Physical Medicine Hard

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the primary effect of endurance exercises on lipid profiles?

Decreases triglycerides and increases HDL (correct)

Increases triglycerides and decreases HDL

Decreases triglycerides and increases LDL

Increases LDL and decreases HDL

Which of the following scenarios is a contraindication for performing range of motion (ROM) exercises?

Isolated sprains

Normal joint laxity

Stable fractures

Active heterotopic ossification (correct)

How do isometric exercises primarily affect muscle length and movement?

Muscles contract while remaining at a fixed length (correct)

Muscles lengthen without tension

Muscles undergo concentric movement

Muscles lengthen and shorten within the ROM

What happens to the ventricular cavity during a strength training regimen?

It remains normal while wall thickness increases Signup and view all the answers

Which type of contraction occurs during an eccentric exercise?

Muscle lengthening under tension Signup and view all the answers

Which of the following effects is NOT associated with isotonic exercises?

Static muscle contraction Signup and view all the answers

What are the primary physiological changes that occur during sustained exercise?

Initial increase followed by stabilization of heart rate and blood pressure Signup and view all the answers

When considering stretching exercises, what characterizes prolonged stretching?

Plastic deformation occurs in connective tissue Signup and view all the answers

In muscle strength training, what type of muscle fibers are primarily recruited in high resistance, low repetition exercises?

Both Type I and Type II fibers Signup and view all the answers

How does stretching improperly result in subluxation?

From static exercises that cause pressure overload Signup and view all the answers

Which symptom is NOT typically associated with inflammatory arthritis?

Joint pain that worsens with rest Signup and view all the answers

What is a hallmark feature of rheumatoid arthritis?

Presence of RF and anti-CCP antibodies Signup and view all the answers

Which type of arthritis is associated with the presence of HLA-B27 gene?

Ankylosing spondylitis Signup and view all the answers

What is the primary cause of secondary osteoarthritis?

Injury or another disease Signup and view all the answers

Which of the following drugs is classified as a disease-modifying antirheumatic drug (DMARD)?

Methotrexate Signup and view all the answers

What characterizes pseudo gout?

Deposition of calcium pyrophosphate crystals Signup and view all the answers

Which of these is NOT a typical feature of osteoarthritis?

Significant morning stiffness Signup and view all the answers

What is a common systemic symptom associated with inflammatory arthritis?

Elevated levels of RF, CRP, or ESR Signup and view all the answers

Which aspect of juvenile idiopathic arthritis distinguishes it from other forms of arthritis in children?

Presence of eye inflammation without symptoms Signup and view all the answers

What type of joint significance do dactylitis and complete swelling indicate?

Psoriatic arthritis Signup and view all the answers

What characterizes the changes that occur during short-term neuronal plasticity?

Modifications in synaptic communication and excitability Signup and view all the answers

Which of the following describes a sprain?

Overstretching or tearing of ligaments Signup and view all the answers

Which joint type is characterized as being freely movable?

Diarthrotic joints Signup and view all the answers

In which phase of soft tissue injuries is the RICE method primarily utilized?

Acute phase Signup and view all the answers

Which condition is characterized by the gradual weakening of muscles due to genetic factors?

Muscular Dystrophy Signup and view all the answers

Electrotherapy, which includes STENS, primarily utilizes which theory for pain control?

Gate control theory Signup and view all the answers

What best describes amphiarthrotic joints?

Partially moveable allowing limited motion Signup and view all the answers

What is a primary symptom of tendinitis?

Sensitivity and swelling around a joint Signup and view all the answers

Which commonly used method is recommended for pain relief during the acute phase of soft tissue injuries?

RICE method Signup and view all the answers

What type of joint is found in the skull and pelvis?

Synarthrotic joints Signup and view all the answers

What is a feature of gonarthrosis that differentiates it from other types of arthritis?

Pain on pressure with crepitus in individuals over 50 Signup and view all the answers

Which type of osteoporosis is specifically related to post-menopausal hormonal changes?

Type 1 Osteoporosis Signup and view all the answers

What imaging modality is considered the gold standard for diagnosing osteoporosis?

DEXA Signup and view all the answers

Which treatment option is the first choice for osteoporosis to reduce bone resorption?

Biphosphonates Signup and view all the answers

Which characteristic is associated with ocular symptoms in Paget's disease?

Hearing loss and nerve entrapment Signup and view all the answers

What is the primary diagnostic finding in osteomalacia?

Looser zones visible on X-ray Signup and view all the answers

What condition is characterized by bowing of legs and cortical thickening?

Paget Disease Signup and view all the answers

With which condition would you expect a positive Trendelenburg test?

Coxarthrosis Signup and view all the answers

Which type of osteoporosis is typically caused by medication, such as steroids or methotrexate?

Secondary Osteoporosis Signup and view all the answers

Which treatment is safe to use during pregnancy for osteoporosis?

Denosumab 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 increase: in isometric exercises.
Cardiovascular effects: increase in isotonic/isometric exercises.
Hormones and androgens: stabilize after prolonged exercise.
Endurance exercises: ↑TG, ↓HDL, ↑HDL in endurance exercises, type 1 fibers.
Strength exercises: high resistance, low repetition, both type 1 & 2 fibers, increased ventricular cavity wall thickness.

Contraindications to ROM Exercises

Tears, unhealed fractures, surgery.
Deep vein thrombosis.
Active heterotopic ossification.
Cardiovascular instability.
Myocardial infarction.

Stretching Exercises

Pathology: (if fibrous or osseous contracture) slight force causes some collagen fiber elongation.
Prolonged stretching: CT undergoes plastic deformation, and cannot return to original size without force.

Complications of Stretching

Tissue damage: painful conditions lasting more than 1 hour.
Subluxation: misalignment, partial dislocation resulting from inappropriate stretching/pressure overload.

Muscle Strength Exercises

Isometric: resistance, static, muscle contraction without 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 lengthening.

Physical Activity

Duration, intensity, frequency: continuous movement using large muscle groups.
Aerobic activity: causes heart, lung, and vascular system to work harder, walking, swimming, soccer etc.
Strength training: Muscles work against resistance, free weights(dumbbells), body weight (push-ups).
Flexibility training: Ability to move a joint through its range of motion, yoga, pilates, etc.

Inflammatory Conditions

Pain pattern: maximal pain on morning, waking up at night due to pain, morning stiffness for over 1 hour.
Inflammatory arthritis: group of diseases caused by overactive immune system (joint pain and stiffness), joint may feel warm, swollen, tender.
Rheumatoid arthritis: most common inflammatory arthritis, multiple small joints of hand 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.
Juvenile idiopathic arthritis: inflammation in joints, sometimes spine and ligaments, last >6 weeks, Swelling or mobility problems, limping if leg affected, some types of eye inflammation without symptoms.
Ankylosing spondylitis: primarily affects spine, hip, sternum, large joints. Over time motion reduction in spine, HLA-B27 gene presence.
Gout: elevated uric acid crystals, risk of kidney stones (big toe).
Pseudogout: calcium pyrophosphate dehydrate, affects wrist/knee.
Sjogren's syndrome & Lupus: can cause inflammatory arthritis.

Treatment

NSAIDs: Ibuprofen, corticosteroids, disease-modifying antirheumatic drugs (DMARDs), methotrexate, biological DMARDs.

Osteoarthritis

Degenerative: disease of synovial joints, breakdown of articular cartilage, proliferation of changes.
Pathology: fibrillation, eburnation (polished surface due to cartilage loss), osteophytes.
Subchondral cysts: primary (idiopathic) osteoarthritis.
Secondary osteoarthritis: due to some other diseases.
Risk factors: age, female, obesity, genetic predisposition (e.g., COL2A1 gene), trauma.

Osteoporosis

Loss of bone density: reduced bone structure.
Primary osteoporosis: Type 1 (postmenopausal due to estrogen), Type 2 (senile).
Secondary osteoporosis: caused by meds like steroids, methotrexate, anti-cancer drugs, or immobilization.
Diagnostic tests: blood tests (vitamin D, serum calcium, phosphorus, parathyroid hormone), DEXA (bone mineral density), and X-ray
Treatment: drugs to stop bone breakdown (bisphosphonates-first choice), Teriparatide (PTH analog), denosumab (RANKL inhibitor). No alcohol, caffeine, or smoking.

Osteomalacia

Vitamin D abnormality: reduced bone resorption.
Diagnostic Tests: DEXA, blood tests, calcium, vitamin D.
Treatment: vitamin D and calcium replacement.
Paget's Disease: osteitis deformans (bone remodeling disorder), often asymptomatic but can cause pain, tenderness, nerve entrapment, and cortical thickening.

Electrotherapy

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

Neuronal Plasticity

Brain and nervous system's ability to modify and reorganize their activities: Enables reconstruction and gain function of damaged nerve cells.
Short term: Within seconds/minutes, changes in synaptic communication and excitability.
Medium term: Hours/days, reshaping and strengthening synaptic connections.
Long term: Weeks/months, changes in gene expression and neurological alterations.

Orthotics and Prosthetics

Orthotics: External devices that support, align, and protect parts of the body.
Prosthetics: Artificial devices that initiate and perform functions of amputated limbs/organs.

Other Conditions

Sprain: soft tissue injury caused by stretching or tearing ligaments around joint.
Strain: stretch or tear in muscle or tendon fibers.
Tendinitis: inflammation of tendon
Synovitis: inflammation of synovial membrane in joint capsule
RICE method: Rest, Ice, Compression, Elevation for acute soft tissue injuries
Immobilization: acute phase pain relief.
Synarthrotic joints: Fixed joints (skull, pelvic bones).
Amphiarthrotic joints: Partially moveable joints (vertebrae, ribs, sternum).
Diarthrotic joints: Freely moveable joints (e.g., hyoid bone, eyeball).
Muscular dystrophy: genetic diseases causing muscle weakness, myopathy.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers key concepts in Physical Medicine and Rehabilitation, including the International Classification of Functioning (ICF), therapeutic exercises, and contraindications to range of motion exercises. It will test your knowledge on vasodilation, cardiovascular effects, and different types of exercises. Prepare to enhance your understanding of rehabilitation techniques and their implications.