ExPres Exam 1 Review

Exam Overview

Exam Details:

• Scheduled for: Monday.

• Format: Paper-based (No computer, Scantron, etc.).

• Materials Needed: Pen/pencil and calculator. Basic calculations may be necessary for various sections, especially in heart rate and blood pressure assessments.

Exam Structure:

• Total Questions: 45 questions divided across various topics relevant to cardiovascular health and exercise physiology.

• Question Formats: Includes multiple choice, true/false, and fill-in-the-blank.

• Points Per Question: 2 points each, totaling 90 points.

• Additional Points: 10 points available from the Y.M.C.A. Cycle Ergometer test, which evaluates aerobic capacity.

VO2 Calculation:

• VO2 Equation: VO2 = 7 + (work rate / body weight) * 1.8.

• Calculation Methods: Understand both the equation and graphing methods for estimating VO2, which is critical for assessing aerobic fitness levels in individuals.

Key Topics for Exam Questions:

Health Screening:

• Normal EKG waveforms:

  • P Wave, QRS Complex, T Wave.

  • Interval segments: Familiarity with ST segment, PR segment, and PR interval is crucial.

    • Example: PR interval: should be between 0.08 to 0.12 seconds long for a normal reading.

Heart Rate Calculation:

• Counting Methods: Count time between R-R intervals using the EKG graph:

  • Each small block = 0.04s;

  • Each large block = 0.2s.

• HR Formula: Heart rate can be calculated using the formula: 60 / (R-R interval).

Positive Electrodes and Lead Identification:

• 12-Lead EKG Familiarization:

  • Learn the types of leads: I, II, III, aVF, aVR, aVL, V1-V6 and their respective positive electrodes.

  • Understand their influence on depolarization direction and strength, which is critical for accurate diagnosis of cardiac abnormalities.

Coronary Artery Reference:

• Lead Associations: Knowing which leads correspond to specific parts of the heart is essential (e.g., leads II/III/aVF for inferior side, V leads for anterior wall).

Cardiovascular Risk Factors:

• Risk Factor Variables:

  • Non-modifiable: Age, family history.

  • Modifiable: Includes obesity, sedentary behavior, smoking, high cholesterol, high blood sugar, and elevated blood pressure.

• Cut Points: It’s important to know the established cut points for these risk factors to assess cardiovascular risk.

Blood Pressure Measurement (Errors to Avoid):

• Understanding Measurement Errors:

  • Overcuffing/undercuffing, full bladder influence, masked hypertension, white coat hypertension, and parallax error must be understood to avoid inaccurate readings.

Signs and Symptoms of Cardiovascular Diseases:

• Key Symptoms Recognition: Be able to identify angina, claudication, dyspnea, syncope, etc. Knowledge of these symptoms aids in early detection of cardiovascular issues.

Blood Pressure and Heart Rate Classifications:

• Blood Pressure Levels:

  • Normal, elevated, hypertensive (noting that 120/80 is classified as hypertensive).

• Heart Rate Classifications:

  • Normal (60-100 bpm), bradycardia, and tachycardia (with particular concern for tachycardia).

Cardiovascular Assessments:

• Maximal Test Responses: Understand how heart rate, VO2, stroke volume, systolic and diastolic blood pressure respond to maximal exercise tests. This is key for fitness evaluations.

Fick Equation and VO2:

• Fick Equation: VO2 = Cardiac Output × AVO2 difference.

• Definitions and Relevance: Be familiar with definitions of cardiac output (CO) and AVO2 difference, and recognize factors influencing them.

VO2 Normative Values:

• Normative Data: Familiarize yourself with normative VO2 data. Recognize high and low values relevant to age groups (e.g., a 20-year-old male needing improvement if below 60% of normative values).

Exercise Testing Protocols:

• Protocols Familiarization:

  • Understand the Bruce and Y.M.C.A. test protocols:

    • Bruce Protocol: Includes stages, timing, and gradients (e.g., 1.7 mph at 10% grade).

    • Y.M.C.A. Protocol: Involves stages, heart rate monitoring, and target heart rates for progression.

Equipment for Muscular Fitness Assessments:

• Types of Equipment: Get familiar with isometric and isokinetic dynamometers, free weights, etc. It is important to note that isokinetic measures provide the best validity, while isometric tests show the highest reliability.

Strength Ratios and Endurance Testing:

• Strength Ratio Standards: Understand the normative ratios (e.g., triceps vs. biceps should be 1:1; hamstrings vs. quadriceps should be 2:3).

  • Make sure McGill endurance test ratios fall below specified benchmarks for functional fitness.

Body Composition Assessment:

• BMI Calculation: Use the formula: Weight (kg) / Height (m)^2.

• BMI Categories: Understand the classifications: underweight, normal, overweight, and obese.

Skinfold Measurements:

• Methodology: Understand anatomical locations and methodology for conducting accurate skinfold measurements, essential for body composition assessments.

Functional Movement Screen (FMS):

• Protocols and Scoring: Familiarize yourself with protocols and scoring for active movements in the FMS and ensure you review the scoring criteria accurately.

Final Notes:

• Total Questions: 45 questions with a detailed breakdown across the aforementioned topics.

• Emphasis on Practical Applications: Focus on practical applications and real-world examples in preparation for the exam to strengthen understanding and retention.