Physiotherapy Competitive Exams

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Physiotherapy competitive exams Part-1 

1.    Genetic factor responsible for ankylosing spondylitis is HLA-B27. HLA-B27 is strongly associated with ankylosing spondylitis and other associated inflammatory diseases, such as psoriatic arthritis, inflammatory bowel disease, and reactive arthritis. HLA-B27 – Human leukocyte antigen B27.

2.    Gower’s sign positive in case of Duchenne muscular dystrophy.Duchenne muscular dystrophy affects the muscles, leading to muscle wasting that gets worse over time.                                                                                                                                   DMD is caused by mutations of the DMD gene on the X chromosome.

Symptoms muscular dystrophy:

·       A curved spine, also called scoliosis.

·       Shortened, tight muscles in their legs, called contractures.

·       Headaches.

·       Problems with learning and memory.

·       Shortness of breath.

·       Sleepiness.

·       Trouble concentrating.

Tests:

·        Gene tests.

·        Muscle biopsy.

·        Blood tests: The doctor will take a sample of the child’s blood and test it for creatine kinase, an enzyme that your muscles release when they are damaged. A high ck level is a sign that the child could have DMD.

3.     The pain receptors are Free nerve endings. These simple pain receptors are found in the dermis around the base of hair follicles and close to the surface of the epidermis where the hair emerges from the skin. Nociceptors, thermoreceptors, and some mechanoreceptors are all free nerve endings.

4.     Difficulty in achieving and maintaining balance, gross or fine motor, incoordination is Ataxia. Ataxia is a term for a group of disorders that affect co-ordination, balance and speech. Ataxia is a movement disorder caused by problems in the brain.

Types of Ataxia:

·        Cerebellar ataxia

·        Sensory ataxia

·        Vestibular ataxia.

Cerebellar Ataxia:

Cerebellum is the part of the brain that’s in charge of balance and coordination. If part of the cerebellum starts to wear away, you can develop cerebellar ataxia. Sometimes it can also affect the spinal cord. It’s most common form of ataxia. For cerebellar Ataxia patients, the Romberg’s sign was positive, the typical symptoms include walking slowly, rolling, etc.

Sensory Ataxia:

Sensory ataxia is caused by the impairment of somatosensory nerve, which leads to the interruption of sensory feedback signals and therefore, the body incoordination is caused.

Vestibular Ataxia:

They sense the movements of the head and help with the balance and spatial orientation. When the nerves in the vestibular system are affected, you can have the following problems: Blurred vision and other eye issues. Nausea and vomiting. Problems standing and sitting.

5.     Knee varus also known as Bow legged or genu varum.

      Genu varum:

It happens when the tibia, the larger bone in the shin, turns inward instead of aligning with the femur, the large bone in the thigh. This causes knees to turn outward.

Causes:

·        Abnormal bone development.

·        Damage to the growth plate.

·        Fluoride poisoning.

·        Fractures that healed improperly.

·        Lead poisoning.

·        Paget’s disease.

·        Rickets.

·        Blount’s disease, a growth disorder of the shinbone.

Best exercises for Knee Varus:

·        External Hip Rotation

·        Internal Hip Rotation

·        Sitting Stretch

·        Wall Stretch

·        Squats

·        Lunges.

6.     What is called as a peripheral heart or second heart in human body Soleus muscle.

Soleus muscle, a flat, broad muscle of the calf of the leg lying just beneath the gastrocnemius muscle.

Origin:

·        Posterior surface of the head and upper 1/3 of the shaft of the fibula

·        Middle 1/3 of the medial border of the tibia, tendinous arch between tibia and fibula.

Insertion:

Posterior surface of the calcaneus via the achilles tendon.

Action:

·        Plantar flexion of the foot at the ankle

·        Reversed origin insertion action: When standing, the calcaneus becomes the fixed origin of the muscle

·        Soleus muscle stabilizes the tibia on the calcaneus limiting forward sway.

7.     Normal tidal volume is 500ml.

Tidal volume: is the amount of air that moves in or out of the lungs with each respiratory cycle.

8.     Longest vein in human body is Long Saphenous.

It originates from the anterior aspect of the medial malleolus and runs along the tibial aspect of the medial calf before crossing the knee.

9.     List of autoimmune diseases: Rheumatoid arthritis, Ankylosing spondylitis, Myasthenia gravis, Guillain- Barre syndrome, Systemic lupus erythematosus.

Rheumatoid arthritis – is a painful type of arthritis.

Symptoms of Rheumatoid arthritis:

·        Pain or aching in more than one joint

·        Stiffness in more than one joint

·        Tenderness and swelling in more than one joint

·        The same symptoms on both sides of the body; such as in both hands or both knees.

·        Weight loss

·        Fatigue or tiredness

·        Weakness.

Ankylosing arthritis - Arthritis of the spine. Ankylosing spondylitis is an inflammatory disease that, over time, can cause some of the bones in the spine to fuse.

Myasthenia gravis – is a chronic autoimmune, neuromuscular disease that causes weakness in the skeletal muscles that worsens after periods of activity and improves after periods of rest. These muscles are responsible for functions involving breathing and moving parts of the body, including the arms and legs.

Guillain-Barre syndrome: is a rare disorder in which the body’s immune system attacks the nerves. Weakness and tingling in the hands and feet are usually the first symptoms. These sensations can quickly spread, eventually paralyzing the whole body.

10. Spinal nerves: 31 pairs of spinal nerves – C1-C8 Cervical nerves, T1-T12 Thoracic nerves, L1-L5 Lumbar nerves, S1-S5 Sacral nerves, 1 Pair Coccygeal nerves.

The spinal nerves consist of 31 symmetrical pairs of nerves that connect the spinal cord to the periphery.

Functions of spinal nerves:

Spinal nerves send electrical signals between brain, spinal cord and rest of the body. The spinal nerves are the major nerves of the body within the peripheral nervous system. These nerves are an integral part of the peripheral nervous system in that they control motor, sensory, and autonomic functions between the spinal cord and the body.

Cervical nerves:

·        C1, C2, and C3 – these cervical spinal nerves help to control the head and neck, including forward, backward, and sideward movements.

·        C4 – these help to control the upper shoulder movements, as well as helping to power the diaphragm.

·        C5 – these help to control the deltoids and biceps, the areas of the upper arm, down to the elbows.

·        C6 – these help to control the wrist extensions, with some supply given to the biceps.

·        C7 – these help to control the triceps as well as the wrist extensor muscles.

·        C8 – these help to control the hands, as well as finger flexion.

Thoracic nerves:

·        T1 and T2 – these thoracic spinal nerves supply the top of the chest, arms and hands.

·        T3, T4, T5 – these nerves supply into the chest wall as well as aid in breathing.

·        T6, T7, T8 – these nerves supply into the chest and down into the abdomen.

·        T9, T10, T11, T12 – these nerves supply into the abdomen and lower in the back.

Lumbar nerves:

·        L1 – these lumbar spinal nerves provide sensations to the groin as well as the genitals.

·        L2, L3 and L4 – these nerves provide sensations to the front of the thighs and the inner side of the lower legs. They also help to control movements of the hip and knee muscles.

·        L5 – these nerves provide sensations to the outer side of the lower legs and the upper foot. These also help to control the hips, knees, feet, and toe movements.

Sacral nerves:

·        S1 – these sacral spinal nerves affect the hips and the groin area.

·        S2 – these nerves affect the back of the thighs.

·        S3 - these nerves affect the medial buttock area.

·        S4 and S5 – these nerves affect the perineal area.

Coccygeal nerves:

·        CO1 – these spinal nerves innervate the skin around the coccygeal region, including around the tailbone.

11. Spinal cord ends at the level – Lower border of L2 vertebrae.

The spinal cord is a long, fragile tube-like band of tissue. It connects the brain to the lower back. Spinal cord carries nerve signals from the brain to the body and vice versa. These nerve signals help you feel sensations and move the body.

Three types of spinal cord injuries:

·        Tetraplegia

·        Paraplegia

·        Triplegia.

Common causes of spinal cord injuries:

·        Motor vehicle accidents, Auto and motorcycle accidents are the leading cause of spinal cord injuries.

·        Falls….

·        Acts of violence….

·        Sports and recreation injuries….

·        Diseases.

Symptoms of spinal cord injuries:

·        Loss of movement

·        Loss of altered sensation, including the ability to feel heat, cold and touch

·        Loss of bowel or bladder control

·        Exaggerated reflex activities or spasms

·        Changes in sexual function, sexual sensitivity and fertility

·        Pain or an intense stinging sensation caused by damage to the nerve fibers in the spinal cord.

·        Difficulty breathing, coughing or clearing secretions from the lungs.

12. Knee valgus also known as – knock knee

Knee valgus or knock knee is a lower leg deformity that exists when the bone at the knee joint is angled out and away from the body’s mid-line.

Five exercises for knock knees:

·        Butterfly flutters

·        Side lunges

·        Cycling

·        Sumo squats

·        Leg raises.

Symptoms of knock knees:

·        Symmetric inward angulation of the knees.

·        Ankles remain apart while the knees are touching.

·        Unusual walking pattern.

·        Outward rotated feet.

Causes of knock knees:

·        Metabolic disease

·        Renal failure

·        Physical trauma

·        Arthritis, particularly in the knee

·        Bone infection

·        Rickets

·        Congenital conditions

·        Growth plate injury

·        Benign bone tumors

·        Fractures that heal with a deformity

·        Being overweight or obese can also put extra pressure on the knees and contribute to knock knee.

13. Genetic factor responsible for Rheumatoid arthritis – HLA-DR4

Inherited susceptibility to rheumatoid arthritis is associated with the DRB1 genes encoding the human leukocyte antigen – DR4 and HLA-DR1 molecules.

14. Side to side curvature of spine is called Scoliosis

Scoliosis is a sideways curvature of the spine.

Three types of Scoliosis:

·        Idiopathic

·        Congenital

·        Neuromuscular.

Causes of Scoliosis:

·        Certain neuromuscular conditions, such as cerebral palsy or muscular dystrophy.

·        Birth defects affecting the development of the bones of the spine.

·        Previous surgery on the chest wall as a baby.

·        Injuries to or infections of the spine.

·        Spinal cord abnormalities.

Symptoms of Scoliosis:

·        Uneven shoulders

·        One shoulder blade that appears more prominent than the other

·        Uneven waist

·        One hip higher than the other

·        One side of the rib cage jutting forward

·        A prominence on one side of the back when bending forward.

15. Muscle of inspiration is Diaphragm

It is a large, dome-shaped muscle that contracts rhythmically and continually, and most of the time, involuntarily. Upon inhalation, the diaphragm contracts and flattens and the chest cavity enlarges. This contraction creates a vacuum, which pulls air into the lungs. The diaphragm, located below the lungs, is the major muscle of respiration.

Three openings of diaphragm:

·        Esophageal opening: The esophagus and vagus nerve, which controls much of the digestive system, pass through the opening.

·        Aortic opening: The aorta, the body’s main artery that transports blood from the heart, passes through the aortic opening

·        Caval opening.

Through the diaphragm are a series of 3 major and some minor apertures that permit the passage of structures between the thoracic and abdominal cavities:

·        Aortic hiatus: aorta, thoracic duct, azygos vein.

·        Esophageal hiatus

·        Vena caval hiatus

·        Lesser apertures

·        Sternocotal foramina.

Functions of the Diaphragm:

During inspiration, the diaphragm contracts to increase the volume of the thoracic cavity, decreasing its pressure, thus drawing air in. The diaphragm relaxes for expiration.