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USP92M Anatomy and physiology for sports massage

Unit reference number: R/507/5630

Level: 3

Guided Learning (GL) hours: 70

Overview

This unit provides the foundation knowledge of anatomy and physiology in relation to sports massage. Learners will develop their knowledge of the structure and function of the skeletal, muscular, circulatory, respiratory, nervous, endocrine and energy systems and changes to these systems throughout the lifespan. Learners will also develop their knowledge of the physical, physiological, neurological and psychological effects of sports massage.

Learning outcomes

On completion of this unit learners will: LO1 Know the structural organisation of the human body

LO2 Know the structure and functions of the skin

LO3 Know the structure and functions of the skeletal system

LO4 Know the structure and functions of joints

LO5 Know the structure and functions of the muscular system

LO6 Know the structure and functions of the nervous system

LO7 Know the structure and functions of the endocrine system

LO8 Know the structure and functions of the cardiovascular system

LO9 Know the structure and functions of the respiratory system

LO10 Know the structure and functions of the lymphatic system

LO11 Know the structure and functions of the digestive system

LO12 Know the structure and functions of the urinary system

LO13 Know the effects of sports massage on the body systems

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Assessment requirements

Learners must complete both assessment requirements related to this unit: 1. External examination 2. Graded synoptic assessment

1. External examination

The theory content of LO1 – LO13 will be tested by an external examination at the end of the period of learning. External examinations will test knowledge and understanding from across the whole vocational area (mandatory units). Learners should use the unit content section of this unit to aid revision since exam questions will test the full breadth of content. External examinations will be set and marked by VTCT and will contribute to the overall qualification grade.

2. Graded synoptic assessment

In the last term or final third of their qualification learners will be required to undertake a graded synoptic assessment. This will require learners to carry out a range of services from across the whole vocational area (mandatory units). Assessment coverage will vary year on year, although all services will be covered over time. VTCT will set a brief for centres which will detail the services to be covered in the graded synoptic assessment. Grading descriptors for the synoptic assessment will also be provided by VTCT. The graded synoptic assessment will be marked and graded by centre staff and externally quality assured by VTCT. The graded synoptic assessment will contribute to the overall qualification grade.

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Unit content

LO1 Know the structural organisation of the human body

Learners must know the structural organisation of the human body:

Structural organisation of the human body from smallest to largest - Chemical level

- Cellular level

- Tissue level

- Organ level

- System level

- Organism level

Structure of the human cell – extracellular fluid, cell membrane, protoplasm, cytoplasm, cytosol, organelles (nucleus, nucleolus, smooth endoplasmic reticulum (ER), rough ER, ribosomes, Golgi apparatus, lysosomes, mitochondria, vacuole), cytoskeleton (microfilaments, intermediate filaments, microtubules, flagella, cilia)

Functions of the human cell – function of each structural component and organelle e.g. ribosomes – site of protein synthesis

Different types of human tissue - Epithelial tissue – simple squamous, columnar, cuboidal, ciliated, stratified

and transitional epithelium cells

- Glandular tissue – exocrine, endocrine

- Connective tissue – areolar, adipose, fibrous, elastic, reticular

- Bone – compact and cancellous

- Lymphoid tissue

- Nervous tissue

- Cartilage – hyaline, elastic, fibrocartilage

- Muscle tissue – smooth, striated, voluntary, involuntary

- Membranes – mucous, synovial, serous

Functions of different types of human tissue – epithelial, glandular, connective, bone, lymphoid, nervous, cartilage, muscle, membranes

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LO2 Know the structure and functions of the skin

Learners must know the structure and functions of the skin:

Structure of the skin – two main layers - Epidermis

Five layers – horny, clear, granular, prickle cell, basal

Outer layer that protects the dermis

No blood or lymphatic vessels

Production of skin cells begins in the deepest layers, as cells move towards surface and away from the base layers they die and fill with keratin (a protein) which causes them to toughen

- Dermis Subcutaneous layer, appendages (arrector pili, eccrine glands, pores,

apocrine glands, sebaceous glands, sensory nerve endings, blood vessels)

Thicker than the epidermis

Mainly formed of collagen fibres, connective tissue and elastin

Structures include – blood and lymphatic vessels, sweat and sebaceous glands, hair follicles, fat cells and nerves

Functions of skin - Sensation – detects pressure, pain, temperature

- Heat regulation – vasoconstriction, vasodilation, shivering and sweating

- Absorption

- Protection from infection and injury and protection from UV radiation (melanin)

- Excretion – sweat

- Secretion of sebum to lubricate

- Synthesis and formation of vitamin D and melanin

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LO3 Know the structure and functions of the skeletal system

Learners must know the structure and functions of the skeletal system:

Functions of the skeleton - Support and shape

- Protection of internal organs

- Muscle attachment and movement

- Production of blood cells

- Storage of minerals, mineral homeostasis

Structures of the skeleton - Axial – cranium, cervical vertebrae (7), thoracic vertebrae (12), lumbar

vertebrae (5), sacral vertebrae (5), coccyx (2-4), sternum, ribs

- Appendicular – scapula, clavicle, humerus, radius, ulna, carpals, metacarpals, phalanges, ilium, ischium, pubis, femur, patella, tibia, fibula, tarsals, metatarsals, phalanges

- Classification based on structure and function Long, e.g. femur, tibia

Short, e.g. tarsals, carpals

Flat, e.g. scapula, pelvis

Irregular, e.g. vertebrae

Sesamoid, e.g. patella

- Location of different bone classifications in the body

Bone growth and structure - Development of cartilage, growth of cartilage, development of ossification

centre, development of diaphysis and epiphysis

- Process of ossification and cells involved in growth, repair and remodelling (osteoblasts, osteoclasts, osteocytes), changes in bone growth with age, bone repair and bone remodelling (intramembranous, endochondral)

- Importance of calcium, factors affecting bone density (exercise, age and osteoporosis)

- Composition of bone to include the microscopic structure of compact and cancellous bone

- Long bone structure Characteristics (greater length than width, slightly curved)

Structure (diaphysis, epiphyses, metaphysis, articular cartilage, periosteum, medullary, endosteum, compact bone, spongy bone, bone marrow)

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LO4 Know the structure and functions of joints

Learners must know the structure and functions of joints:

Structural and functional classifications – fibrous/immovable e.g. cranium, cartilaginous/slightly moveable, e.g. vertebrae, synovial/freely moveable, e.g. knee

Joint structure - Fibrous – synarthrosis, immovable, have no joint cavity, are connected via

fibrous connective tissue, e.g. skull bones are connected by fibrous joints

- Cartilaginous – amphiarthosis, slightly moveable, a joint in which the surfaces are connected by disks of fibrocartilage, as between vertebrae

- Synovial – diarthrosis, freely moveable, all diarthroses have this characteristic space between the bones that is filled with synovial fluid

Characteristics of synovial joints – articulating bone, articular capsule, fibrous capsule, synovial cavity, synovial membrane, synovial fluid (lubrication), articular cartilage (shock absorption, decrease friction between bones), bursae (shock absorption), menisci, periosteum, accessory ligaments (intra / extra capsule), fat pads

Structure, function and properties of ligaments, e.g. attach bone to bone, joint stability

Structure, function and properties of tendons, e.g. attach muscles to bone

Types of synovial joint and their location in the body - Gliding (side to side, back and forth, e.g. between carpals and tarsals)

- Pivot (rotation, e.g. atlas and axis)

- Saddle (flexion, extension, abduction, adduction, circumduction, e.g. thumb)

- Ellipsoid (flexion, extension, abduction, adduction, circumduction, e.g. wrist)

- Ball and socket (flexion, extension, abduction, adduction, rotation, circumduction, e.g. hip and shoulder)

- Hinge (flexion and extension, e.g. knee and elbow)

Joint movement potential and actions - Shoulder (flexion, extension, abduction, adduction, horizontal

flexion/adduction, horizontal extension/abduction, internal rotation, external rotation)

- Elbow and radioulnar joints (flexion, extension, supination, pronation)

- Shoulder girdle (elevation, depression, protraction, retraction)

- Spine (flexion, extension, lateral flexion, rotation)

- Hip (flexion, extension, abduction, adduction, internal rotation, external rotation)

- Knee (flexion, extension)

- Ankle and foot (plantarflexion, dorsiflexion, inversion, eversion)

Joint actions during different sporting movements, significance of joint type and structure for movement potential, associated joints crossed by muscles, associated muscle group contractions, analysis of different multi-joint and single joint exercises

Associated range and stability of motion / movement of synovial joint types – range norms, factors affecting stability (shape of articular surfaces, capsule, ligaments, muscle tone, gravity)

Associated injury risk to joint types and ligaments, e.g. positions of strength and weakness, shearing forces, joint alignment during movement, greater range of movement allows increased risk of injury

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Effects of exercise and movement on joints - Short-term – synovial fluid, joint lubrication, increased circulation of blood and

delivery of nutrients

- Long-term – increased bone mineral density, increased joint stability and mobility, effects of appropriate or inappropriate repetitive loading on cartilage

Structure of the spine - Vertebrae structure (facet joints, vertebral foramen, spinal cord, spinal canal,

cartilaginous discs)

- Natural, mild S-shaped curve of the spine (cervical and lumbar lordosis, thoracic and spinal kyphosis), primary curves of the spine, secondary (developmental) curves of the spine

- Optimum position of spine and pelvis, maintenance of the natural spinal curvature (cervical, thoracic, lumbar), maintenance of posture in standing, sitting, lying positions

- Normal thoracic kyphosis (20 – 45°), normal lumbar lordosis (20 – 45°),

scoliosis (a right‑left curve of more than 10°)

- Range of motion of vertebral regions Cervical (rotation, flexion and extension)

Thoracic (rotation, limited flexion and extension)

Lumbar (flexion, extension, hyperextension)

Sacral (no range of motion)

Coccyx (no range of motion)

- Postural deviations – excessive deviations (hyperlordotic and hyperkyphotic), less than normal deviations (hypolorditic and hypokyphotic), definitions and causes (hyperkyphosis, hyperlordosis, scoliosis), effect of pregnancy on posture, e.g. how carrying a baby affects the natural curve

- Stabilising ligaments of the spine – structure and function, ligaments (ligamentum flavum, anterior and posterior longitudinal ligaments), intrasegmental and intersegmental ligament systems, role of spinal ligaments in core stability

Structures of the pelvic girdle - Structural bones (ilium, ischium, pubis, sacro-iliac joint)

- Ligaments (iliolumbar, sacrospinous, sacrotuberous, anterior and posterior sacroiliac), pubis symphysis articulation, sacroiliac articulation

- Importance of pelvic girdle for weight bearing exercise

- Male and female differences (effect of pelvic width on femur Q-angle and the relation to knee injury risk)

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LO5 Know the structure and functions of the muscular system

Learners must know the characteristics of the types of muscle tissue:

Types of muscle tissue – skeletal, cardiac, smooth

Characteristics of each type – location, microscopic structure, nervous control, fibre diameter, fibre length, and contraction speed

- Cardiac muscle (striated, involuntary, large fibre diameter, moderate fibre length, moderate speed of contraction, e.g. heart muscle/myocardium)

- Smooth muscle (no striations, involuntary, small fibre diameter, short to long fibre length, slow speed of contraction, e.g. artery walls)

- Skeletal muscle (striated, voluntary, up to very large fibre diameter, short to moderate fibre length, up to fast speed of contraction, attach to bones, e.g. quadriceps)

Learners must know the location of the major anterior and posterior skeletal muscles:

Anterior and posterior muscles – scalene, sternocleidomastoid, levator scapular, pectoralis major/minor, deltoids, biceps, triceps, trapezius, rhomboids, rotator cuff (supraspinatus, infraspinatus, teres minor, subscapularis), teres major, brachioradialis, coracobrachialis, common wrist flexors/extensors, brachialis, serratus anterior, latissimus dorsi, erector spinae, quadratus lumborum, rectus abdominis, obliques (internal/external), transversus abdominis, diaphragm, intercostals, Iliopsoas (psoas and iliacus), gluteus maximus, abductors (gluteus medius, minimus, tensor fascia latae), piriformis, gracilis, adductors (longus, magnus, brevis), quadriceps (rectus femoris, vastus group), hamstrings (biceps femoris, semitendinosis, semimembranosis), pectineus, sartorius, gastrocnemius, soleus, plantaris, popliteus, tibialis anterior, peroneus (fibularis) longus, brevis, tertius, tibialis posterior, extensor/flexor digitorum longus, extensor/flexor hallucis longus

Learners must know the location of the muscle attachment sites:

Muscle attachment sites and insertion for major anterior and posterior muscles (as above)

Learners must know the roles of muscles during movement:

Roles of muscles – agonist (prime mover), antagonist, fixator, synergist, muscles working in pairs, muscle roles during functional and sporting movements

Learners must know the different types of muscle contraction:

Isotonic (concentric, eccentric), isometric/static and isokinetic

Learners must know the actions of anterior and posterior muscles:

Contractions and muscle roles during different joint actions and exercises - Pectoralis major (adduction of arm, horizontal flexion of arm)

- Deltoids (abduction of the shoulder, flexion and extension of the shoulder)

- Biceps (flexion of the elbow)

- Rectus abdominis (flexion of the spine)

- External and internal obliques (lateral flexion and rotation of the spine)

- Transversus abdominis (isometric stabilisation of the spine)

- Hip flexors – iliacus, psoas major, rectus femoris (flexion of the hip)

- Quadriceps – rectus femoris, vastus lateralis, vastus intermedius, vastus medialis (extension of the knee, flexion of the hip)

- Adductors – adductor magnus, adductor longus, adductor brevis, gracilis, pectineus (adduction of the hip)

- Anterior tibialis (dorsi flexion of the ankle)

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- Trapezius (extension of the neck, elevation of the shoulder, depression of the scapula, retraction of the scapula)

- Triceps (extension of the elbow)

- Latissimus dorsi (adduction of the shoulder, shoulder extension)

- Erector spinae (extension of the spine)

- Gluteus maximus (extension of the hip)

- Abductors – gluteus medius, tensor fasciae latae (abduction of the hip)

- Hamstrings – biceps femoris, semimembranosus, semitendinosus (flexion of the knee, extension of the hip)

- Gastrocnemius (plantar flexion of the ankle, assist flexion of knee)

- Soleus (plantar flexion of ankle with bent knee)

Learners must know the principles of muscle contraction:

Gross muscle structure – tendon (attach muscle to bone), epimysium, perimysium, endomysium, fascicle

Arrangement of fasciculi (parallel, fusiform, pennate)

Cellular structure – muscle fibres, myofibrils, myofilaments (actin, myosin), sarcolemma, sarcomere

Sliding filament theory (myosin and actin, cross bridges, shortening of sarcomere), process (attachment of myosin to actin, power stroke, detachment, ATP and energy transfer), troponin, tropomyosin, calcium, sarcoplasmic reticulum, neurotransmitters, synapse, resting potential, action potential, all or none law

Different skeletal muscle fibre types and their characteristics - Slow twitch oxidative type 1 (red in colour, low intensity, long

duration/endurance, high in mitochondria, high in myoglobin, slow contraction speed, resistant to fatigue)

- Fast twitch or intermediate type 2a (pink or white in colour, intermediate contraction speed and rate of fatigue, adapt characteristics to training to become more like type 1 or type 2b fibres)

- Fast twitch type 2b (white in colour, high intensity, short duration, low in mitochondria, low in myoglobin, fast contraction speed, fast to fatigue)

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LO6 Know the structure and functions of the nervous system

Learners must know the structure of nervous system:

Central nervous system (CNS) components – brain, spinal cord

Peripheral nervous system (PNS) divisions – somatic nervous system, autonomic nervous system, sensory and motor / afferent and efferent nerves

Autonomic nervous system (ANS) subdivisions – sympathetic branch, parasympathetic system)

Learners must know the functions of each subdivision of the nervous system:

Main functions – sense changes to stimuli, information processing, response to stimuli

Central nervous system – processing centre, receive messages from peripheral nervous system about environment, interprets information, sends messages back to the peripheral nervous system, higher cognitive processes

Peripheral nervous system – connects the CNS to the limbs and organs, transmits information from receptors to CNS, transmits information from CNS to muscles and glands, communication relay going back and forth between the brain and extremities

Somatic system roles – sensory input, control of voluntary muscle

Autonomic nervous system – sense hormonal balance, regulates the functions of internal organs e.g. heart, stomach and intestines, control of involuntary muscle, control of endocrine glands

- Sympathetic division roles – increase heart rate, increase breathing rate, mobilise energy stores, regulation of blood pressure, blood flow redistribution, most active during exercise/sport

- Parasympathetic division roles – slows down functions, more active during rest and recovery

Learners must know the characteristics of different types of nerves:

Types of nerves – motor, sensory, inter-neurons

Structure and function of a neuron - Structure – dendrites, nucleus, cytoplasm, axon, axon terminals, myelin

sheath, nodes of Ranvier, nerve endings, cell body

- Function – transmit signals to muscles

Neuralgia – supporting structure – astrocytes, oligodendrocytes and microcytes

The relationship between the nervous system and principles of muscle contraction and motor unit recruitment

- Nervous control and nerve impulse transmission – role of the brain and spinal cord, nerve impulse, sensory neurones, receptor organs, synapse, motor neurones, axon terminal, acetylcholine, neuromuscular junction, effector organs, action potentials

- Motor unit recruitment – motor units (motor neuron, muscle fibre), small motor units (type I), large motor units (type II), size principle, factors affecting recruitment patterns (specific movement pattern, high and low firing threshold, skill and experience of participant), all or none law (if a stimulus is above threshold individual muscle fibres fully contract, if a stimulus is below threshold muscles fibres do not contract), strength of muscle contraction

- Muscle proprioceptors and the stretch reflex – function of muscle spindles (detect changes in muscle length), function of Golgi tendon organs (detect changes in muscle tension), stretch reflex (contraction of stretched muscle, reflex arc) inverse stretch reflex (inhibition of muscle contraction, reflex arc)

Reciprocal inhibition – agonist muscle contraction, antagonist muscle relaxation, relevance to sport/exercise (allows appropriate muscle contraction, can be used to promote flexibility development)

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LO7 Know the structure and functions of the endocrine system

Learners must know the structure of the endocrine system:

Structure of the endocrine system – major glands (hypothalamus, pituitary, thyroid, parathyroid, pineal and adrenal, pancreas, ovaries, testes)

Learners must know the role of hormones:

Regulate chemical composition and volume of body fluids within internal environment

Regulate metabolism and energy balance

Regulate contraction of smooth and cardiac muscle

Maintain homeostasis

Regulate immune system activity

Regulate growth and development

Reproductive processes Learners must know the key hormones and actions:

Hormones – thyroxine, adrenaline, noradrenaline, human growth hormone, melatonin, cortisol, insulin, glucogon, oestrogen, progesterone, testosterone, adrenocorticotropic hormone (ACTH)

- Growth hormone (growth of body cells, protein anabolism, elevation of blood glucose)

- Thyroid hormone – thyroxine and parathyroid hormone (metabolism, growth, development, nervous system control)

- Corticosteroids – cortisol (regulate metabolism, stress hormone)

- Adrenaline and noradrenaline (control of sympathetic nervous system, ‘fight or flight’ response before exercise)

- Insulin (lowers blood glucose, increases lipogenesis, stimulates protein synthesis)

- Glucagon (raises blood glucose, conversion of nutrients to glucose for energy release)

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LO8 Know the structure and functions of the cardiovascular system

Learners must know the structure of the cardiovascular system:

Heart – endocardium, myocardium, pericardium, atria, ventricles, septum, nodes)

Heart valves – atrio-ventricular valves (bicuspid valve, tricuspid valve), semi-lunar valves (aortic and pulmonary)

Cardiac conduction – sinoatrial node, atrioventricular node, right and left bundle branches, bundle of His, Purkinje fibres

Blood vessels – aorta, arteries, arterioles, vena cava (superior and inferior), veins, venules, capillaries, pulmonary veins, pulmonary arteries

Structure of blood vessels – comparison between blood vessels (wall thickness, internal diameter, direction of blood flow, pressure, presence of one-way valves)

Learners must know the functions of the cardiovascular system:

Transport of – oxygen, carbon dioxide, nutrients, waste products, hormones, medication

Regulation of – body temperature

Protection – blood loss and fighting foreign microbes

Function of heart – circulation of blood, receiving and pumping blood to body and lungs

Function of heart valves – control blood flow through heart chambers, prevent backflow of blood

Functions of blood vessels – transport blood, blood flow distribution by vasoconstriction and vasodilation

- Arteries and arterioles (transport blood away from the heart to muscles and organs, pulmonary arteries carry deoxygenated blood to lungs)

- Veins and venules (transport blood back to the heart from tissues and organs, venous return, blood pooling, pulmonary veins carry oxygenated blood from the lungs)

- Capillaries (exchange of gases and nutrients between blood and tissues or blood and alveolar air in lungs)

Learners must know the flow of blood around the circulatory systems:

Systemic circulation – oxygenated blood from lungs, pulmonary vein, left atrium, left ventricle, aorta, arteries, arterioles, capillaries, muscles and organs

Pulmonary circulation – deoxygenated blood from muscles and organs, capillaries, venules, veins, vena cava, right atrium, right ventricle, deoxygenated blood to the lungs for oxygenation

Other – renal, brain and hepatic portal system

Coronary – circulation of blood to the heart. (Oxygenated blood, root of aorta, aortic sinuses, epicardial coronary arteries, left coronary artery, circumflex artery, left anterior descending artery, right coronary artery, anastomoses, marginal arteries, cardiac veins, right atrium)

Functional considerations – heart rate (maximal and resting), stroke volume, cardiac output

Learners must know the composition of blood:

Plasma, plasma proteins, red blood cells (erythrocytes), white blood cells (leukocytes) and platelets (thrombocytes)

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Learners must know the definition of blood pressure:

Blood pressure definition – the pressure exerted by the blood against the walls of the arteries

Systolic pressure – pressure exerted during systole, ventricular contraction

Diastolic pressure – residual pressure during diastole, ventricular relaxation

Blood pressure classifications – see NICE guidance for current classifications for clinical blood pressure (hypertension) 140/90. Associated health risks of hypertension – cardiovascular disease, stroke, coronary heart disease, coronary artery disease, kidney disease, loss of vision

Factors affecting blood pressure – nutrition, exercise, alcohol, smoking, stress, medication, medical conditions and age

Diseases – arteriosclerosis, atherosclerosis, disease processes (inflammation, thickening of artery walls, loss of elasticity, endothelial damage, smooth muscle fibre proliferation, lesions formed by fatty plaque)

Effects of exercise - Short term – no change in diastolic pressure, progressive increase in systolic

pressure during CV training, rapid and greater increase in systolic pressure during resistance training, reduced BP for up to 24 hours after physical activity. Beware of Valsalva manoeuvre during resistance training as this can cause a sharp severe increase, followed by a sudden drop, in blood pressure,

- Long term – reduction in resting blood pressure, improved regulation of blood pressure

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LO9 Know the structure and functions of the respiratory system

Learners must know the structure and function of respiratory system:

Nose – cilia, mucus and goblet cells

Structure of lungs – left lung – two lobes, right lung – three lobes, trachea, bronchi, bronchioles, sub-divisions, alveoli, capillaries

Diaphragm

Function of lungs – paired organs for ventilation, external respiration, elimination of carbon dioxide, supply of oxygen

Learners must know the main muscles involved in breathing:

Muscles used during normal breathing – inhalation (inspiration), exhalation (expiration), muscles involved (diaphragm, external intercostals)

Accessory muscles used during forced inspiration – sternocleidomastoid, scalene and pectoralis minor

Accessory muscles during forced expiration – internal intercostals, transversus abdominus and rectus abdominus

Functional considerations, e.g. total lung capacity, vital capacity Learners must know the passage of air through the respiratory system:

Upper respiratory tract – mouth, nose and pharynx, larynx

Lower respiratory tract – trachea, bronchi, bronchioles, alveoli, alveolar sacs

Process of gaseous exchange – pulmonary ventilation, external respiration, internal respiration, surface area for gas exchange (300 million alveoli, 2400km of airways), partial pressure difference (higher and lower partial pressures), diffusion of gases, effect of breathing rate and depth

- Gaseous exchange in lungs external respiration (oxygen in alveoli passes to pulmonary capillaries and carbon dioxide in capillaries passes to alveoli), removed via exhalation

- Gaseous exchange in tissues internal respiration (oxygen in capillaries passes into cells for aerobic energy production, carbon dioxide in cells moves to local capillaries for circulation back to heart and lungs for removal)

Relative composition of inhaled air (21% oxygen, 0.04% carbon dioxide), relative composition of alveolar air (14% oxygen, 5.5% carbon dioxide), relative composition of exhaled air (16% oxygen, 4.5% carbon dioxide)

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LO10 Know the structure and functions of the lymphatic system

Learners must know the structure of the lymphatic system:

Primary and secondary lymph organs

Lymphatic vessels - Thoracic duct

- Right lymphatic duct

Lymphatic capillaries

Lymph fluid – monocytes, lymphocytes

Lymphatic nodes - Occipital

- Popliteal

- Inguinal

- Axillary

- Cubital

- Spleen

Learners must know the functions of the lymphatic system:

Fight and prevent infection – white blood cells, immunity, distribution of fluid throughout the body, transportation of fats

Remove excess tissue fluid (oedema) and return it to the bloodstream

Learners must know the structure of lymph nodes:

Capsule, trabeculae, cortex, follicles, medulla, medullary cords, afferent vessels and efferent vessels

Learners must know the functions of a lymph node:

Filtration of foreign substances, destruction of foreign substances, immune response

Learners must know the location of the major lymph nodes:

Occipital – back of neck

Submandibular – below jaw

Cervical – neck

Auricular – ear

Axillary – armpit

Abdominal – spleen on left side of the abdomen just inferior (below) to rib cage

Inguinal – groin

Popliteal – behind knee

Supratrochlear (cubital) – crook of elbow

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LO11 Know the structure and functions of the digestive system

Learners must know the structure of digestive system:

Mouth, tongue, teeth, salivary glands (parotid, submandibular, sublingual, buccal), pharynx (epiglottis), oesophagus, stomach, small intestine (duodenum, jejunum, ileum), pancreas, liver, gall bladder, large intestine, rectum, anus

Learners must know the functions of the digestive system:

Ingestion

Mouth – mastication, food chewed and moistened, salivary amylase breaks down starch into simple sugars

Oesophagus – peristalsis pushes food towards the stomach. No chemical breakdown

Stomach – pepsin breaks protein down into smaller amino acid chains. Peptides and lipase break down short chain triglycerides into fatty acids and monoglycerides. Hydrochloric acid kills bacteria and enables enzymes e.g. pepsin to perform their actions. Food churned and broken down into chyme

Small intestine (duodenum, jejunum and ileum) - breaks down nutrients into usable components. Chemical digestion using bile to emulsify lipids (fats) and pancreatic juice containing enzymes. Transports nutrients into blood stream

Pancreas – secretes pancreatic juice containing enzymes that assist breakdown of carbohydrates, protein and fat in small intestine. Role of pancreatic enzymes - trypsin, amylase, lipase

Liver – secretion of bile to emulsify fat and assist breakdown and absorption of fats

Gall bladder – located under the liver, stores and releases bile into small intestine

Large intestine – final stage of digestive process. Partial breakdown of cellulose (soluble fibre), reabsorption of the water from undigested food, undigested food fibre forms faeces and pass to the rectum

Rectum – expels faeces

Kidneys – help to keep blood composition constant. Filter blood to remove excess water and waste products, which are secreted as urine

Appendix – no known function in digestion. Vestigial part of colon with an immune system function

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LO12 Know the structure and functions of the urinary system

Learners must know the structure of urinary system:

Structure – kidneys, ureters, bladder, urethra Learners must know the functions of urinary system:

Main functions – controlling blood composition, controlling blood volume and pressure, removing and restoring water and solutes

Functions of each urinary structure – kidneys, ureters, bladder, urethra - Kidneys – filter waste from the blood, produce urine

- Ureter – tubes where urine leaves the kidneys and passes to the bladder

- Bladder – stores urine until excreted

- Urethra – carries urine from the bladder out of the body

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LO13 Know the effects of sports massage on the body systems

Learners must know the physical effects of sports massage:

Tissue permeability, stretching of muscle tissue and fascia, decreased excess scar tissue, realignment with underlying structures

Learners must know the physiological and neurological effects of sports massage:

Increased blood supply and vasodilation, increased lymph flow, waste removal, decreased swelling, enhanced immune system, pain reduction, muscle relaxation, reduction in neural stimulation (contraction) of muscles, reduction in the production of sympathetic (‘stress’) hormones

Learners must know psychological effects of sports massage:

Sympathetic response – increase mental alertness, stimulate client to help prepare them for activity, increase adrenaline and endorphins in the body

Parasympathetic response – reduction in physical tension, feeling of wellbeing and relaxation, stress and anxiety reduction

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Skin cancer awareness

Please note this information will not be assessed for the achievement of this unit. Public awareness of skin cancer has never been higher, and yet skin cancer remains the

fastest growing cancer in the UK, especially amongst young people. The chances of a

positive outcome can be dramatically increased with early identification and diagnosis.

Professionals in hair, beauty, sports massage and health and wellbeing industries work

closely with clients and in many cases have sight of areas of skin which may not be easily

visible to the client. An informed awareness of the signs, symptoms and changes of

appearance to be aware of when checking for early signs of cancer is a crucial tool for the

conscientious practitioner in order to provide the most thorough service and in some cases,

possibly lifesaving information signposting.

Signs to look for when checking moles include utilising the ABCDE guide:

A - Asymmetry – the two halves of the area/mole may differ in their shape and not match.

B - Border – the edges of the mole area may be irregular or blurred and sometimes show

notches or look ‘ragged’.

C - Colour – this may be uneven and patchy. Different shades of black, brown and pink may

be seen.

D - Diameter – most but not all melanomas are at least 6mm in diameter. If any mole gets

bigger or changes see your doctor.

E - Elevation/evolving – elevation means the mole is raised above the surface and has an

uneven surface. Looks different from the rest or changing in size, shape or colour. Anyone

can get a suspicious mole or patch of skin checked out for free by the NHS by visiting their

doctor, who may then refer to a dermatologist (an expert in diagnosing skin cancer).

If you require any additional NHS information please refer to https://www.nhs.uk/be-clear-on-

cancer/symptoms/skin-cancer

If your learners are interested in learning more about skin cancer awareness alongside this

qualification, VTCT runs the following qualification: VTCT Level 2 Award in Skin Cancer

Awareness for Non-Healthcare Professionals.

This qualification has been specifically designed for those working in the sports massage,

health and wellbeing, beauty, hairdressing and barbering sectors. It will enable learners to

identify any changes to their client’s skin and to highlight those changes to the client using

appropriate language and communication skills. It will enable the learner to raise awareness

of skin cancer and signpost their clients to public information about skin cancer.

This qualification will enable hair, beauty and wellbeing professionals to gain the appropriate

knowledge and communication skills required to provide non-diagnostic, professional advice

and information to clients in a discrete, empathetic and confidential manner.

For more information please refer to the Record of Assessment book:

https://qualifications.vtct.org.uk/finder/qualfinder/1Record%20of%20Assessment%20Book/A

G20529.pdf

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Resources

The special resources required for this unit must support learners to apply their knowledge of anatomy and physiology to sports massage. Recommended text books:

Bursztyn, P (1990) Physiology for Sports People. A serious user’s guide to the body. USA. Manchester University Press

Edward Alcamo, I. Ph.D. (2003) Anatomy Colouring Book. 2nd edition. USA. Random House

McArdle, W.D. Katch, F.I. and Katch, V.L (1996) Exercise Physiology. Energy, Nutrition and Human Perfromance. USA. Lea and Febiger

Norris, C (2007) The Complete Guide to Stretching. 2nd edition. UK. A&C Black/Bloomsbury Publishing

Norris, C (2011) The Complete Guide to Sports Injuries. UK. A&C Black/Bloomsbury Publishing

Norris, C (2013) The Complete Guide to Exercise Therapy. UK. A&C Black/Bloomsbury Publishing

Paine, T (2000) The Complete Guide to Sports Massage. 2nd edition. UK. A&C Black/Bloomsbury Publishing

Palastanga, N. Field, D. and Soames, R (1989) Anatomy and Human Movement. UK. Butterworth Heinemann

Sharkey, B (1990) Physiology of Fitness. 3rd Edition. Champaign, Illinois. USA. Human Kinetics

Stone, R. and Stone, J (1990) Atlas of Skeletal Muscles. USA. Wm. C. Brown Publishers

Thompson, C (1989) Manual of Structural Kinesiology. 11th Edition. USA. Times Mirror Mosby Publishing

Totora, G & Anagnostakos, N (1987) Principle of Anatomy and Physiology. 5th Edition. USA. Harper and Row

NB: This list is not exhaustive. There are many other valuable text books Recommended websites:

The SMA Code of Ethics and Conduct – www.thesma.org

Institute of Sport and Remedial Massage – www.theisrm.com/terms.php

Complementary and Natural Healthcare Council (CNHC) – www.cnhc.org.uk

Federation of Holistic Therapists (FHT) – www.fht.org.uk

The council for soft tissue therapies – www.gcmt.org.uk

The National Institute for Health and Care Excellence (NICE) – www.nice.org.uk

The American College of Sport Medicine (ACSM) – www.acsm.org

The Department of health – www.gov.uk/government/organisations/department-of-health

The British Association of Sport and Exercise Science – www.bases.org.uk

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Delivery guidance

Teachers are encouraged to use innovative, practical and engaging delivery methods to enhance the learning experience. Learners may benefit from the use of:

Interactive information and technology systems and software so they can actively learn about anatomical and physiological concepts and theories

Anatomical models e.g. skeleton, spine, knee, heart, digestive system, to provide a visual and kinaesthetic resource to enhance presentations and discussions

Interactive workshops that enable application of knowledge in a practical context e.g. joint action exploration workshop, muscle actions experiential workshop

Interactive games and quizzes, including labelling diagrams and labelling the position of bones and muscles on peers, the use of flash cards to recall information and/or the design of posters to reinforce learning

Links with other units

This unit is closely linked with the following units:

USP94M Assessment for sports massage

Learners will be required to apply their knowledge of anatomy and physiology when conducting client assessments. This will ensure they are able to differentiate pathological changes from acceptable normal function. The content of the anatomy and physiology for sports massage unit should be delivered before the delivery of the assessment for sports massage unit.

USP95M Sports massage treatments

Learners will be required to apply their knowledge of anatomy and physiology when conducting sports massage treatment. Sports massage therapists need to understand the body systems and structures when applying massage, so they can understand the effects of massage on the body. Knowledge of anatomy and physiology will also help them to understand and recognise contra-indications and cautions for massage. The content of the anatomy and physiology for sports massage unit should be delivered before the delivery of the sports massage treatments unit

USP96M Understand the principles of soft tissue dysfunction

Learners will be required to apply their knowledge of anatomy and physiology when studying the principles of soft tissue dysfunction. Learners must understand the pathological and functional changes that can take place when injury and dysfunctional tissue are present. The content of the anatomy and physiology for sports massage unit should be delivered before the delivery of the principles of soft tissue dysfunction unit

USP97M Health and lifestyle

Learners will be required to apply their knowledge of anatomy and physiology when studying health and lifestyle. Lifestyle choices have a direct effect on the anatomical structures and impact all physical and physiological processes and contribute to either positive health and wellbeing or ill health. The content of the anatomy and physiology for sports massage unit should be delivered before the delivery of the health and lifestyle unit.

Graded synoptic assessment

At the end of the qualification which this unit forms part of, there will be a graded synoptic assessment which will assess the learner’s ability to identify and use effectively in an integrated way an appropriate selection of skills, techniques, concepts, theories, and knowledge from a number of units from within the qualification. It is therefore necessary and important that units are delivered and assessed together and synoptically to prepare learners suitably for their final graded assessment.

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Version Details of amendments Date

v7 Skin cancer information page added

13/06/17