Phys Med Question Bank Flashcards
What is the primary role of the respiratory system in exercise performance?
a) To improve muscle hypertrophy
b) To deliver oxygen and eliminate carbon dioxide
c) To regulate body temperature during activity
d) To enhance blood glucose levels
Correct Answer: b) To deliver oxygen and eliminate carbon dioxide
A) To improve muscle hypertrophy: Incorrect. Muscle hypertrophy is related to strength training and protein synthesis, not directly to the respiratory system’s role.
B) To deliver oxygen and eliminate carbon dioxide: Correct. The respiratory system’s primary function during exercise is to meet the increased oxygen demands of muscles and eliminate CO₂ produced during metabolism.
C) To regulate body temperature during activity: Incorrect. While the respiratory system contributes to heat exchange, this is not its primary role in exercise performance.
D) To enhance blood glucose levels: Incorrect. Blood glucose regulation is controlled by the endocrine system, primarily through insulin and glucagon.
Which of the following conditions commonly affects respiratory function in athletes?
a) Hypertension
b) Asthma
c) Diabetes
d) Hyperthyroidism
Correct Answer: b) Asthma
A) Hypertension: Incorrect. This condition impacts the cardiovascular system but does not directly impair respiratory function.
B) Asthma: Correct. Asthma, including exercise-induced asthma, is a common respiratory condition affecting athletes.
C) Diabetes: Incorrect. While diabetes can impact overall health, it is not a direct respiratory condition.
D) Hyperthyroidism: Incorrect. This condition affects metabolism and heart rate, not respiratory function.
Which symptom is most commonly associated with vocal cord dysfunction (VCD)?
a) Productive cough
b) Sudden wheezing during exercise
c) Persistent chest pain
d) Swelling in the legs
Correct Answer: b) Sudden wheezing during exercise
A) Productive cough: Incorrect. A productive cough is more typical of infections or chronic bronchitis.
B) Sudden wheezing during exercise: Correct. VCD is characterized by wheezing caused by inappropriate closure of the vocal cords, often triggered by exercise.
C) Persistent chest pain: Incorrect. Chest pain is more commonly linked to musculoskeletal issues or cardiac conditions.
D) Swelling in the legs: Incorrect. Leg swelling is unrelated to VCD and is more indicative of circulatory or cardiac issues.
What mechanism causes bronchoconstriction in exercise-induced asthma (EIA/EIB)?
a) Increased environmental pollutants
b) Mast cell degranulation
c) Dehydration of airways
d) Hypoxia during maximal exertion
Correct Answer: b) Mast cell degranulation
A) Increased environmental pollutants: Incorrect. Pollutants can trigger EIA but are not the primary mechanism.
B) Mast cell degranulation: Correct. Mast cell degranulation releases mediators like histamine, causing bronchoconstriction and airway hyperreactivity.
C) Dehydration of airways: Incorrect. Dehydration may exacerbate symptoms but is not the underlying mechanism.
D) Hypoxia during maximal exertion: Incorrect. Hypoxia is a consequence of reduced oxygen delivery, not a cause of EIA.
When assessing dyspnoea in athletes, which factor is most critical to determine its cause?
a) History of smoking
b) Onset, duration, and triggers of symptoms
c) BMI and body composition
d) Dietary habits
Correct Answer: b) Onset, duration, and triggers of symptoms
A) History of smoking: Incorrect. While smoking history is relevant, it is not as critical as understanding the onset and triggers of symptoms in athletes.
B) Onset, duration, and triggers of symptoms: Correct. These details are essential to differentiate between respiratory, cardiac, and other causes of dyspnoea.
C) BMI and body composition: Incorrect. While obesity can contribute to dyspnoea, it is not the most critical factor in this assessment.
D) Dietary habits: Incorrect. Diet is unrelated to dyspnoea unless it contributes to anemia or reflux.
What is the diagnostic gold standard for exercise-induced asthma (EIA)?
a) Chest X-ray
b) Spirometry with a methacholine challenge
c) Blood gas analysis
d) Echocardiogram
Correct Answer: b) Spirometry with a methacholine challenge
A) Chest X-ray: Incorrect. A chest X-ray may identify structural or infectious issues but does not diagnose EIA.
B) Spirometry with a methacholine challenge: Correct. This test evaluates airway hyperresponsiveness, confirming EIA.
C) Blood gas analysis: Incorrect. This test is more useful in acute respiratory failure, not EIA diagnosis.
D) Echocardiogram: Incorrect. This is used to assess cardiac function, not respiratory conditions.
Which of the following conditions commonly affects respiratory function in athletes?
a) Hypertension
b) Asthma
c) Diabetes
d) Hyperthyroidism
Correct Answer: b) Asthma
A) Hypertension: Incorrect. This condition impacts the cardiovascular system but does not directly impair respiratory function.
B) Asthma: Correct. Asthma, including exercise-induced asthma, is a common respiratory condition affecting athletes.
C) Diabetes: Incorrect. While diabetes can impact overall health, it is not a direct respiratory condition.
D) Hyperthyroidism: Incorrect. This condition affects metabolism and heart rate, not respiratory function.
Which non-pharmacological intervention is beneficial for managing exercise-induced bronchospasm?
a) Gradual warm-up routines
b) Avoiding exercise altogether
c) Ice baths post-exercise
d) High-intensity interval training
Correct Answer: a) Gradual warm-up routines
A) Gradual warm-up routines: Correct. Gradual warm-ups reduce the likelihood of EIB by preparing the airways for increased demand.
B) Avoiding exercise altogether: Incorrect. EIB can often be managed effectively, so avoiding exercise is unnecessary.
C) Ice baths post-exercise: Incorrect. Ice baths do not address respiratory symptoms.
D) High-intensity interval training: Incorrect. This type of training can exacerbate EIB if not carefully managed.
What is the primary treatment for acute respiratory symptoms in athletes with asthma?
a) Inhaled corticosteroids
b) Short-acting beta-2 agonists (e.g., salbutamol)
c) Sodium cromoglycate
d) Leukotriene antagonists
Correct Answer: b) Short-acting beta-2 agonists (e.g., salbutamol)
A) Inhaled corticosteroids: Incorrect. These are used for long-term asthma management, not acute symptoms.
B) Short-acting beta-2 agonists (e.g., salbutamol): Correct. These provide rapid relief for acute bronchospasm.
C) Sodium cromoglycate: Incorrect. This is preventive, not used for acute symptom relief.
D) Leukotriene antagonists: Incorrect. These reduce inflammation but are not first-line for acute symptoms.
Chest pain during exercise could indicate all of the following EXCEPT:
a) Musculoskeletal injuries
b) Gastroesophageal reflux disease (GERD)
c) Carotid artery dissection
d) Exercise-induced asthma
Correct Answer: c) Carotid artery dissection
This condition affects the carotid arteries and does not typically present with chest pain during exercise.
A) Musculoskeletal injuries: Incorrect. Chest pain can result from strains or muscle injuries.
B) Gastroesophageal reflux disease (GERD): Incorrect. GERD can cause chest discomfort, especially during exercise.
D) Exercise-induced asthma: Incorrect. Chest tightness is a common symptom of asthma.
What is an appropriate exercise prescription adaptation for athletes with vocal cord dysfunction?
a) Use of leukotriene antagonists
b) Avoiding controlled breathing techniques
c) Incorporating speech therapy and reducing trigger exposure
d) Increasing exercise intensity to desensitize the airways
Correct Answer: c) Incorporating speech therapy and reducing trigger exposure
A) Use of leukotriene antagonists: Incorrect. These are for asthma, not vocal cord dysfunction.
B) Avoiding controlled breathing techniques: Incorrect. Controlled breathing can be beneficial for managing VCD.
C) Incorporating speech therapy and reducing trigger exposure: Correct. Speech therapy helps improve vocal cord control, and reducing exposure to triggers prevents symptoms.
D) Increasing exercise intensity to desensitize the airways: Incorrect. This approach could worsen VCD symptoms.
How is the pendular exercises performed and what does it help?
Purpose:
* Increase shoulder circulation and decrease effusion
* Provide mild traction of the glenohumeral joint
* Provide gravity-assisted motion at ranges between 45 and 90 degrees
(depending on angle of trunk)
* Maintain shoulder range of motion (below 90 degrees)
* Decrease pain
* Maintain passive range of motion during immediate postoperative phase,
especially if active movement is contraindicated (see specific precautions)
Position
* Standing in a staggered stance, supporting the upper body on the unaffected arm placed in front of the body on a table or plinth below the level of the shoulder
* The trunk is hinged forward at the hips without any rotation.
* The affected arm hangs passively using gravity to provide movement with as little upper extremity muscle activity as possible.
How to Perform Pendular Exercise
* Shift the body weight forward and backward (not the arm, the arm moves as a passive motion), creating momentum for the arm to passively swing forward and backward, driving the movement from hip and knee flexion and extension and the weight shift, not the arm.
* Shift the body weight side to side, creating momentum for the arm to passively swing side to side.
* Move the body in a circular motion to create clockwise and counterclockwise circular motion of the arm.
* Relaxation is necessary for the pain-relieving effects of traction from the weight of the dangling arm. The body should be perpendicular to the ground to allow the arm to be vertical and use gravity to provide some distraction.
Progression
* Increase range.
* Increase repetitions.
* Progress to active-assisted or active movement against gravity.
Precautions
* Pendular exercises are intended to be relatively passive. If there is hypermobility or recently repaired structures where strain (tension) should be limited, pendular exercises may not be appropriate (contraindicated) during the early protection phases.
* For example, after a supraspinatus tendon repair, pendular exercises may place excessive tension on the healing structure if the shoulder is suspended and allowed to hang without muscle contraction from the rotator cuff, and adduction across the body places further strain on the structure.
* Pendular (and other exercises/movements) are contraindicated for some fractures of the upper extremity until early callus formation is present.
* As for all postsurgical patients, contraindications and precautions are determined by the surgeon. The tissue strength, extent of damage, and surgical methods will all influence the length of time needed for sufficient scar tissue formation and tissue repair, as well as the type of forces that are likely to place excess force on the tissue.
* Patients who have downward sloping shoulders, inferior subluxation, or instability
should not perform this exercise unless the arm is supported using a sling.
* Cautious use of the exercise with acute tendinopathy (high severity, irritability)
How are Wall Angels performed and what is it useful for?
Purpose:
Purpose: Strengthens the scapular muscles and improves thoracic and shoulder flexibility.
- Posture Improvement: Helps correct rounded shoulders and forward head posture.
- Scapular Stability: Encourages better scapular movement and control.
- Shoulder Mobility: Increases range of motion in the shoulder joints, especially in abduction and external rotation.
- Thoracic Spine Activation: Engages muscles in the upper back and improves thoracic extension.
- Core Stability: Requires core engagement to maintain a neutral spine against the wall.
Starting Position:
* Stand with your back against a wall, feet about 6 inches away from the wall, and your knees
slightly bent.
* Press your lower back, mid-back, and head gently against the wall to ensure a neutral spine.
* Arm Position:
* Lift your arms to form a 90-degree angle at the elbows, creating a “W” shape with your arms.
* Your shoulders, elbows, and wrists should all be touching the wall, if possible.
Movement:
* Slowly slide your arms up along the wall toward an overhead “Y” position, maintaining contact with the wall.
* Aim to reach as high as comfortable, keeping wrists, elbows, and shoulders aligned with the wall.
* Once you’ve reached your maximum range, slowly slide your arms back down to the starting “W” position.
Repetitions:
* Perform 8-10 repetitions, moving slowly and with control, ensuring the back stays flat against the
wall.
How is the Oscillations or Prolonged Self-Stretching and Flexibility
Purpose:
* Prolonged stretch, as tolerated, for improving rotation
Position: Supine
* The involved arm abducted 45 degrees (or higher, based on
available range), supported on a pillow or foam pads if needed
Action
* Using the weight of the arm with or without holding a light weight, allow gravity to move the shoulder into either external or internal rotation, reaching the end range
* Hold for as long as tolerated.
Advantages
* Can be used as a home program.
* Prolonged stretch is used to promote connective tissue adaptations and extensibility.
* Gravity is used to provide a low-load prolonged positional stretch using the weight of the arm with or without free weights.
Progression
* Increase time in position.
* Increase sets.
* Increase weight
How do you perform the Four-Point Kneeling on Exercise Ball Weight Shifting
Purpose
* Supported weight shifting for early closed chain neuromuscular coordination
* Improve local stabilizer function.
Precautions
* This exercise is not indicated for patients with major rotator cuff tears, extensive
arthritis, or labral tears.
Position
* Four-point kneeling with abdomen supported on an exercise ball
* Hands placed slightly wider than shoulder width
* Slight external rotation.
Action
* Maintain cervicothoracic alignment and scapulothoracic connection.
* Weight shift slightly to one side, taking more weight onto one arm than the other
Advantages
* Exercise ball provides support for body weight.
* Ball height will determine how much support is provided relative to the patient’s arm and leg length.
* Muscle activation, endurance, and neuromuscular coordination is in a closed chain position for stabilization, particularly for generalized instability or impaired proprioception.
Progression
* Time in the shifted position can be increased, based on ability to hold position without loss of core position or scapulothoracic connection.
* Movement from one arm to the next can be increased to
challenge the weight acceptance and neuromuscular coordination.
* Use unstable base; hands on balance board to challenge and
initiate rotator cuff and scapulothoracic muscle activity.
* Lift knees off the ground to a plank position over the ball or roll the body forward until the lower legs are supported by the ball requiring a longer lever arm and a more unstable challenge for the upper extremities
* Remove support from the exercise ball by deflating the ball or
using a smaller ball.
* Progress to four-point kneeling without a ball.
