ability of the nervous system to coordinate muscle movements (A)</p> Signup and view all the answers

    Flashcards

    Physiologic Processes

    Changes in body systems during exercise including endocrine, cardiovascular, pulmonary, and neuromusculoskeletal.

    Endocrine System

    A system that regulates hormones impacting metabolism and energy during exercise.

    Tissue Healing Phases

    Stages of recovery following injury: inflammation, repair, and remodeling.

    Exercise Prescription

    A tailored plan of physical activity aimed at improving health or rehabilitating injury.

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    Cardiovascular System Impact

    The body's response and adaptations of the heart and blood vessels during exercise.

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    Krebs Cycle

    A metabolic pathway for oxidizing acetyl CoA, producing energy carriers.

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    Electron Transport Chain

    Series of proteins in mitochondrial membrane that transfers electrons to form ATP.

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    Oxidative Phosphorylation

    Process of generating ATP using the electron transport chain and oxygen.

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    Acetyl CoA

    The starting molecule for the Krebs Cycle derived from carbohydrates and fats.

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    Energy Carriers in Krebs Cycle

    NADH and FADH2, produced during the Krebs Cycle, used for ATP formation.

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    Therapeutic Interventions

    Systematic, planned interventions to improve function and health.

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    Muscle Performance

    The ability of muscle to produce tension and perform work.

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    Mobility

    The ability to move freely without restriction.

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    Hydrolysis of ATP

    The breakdown of ATP to release energy, requiring water.

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    Phosphagen System

    The energy system providing ATP for short-term, high-intensity activities.

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    Glycolysis

    The anaerobic breakdown of carbohydrate to produce ATP.

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    Energy Investment Phase

    The initial stage of glycolysis requiring 2 ATP to begin.

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    Lactate Threshold

    Intensity point at which blood lactate increases significantly.

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    Oxidative System

    Aerobic energy system utilizing carbs, fats, and proteins for energy.

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    ATP Regeneration

    The process of replenishing ATP through energy systems.

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    Type II Muscle Fibers

    Muscle fibers with higher concentrations of creatine phosphate.

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    Biochemical Pathways

    Processes involved in energy production from ATP.

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    Substrate-Level Phosphorylation

    Direct ATP formation by transferring phosphate from ADP.

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    Passive vs Active Mobility

    Passive mobility relies on tissue extensibility; active requires muscle activation.

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    Lactate Accumulation

    Build-up of lactate due to reliance on glycolysis during high-intensity exercise.

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    Fibroblasts

    Cells that produce collagen and elastin during tissue repair and remodeling.

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    Acute Inflammation Signs

    Primary signs include redness, warmth, pain, swelling, loss of function after injury.

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    Beta Oxidation

    Process allowing fats to be used in oxidative energy production in cells.

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    Delayed Recovery

    Impaired recovery between tasks due to energy system deficiencies, affecting performance.

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    Acetyl CoA Production

    Each glucose molecule produces two molecules of acetyl CoA, entering the Krebs Cycle.

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    Krebs Cycle Energy Yield

    Most energy from the Krebs cycle is derived from NADH and FADH2.

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    GTP Function

    GTP can transfer a phosphate group to ADP to form ATP, acting as a high energy compound.

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    Electron Transport Chain Role

    NADH and FADH2 pass electrons down carriers called cytochromes to aid ATP production.

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    ATP Production from NADH

    One molecule of NADH can produce three molecules of ATP in the ETC.

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    Beta-Oxidation Process

    Free fatty acids undergo beta-oxidation in mitochondria, forming acetyl CoA and hydrogen protons.

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    Glycogen vs Glucose

    Muscle glycogen is the main energy source during moderate to high-intensity exercises.

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    Fatigue and Substrate Depletion

    Depletion of phosphagens and glycogen leads to fatigue during various activities.

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    Repletion of Muscle Glycogen

    Muscle glycogen can be replenished within 24 hours with carb intake after exercise.

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    Oxygen Uptake Definition

    Oxygen uptake measures how well the body uses oxygen during exercise.

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    Inflammatory Response Sequence

    The inflammatory response sequence begins with injury, followed by vascular reaction, and clot formation.

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    Fibroblastic-Repair Phase

    This phase involves fibroblasts laying down collagen fibers to repair tissue, lasting weeks after injury.

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    Chronic Inflammation Characteristics

    Chronic inflammation occurs when acute response fails, leading to prolonged tissue damage and fibrosis.

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    Factors Impeding Healing

    Extent of injury, edema, and poor vascular supply can all delay the healing process.

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    Study Notes

    Therapeutic Interventions - Week 1

    • Therapeutic interventions aim to improve, restore, or enhance function, remediate or prevent impairments, and prevent or reduce health risk factors.
    • Function depends on balance, stability, neuromuscular control, muscle performance, cardiopulmonary endurance, mobility, and flexibility.
    • Passive mobility relies on soft tissue extensibility.
    • Active mobility involves neuromuscular activation.
    • Bioenergetics deals with energy production in exercise.

    Bioenergetics and ATP

    • ATP (adenosine triphosphate) powers muscular activity.
    • ATP is a high-energy molecule storing energy in its phosphate bonds.
    • ATP hydrolysis (breakdown) releases energy.
    • Muscle cells have limited ATP stores, requiring continuous replenishment via three energy systems:
      • Phosphagen
      • Glycolytic
      • Oxidative

    Phosphagen System

    • Provides ATP quickly for short, high-intensity activities.
    • Active at the start of all exercise.
    • Involves the donation of a phosphate group from phosphocreatine(PCr) to ADP to form ATP.
    • The creatine kinase reaction is crucial.
    • Limited by creatine phosphate stores.
    • Type II muscle fibers have higher creatine phosphate concentrations.

    Glycolysis

    • Breakdown of carbohydrates to synthesize ATP.
    • Anaerobic pathway.
    • Glycolysis can occur in the fast or slow pathway.
    • Considered anaerobic. Higher capacity than phosphagen system for activities lasting 30 seconds to 2–3 minutes.
    • Forms pyruvate (or lactate) from glucose or glycogen.
    • Yields a net 2 ATP (or 3 ATP from glycogen).
    • The rate is controlled by allosteric regulation, primarily by phosphofructokinase.

    Lactate Threshold

    • The exercise intensity where blood lactate rises abruptly above baseline.
    • Represents increased anaerobic energy production.
    • Typically begins at 50-60% maximal oxygen uptake for untrained individuals.

    Oxidative System

    • Aerobic pathway utilizing carbohydrates (initially), fats, and proteins, for energy that is dominant during prolonged, low-intensity exercise.
    • Involves the Krebs cycle and electron transport chain in the mitochondria.
    • Produces large amounts of ATP from complete oxidation.
    • The Krebs cycle (Citric Acid Cycle) generates energy carriers NADH and FADH2 from acetyl-CoA.
    • Electron transport chain (oxidative phosphorylation) uses NADH and FADH2 to produce massive amounts of ATP.
    • 38 ATP are produced at the end of this process from the degradation of 1 glucose molecule. Muscle glycogen starts with 39 ATP.

    Fat and Protein Oxidation

    • Fats are oxidized via beta-oxidation, forming acetyl-CoA.
    • Proteins are broken down into amino acids and converted to glucose (gluconeogenesis).

    Energy Capacity

    • Exercise intensity determines the dominant energy system (phosphagen, glycolytic, oxidative).
    • Substrate depletion (e.g., glycogen) can limit exercise performance.
    • Replenishment of energy substrates can take time.

    Oxygen Uptake

    • Oxygen uptake increases during exercise to meet the increased energy demand.
    • An oxygen deficit occurs at the start of exercise.
    • Excess post-exercise oxygen consumption (EPOC) is the elevated oxygen uptake after exercise.

    Inflammation and Tissue Healing

    • Tissue healing involves three phases:
      • Inflammatory
      • Fibroblastic repair (proliferative)
      • Maturation/remodeling
    • Inflammation involves redness, warmth, pain, swelling, and loss of function.
    • Hemostasis (stopping bleeding) occurs first.
    • Neutrophils and macrophages clear debris.
    • Fibroblasts lay down collagen and elastin.
    • Collagen realignment occurs during remodeling (typically takes a long time - up to years).

    Exercise Prescription During Healing Phases

    • Acute: Protect (RICE - rest, ice, compression, elevation), passive range of motion, non-destructive movements.
    • Subacute/Proliferative: Controlled motion, selective stretching and progressive mobilization. Promote healing with gradually increasing strength, muscular endurance, and cardiopulmonary exercises.
    • Chronic: Minimal to no protection, progressive strengthening, functional exercises.

    Factors Impeding Healing

    • Injury severity, edema, hemorrhage, poor vasculature, tissue separation, muscle spasm, atrophy, corticosteroids, infection, poor nutrition, and age.

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    Description

    This quiz covers the fundamentals of therapeutic interventions, focusing on how various modalities aim to enhance physical function and address health risks. It includes topics on mobility, bioenergetics, and the role of ATP in muscle performance. Test your understanding of these critical concepts in physical therapy and exercise science.

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