PPA Past Papers Exam Questions and

PPA Past Papers Exam Questions and Answers (Solved Papers) Describe and differentiate the mechanisms and key clinical features of somatic referred pain, radicular pain and

radiculopathy - Correct Answers ✅Somatic Referred Pain:

"ache"

• Pain perceived at a location other than the site of the painful

stimulus/ origin

• Patients with chronic musculoskeletal pains have enlarged

referred pain areas to experimental stimuli

• The area of referred pain is related to the intensity and

duration of ongoing/evoked pain

• (Different to visceral referred pain)

Radicular Pain: "sharp"

• Irritation of a spinal nerve or nerve root
• Sx follows a dermatomal distribution
• May not be seen on a scan
• Often associated w/ +ve neurodynamic test + peripheral

pain = often worse than actual BP

• Shooting, tingling, P&N and band like in character
• Conservative care rather than surgery suggested
• Often caused by inflammation in response to nuclear disc

material (e.g. herniation) or mechanical compression

Radiculopathy: 1 / 4

PPA Past Papers Exam Questions and Answers (Solved Papers)

• Conduction is blocked in axons of spinal nerve or nerve root

by either compression or ischemia;

• Numbness, weakness and/or reduced reflexes are some

symptoms;

• Causes include disc herniation, foraminal stenosis,

meningeal disorders, neurological disorders, epidural disorders;

• Indicated by a +ve neurological exam
• Increased justification for surgery

Provide 2 evidence - based examples of "red flags" for a specific serious spinal pathology - Correct Answers

✅Fracture: female*, >70*, prolonged corticosteroid use**,

trauma

Cancer: past history of cancer* (2-3-% increased risk);

unexplained weight loss When taking a history from a person with spinal pain it is common to ask about aggravating factors. Briefly describe 4 ways this information can be used. - Correct Answers ✅1.To assist in identifying potential easing factors (i.e. directional preference) to further justify Tx options

• To recognise and consider activity/participation limitations

that may result due to agg. Sx being reproduced

• Gauge the irritability of the patient and further consider

which tests are most important to limit pain 2 / 4

PPA Past Papers Exam Questions and Answers (Solved Papers)

• To gauge a baseline p value for certain activities that can

be referred back to during treatment to ensure it is working What peripheral nerve is tested with PF (S1)? - Correct Answers ✅tibial nerve What peripheral nerve is tested with shoulder abd. (C5)? - Correct Answers ✅axillary nerve What peripheral nerve is tested with knee extension (L3)? - Correct Answers ✅femoral nerve Use the example of a C7 nerve root problem compared to a median nerve problem to explain how you would differentiate between the two. (peripheral v/s spinal nerve) - Correct Answers ✅C7 nerve root problem = bilateral Sx Median nerve root problem = unilateral Sx (stretching of n. in tunnel) List one muscle (or muscle group) tested during a neurological examination for all of the following spinal nerves.

• Correct Answers ✅C1 & 2 - neck flexion

C3 - lateral neck flexion C4 - shoulder elevation 3 / 4

PPA Past Papers Exam Questions and Answers (Solved Papers) C5 - shoulder abd.C6* - elbow flexors; wrist ext.C7* - elbow ext. ; wrist flex.C8 - thumb ext.T1 - finger add.

L1 - ?

L2 - iliopsoas (hip flexors) L3* - quadraceps (knee ext.) L4 - tib ant. (ankle DF + inversion) - can get pt. to walk on heals L5 - peroneals (ankle eversion); EHL (Ext. big tow @ IPL jt.) S1* - gastroc. (ankle PF) - can test w/ calf raise S2 - big toe ext. + sphinctors If a person has reduced sensation in the following regions

which spinal nerve is most likely involved: KEY SENSORY PTS /

DERMATOMES - Correct Answers ✅C2: at least one cm

lateral to the occipital protuberance at the base of the skull; 3cm behind ear

C3: in the supraclavicular fossa, @ the midclavicular line

C4: over the AC jt.

C5: on the lateral (radial) side of the antecubital fossa, just

proximal to the elbow

C6: on the dorsal surface of the proximal phalanx of the

thumb

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