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42 yo female accountant Chief Complaint 4-month history of intermittent right-sided neck pain and intermittent headaches that have gradually increased in frequency. She cannot identify a specific injury but recalls an association with a period of increased lifting and carrying when moving.   Subjective History Symptoms: R sided neck pain that sometimes radiates to the medial shoulder blade region and sometimes to the head. Pain begins in the neck and may spread into the right temporal region. Reports a “deep ache” in the shoulder blade and base of the head that creates a headache when exacerbated. Symptoms worsen with: Prolonged computer work Repetitive or long term looking over the right shoulder while driving Lifting or carrying 20 lbs for longer than 10 minutes   Symptoms decrease with: Heat Pain Ratings          Current: 2/10                  Best: 0/10                            Worst: 7/10   Additional Information: Symptoms alleviated with 600mg ibuprofen Denies dizziness, diplopia, dysarthria  Sleep occasionally disturbed when symptoms are more severe.   Medical History Infrequent episodes of neck pain over the past several years. No history of concussion. No cervical surgery. No known migraine diagnosis.   Patient Goals Reduce neck pain and headaches. Complete a workday without symptom escalation. Return to Pilates and group exercises classes comfortably.   Neck Disability Index (NDI) 18/50 (36%) Patient Specific Functional Scale (PSFS) Activity Score:                Working at computer >4 hours       4/10                                                Checking blind spot while driving 3/10                                                 Reading for 30 minutes                      5/10   Objective Examination Observation:     Mild forward head posture Slight upper cervical extension posture noted at rest. Cervical AROM:  Flexion            45° Extension        55° with R sided neck pain Right Sidebend           30°  (R end AROM pain) Left Sidebend              38° (R side “stretch”)   Neurological Examination Myotomes C5-T1: Strong  Dermatomes C4-T1: Intact   Reflexes Biceps: 2+ Brachioradialis: 2+ Triceps: 2+   Strength Deltoids 4+/5 bilaterally *3/10 pain in R neck Biceps 5/5 Triceps 5/5 External Rotation 4/5 bilaterally *3/10 pain R neck Tenderness to palpation: Right cervical paraspinals Right upper trapezius *Palpation reproduces local neck pain and partially reproduces headache symptoms.   Special Tests Spurling Test — Negative Cervical Distraction– Mild symptom relief Upper Limb Tension Test A  — Negative

Which answer correctly describes the CORRECT order for the secretion of hormones in the cortisol hormone pathway?

At the lateral (thumb) side of the hand, the digit is called the _____ digit.

Type II diabetes and leptin resistance in obesity both involve:

A snack contains 20 g of carbohydrate and 10 g of fat. How many total kilocalories does it provide?Show your work. Give the total in kcal. A basic calculator is permitted.Quick referenceConversionFormulaL/min to mL/minL/min × 1,000Relative VO₂mL/min ÷ body mass (kg) = mL·kg⁻¹·min⁻¹METsrelative VO₂ ÷ 3.5RERVCO₂ ÷ VO₂ (below 0.85 = more fat; above 0.85 = more carbohydrate)Energy yieldCarbohydrate ≈ 4 kcal/g · Fat ≈ 9 kcal/g · Protein ≈ 4 kcal/gIntensityLight < 3 METs · Moderate 3–6 METs · Vigorous > 6 METs

In your own words, explain the crossover concept. Which fuel is used most at low intensity, and which at high intensity?Answer in 2–3 complete sentences.Word bank — use these terms to help build your answer. Some may be used more than once; some may not be used.absolute VO₂relative VO₂body weightEPOCphosphagen (ATP-PC)glycolysisoxidativehigh intensitylow intensityfatcarbohydratebody temperatureinsulinglucagonraiseslowers

Which two factors drive the shift toward carbohydrate as exercise intensity rises?

At low intensity (about 30% VO₂max), the main fuel is:

Which energy system supplies ATP the fastest for a maximal jump or short sprint?

As a runner speeds up from an easy jog to a hard pace, her RER would most likely: