NASM CPT Part 2 Comprehensive Study Notes
Skeletal System and Bones
Human skeleton has 206 bones total.
Axial skeleton: 80 bones (core of the body: skull, ears, neck, back, rib cage).
Appendicular skeleton: 126 bones (limbs/appendages).
Longest bone in the body: the femur (upper leg).
Patella is a sesamoid bone (kneecap).
Five main bone classifications: long bones, short bones, flat bones, irregular bones, sesamoid bones (sesamoids often lumped with irregulars).
Cells and Bone Remodeling
Osteoblasts: bone-building/repair cells.
Osteoclasts: bone-destroying cells.
Joints and Movement
Synovial joints are the most common joints in the body.
Types of synovial joints (conceptual overview):
Pivot joints (e.g., radius and ulna) allow rotation.
Hinge joints (e.g., elbow) move in one plane (flexion/extension).
Condyloid joints (in hands/feet) with multiple planes of motion.
Saddle joints (e.g., thumb base).
Plane (gliding) joints.
Ball-and-socket joints (shoulder, hip) allow numerous ranges of motion.
Skeletal-Muscular-Nervous Interaction (Kinetic Chain)
Kinetic chain: skeletal system + muscular system + nervous system.
Skeletal system: provides support, protects organs, forms blood, stores minerals.
Muscular system: links nervous and skeletal systems; enables movement.
Muscle Types and Functions
Three muscle types:
Skeletal muscle: voluntary, you can directly control it (e.g., biceps).
Smooth muscle: involuntary (e.g., digestive organs).
Cardiac muscle: heart muscle.
Sarcomere: basic contractile unit of a muscle fiber.
Motor unit: motor neuron plus the muscle fibers it innervates.
Nervous System Overview
Central nervous system (CNS): brain and spinal cord; processes sensory information.
Peripheral nervous system (PNS): nerves extending from the spine to the body; transmits information to/from CNS.
Neuron structure: axon, cell body, dendrites.
Autonomic nervous system (part of PNS): regulates involuntary functions.
Sympathetic nervous system: fight-or-flight.
Parasympathetic nervous system: resting-digesting.
Somatic nervous system: controls voluntary movement and external stimuli processing.
Basic Neurophysiology Terms
Neuron: basic unit of nervous system (axon, cell body, dendrites).
Sarcomere: basic contractile unit of muscle fiber.
Motor unit: motor neuron + muscle fibers it innervates.
Cardiorespiratory and Muscle Fiber Types
Type I muscle fibers: slow-twitch; endurance; aerobic; rely on fat as fuel.
Type II muscle fibers: fast-twitch; anaerobic; power/sprint activities; use carbs (glucose).
Blood Vessels and Circulation
Arteries: carry oxygen-rich blood away from the heart to the body.
Veins: carry deoxygenated blood from the body back to the heart/lungs.
Capillaries: smallest vessels; site of nutrient and gas exchange; provide nutrients to tissues.
Heart Anatomy and Function
Four heart chambers: right atrium, left atrium (top, smaller); right ventricle, left ventricle (bottom, larger).
Atria act as reservoirs; ventricles pump blood.
SA node (sinoatrial node): pacemaker of the heart.
Blood flow through the heart (five steps):
1) Oxygen-poor blood enters the right atrium.
2) Blood moves to the right ventricle.
3) Right ventricle pumps blood to the lungs for re-oxygenation.
4) Oxygenated blood returns to the heart.
5) Oxygenated blood moves from the left atrium to the left ventricle, which then pumps to the entire body via the aorta.Emphasis: the left ventricle pumps oxygen-rich blood to the body.
Blood Pressure and Circulation Basics
BP categories (general reference):
Normal: < 120/80.
Elevated: systolic 120–129 and diastolic < 80.
Stage 1 hypertension: systolic 130–139 or diastolic 80–89.
Stage 2 hypertension: systolic ≥ 140 or diastolic ≥ 90.
Blood Flow and Circulation (Recap)
Arteries carry oxygen-rich blood away from the heart.
Veins carry deoxygenated blood back to the heart.
Capillaries are the exchange sites for nutrients and gases.
Posture, Kinetic Chain Checkpoints, and Postural Deviations
Kinetic chain checkpoints for posture analysis: feet/ankles, knees, lumbo-pelvic-hip complex, hips, shoulders, head/neck.
Common postural deviations to recognize: lordotic posture, kyphotic posture, sway back, flat back, scoliosis.
Primary focus patterns:
Overly lordotic posture (excessive lumbar lordosis) often with lower cross syndrome.
Overly kyphotic posture (excessive thoracic kyphosis) often with upper cross syndrome.
Lower Cross Syndrome and Anterior Pelvic Tilt (APT)
Lower cross syndrome: excessive lumbar lordosis; hip flexors tight/short; lumbar extensors tight; glutes/hamstrings/core lengthened/underactive.
Anterior pelvic tilt: essentially the same as lower cross syndrome; hip flexors tight; hamstrings/glutes weak; core weak; lumbar extensors tight; stretch lumbar extensors, strengthen core and glutes/hamstrings.
Upper Cross Syndrome and Forward Head/Posture
Upper cross syndrome: anterior chest/pecs, lats, neck extensors tight; rhomboids and lower/middle traps, neck flexors underactive.
Forward head posture commonly accompanies upper cross syndrome; overactive: cervical spine extensors, upper traps, pecs, SCM, levator scapulae; underactive: deep cervical flexors.
Common cause: poor lifestyle choices (e.g., desk job, slouched posture).
Specific Postural Deviations and Associated Muscles (Overview from NASM patterns)
Forward head posture / upper cross: overactive cervical spine extensors, upper traps, pecs, SCM; underactive deep cervical flexors.
Upper cross syndrome specifics: overactive levator scapulae and cervical spine extensors; underactive lower traps.
Anterior pelvic tilt: overlap with lower cross; hip flexors overactive; glutes/hamstrings underactive; core underactive; lumbar extensors overactive.
Assessments and Movement Screens
Overhead Squat: primary movement assessment; checks dynamic posture, core stability, neuromuscular control; detects muscle imbalances (e.g., knee valgus, limited ankle mobility).
Setup: stand on flat surface, feet shoulder-width apart, feet pointing forward, ankles neutral, shoes off; elbows fully extended; arms overhead; depth to parallel (femur parallel to ground) or adjust if needed.
Reps: ~5 reps; view from front and side.
Front view observations: feet straight ahead; knees track over 2nd/3rd toes.
Side view observations: assess lumbopelvic-hip complex, hips, shoulders.
Common compensation patterns (overactive/underactive):
Feet turn out: overactive gastrocnemius/soleus, hamstrings; underactive tibialis anterior (anterior/posterior tibialis) and glutes.
Knees cave in (valgus): overactive TFL and adductors; underactive gluteus maximus and medius; tibialis anterior/posterior underactive.
Low back excessive arch: overactive hip flexors, lumbar extensors, lats; underactive gluteus maximus, hamstrings, abdominals.
Excessive forward lean: overactive hip flexors, gastroc/soleus, core (rectus abdominis, external obliques); underactive gluteus maximus, hamstrings, lumbar extensors.
Arms fall forward: overactive lats, pecs, teres major; underactive deep cervical flexors.
If one side overactive, opposite side often underactive (e.g., overactive hip flexors with underactive gluteals).
Single Leg Squat Assessment (advanced): requires balance; anterior view only; ~5 reps per side; deep up to ~60° knee flexion.
Setup: feet flat, hands on hips, eyes forward; lift one foot ~6 inches off ground; neutral ankle/knee facing forward.
Common pattern: knee caving in (valgus); overactive adductors and TFL; underactive gluteus maximus/medius and tibialis muscles.
Compensations: inward knee collapse, trunk lean variations; higher reliability when used with appropriate client capability.
Overhead and single-leg squat compensation patterns (recap):
Knees caving: overactive adductors; underactive glutes; possible tibialis underactivity.
Forward leaning or arching: overactive hip flexors, gastroc/Soleus; underactive glutes/hamstrings/abs.
Trunk/hip posture correlations: if one pattern present, expect reciprocal underactivity patterns.
Pushing and Pulling Assessments (standing, split stance; ~10 reps; side view):
Setup: split stance; push or pull with cables; light-to-moderate challenge.
Common compensations: head too far forward; elevated shoulders/scapula; overactive levator scapulae and upper traps; underactive deep cervical flexors; scapular elevation.
Additional compensation: low back arch; overactive hip flexors, lumbar extensors, lats; underactive glute max, glute medius, abs.
Question example (knotty judgment): if shoulder elevated and head forward, which muscles are overactive? Best answer: levator scapulae and cervical spine extensors.
Pulse assessment and heart rate basics
Pulse sites: carotid and radial; radial preferred (less invasive).
Normal resting HR (approx): male 60-70 BPM; female 72-80 BPM.
Overtraining indicator: HR higher than typical resting HR by ~5 BPM for several days.
Exercise HR measurement: measure for 10 seconds, multiply by 6 to get BPM.
Specialized tests and measurements
Push-up test (max push-ups): muscular endurance; men do standard push-ups; women do knee push-ups; depth to 90° elbow; hands slightly wider than shoulders; 60 seconds or to exhaustion.
Bench press assessment: estimates 1RM; setup: barbell with hands slightly wider than shoulder width; neutral lumbar spine; avoid excessive arch.
Protocols: after warm-up, perform 3 reps; rest 2 minutes; add 5-10% (or 10-20 lb) to initial load; repeat until progression stops; use charts to estimate 1RM.
Squat strength assessment: stand with feet shoulder-width; knees aligned with toes; use comfortable warm-up weight; progressive loading with rest.
Lower extremity power and speed tests
Vertical jump test: measures lower body power; up to 3 attempts with 2-minute rest between attempts.
Broad (long) jump: maximal horizontal jump distance; up to 3 attempts; 2 minutes rest between attempts.
Left Test (Lower Extremity Functional Test, LEFT): assesses agility, neuromuscular control, acceleration, deceleration; involves sprint, side shuffle, karaoke, back pedal between cones.
SAQ (Speed, Agility, Quickness) for different populations
Youths: 1-3 days/week; 4-8 drills; 1-4 sets; 3-5 reps; 15-60 seconds rest.
Key drills: Red Light Green Light, Follow the Snake (SAQ drills for youths).
Seniors: varied drills (cone/hurdle step overs, stand-up to figure eight).
Seniors: resistance training at 40-80% of 1RM for basic training (no precise numbers needed beyond this range).
Other aerobic and conditioning tests
40-yard dash: speed assessment (max sprint capability).
Pro Shuttle (5-10-5): agility assessment (acc/dec, shuttle runs).
VO2 max (maximal oxygen uptake): most valid measure of aerobic fitness; practically not used in typical client settings.
Resting VO2: VO2_{rest} = 3.5 rac{ml}{kg \, min}.
Other cardio rating scales: Talk Test; VT1 and VT2 (ventilatory thresholds).
Talk Test and Ventilatory Thresholds
Talk test: informal cardio-respiratory assessment; ability to hold a conversation indicates intensity.
VT1 (Ventilatory Threshold 1): point where body starts using roughly equal amounts of carbs and fats (50/50) for fuel; breathing becomes clearly audible.
VT2 (Ventilatory Threshold 2): higher-intensity level; for performance goals; client cannot verbally respond or must answer with single words.
Cardio Training Zones (NASM framework)
Zone 1: LIGHT – 3-4/10 or 12-13 on the Borg scale; below VT1; easy conversation.
Zone 2: MODERATE – 5-6/10 or 14-15 Borg; sweating noticeable; speaking harder; near VT1 to mid VT2.
Zone 3: HARD – 7-8/10 or 16-17 Borg; profuse sweating; capable of short phrases only.
Zone 4: VERY HARD – 9-10/10 or 18-20 Borg; near or above VT2; very limited or no talking.
Health and Nutrition Foundations
Body Mass Index (BMI):
Healthy range: 18.5 \leq BMI \leq 24.9
Underweight: BMI < 18.5
Overweight: 25 \leq BMI < 30
Obese: BMI \geq 30
Waist circumference risk factors (men/women): ~39.3" (often rounded to 40) for men; ~35.4" (often rounded to 35) for women.
Waist-to-hip ratio risk factors: >1.0 for men or >0.86 for women.
Body fat ranges (healthy, general guidance): men 10-20%; women 20-30%.
Bioelectrical impedance analysis (BIA): estimates body composition by measuring electrical impedance; hydration status affects results (dehydration can overestimate fat).
Skinfold measurements: four-site NASM approach — biceps, triceps, subscapular, iliac crest; measurements taken on the right side; multiple measurements averaged; not ideal for obese clients.
Nutrition Basics and Professional Boundaries
NASM role: trainers are not dietitians; no medical nutrition therapy or meal planning; use dietary guidelines and MyPlate resources; refer to registered dietitians for medical or complex cases (e.g., diabetes with weight loss goals).
Calorie and macronutrient basics:
1 gram protein = 4 \, kcal.
1 gram carbohydrate = 4 \, kcal.
1 gram fat = 9 \, kcal.
1 gram alcohol = 7 \, kcal.
Fiber is not a macronutrient (do not memorize fiber as a macro).
Macronutrient RDAs (rough ranges):
Protein: 0.8 \, g/kg \, body \, weight for sedentary adults; higher for athletes (roughly 1.2-1.7 g/kg for endurance/strength athletes; 1.4-2.0 g/kg bodybuilders in some sources).
Carbs: roughly 3-5 \, g/kg \, body \, weight for lightly active adults; $45-65\%$ of daily calories.
Fat: 20-35\% of total daily calories; saturated fats ≤ 10\% of total calories.
Nutrition for athletes: higher protein and carbohydrate intake as needed, with variability across sources.
Energy balance: there are 3,500 kcal in a pound of fat; a daily deficit of 500 kcal approximates 1 lb fat loss per week.
Fat-soluble vs water-soluble vitamins:
Fat-soluble: A, D, E, K (can accumulate if consumed in excess).
Water-soluble: C and B vitamins (generally excess excreted in urine).
Major minerals: calcium, phosphorus, magnesium, sodium, potassium, chloride, sulfur.
Subtypes of carbohydrates:
Monosaccharides: glucose, fructose, galactose.
Disaccharides: sucrose, maltose.
Polysaccharides: glycogen, fiber, starch.
Hydration and Fluid Replacement
Hydration guidelines around events:
Morning/evening prior: ~16 oz water before event.
Right before: ~13-20 oz.
During exercise: ~12-16 oz every 10-15 minutes.
Sports drink recommended for efforts > 90 minutes due to electrolytes.
After exercise: drink 1.25 times the amount of weight lost during sweat; include electrolytes and sodium.
Hormones, Pharmacology, and Medical Considerations (brief overview)
Beta blockers and diuretics (BP meds):
Beta blockers lower resting and exercise HR; HR response to exercise blunted.
Diuretics increase urine excretion; may raise dehydration risk.
Diabetes types:
Type 1: insulin-dependent; typically requires insulin injections.
Type 2: insulin resistance; more related to lifestyle factors.
Glycogen, gluconeogenesis, and energy production:
Glycogen is the stored form of glucose.
Gluconeogenesis is glucose production, which can involve protein.
All metabolic pathways contribute to ATP production for muscle contraction.
Exercise Science Concepts and Principles
All-or-nothing principle: motor units contract fully or not at all.
Neuromuscular specificity: relates to contraction speed and exercise selection.
Mechanical specificity: relates to weight and movements applied to the body.
Stretch-Shortening Cycle (plyometrics): three parts:
Eccentric phase: muscle lengthening (deceleration/loading).
Amortization phase: transition delay between eccentric and concentric.
Concentric phase: rapid shortening and energy release.
Training adaptations and the GAS model:
Phase 1: Alarm reaction (Fight/flight).
Phase 2: Resistance development (increased capacity).
Phase 3: Exhaustion (overload leads to breakdown/injury).
Specific Adaptation to Imposed Demands (SET): adaptations occur in response to specific demands of training.
OPT model (NASM): five phases, different rep/tempo/rest patterns and emphasis across phases (Phase 1 Stabilization Endurance, Phase 2 Strength Endurance, Phase 3 Hypertrophy, Phase 4 Maximal Strength, Phase 5 Power).
Resistance training routines organization:
Single set, multiple sets, pyramid, supersets, complex training, drop sets, giant sets, circuit training, split routines.
Loading patterns: vertical loading (upper then lower) vs horizontal loading (one exercise block at a time).
Peripheral heart action system: alternating upper and lower body exercises to improve circulation and fat loss.
Youth vs adult training considerations: youth have different glycolytic enzyme profiles and heat tolerance; generally lower capacity for long, high-intensity tasks.
Special Topics: Pregnancy, Obesity, and Medical Contraindications
Pregnancy: avoid supine floor exercises after first trimester; avoid exercise if hypertensive; adjust intensity and exercise selection accordingly.
Obese individuals: higher cardio frequency (5 days/week) and 60-80% HR max for 40-60 minutes; consider joint stress and program progression.
Common contraindications and safety considerations in training sessions: redirect conversations back to workout if client shares personal issues; ensure privacy and professionalism.
Exercise Programming and Business Concepts
Starting a personal training business:
Sole proprietorship: simple but no personal liability protection.
LLC (Limited Liability Company): protection for personal assets; easier to manage than S-corp but may require some forms.
Independent contractor vs employee: independent contractors pay own Social Security/Medicare taxes; employees have employer withholdings and benefits; most NASM CPTs work as employees in gyms.
Roles and responsibilities:
Independent contractor: self-employed; may rent space; tax responsibilities on own.
Worker/employee: employer controls hours/uniforms/work methods; typical in big gyms.
Plyometrics and Performance Training
Stretch-Shortening Cycle basics (three-part): eccentric, amortization, concentric.
Common training plan choices and sequencing (brief recap): single sets, multiple sets, pyramid, supersets, circuits, giant sets, drop sets, complex, etc.
Exam Preparation and Strategies
Practice quizzes and practice tests: aim for ~80% or higher; use NASM chapter quizzes; review part one and part two videos multiple times.
Recommended resources: pocket prep app (NASM) for additional practice questions.
Quick scenario questions to practice: identify phase, tempo, and rep schemes; diagnose overactive/underactive muscle patterns; apply NASM logic to compensations.
Final study tips: review the OPT model, movement compensations, and common test questions; recognize patterns in muscle imbalances for overhead squat, pushing/pulling, and single-leg squat assessments.
Quick Summary of Key Formulas and Quick Facts to Memorize
Max heart rate: HR_{max} = 220 - ext{age}
Resting VO2: VO2_{rest} = 3.5 rac{ml}{kg \, min}
Calorie content per macronutrient:
1 ext{ g protein} = 4 ext{ kcal}
1 ext{ g carbohydrate} = 4 ext{ kcal}
1 ext{ g fat} = 9 ext{ kcal}
1 ext{ g alcohol} = 7 ext{ kcal}
1 lb of fat ≈ 3500 kcal.
BMI healthy range: 18.5 \leq BMI \leq 24.9; underweight < 18.5; overweight 25-29.9; obese ≥ 30.
Daily protein/carbs/fat ranges (rough NASM RDAs):
Protein: 0.8 \, g/kg \, body \, weight (sedentary); higher for athletes (rough: 1.2-1.7 g/kg or 1.4-2.0 g/kg depending on goals).
Carbs: 3-5 \, g/kg \, body \, weight or 45-65% of total calories.
Fat: 20-35% of total calories; saturated fat ≤ 10% of total calories.
Hydration guidance (typical, not athlete-specific): pre-event ~16 oz; pre-event just before ~13-20 oz; during 12-16 oz every 10-15 min; after exercise use 1.25x body weight lost in sweat; include electrolytes.
Note: This set of notes covers a broad range of NASM CPT content referenced in the transcript, including anatomy, physiology, movement assessments, exercise science principles, nutrition basics, hydration, testing protocols, special populations, and business considerations. Use these notes alongside NASM official materials and practice quizzes to prepare for exam-style questions.