Physical Medicine medium

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Questions and Answers

What is the primary purpose of orthotics?

To strengthen synaptic connections

To reconstruct damaged nerve cells

To support, align or protect a part of the body (correct)

To imitate the functions of amputated limbs or organs

Which type of joint allows for the most movement?

Synarthrotic joints

Amphiarthrotic joints

Diarthrotic joints (correct)

Special joints

What characterizes the acute phase treatment of soft tissue injuries?

Utilizing the RICE method along with pain relief (correct)

Using oral medication for pain relief only

Applying heat to the affected area

Immediate surgical intervention

What is a common symptom of tendinitis?

Swelling and erythema Signup and view all the answers

What does electrotherapy primarily aim to achieve?

Pain relief and muscle strengthening Signup and view all the answers

What happens to the ventricular cavity during endurance exercises?

It enlarges. Signup and view all the answers

Which of the following conditions is a contraindication for ROM exercises?

Deep vein thrombosis (DVT). Signup and view all the answers

Which type of exercise is characterized by muscle contraction without movement?

Isometric resistance. Signup and view all the answers

What is a potential complication of stretching exercises?

Subluxation. Signup and view all the answers

In strength training, which type of exercise involves muscles working against resistance?

Strength training. Signup and view all the answers

What effect does prolonged stretching have on collagen fibers?

It creates plastic deformation. Signup and view all the answers

Which hormone levels can increase as a result of performing exercises?

Post pituitary hormones and androgens. Signup and view all the answers

Which type of exercise primarily engages Type I muscle fibers?

Low resistance, high repetition. Signup and view all the answers

What is the primary cause of Type 1 primary osteoporosis?

Estrogen deficiency post-menopause Signup and view all the answers

Which diagnostic tool is considered the gold standard for assessing bone mineral density?

DEXA scan Signup and view all the answers

What type of joint condition is characterized by joint stiffness lasting less than 30 minutes?

Gonarthrosis Signup and view all the answers

Which of the following treatments is considered first choice for osteoporosis?

Biphosphonates Signup and view all the answers

What is a common physical sign of Coxarthrosis?

Antalgic limping Signup and view all the answers

Which condition is characterized by alkaline phosphate elevation?

Paget Disease Signup and view all the answers

Which of the following is NOT a characteristic feature of osteoporosis?

Increased joint space in X-rays Signup and view all the answers

What is a common treatment option for osteomalacia?

Vitamin D and calcium replacement Signup and view all the answers

Which symptoms are associated with inflammatory joint pain?

Warmth in affected joints Signup and view all the answers

What is a characteristic of rheumatoid arthritis?

It is symmetrical and affects multiple small joints Signup and view all the answers

Which factor is a risk for developing osteoarthritis?

Age Signup and view all the answers

Which statement is true about psoriatic arthritis?

It can involve both large and small joints Signup and view all the answers

What characterizes ankylosing spondylitis?

Can lead to reduced motion in the spine over time Signup and view all the answers

Which of the following conditions can lead to inflammatory arthritis?

Sjögren Syndrome Signup and view all the answers

Which treatment is commonly used for inflammatory arthritis?

Disease-modifying antirheumatic drugs (DMARDs) Signup and view all the answers

What is the most common form of inflammatory arthritis?

Rheumatoid arthritis Signup and view all the answers

Study Notes

Physical Medicine and Rehabilitation

ICF: International Classification of Functioning; impairment = deviation/loss of body structure or function.
Therapeutic Exercises:
- Vasodilation in exercising muscles, vasoconstriction in non-exercising areas.
- Vascular resistance in muscles to meet demand; ↑ BP in isometric exercises.
- ↑ cardiovascular effects in isotonic/isometric exercises; if exercise continues, heart rate and BP stabilize.
- Post pituitary hormones and androgens affect TG, LDL, HDL, and HDL in endurance exercises.
- Endurance: low resistance, high repetition exercises, type 1 fibers; ventricular cavity enlarges.
- Strength: high resistance, low repetition exercises, both type 1 & 2 fibers; ventricular cavity normal, wall thickness increased.
Contraindications to ROM Exercises: tears, unhealed fractures, surgery, deep vein thrombosis, active heterotopic ossification, cardiovascular instability, myocardial infarction.
Stretching Exercises:
- Pathology: fibrous or osseous contracture; with slight force, some elongation of collagen fibers; prolonged stretching—CT undergoes plastic deformation and cannot return to original size even without force.

Complications of Stretching

Tissue damage in painful conditions lasting more than 1 hour.
Subluxation (misalignment/partial dislocation) - result of inappropriate stretching/pressure overload.
static/dynamic exercises.

Muscle Strength Exercises

Isometric: resistance, static; muscle contracts w/o movement.
Isotonic: same tonus, muscle lengthens and shortens within ROM (dumbbells).
Isokinetic: dynamic speed of muscle contraction; controlled by mechanical device, constant velocity; eccentric contractions: muscle tightening when it is long.

Physical Activity

Aerobic activity: continuous movement using big muscle groups (walking, swimming, soccer); causes heart, lungs, & vascular system to work harder.
Strength training: muscles work against resistance (free weights, body weight).
Flexibility training: ability to move a joint through its range of motion (yoga, pilates).

Inflammatory Conditions

Inflammatory pain pattern (at least one of three symptoms): maximal morning pain, waking up night pain, morning stiffness greater than 1 hour.
Inflammatory Arthritis: group of diseases caused by overactive immune systems; joint pain and stiffness; joint may feel warm, swollen, and tender; systemic diseases include RF, CRP, ESR elevated.
Rheumatoid Arthritis: most common inflammatory arthritis; multiple small joints of hands and feet, symmetrical inflamed synovium; warmth, pain, stiffness, RF, anti-CCP, antibodies (+).
Psoriatic Arthritis: Spondylarthropathy—combination of psoriasis; pain, swelling, large/small joints, sometimes spine; can cause complete swelling of fingers/toes (dactylitis).
Juvenile Idiopathic Arthritis: inflammation in joints, sometimes spine & ligaments; lasting > 6 weeks; swelling or mobility problems (limp if leg is affected); some types—eye inflammation without symptoms.
Ankylosing Spondylitis: most common inflammatory spondylarthritis; primarily affects spine, hip, sternum, and large joints; over time, noticeably reduced motion in the spine; presence of HLA-B27 gene can help confirm.
Gout: Elevated uric acid crystals; risk of kidney stones, commonly in the big toe.
Pseudogout: Calcium pyrophosphate dehydrate deposition disease; affects wrist and knees.
Sjogren’s Syndrome & Lupus: Can cause inflammatory arthritis as a symptom.

Treatments

NSAIDs (ibuprofen), corticosteroids, disease-modifying antirheumatic drugs (DMARDs) (methotrexate, biologic DMARDs).

Osteoarthritis

Degenerative disease of synovial joints; characterized by breakdown of articular cartilage; pathology: fibrillation, eburnation(polished surface due to cartilage loss), osteophytes (bone spurs), subchondral cysts; primary OA (idiopathic).
Secondary OA: due to some other disease.
Risk factors: older age, female, obesity, genetic factors (COL2A1 gene), trauma.
Symptoms: joint pain (degenerative), stiffness (after inactivity); Limited ROM, deformity (restriction of ADLs); radiological findings: narrow joint space, osteophytes (bone spurs), subchondral sclerosis, bone cysts.
Gonarthrosis (OA of knee): joint stiffness <30 minutes; pain on pressure, crepitus; lab. within normal limits.
genu varum: bowed legs; genu valgum: knock knees.
Coxarthrosis (OA of hip): Pain of hip, gluteal area, radiating to knee; limited walking, antalgic limping, & ROM, Trendelenburg test (+); lab. within normal limits.

Osteoporosis

Primary osteoporosis: type 1 (post-menopausal, trabecular bone loss) and type 2 (senile, cortical bone loss).
Secondary osteoporosis: caused by medications (steroids, methotrexate), cancer treatments, anti-cancer medications (antacids), immobilization.
Diagnostic tools: blood tests (vit D, serum Ca, P, PTH, FSH), gold standard is DEXA (dual-energy X-ray absorptiometry)—bone mineral density; scores compared to healthy young adults; osteopenia (-2.5 to -1 SD); osteoporosis (< -2.5 SD); severe osteoporosis plus fractures; silent bone disease unless fractures; loss of height, postural abnormalities (vertebral fractures)
Treatment: –– Medications to stop bone resorption; biphosphonates (first choice), teriparatide (analog to PTH). –– Anabolic medications (teriparatide): safe during pregnancy; Denosumab (RANK inhibitor); Calcium and vitamin D supplementation.
Other conditions — Osteomalacia low vitamin D, abnormal bone structure, X-ray and labs confirm; treatment :vit D & calcium replacement. — Paget Disease osteitis deformans—deformed bone; symptoms: pain, tenderness, nerve entrapment; diagnostic test: alkaline phosphatase in blood; treatment calcitonin

Other conditions

Sprains: soft-tissue injury from overstretching/tearing of ligaments around a joint; swelling and pain.
Strains: stretch or tear of muscle or tendon fibers.
Tendintis: inflammation of tendons; pain, swelling redness, and sensitivity around the tendons.
Synovitis: inflammation of synovial membrane inside the joint capsule; swelling, pain, and restricted ROM.
Synarthrotic Joints: fixed joints (e.g., skull).
Amphiarthrotic Joints: partially moveable joints (e.g., ribs, sternum, vertebrae).
Diarthrotic Joints: freely moveable joints (e.g., most limbs).
Special Joints: hyoid bone + eyeball.
Muscular Dystrophy: genetic diseases that cause muscles to weaken progressively.
Myopathy: disease characterized by muscle weakness and pain due to abnormal muscle structure.

Electrotherapy

Electrical stimulation for muscle strengthening, pain relief, functional improvement.
TENS: pain control, modulation of pain uses gate control theory
Contraindications: cardiac pacemaker, unstable angina, carotid sinus application, thrombosis.

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Description

This quiz covers key concepts in Physical Medicine and Rehabilitation, including the ICF framework, therapeutic exercises, and contraindications for range of motion exercises. Test your knowledge on the effects of different types of exercises on cardiovascular health and muscle functionality.