Deck 10: Trauma

Question 1

The most common type of spondylolisthesis occurring before the age of 30 is _____, and is most commonly found at _____.

A) type II, L5
B) type II, L4
C) type III, L5
D) type III, L4

Answer 1

type II, L5

Question 2

The most accurate imaging method for staging osteochondritis dissecans is __________.

A) magnetic resonance imaging
B) computed tomography
C) linear tomography
D) plain film radiography

Answer 2

magnetic resonance imaging

Question 3

Which imaging modality most reliably demonstrates the presence of fracture during the 2- to 6-week interval post injury?

A) Radionuclide bone scintigraphy
B) Computed tomography
C) Magnetic resonance imaging
D) Plain film radiography

Answer 3

Radionuclide bone scintigraphy

Question 4

The most common site of stress fracture is the __________.

A) pars interarticularis of L5
B) anterior margins of the middle thoracic vertebrae
C) body of the calcaneus
D) second metatarsal shaft

Question 5

Which of the following radiographic findings is not associated with slipped capital femoral epiphysis?

A) Thickening of the lateral femoral neck (Herndon hump)
B) A small saucer defect of the articular cortex
C) Rounded deformity of the proximal femur (pistol-grip femur)
D) Breaking of the medial aspect of the involved epiphysis

Question 6

Which of the following lists the five stages of bone healing, in chronological order of development?

A) Hematoma, inflammation, callus, consolidation, remodeling
B) Inflammation, hematoma, consolidation, remodeling, callus
C) Consolidation, inflammation, callus, hematoma, remodeling
D) Consolidation, inflammation, remodeling, hematoma, callus

Question 7

Repetitive applications of compressive, rotational, or tensile forces to normal bone may lead to which of the following types of fracture?

A) Stress
B) Insufficiency
C) Impacted
D) Unstable

Question 8

Which of the following best characterizes osteochondritis dissecans?

A) Infectious etiology
B) Most commonly found at the femoral head
C) Occurs before 50 years with peak incidence during adolescence
D) Displays zonal phenomena on radiographs

Question 9

Which of the following best defines spondylolisthesis?

A) An anterior displacement of a vertebra in relation to the segment immediately below
B) A posterior displacement of a vertebra in relation to the segment immediately below
C) An anterior displacement of a vertebra in relation to the segment immediately above
D) A posterior displacement of a vertebra in relation to the segment immediately above

Question 10

Which demographic factor negatively impacts the rate of fracture healing?

A) Asian race
B) Male gender
C) Female gender
D) Increasing age

Question 11

What is the most common site for osteochondritis dissecans?

A) The medial condyle of the distal femur
B) The medial epicondyle of the distal humerus
C) The medial malleolus of the distal tibia
D) The lateral malleolus of the fibula

Question 12

The presence of multiple fractures in various stages of healing is a classic radiographic presentation of __________.

A) myositis ossificans
B) battered child syndrome
C) osteochondritis dissecans
D) spondylolisthesis

Question 13

Which of the following fractures generates more than two fragments?

A) Torus
B) Stress
C) Comminuted
D) Transverse

Question 14

Choose the fracture that results from rotational stresses and has an oblique fracture plane encircling the long axis of the bone.

A) Spiral fracture
B) Hangman fracture
C) Teardrop fracture
D) Transverse fracture

Question 15

On which of the following radiographic projections would the neural arch resemble a "Scottie dog"?

A) Oblique cervical
B) Lateral lumbar
C) Oblique lumbar
D) Lateral cervical

Question 16

Complete loss of articulation between the opposing bone ends following trauma defines a __________.

A) subluxation
B) fracture
C) dislocation
D) distraction

Question 17

Which of the following radiographic findings on lateral lumbar radiographs indicates spondylolisthesis?

A) Inverted Napoleon hat sign
B) Bowline of Brailsford
C) Collared "Scottie dog"
D) Disruption of the posterior body (George's) line

Question 18

Which of the following is not a common finding of myositis ossificans circumscripta?

A) Detritus within the zone of provisional calcification
B) Faint tissue calcifications within 2 to 6 weeks after onset of symptoms
C) Zonal phenomenon of a radiodense ring surrounding a radiolucent center
D) Common location in the brachialis, adductor longus, and soleus

Question 19

At which time has a bone healing from fracture regained much of its initial strength?

A) 3 to 6 weeks
B) 1 to 3 months
C) 3 to 6 months
D) 1 to 3 weeks

Question 20

Which of the following roentgenometric evaluations is most often used to assess the extent of anterior displacement with spondylolisthesis?

A) Posterior body (George's) line
B) Meyerding system
C) Cobb method
D) Lumbar spine lordosis angle

Question 21

Which of the following fractures is an incomplete fracture of long bones seen in children that presents as a cortical bulge on the concave side of a bending long bone?

A) Torus
B) Greenstick
C) Pathological
D) Oblique

Question 22

What is another name for traumatic spondylolisthesis?

A) Teardrop fracture
B) Type II
C) Hangman fracture
D) Clay shoveler fracture

Question 23

Where is the humeral head most commonly positioned when dislocated?

A) Intrathoracic
B) Subcoracoid
C) Subclavicular
D) Subglenoid

Question 24

Avulsion of the greater tuberosity of the humerus is known as __________.

A) hatchet defect
B) Bankart fracture
C) flap fracture
D) Essex-Lopresti injury

Question 25

Which fracture is associated with an axial compression force applied to the cervical spine?

A) Teardrop
B) Hangman
C) Jefferson
D) Transverse process

Question 26

Atlantodental dislocation is indicated radiographically by an atlantodental interval larger than ______ mm in the adult or ______ mm in children.

A) 5, 3
B) 5, 7
C) 3, 5
D) 7, 5

Question 27

Unilateral facet dislocation is usually a(n) _______ lesion that occurs most often at C4-C7 level and is usually due to a(n) _______ injury.

A) unstable, hyperflexion
B) stable, hyperextension
C) stable, flexion-rotation
D) unstable, axial compression

Question 28

What is the most common bone fractured during birth and childhood?

A) Radius
B) Ulna
C) Clavicle
D) Humerus

Question 29

Which of the following fractures is an avulsion of the spinous process occurring at C6, C7, or T1 levels?

A) Burst
B) Clay shoveler
C) Hangman
D) Jefferson

Question 30

Which statement best describes the relationship between spondylolisthesis and low back pain?

A) There is a direct relationship between the two.
B) There is an indirect relationship between the two.
C) There does not appear to be a correlation between the two.
D) Spondylolisthesis is always symptomatic.

Question 31

In 95% of glenohumeral dislocations, the humerus is displaced __________ in relation to the glenoid.

A) anterior and inferior
B) anterior and superior
C) posterior and inferior
D) posterior and superior

Question 32

The most common type of Salter-Harris fracture is type ___________.

A) I
B) II
C) III
D) IV

Question 33

What causes a Hangman fracture?

A) Hyperextension mechanism
B) Rotational hyperflexion mechanism
C) Lateral flexion mechanism
D) Axial compression mechanism

Question 34

The most mechanically stable odontoid fracture is ______ and is described as a(n) ______.

A) type II, avulsion of the tip of the odontoid process
B) type I, avulsion of the tip of the odontoid process
C) type I, transverse fracture at the base of the odontoid process
D) type II, transverse fracture at the base of the odontoid process

Question 35

What is the term for a stress fracture of diseased bone?

A) Insufficiency fracture
B) Occult fracture
C) Torus fracture
D) Stellate fracture

Question 36

Which of the following lists of cervical spine injuries is ordered from least stable to most stable?

A) Flexion teardrop, Jefferson fracture, Clay shoveler fracture, Transverse atlantal ligament rupture
B) Pillar fracture, Transverse atlantal ligament rupture, Flexion teardrop, Clay shoveler fracture
C) Clay shoveler fracture, Transverse atlantal ligament rupture, Jefferson fracture, Flexion teardrop
D) Transverse atlantal ligament rupture, Flexion teardrop, Jefferson fracture, Clay shoveler fracture

Question 37

Which of the following is a transverse fracture through the spinous process and neural arch that extends into and possibly through the vertebral body?

A) Chance
B) Pars interarticularis
C) Golfer
D) Clay shoveler

Question 38

Which of the following is not a fracture of the skull and face?

A) Chance fracture
B) Diastatic fracture
C) LeFort fracture
D) Tripod fracture

Question 39

A transverse fracture through a portion of the physis that extends obliquely through a portion of the epiphysis is the following Salter-Harris type __________.

A) I
B) II
C) III
D) IV

Question 40

Which of the following best characterizes scapular fracture?

A) Most commonly involves the body and neck
B) Commonly fractured bone
C) Usually the result of a fall on the outstretched hand
D) Usually are isolated injuries

Question 41

Which of the following is a small fracture, typically of the posterior surface of the patella and associated with patellar dislocation?

A) Chisel
B) Duverney
C) Flake
D) Rolando

Question 42

Which carpal bone is most often fractured?

A) Lunate
B) Hamate
C) Scaphoid
D) Triquetrum

Question 43

What is the most common childhood elbow fracture?

A) Comminuted intracondylar
B) Supracondylar
C) Olecranon
D) Coronoid process

Question 44

Which of the following is an incomplete fracture occurring on the convex side of a bowing long bone of a child?

A) Greenstick fracture
B) Torus fracture
C) Barton fracture
D) Chauffeur fracture

Question 45

Which carpal bone most often dislocates?

A) Scaphoid
B) Capitate
C) Lunate
D) Hamate

Question 46

Which of the following muscles is a component of the rotator cuff?

A) Teres major
B) Serratus anterior
C) Teres minor
D) Levator scapulae

Question 47

Fraying of the superior margin of the glenoid labrum describes which of the following SLAP lesion expressions?

A) Type I
B) Type II
C) Type III
D) Type IV

Question 48

Which of the following is not a type of forearm fracture?

A) Essex-Lopresti
B) Nightstick
C) Monteggia
D) Malgaigne

Question 49

What is the most common orientation of a patellar fracture?

A) Vertical
B) Transverse
C) Oblique
D) Stellate

Question 50

What is the most common joint dislocation in children?

A) Elbow
B) Shoulder
C) Interphalangeal
D) Clavicle

Question 51

In which of the following fractures is there palmar (anterior) angulation of the distal fragment?

A) Colles
B) Torus
C) Smith
D) Greenstick

Question 52

A dorsal chip fracture at the site of the extensor tendon insertion on the distal phalanx results in a flexion deformity of the finger known as __________.

A) swan neck deformity
B) mallet finger
C) boutonniere deformity
D) buttonhole deformity

Question 53

Most hip dislocations are __________.

A) posterior
B) anterior
C) internal
D) external

Question 54

Which of the following is the least likely location of a pelvic avulsion fracture?

A) ASIS
B) AIIS
C) Ischial tuberosity
D) PSIS

Question 55

A fracture of the distal radius with dislocation of the distal radioulnar joint describes the __________ fracture.

A) Monteggia
B) Galeazzi
C) Nightstick
D) Essex-Lopresti

Question 56

What is the most common location for an intracapsular hip fracture?

A) Subcapital
B) Capital
C) Midcervical
D) Basicervical

Question 57

Complete fracture of the femur without displacement of the fracture fragments describes a Garden type __________ fracture.

A) I
B) II
C) III
D) IV

Question 58

Which of the following fractures involves all four pubic rami?

A) Bucket handle
B) Malgaigne
C) Duverney
D) Straddle

Question 59

What is the most common adult elbow fracture?

A) Olecranon process
B) Radial head
C) Coronoid process
D) Supracondylar

Question 60

Which of the following fracture patterns involves unilateral fracture of the superior and inferior pubic ramus and a third fracture near, or separation of, the contralateral sacroiliac joint?

A) Malgaigne fracture
B) Bucket handle fracture
C) Duverney fracture
D) Straddle fracture

Question 61

Segond fractures are found with concurrent tears of the _____ more than 90% of the time and _____ tears more than 75% of the time.

A) posterior cruciate ligament, meniscal
B) anterior cruciate ligament, collateral ligament
C) posterior cruciate ligament, collateral ligament
D) anterior cruciate ligament, meniscal

Question 62

Which of the following is not a fracture located within the foot?

A) Jones
B) Bedroom
C) March
D) Cotton

Question 63

A trimalleolar fracture involving the medial and lateral malleolus and posterior lip of the distal tibia is known as a __________ fracture.

A) Dupuytren
B) Cotton
C) Maisonneuve
D) pilon

Question 64

Which of the following cervical spine fractures is most commonly associated with posttraumatic neurologic deficit?

A) Jefferson
B) Atlas posterior arch
C) Flexion teardrop
D) Extension teardrop

Question 65

What kind of fracture is at the base of the fifth metatarsal and appears transverse in orientation to the long axis of the metatarsals?

A) March
B) Bedroom
C) Jones
D) Pott

Question 66

Which tarsal bone is most commonly fractured?

A) Talus
B) Navicular
C) Calcaneus
D) Cuboid

Question 67

Which of the following fractures is most commonly associated with a lateral flexion mechanism of injury?

A) Transverse process
B) Clay shoveler
C) C1 burst
D) Unilateral facet dislocation

Question 68

If a patient presented with patellofemoral joint pain accentuated on flexion of the knee, a clinician would first suspect __________.

A) chondromalacia patella
B) anterior cruciate ligament rupture
C) patellar dislocation
D) knee dislocation

Question 69

A 43-year-old male pedestrian is struck in the side of the knee by the bumper of a motor vehicle. Which type of fracture is most likely to be present in the lateral tibial plateau?

A) Insufficiency
B) Stellate
C) Torus
D) Impaction

Question 70

Avulsion of the lateral capsular ligament secondary to internal tibial rotation while the knee is flexed describes a __________ fracture.

A) Segond
B) trampoline
C) Dupuytren
D) Maisonneuve

Question 71

Traumatic spondylolisthesis is most commonly observed at which of the following spinal levels?

A) C1
B) C2
C) L1
D) L5

Question 72

A fracture of the fibula occurring approximately 2 to 3 inches proximal to the distal tip of the fibula with associated tear of the deltoid ligament and lateral displacement of the talus is a __________ fracture.

A) Tillaux
B) pilon
C) Pott
D) triplane