Chapter 9

Question 1

1.	Which of the following cells produce new bone?
a.
Osteocytes
b.
Osteoblasts
c.
Osteoclasts
d.
Stem cells from the bone marrow

Answer 1

b.

Osteoblasts

Question 2

2.	What is the chemical transmitter released at the neuromuscular junction?
a.
Norepinephrine
b.
GABA
c.
Serotonin
d.
Acetylcholine

Answer 2

d.

Acetylcholine

Question 3

3.	What are the two types of bone tissue?
a.
Vascular and nonvascular
b.
Spongy and calcified
c.
Compact and cancellous
d.
Dense and pliable

Answer 3

c.

Compact and cancellous

Question 4

4. Which of the following would identify an open or compound fracture?
   a.
   The skin and soft tissue are exposed at the fracture site.
   b.
   A bone is crushed into many small pieces.
   c.
   The bone appears bent with a partial fracture line.
   d.
   One end of a bone is forced into an adjacent bone.

Answer 4

a.

The skin and soft tissue are exposed at the fracture site.

Question 5

5.	Which of the following describes a Colles’ fracture?
a.
The distal radius is broken.
b.
The distal fibula is broken.
c.
A vertebra appears crushed.
d.
A spontaneous fracture occurs in weakened bone.

Answer 5

a.

The distal radius is broken.

Question 6

6. During the fracture healing process, the hematoma:
   a.
   is broken down and absorbed immediately.
   b.
   provides the base for bone cells to produce new bone.
   c.
   is the structure into which granulation tissue grows.
   d.
   produces fibroblasts to lay down new cartilage.

Answer 6

c.

is the structure into which granulation tissue grows.

Question 7

7. When a fracture is healing, the procallus or fibrocartilaginous callus:
   a.
   can bear weight.
   b.
   serves as a splint across the fracture site.
   c.
   is the tissue that lays down new cartilage.
   d.
   is made up of new bone.

Answer 7

b.

serves as a splint across the fracture site.

Question 8

8.	The inflammation surrounding a fracture site during the first few days may complicate healing by causing:
a.
excessive bone movement.
b.
severe ischemia and tissue necrosis.
c.
malunion or nonunion.
d.
fat emboli to form.

Answer 8

b.

severe ischemia and tissue necrosis.

Question 9

9.	What is a sign of a dislocation?
a.
Crepitus
b.
Pain and tenderness
c.
Increased range of motion at a joint
d.
Deformity at a joint

Answer 9

d.

Deformity at a joint

Question 10

10.	All of the following predispose to osteoporosis EXCEPT:
a.
weight-bearing activity.
b.
a sedentary lifestyle.
c.
long-term intake of glucocorticoids.
d.
calcium deficit.

Answer 10

a.

weight-bearing activity.

Question 11

11. Which of the following statements does NOT apply to osteoporosis?
    a.
    Bone resorption is greater than bone formation.
    b.
    It causes compression fractures of the vertebrae.
    c.
    Osteoporosis is always a primary disorder.
    d.
    It often leads to kyphosis and loss of height.

Answer 11

c.

Osteoporosis is always a primary disorder.

Question 12

12.	Which of the following best describes the typical bone pain caused by osteogenic sarcoma?
a.
Intermittent, increasing with activity
b.
Sharp, increased with joint movement
c.
Mild, aching when weight-bearing
d.
Steady, severe, and persisting with rest

Answer 12

d.

Steady, severe, and persisting with rest

Question 13

13.	How is Duchenne’s muscular dystrophy inherited?
a.
Autosomal recessive gene
b.
X-linked recessive gene
c.
Autosomal dominant gene
d.
Codominant gene

Answer 13

b.

X-linked recessive gene

Question 14

14. Which of the following is true about Duchenne’s muscular dystrophy?
    a.
    There is difficulty climbing stairs or standing up at 2 to 3 years of age.
    b.
    It involves only the legs and pelvis.
    c.
    Skeletal muscle atrophy can be seen in the legs of a toddler.
    d.
    It cannot be detected in any carriers.

Answer 14

a.

There is difficulty climbing stairs or standing up at 2 to 3 years of age.

Question 15

15.	The most common type of joint, which are freely movable, are called:
a.
Synarthroses
b.
Amphiarthroses
c.
Anarthroses
d.
Diarthroses

Answer 15

d.

Diarthroses

Question 16

16. Which of the following is characteristic of osteoarthritis?
    a.
    Inflammation and fibrosis develop at the joints.
    b.
    Degeneration of articulating cartilage occurs in the large joints.
    c.
    It progresses bilaterally through the small joints.
    d.
    There are no changes in the bone at the affected joints.

Answer 16

b.

Degeneration of articulating cartilage occurs in the large joints.

Question 17

17.	What is a typical characteristic of the pain caused by osteoarthritis?
a.
Decreases over time
b.
Quite severe in the early stages
c.
Aggravated by general muscle aching
d.
Increased with weight-bearing and activity

Answer 17

d.

Increased with weight-bearing and activity

Question 18

18. What limits joint movement in osteoarthritis?
    a.
    The osteophytes and irregular cartilage surface
    b.
    The wider joint space
    c.
    Decreased amount of synovial fluid in the cavity
    d.
    Fibrosis involving the joint capsule and ligaments

Answer 18

a.

The osteophytes and irregular cartilage surface

Question 19

19. Joints affected by osteoarthritis can sometimes affect healthy joints by:
    a.
    causing enzymes to be released that travel to other joints.
    b.
    bacteria traveling from the affected join to a healthy one through the bloodstream.
    c.
    inflammation and edema affecting the entire limb.
    d.
    the affected individual’s exerting stress on the normal joint to protect the damaged one.

Answer 19

d.

the affected individual’s exerting stress on the normal joint to protect the damaged one.

Question 20

20. What is the typical joint involvement with rheumatoid arthritis?
    a.
    Random single joints, progressing to involve other joints
    b.
    Bilateral small joints, symmetrical progression to other joints
    c.
    Abused or damaged joints first, then joints damaged by compensatory movement
    d.
    Progressive degeneration in selected joints

Answer 20

b.

Bilateral small joints, symmetrical progression to other joints

Question 21

21. What is the basic pathology of rheumatoid arthritis?
    a.
    Degenerative disorder involving the small joints
    b.
    Chronic inflammatory disorder affecting all joints
    c.
    Systemic inflammatory disorder due to an autoimmune reaction
    d.
    Inflammatory disorder causing damage to many organs

Answer 21

c.

Systemic inflammatory disorder due to an autoimmune reaction

Question 22

22. How is the articular cartilage damaged in rheumatoid arthritis?
    a.
    Enzymatic destruction by the pannus
    b.
    Inflamed synovial membrane covers the cartilage
    c.
    Fibrous tissue connects the ends of the bones
    d.
    Blood supply to the cartilage is lost

Answer 22

a.

Enzymatic destruction by the pannus

Question 23

23.	How does the joint appear during an exacerbation of rheumatoid arthritis?
a.
Relatively normal
b.
Enlarged, firm, crepitus with movement
c.
Deformed, pale, and nodular
d.
Red, warm, swollen, and tender to touch

Answer 23

d.

Red, warm, swollen, and tender to touch

Question 24

24.	Ankylosis and deformity develop in rheumatoid arthritis because:
a.
skeletal muscle hypertrophies.
b.
fibrosis occurs in the joint.
c.
replacement cartilage changes alignment.
d.
ligaments and tendons shorten.

Answer 24

a.

skeletal muscle hypertrophies.

Question 25

25.	Systemic effects of rheumatoid arthritis are manifested as:
a.
nodules in various tissues, severe fatigue, and anorexia.
b.
headache, leukopenia, and high fever.
c.
swelling and dysfunction in many organs.
d.
progressive damage to a joint.

Answer 25

a.

nodules in various tissues, severe fatigue, and anorexia.

Question 26

26.	What is a common effect of long-term use of glucocorticoids to treat rheumatoid arthritis?
a.
Leukocytosis
b.
Osteoporosis
c.
Severe anemia
d.
Orthostatic hypotension

Answer 26

b.

Osteoporosis

Question 27

27. Juvenile rheumatoid arthritis (JRA) differs from the adult form in that:
    a.
    only small joints are affected.
    b.
    rheumatoid factor is not present in JRA, but systemic effects are more severe.
    c.
    onset is more insidious in JRA.
    d.
    deformity and loss of function occur in most children with JRA.

Answer 27

b.

rheumatoid factor is not present in JRA, but systemic effects are more severe.

Question 28

28. Which of the following distinguishes septic arthritis?
    a.
    Multiple joints that are swollen, red, and painful at one time
    b.
    Presence of mild fever, fatigue, and leukocytosis
    c.
    Purulent synovial fluid present in a single, swollen joint
    d.
    Presence of many antibodies in the blood

Answer 28

c.

Purulent synovial fluid present in a single, swollen joint

Question 29

29.	Which of the following may precipitate an attack of gout?
a.
A sudden increase in serum uric acid levels
b.
Severe hypercalcemia
c.
Mild trauma to the toes
d.
Development of a tophus

Answer 29

a.

A sudden increase in serum uric acid levels

Question 30

30. Where does inflammation usually begin in an individual with ankylosing spondylitis?
    a.
    Costovertebral joints with progression down the spine
    b.
    Cervical and thoracic vertebrae, causing kyphosis
    c.
    Sacroiliac joints with progression up the spine
    d.
    Peripheral joints and then proceeds to the vertebrae

Answer 30

c.

Sacroiliac joints with progression up the spine

Question 31

31. What is a common outcome of fibrosis, calcification, and fusion of the spine in ankylosing spondylitis?
    a.
    Damage to the spinal nerves and loss of function
    b.
    Frequent fractures of long bones
    c.
    Impaired heart function
    d.
    Rigidity, postural changes, and osteoporosis

Answer 31

d.

Rigidity, postural changes, and osteoporosis

Question 32

32.	Which statement applies to menisci?
a.
They are found in the hip joints.
b.
They are secretory membranes in joints.
c.
They prevent excessive movement of joints.
d.
They are found in the shoulder joint.

Answer 32

c.

They prevent excessive movement of joints.

Question 33

33. Which factors delay healing of bone fractures?
34. Lack of movement of the bone
35. Prolonged inflammation and ischemia
36. Presence of osteomyelitis
37. Close approximation of bone ends
    a.
    1, 2
    b.
    1, 3
    c.
    2, 3
    d.
    3, 4

Answer 33

c.

2, 3

Question 34

34.	What is the likely immediate result of fat emboli from a broken femur?
a.
Additional ischemia in the broken bone
b.
Nonunion or malunion of the fracture
c.
Pulmonary inflammation and obstruction
d.
Abscess and infection at a distant site

Answer 34

Pulmonary inflammation and obstruction

Question 35

35.	A sprain is a tear in a:
a.
ligament.
b.
tendon.
c.
skeletal muscle.
d.
meniscus.

Answer 35

a.

ligament.

Question 36

36.	Therapeutic measures for osteoporosis include:
a.
non–weight-bearing exercises.
b.
dietary supplements of calcium and vitamin D.
c.
transplants of osteoblasts.
d.
avoidance of all hormones.

Answer 36

b.

dietary supplements of calcium and vitamin D.

Question 37

37. What is the distinguishing feature of primary fibromyalgia syndrome?
    a.
    Joint pain and stiffness throughout the body
    b.
    Degeneration and atrophy of skeletal muscles in back and lower limbs
    c.
    Localized areas of constant pain
    d.
    Specific trigger points for pain and tenderness

Answer 37

d.

Specific trigger points for pain and tenderness

Question 38

38.	Ewing’s sarcoma metastasizes at an early stage to the:
a.
brain.
b.
liver.
c.
lungs.
d.
other bones.

Answer 38

c.

lungs.

Question 39

39.	Immovable joints are called:
a.
amphiarthroses.
b.
synarthroses.
c.
diarthroses.
d.
synovial joints.

Answer 39

b.

synarthroses.

Question 40

40.	Rickets results from:
a.
excessive bone resorption by osteoclasts.
b.
a deficit of vitamin D and phosphates.
c.
replacement of bone by fibrous tissue.
d.
hyperparathyroidism.

Answer 40

b.

a deficit of vitamin D and phosphates.

Question 41

41.	Paget’s disease often leads to which of the following?
a.
A reduction in bone fractures
b.
Decreased intracranial pressure
c.
Cardiovascular disease
d.
Disintegration of joint cartilage

Answer 41

c.

Cardiovascular disease

Question 42

42.	Bones classified as “irregular” would include:
a.
skull bones.
b.
the mandible.
c.
wrist bones.
d.
the femur.

Answer 42

b.

the mandible.

Question 43

43. A dislocation is:
    a.
    the tearing of a tendon in the joint.
    b.
    the separation of bones in the joint with a loss of contact.
    c.
    the twisting of a joint, causing excessive inflammation of the surrounding tissue.
    d.
    the overstressing of ligaments, causing loss of elasticity.

Answer 43

b.

the separation of bones in the joint with a loss of contact.

Question 44

44.	A diagnostic test that measures the electrical charge of muscle contraction and can help differentiate muscle disorders from neurological disease is a/an:
a.
electromyogram.
b.
arthroscopy.
c.
radiograph.
d.
electroencephalograph.

Answer 44

a.

electromyogram.

Question 45

45.	The type of compound fracture in which there are multiple fracture lines and bone fragments is referred to as a/an:
a.
compression fracture.
b.
greenstick fracture.
c.
simple fracture.
d.
comminuted fracture.

Answer 45

d.

comminuted fracture.

Question 46

46.	Fluid-filled sacs composed of synovial membrane located between structures such as tendons and ligaments and act as additional cushions are called:
a.
articular capsules.
b.
bursae.
c.
synovial sacs.
d.
hyaline chambers.

Answer 46

b.

bursae.