1. Diabetes (Endocrine System)
1.1. Common types of Diabetes?
1.1.1. Pre-Diabetes
1.1.1.1. Cause: elevated sugar levels within the blood (5.7-6.4% of fasting blood glucose levels) that are higher than normal - but not high enough levels to be considered Type II
1.1.1.1.1. Risk Factors: obesity, age above 45, family history, smoking, race/ethnicity, PCOS, high cholesterol, high blood pressure
1.1.2. Types I
1.1.2.1. Cause: pancreas fails to produce insulin to remove sugar out of bloodstream into the cells
1.1.2.1.1. Risks: family history of type I
1.1.3. Type II
1.1.3.1. Cause: high blood sugar levels that average 6.5% or higher OR fasting blood glucose level 126 or greater
1.1.3.1.1. Risk Factors: obesity, age above 45, family history, smoking, race, PCOS, high cholesterol, high blood pressure
1.1.4. Gestational Diabetes
1.1.4.1. Cause: increase of blood sugar levels during pregnancy
1.1.4.1.1. Risks: family history of pre-diabetes, 25 yeas of age or older, overweight before pregnancy, race/ethnicity
1.2. Side effects related to loss of endurance?
1.2.1. Tiredness
1.2.2. Fatigue
1.2.3. Lack of motivation
1.2.4. Lack of energy
1.3. How to manage/counteract a loss of endurance in those with Diabetes?
1.3.1. Adapt to a fixed routine
1.3.1.1. Staying moving or active throughout the day or set specific time period to workout
1.3.1.2. This will help make body more sensitive to insulin and help prevent loss of endurance
1.3.2. Change duration or intensity of exercise
1.3.2.1. Set smaller goals of activity to keep from fatiguing out and losing steam during workouts
1.3.2.2. Try activities that "double duty" - find ways to target multiple categories of health
1.3.3. Maintain healthy diet
1.3.3.1. Consume adequate amount of glucose, especially before or after partaking in exercises
1.3.3.2. Monitor blood glucose levels regularly to have capability of completing exercise for strenuous amounts of time
2. Anemia (Hematological System)
2.1. Anemia Classified by Etiology
2.1.1. Blood loss - Massive or chroinic hemorraghe
2.1.1.1. Acute or Chronic
2.1.1.2. GI Bleeding
2.1.1.3. Menorrhagia; Metrorrhagia
2.1.2. Excessive Hemolysis
2.1.2.1. Sickle Cell Anemia
2.1.2.1.1. Genetic disorder resulting from the presence of a mutated form of Hemoglobin that is sickle shaped. This RBC is unable to bind and carry O2.
2.1.2.2. Hemolytic Disorders
2.1.2.2.1. RBCs are being destroyed faster than they can be made
2.2. Anemia Classified by RBC Size
2.2.1. Macrocytic Cells
2.2.1.1. Larger than normal immature RBCs. Structure is large, irregular, and oval instead of biconcave. Has flimsy cell membranes with a shorter lifespan.
2.2.1.1.1. B12/folate deficiency
2.2.1.1.2. Myelodysplastic Syndromes
2.2.2. Microcytic Cells
2.2.2.1. Small often hypochromic RBCs
2.2.2.1.1. Sideroblastic Anemia
2.2.2.1.2. Thalassemia
2.2.2.1.3. Iron Deficiency
2.3. Aplastic Anemia
2.3.1. Syndrome of bone marrow failure; body stops producing enough new blood cells
2.3.1.1. Likely caused by malabsorption, cells are hypochromic, and there are low stores of Fe2+
3. Additional General Clinical Manifestations of Anemias
3.1. Angular stomatitis, Koliynychia, Pica, Dizziness, Headaches, Heart Palpations (+subsequent anxiety), Dyspnea
3.2. Fatigue, Weakness, Restlessness and tingling, Pallor, Cold hands and feet, Hypothyroidism
4. Clinical Manifestations of Anemia make a patient feel weak, tired, and fatigued, and affect both the neuromuscular system and musculoskeletal systems. These symptoms contribute to loss of endurance and these patients require special precautions for exercise due to this loss of endurance. In same cases, the patient should not be exercsied at all
5. Decreased amount of hemoglobin in the blood, or RBCs unequipped to carry O2 are unable to provide systems of the body with adequate blood/O2 supply, so these body systems are lacking and cause problematic manifestations in the patient
6. A loss of endurance can occur when the pancreas does not produce a high or low enough level of the hormone insulin within the body.
6.1. The main role of blood glucose in the body is to provide energy to through a certain amount of insulin.
6.1.1. If these levels are too high or too low, it can significantly affect the body by creating complications.
6.2. The increase in time it takes for energy to travel from the blood to the cells throughout the body is called **"hyperglycemia".**
6.2.1. This can cause exhaustion and issues with sustaining an activity for long bouts of time.
6.3. When bodily cells are not receiving enough, or have too little levels of blood glucose is called "**hypoglycemia**".
6.3.1. It can be exercise-induced, resulting in weakness and fatigue in the body, implementing danger to the body during activity.
7. Prevents the endocrine system from attack and keeps the body healthy!
8. Lead to an increased risk of injury for the individual during activity.
9. Respiratory
9.1. Asthma
9.1.1. Etiology: Immunologic IgE mediated or idiopathic
9.1.1.1. Symptoms: Episodic wheezing, coughing, dyspnea
9.1.1.1.1. The symptoms can be tiring and can also cause reduced oxygen levels in the blood due to decreased efficiency of perfusion
9.1.1.1.2. This also makes exercising more difficult because as you breath more quickly, you cause cold, dry air to travel to lungs and irritate the airways which causes your muscles around the airway to tighten.
9.2. Emphysema
9.2.1. Etiology: long-term exposure to airborne irritants (tobacco, smoking, pollutants)
9.2.1.1. Symptoms: frequent coughing or wheezing, SOB, tightness in chest
9.2.1.1.1. It is common to see shortness of breath and impaired gas exchange in this condition which leads to the decrease of oxygen to the tissues
9.2.1.1.2. This condition also may increase the heart rate response when exercising due to the decreased oxygen and increased demand
9.3. Chronic bronchitis
9.3.1. Etiology: exposure to airborne pollutants (cigarette smoke, excessive dust in the air or chemicals)
9.3.1.1. Symptoms: blueish finger nails, swollen feet, wheezing, heart failure
9.3.1.1.1. This condition may show a decrease in stamina due to labored breathing and the comorbidity of heart failure
9.3.1.1.2. Exercise may provoke significant distress due to the poor circulation and swollen feet may be uncomfortable to stand on for prolong periods of time
9.4. Bronchiectasis
9.4.1. Etiology: larger airways due to an infection or injury to the airways or idiopathic
9.4.1.1. Symptoms: SOB, wheezing, coughing up blood or sputum, chest & joint pain
9.4.1.1.1. This condition is often associated with high levels of fatigue and is also associated with lower levels of oxygen in the blood stream which in severe cases may damage the heart and brain
9.4.1.1.2. Additionally, sputum in the airways will make breathing much more difficult and chest and joint pain will decrease the amount of exercise possible or limit the amount of exercise you could do
10. Cardiovascular
10.1. Valve Disorder
10.1.1. One or more of the valves in the heart does not work which leads to the failure to maintain unidirectional flow and the inability to properly get blood out to the rest of the body. These events lead to heart failure.
10.1.1.1. Symptoms: Whooshing sound, chest pain, fatigue, SOB- particularly when active or lying down, swelling of your ankles and feet, dizziness, fainting, irregular heartbeat
10.1.1.1.1. Causes: congenital, infectious, autoimmune, degenerative, aging
10.2. Metabolic Syndrome
10.2.1. cluster of conditions that occur together, increases risk of heart disease, type 2 diabetes, NAFLD
10.2.1.1. MUST diagnose 3 of the 5: o 1. obesity 2.large waistline (apple shape/abdominal obesity) 3.high BP 4. high blood triglycerides 5. low HDL cholesterol
10.3. Hypertension
10.3.1. strain on the heart due to high blood pressure
10.3.1.1. silent killer- often symptomless until eventual catastrophic event
10.4. Athersosclerosis
10.4.1. A buildup of fats, cholesterol and other substances in and on the artery walls.
10.4.1.1. chest pain or pressure (angina)
10.5. Stable Angina
10.5.1. a type of chest pain that occurs when your heart muscle needs more oxygen than usual but it's not getting it at that moment because of heart disease
10.5.1.1. occurs with stress or activity –goes away with rest
10.5.1.1.1. most common cause is Stenosis of the Coronary Arteries –usually from spasm but can be any other reason—no actual blockage
10.5.1.1.2. most common reason is caused by a spasm
10.6. Myocardial Damage by Ischemia
10.6.1. diseases that cause blood flow to the heart to decrease
10.6.1.1. Unstable Angina
10.6.1.1.1. chest discomfort or pain caused by an insufficient flow of blood and oxygen to the heart
10.6.1.2. Non-ST elevation myocardial infarction (NSTEMI)
10.6.1.2.1. a type of heart attack that usually happens when your heart’s need for oxygen can’t be met
10.6.1.3. ST-elevation myocardial infarction (STEMI)
10.6.1.3.1. occurs due to obstruction of the coronary arteries which leads to transmural myocardial ischemia resulting in myocardial injury or necrosis
10.7. Peripheral Arterial Disease (PAD)
10.7.1. The narrowing of the peripheral arteries that carry blood away from the heart to other parts of the body.
10.7.2. anterograde failure of blood flow
10.7.2.1. primary causes – diabetes, atherosclerosis
10.7.2.1.1. symptoms- intermittent claudication, ischemic pain, redness, ulcers, impaired gait
10.7.3. endothelial damage to arteries & arterioles
10.8. Shock
10.8.1. occurs when the rate of arterial blood flow is inadequate to meet metabolic tissue needs and is the consequence of CV collapse
10.8.1.1. state of hypoperfusion
10.8.1.1.1. o initially: body attempts to maintain homeostasis o late: blood circulation slows and eventually stops
11. Musculoskeletal
11.1. Atrophy
11.1.1. Decreased Workload
11.1.1.1. Lack of Activity
11.1.1.2. Orthopedic Casts
11.1.1.3. Bedridden Individuals
11.1.1.4. If a muscle is left unworked for an extended amount of time the body will began to reduce it's size by providing more resources to other areas of the body still being worked.
11.1.2. Loss of Innervation
11.1.2.1. Multiple Sclerosis
11.1.2.1.1. Etiology: Autoimmune Disease
11.1.2.1.2. Can be Relapsing-Remitting or Progressive
11.1.2.2. Myasthenia Gravis
11.1.2.2.1. Etiology: Autoimmune Disease
11.1.3. Chronic Malnutrition
11.1.3.1. Intake Issue
11.1.3.1.1. Anorexia
11.1.3.1.2. Bulimia
11.1.3.2. Absorption Issue
11.1.3.2.1. Inadequate Vitamin B-12