Question 1

What technique is performed at every infant examination during the first year of life to detect hip dislocation?
A)Ballottement maneuvers
B)Barlow-Ortolani maneuvers
C)Range of motion
D)Thomas McMurray assessment
E)Trendelenburg test

Accepted Answer

At every examination during an infant's first year of life, the Barlow-Ortolani maneuver is performed. This test involves stabilizing the pelvis and flexing one hip and knee to 90 degrees. It detects hip dislocation and is signified by a clicking noise with the maneuver.

Question 2

A dowager hump is
A)the hallmark of osteoporosis.
B)pathognomic of scoliosis.
C)indicative of tendonitis.
D)characteristic of rickets.
E)indicative of muscular dystrophy.

Accepted Answer

Osteoporosis leads to vertebral compression and kyphotic bowing of the spine known as dowager's hump.

Question 3

In differentiating osteoarthritis from rheumatoid arthritis (RA), the patient with osteoarthritis typically exhibits
A)metatarsus adductus.
B)depression.
C)sudden onset.
D)less weakness and fatigue.
E)pain most pronounced after periods of rest.

Accepted Answer

One of the key differences between the symptoms of osteoarthritis and those of RA is that fatigue is uncommon in osteoarthritis patients. The joints of patients with RA are stiff after rest.

Question 4

Anterior cruciate ligament integrity is assessed via the _____ test.
A)Lachman
B)straight leg raise
C)valgus stress
D)Homan
E)Thomas

Accepted Answer

The Lachman test evaluates anterior cruciate ligament integrity. The straight leg raise test assesses nerve root damage, the valgus stress test assesses instability of the lateral and medial collateral ligaments, the Homan test assesses for blood clots in the legs, and the Thomas test is used to detect flexion contractures of the hips.

Question 5

A 45-year-old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression?
A)Positive straight leg raise result
B)Positive Trendelenburg sign
C)Negative Romberg test result
D)Contralateral straight leg raise result
E)Positive drawer test result

Accepted Answer

This patient, according to the pattern of radiculopathy, has an L3-L4 injury to the right side. The most alarming finding would be crossover pain to the affected leg while raising the unaffected leg because this finding is more suggestive of herniation.

Question 6

The Thomas test is used to detect
A)hip dislocation.
B)unstable sacroiliac joints.
C)knee instability.
D)flexion contractures of the hip.
E)asymmetry in the level of the iliac crests.

Accepted Answer

The Thomas test requires the patient to lie supine with one leg stretched out flat and the other raised and bent in toward the chest. If the patient is unable to keep the extended leg flat on the table, this is an indicator of a hip flexion contracture. The Thomas test does not assess hip dislocation, sacroiliac joints, knee instability, or asymmetry of the iliac crests.

Question 7

A red, hot swollen joint in a 40-year-old man should lead you to suspect
A)trauma.
B)bursitis.
C)gout.
D)cellulitis.
E)tenosynovitis.

Accepted Answer

Gout is characterized as red, hot swollen joints, especially the great toe. Gout is commonly linked to men older than 40 years.

Question 8

A 7-year-old child who begins to limp and complains of persistent hip pain may have
A)myelomeningocele.
B)Dupuytren contracture.
C)Legg-Calvé-Perthes disease.
D)osteoarthritis.
E)congenital hip dislocation.

Accepted Answer

Constant hip pain with a limp in a young child is indicative of Legg-Calvé-Perthes disease. This condition results in avascular necrosis of the femoral head caused by inadequate blood supply. Myelomeningocele, Dupuytren contracture, osteoarthritis, and congenital hip dislocation are not characterized by age group and these symptoms.

Question 9

Term infants normally resist
A)ankle dorsiflexion.
B)McMurray test.
C)forefoot adduction.
D)knee extension.
E)elbow flexion.

Accepted Answer

Along with elbows and hips, newborns tend to resist extension of the knee; however, movements should be symmetrical.

Question 10

Dupuytren contracture affects the
A)hip flexor muscle.
B)plantar fascia.
C)carpal tunnel.
D)palmar fascia.
E)rotator cuff.

Accepted Answer

A contracture of the palmar fascia of one or multiple fingers is called a Dupuytren contracture.

Question 11

A 3-year-old boy is brought to the clinic complaining of a painful right elbow. He is holding the right arm slightly flexed and pronated and refuses to move it. The mother states that symptoms started right after his older brother had been swinging him around by his arms. This presentation supports a diagnosis of
A)radial head subluxation.
B)femoral anteversion.
C)carpal tunnel syndrome.
D)Osgood-Schlatter disease.
E)osteomyelitis.

Accepted Answer

The symptoms this child is experiencing are indicative of a radial head subluxation, or nursemaid's elbow. The symptoms are not consistent with femoral anteversion, carpal tunnel syndrome, Osgood-Schlatter disease, or osteomyelitis.

Question 12

You note that a child has a positive Gower sign. You know that this indicates generalized
A)arthropathy.
B)muscle weakness.
C)bursitis.
D)muscle hypertrophy.
E)scoliosis.

Accepted Answer

Gower sign is generalized muscle weakness and is characterized by a child trying to stand up by flexing at the knee, pushing down on the thighs while trying to pull up the trunk. It is often associated with muscular dystrophy.

Question 13

A positive straight leg raise test usually indicates
A)leg length discrepancy.
B)knee instability.
C)lumbar nerve root irritation.
D)hip bursitis.
E)improperly conditioned muscles.

Accepted Answer

Lumbar nerve root irritation at the L4, L5, and S1 levels can be assessed by asking the patient to lie supine with the neck flexed and to raise one leg. If pain is felt, it is a positive straight leg raise result. The straight leg raise test does not assess leg length, knee stability, hip bursitis, or muscle condition.

Question 14

What temporary disorder may be experienced by pregnant women during the third trimester because of fluid retention?
A)Carpal tunnel syndrome
B)Osteitis deformans
C)Radial head subluxation
D)Talipes equinovarus
E)Legg-Calvé-Perthes disease

Accepted Answer

Carpal tunnel syndrome may be experienced by pregnant women during their last trimester because of fluid retention. Fluid retention at the tunnel causes pressure and inflammation at the medial nerve. This results in the symptoms of the syndrome.

Question 15

Which one of the following techniques is used to detect a torn meniscus?
A)Phalen test
B)McMurray test
C)Thomas test
D)Trendelenburg test
E)Drawer test

Accepted Answer

The McMurray test points to a meniscus tear. The Phalen test detects carpal tunnel syndrome. The drawer test detects an anterior cruciate ligament tear, the Thomas test detects hip contraction, and the Trendelenburg test detects weak hip abductor muscles.

Question 16

Arm length is measured from the acromion process through the
A)olecranon joint to carpal thumb hinge.
B)olecranon process to distal ulnar prominence.
C)proximal radial prominence to distal joint.
D)proximal ulnar joint to middle fingertip.
E)olecranon process to the second fingertip.

Accepted Answer

Total arm length is assessed by the standard measurement of the length from the shoulder (acromion process) through the elbow (olecranon process) joint to the wrist (distal ulnar prominence).

Question 17

Your examination of an infant reveals a positive Allis sign. To confirm this finding, you would perform a
A)startle reflex.
B)Barlow-Ortolani maneuver.
C)Trendelenburg test.
D)tibial torsion test.
E)Lachman test.

Accepted Answer

The Allis sign will show unequal upper leg lengths, suggestive of a hip dislocation. The Barlow-Ortolani maneuver can confirm results for hip dislocation.

Question 18

During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee, you should initially perform the _____ test.
A)varus stress
B)valgus stress
C)Apley
D)Lachman
E)drawer

Accepted Answer

The injury described will most likely result in a medial meniscus or medial collateral ligament damage. Your initial assessment would be to apply the valgus stress test to assess the medial meniscus.

Question 19

When performing the drawer test, the examiner would place the patient in a supine position and flex the knee 45 to 90 degrees, placing the foot flat on the table, and then
A)grasp and evert the foot and extend the knee.
B)grasp and invert the foot and rotate the knee.
C)grasp the lower leg with both hands and draw the tibia forward and then backward.
D)apply varus stress with the foot planted.
E)apply valgus stress after the leg is extended.

Accepted Answer

The next step is to place both hands on the lower leg with the thumbs on the ridge of the anterior tibia just distal to the tibial tuberosity. Draw the tibia forward, forcing the tibia to slide forward of the femur. Then push the tibia backward. Anterior or posterior movement of the knee greater than 5 mm in either direction is an unexpected finding.

Question 20

An adult with bowed tibias and a shortened thorax may have
A)	ankylosing spondylitis.
B)	Paget disease.
C)	rheumatoid arthritis.
D)	Dupuytren contracture.
E)	Sprengel deformity.

Accepted Answer

Paget disease can cause bowed tibias and a shortened thorax due to abnormal bone remodeling and deformities.

Quiz 21: Musculoskeletal System

What technique is performed at every infant examination during the first year of life to detect hip dislocation?

A dowager hump is

In differentiating osteoarthritis from rheumatoid arthritis (RA) , the patient with osteoarthritis typically exhibits

Anterior cruciate ligament integrity is assessed via the _____ test.

A 45-year-old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression?

The Thomas test is used to detect

A red, hot swollen joint in a 40-year-old man should lead you to suspect

A 7-year-old child who begins to limp and complains of persistent hip pain may have

Term infants normally resist

Dupuytren contracture affects the

You note that a child has a positive Gower sign. You know that this indicates generalized

A positive straight leg raise test usually indicates

What temporary disorder may be experienced by pregnant women during the third trimester because of fluid retention?

Which one of the following techniques is used to detect a torn meniscus?

Arm length is measured from the acromion process through the

Your examination of an infant reveals a positive Allis sign. To confirm this finding, you would perform a

During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee, you should initially perform the _____ test.

When performing the drawer test, the examiner would place the patient in a supine position and flex the knee 45 to 90 degrees, placing the foot flat on the table, and then

An adult with bowed tibias and a shortened thorax may have