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Patient with severe cramping, increased fatigue and trying to get in shape

- - - - Muscle ( organ)
        
        hundred to thousands of muscle cells
        
        connective tissue
        
        epimysium
        
        blood vessels
        
        nerve fibers
      - Fascicle
        
        bundle of muscle cells
        
        surrounded by perimysium
      - muscle fiber
        
        elongated cell
        
        striated
        
        surrounded by endomysium
      - myofibril
        
        composed of sarcomeres
      - sarcomere
        
        contractile unit
        
        composed of myofilaments
      - Myofilament
        
        thick
        
        myosin molecules
        
        thin
        
        Actin
        
        tropomyosin
        
        troponin
    - - sarcolemma
        
        plasma membrane
      - sarcoplasm
        
        cytoplasm of muscle cell
        
        contains glycosomes
        
        store glycogen
        
        produce glucose for ATP
        
        myoglobin
        
        red pigment
        
        stores oxygen
      - striations
        
        series of dark and light bands
        
        A band
        
        H zone
        
        M line
        
        I band
        
        Z disc
      - Sarcoplasmic Reticulum
        
        elaborated smooth endoplasmic reticulum
        
        regulates levels of Ca
      - T Tubules
        
        elongated tube
        
        allow the action potential to to penetrate deep in cell
  - - - motor neuron fires an action potential
      - Axon terminal releases Acetylcholine into sypnatic cleft
      - Ach binds to chemicallly gated ion channels causes depolarization
        
        Na goes in and K goes out
        
        End plate potential
      - depolarization
        
        Action potential
        
        in sarcolemma
        
        open voltage gated sodium channels
      - Action Potentia in sarcolema
        
        travels down T tubules
      - Sarcoplasmic Reticulum
        
        releases Ca
      - Ca bind with troponin
        
        shifts tropomyosin
        
        uncovering myosin-binding sites in actin
      - Myosin heads bind to actin
        
        cross bridge
        
        muscle contraction
    - - response of a muscle to a single stimulation
      - muscle contract and then relax
      - three phases
        
        latent period
        
        first millisecond
        
        cross bridge begin to cycle
        
        muscle tension is not yet measurable
        
        Period of contraction
        
        cross bridge are active
        
        from onset to peak
        
        period last 10-100ms
        
        Period of relaxation
        
        final phase
        
        lasts 10-100ms
        
        number of contractile forces are decline
        
        muscle tension decreases to zero
    - - smooth muscle contractions
      - graded in two ways
        
        increase in frequency
        
        causes temporal summation
        
        greater the strength of contraction
        
        increase in strength of stimulation
        
        causes recruitment
        
        more motor units are activated
        
        stronger contraction
    - - individual twitches
        
        second stimulus delivered after relaxation is complete
      - unfused tetanus
        
        higher frequency
        
        result in unfused tetanus
      - temporal summation
        
        additional stimuli delivered before relaxation
        
        produce a wave summation
      - fused tetanus
        
        higher stimulus frequencies
        
        no relaxation is between stimuli
    - - isotonic contractions
        
        change length
        
        overcoming the load
        
        two types
        
        concentric contractions
        
        muscle shortness and does work
        
        eccentric contractions
        
        generate force as it lengthens
        
        causes microtrauma
      - isometric contractions
        
        muscle contractions don't always shorten and move a load
        
        there is a tension but no movement
    - - ATP
        
        move and detach cross bridge
        
        operate calcium pump in the SR
        
        operate the Na and K pump in plasma membrane
        
        only energy source directly for contractile activities
        
        must be regenerated fast
        
        generation of ATP
        
        direct phosphorylation
        
        creatine phosphate and ADP
        
        creatine and ATP
        
        15 seconds
        
        Anaerobic Pathway
        
        after direct phosphorylation
        
        glycolysis
        
        break down of glucose
        
        without oxygen
        
        2 ATP per glucose
        
        pyruvic acid
        
        turns into lactic acid
        
        causes soreness during workout
        
        30-40 seconds
        
        Aerobic Pathway
        
        makes 95% of ATP used by muscles
        
        require oxygen and mitochondria
        
        breaks down glucose
        
        to water and carbon dioxide
        
        generates large amounts of ATP
        
        glucose, CO2, H2O
        
        produce 32 ATP
    - - ionic imbalance
        
        K is lost from muscle cell
        
        disturb membrane potential
        
        reduce action potential
        
        will affect the voltage proteins
        
        affects amount of Ca release from the SR
    - - Frequency of stimulation
        
        temporal summation
        
        greater force the muscle exerts
      - Number of muscle fibers recruited
        
        more motor units
        
        more force
      - size of muscle fibers
        
        larger fibers
        
        more powerful movement
        
        can develop more tension
      - degree of muscle stretch
        
        muscle length
        
        length tension
- - - - hypoproteinemia
      - vital
        
        bones
        
        resist tension
        
        muscles
        
        grow
        
        skin
        
        elastic
      - symptoms
        
        fatigue
        
        bacterial infections
        
        breaking, falling out hair
        
        brittle nails and dry skin
        
        mood changes
        
        protein cravings
    - - loss of body fluid
      - nerve fuction
        
        Na and K
      - Sliding filament theory
        
        Calcium
      - muscle relaxation
        
        Magnesium
      - Resting state of muscles
        
        Chloride
  - - - hyponatremia
        
        low sodium levels
      - hypocalcemia
        
        low calcium levels
      - hypomagnesemia
        
        low magnesium levels
      - hypokalemia
        
        low serum potassium levels
      - exercise
        
        electrolyte depletion
    - - fatigue
        
        causes
        
        low levels of ATP
        
        ionic imbalance
        
        increased inorganic phosphate
        
        increase of magnesium
        
        decreased glycogen
        
        physiological inability to contract
    - - loss of muscle tissue
      - poor nutrition
    - - over working muscle
      - muscles need time to recover
      - muscles need nutrition to recover
      - damages muscle
    - - Pros
        
        weight lost
        
        lower in calories
        
        low rates
        
        heart disease
        
        diabetes
        
        cancer
        
        cholesterol
        
        high in fiber
      - cons
        
        vitamin and mineral loss
        
        vitamin D
        
        iron
        
        Calcium
        
        magnesium
        
        Vitamin B12
        
        no meat consumption
        
        incomplete protein
        
        hard to gain muscle
    - - side effects
        
        blood sugar decreases
        
        affects brain
        
        fatigue
        
        increase production of cortisol
        
        stress
        
        hungry
        
        metabolism slows down
        
        hard to lose weight
        
        cells go in survival mode
        
        eat alot
      - malnutrition
        
        lack of minerals
        
        lack of nutrients
- - - - gain muscle
        
        resistance exercise
        
        isotonic
        
        weight training
        
        hypertrophy
        
        increase on muscle size
        
        concentric
        
        muscle shortens
        
        flextion
        
        eccentric
        
        muscle generates force as it lengthens
        
        extension
        
        muscle over comes load
        
        isometric
        
        muscle against immovable force
        
        anaerobic pathway
        
        energy source
        
        glucose
        
        glycolysis and lactic acid formation
        
        no oxygen use
        
        product
        
        2 ATP per
        
        lactic acid
      - lose weight
        
        vascular exercise
        
        running
        
        jogging
        
        swimming
        
        biking
        
        cardio machines
        
        treadmill
        
        elliptical
        
        stationary cycles
        
        stepping machine
        
        aerobic exercise
        
        use of oxygen
        
        reaise heart rate
        
        at least 20 mins a day
        
        energy source
        
        glucose
        
        pyruvic acid
        
        fatty acids
        
        amino acids
        
        product
        
        32 ATP per
        
        glucose
        
        CO2
        
        H2O
        
        changes in muscle
        
        number of capillaries around muscle fibers increase
        
        number of mitochondria in muscle fiber increase
        
        synthesize more myoglobin
  - - - continue drinking water
        
        circulation
        
        digestion
        
        body temperature
      - start drinking sports drink
        
        electrolytes
        
        Ca
        
        muscle contractions
        
        bone formation
        
        blood
        
        Ma
        
        bone formation
        
        prevent osteoporosis
        
        nerve fuction
        
        blood glucose levels
        
        production of energy
        
        potasium
        
        fluid balance
        
        muscle contraction
        
        nerve signals
        
        Sodium
        
        body fluid balance
        
        nerve impulses
        
        phosphate
        
        cell energy
        
        cell membrane
        
        DNA
        
        prevents
        
        heat stress
        
        abnormal muscle function
        
        low performance
        
        cramps
        
        osteoporosis
    - - high protein diet
        
        reduces appetite
        
        benefits bones
        
        boost metabolism
        
        examples
        
        90% (or Leaner) Ground Beef
        
        Beans & Lentils
        
        Fish
        
        Tofu & Other Soy Foods
        
        Nuts, Nut Butters & Seeds
        
        Pork Loin
        
        eggs
        
        benetifs bones
      - eat before, during and after workout
      - whole carbs
        
        energy
        
        expamples
        
        vegetables
        
        whole fruits
        
        legumes
        
        potatoes
        
        whole grains
      - creatine
        
        help muscle cell
        
        produce energy
        
        improves high intensity exercise performance
        
        speeds muscle growth
    - - well balance meals
      - prevent
        
        over eating
        
        gain weight
        
        slow metabolism
        
        diet related illness
      - ensures body gets energy needed to perform
      - reduces hunger
      - provides all vitamins and minerals