Part 2

Question 1

Principles of treatment of an acute distortion:

• immobilisation
• cold
• compresses
• warmth

Answer 1

• immobilisation

* cold

Question 2

During palpation of the injured patient, one may
detect:

painfulness
crackling (crepitation)
fluctuance
subcutaneous emphysema

Answer 2

All answers are correct!

Question 3

In case of slleen rupture, the following
changes of the common blood count are
observed:

• decreased haemoglobin
• increased eosinophilic count
• decreased red blood cell count
  
  • increased red blood cell sedimentation rate

Answer 3

• decreased haemoglobin

* decreased red blood cell count

Question 4

In case of a traumatic hollow abdominal organ injury, the X-ray imaging reveals:

• Dilated small bowel loops
• Air fluid interfaces
• Free air collection under the diaphragm
• Distended large bowel

Answer 4

All are correct

Question 5

In case of a traumatic hollow abdominal
organ injury the palpatory signs are the
following:

• Ortner’s sign
• Rovsing’s sign
• Blumberg’s sign
• Jordan’s sign

Answer 5

• Rovsing’s sign

* Blumberg’s sign

Question 6

What is Post-traumatic disease?

•any stress (trauma, surgical operation, anaesthesia, burns,
vascular occlusion, dehydration, starvation, sepsis, acute diseases) or even mental stress may provoke a metabolic response to trauma

• homeostasis disorders in relation to trauma reflect disorders
of organs and organ systems possibly leading to dangerous Compline. Complications including lethal complications

•expressed signs of the post-traumatic disease are only characteristic to ASA class III - V and E patients

• the body reaction to trauma is local reaction (inflammation) and systemic response (protective metabolic reaction aimed to
accumulate energy and plastic materials for tissue reparation)

Answer 6

• homeostasis disorders in relation to trauma reflect disorders
of organs and organ systems possibly leading to dangerous Compline. Complications including lethal complications

Question 7

The following statements
are true regarding
‘commotio’:

• usually there are no clinical signs

• chronic trauma (vibration) leads to sclerotic process
of the skin and subcutis, damaged joints, nerves, osteophytes form themselves

• brain commotion (commotio cerebri) causes nausea,
vomiting, loss of consciousness as well as retrograde amnesia and long duration headache are possible

• chest contusion may provoke arrhythmias

Answer 7

All answers are correct!

Question 8

Soft tissue contusion has the following signs:

• edema
• haematomas
• pain
• impaired function
• If large area is injured the possible general signs are general malaise and fever
• expressed edema and massive hepatomas insides the tissues may mask bone fractures and dislocations

Answer 8

All are correct

Question 9

what are the principles of treatment of contusion?

• immobilisation, local cold, later - physiotherapy and
massage
• narcotic analgesics
• large haematomas are evacuated
• if the tissue stratify the cavities form themselves and the pressure bandage is necessary
• PRICE principle is employed
(protect, rest, ice, compress, elevate)

Answer 9

All are correct

Question 10

which ligament are important for the stability of the spine?

• anterior longitudinal
• posterior longitudinal • interspinosal
• yellow

Answer 10

All of them are needed for stability of the spine

Question 11

What is typical for spondyloarthrosis deformans?

• narrowed articular space
• osteosclerosis of articular surfaces
• osteophytes

Answer 11

All of them!

Question 12

What is not typical for intervertebral osteochondrosis?

• irregular narrowing of the disk
• subchondral sclerosis
• subchondral osteoporosis
• gaseous degeneration
• osteophytes

Answer 12

• gaseous degeneration

Is not typical for intervertebral osteochondrosis!

Question 13

Which proposition is correct? Roentgenography is suitable for:

• screening of osseous pathology
• survey information about the spine, its axis
• may be diagnostic
• we can’t fully evaluate spinal canal

Answer 13

All are correct!

Question 14

Which method is not used for diagnosis of lumbosacral hernia?

• CT
• CT myelography
• MRI
• Roentgenography

Answer 14

• roentgenography

Question 15

Which statement about
anterior cruciate ligament is
correct?

• arises from lateral side of medial formal condyle and is
attached to the posterior intercondylar area of the tibia

• arises from medial femoral epicondyle and is attached to medial side of tibia
• arises from medial side of lateral condyle and is attached to the anterior intercondylar area of the tibia

• arises from lateral femoral epicondyle and is attached to
fibular head

Answer 15

• arises from medial side of lateral condyle and is attached to the anterior intercondylar area of the tibia

Question 16

Which muscle forms the anterior wall of the crucopopliteal canal?

• soleus muscle
• peroneus brevis muscle
• peroneus longus muscle
• gastrocnemius muscle
• tibialis posterior muscle

Answer 16

• tibialis posterior muscle

Question 17

Femoral nerve enters the thigh through the:
• canalis inguinalis
• lacuna vasorum
• canalis obturatorius 
• lacuna musculorum

Answer 17

• lacuna musculorum

Question 18

Popliteal fossa is bounded by what muscles?

• peroneus brevis muscle
• semitendinosus mucsle
• semimembranosus muscle
• tibial anterior muscle
• biceps femoris muscle

Answer 18

• semitendinosus mucsle
• semimembranosus muscle
• biceps femoris muscle

Question 19

Great saphenous veins drains to the ——- vein.

Answer 19

Femoral communis vein

Question 20

If a patient cannot extend the foot, which of their nerves is damaged?

Answer 20

Nervus perneus profundus

Question 21

Which pathological method is the best for examining of soft tissues?

• roentgenography
• scintigraphy
• computed tomography
• magnetic resonance imaging

Answer 21

MRI is the best pathological method for examining of soft tissues!

Question 22

Neuromuscular transmission is inhibited by?

• acetylcholine
• curare
• Ca2+
• tropomyosin
• noradrenaline

Answer 22

• Curare

Curare, a selective skeletal muscle relaxant, has been used clinically to reduce shivering and as an anesthetic auxiliary in abdominal surgery.

It is also widely used in animal experiments to block neuromuscular junction activity.

Question 23

In the skeletal muscle, the:

• contraction precedes (is earlier than) the action potential
• action potential lasts as long as the contraction
• action potential lasts longer than the contraction
• contraction and action potential begin at the same time (simultaneously)
• action potential precedes the contraction

Answer 23

• action potential precedes the contraction

Question 24

Tetanic contraction of a skeletal muscle fibre results from a cumulative increase in the intracellular concentration of which of the following?

• Na+
• K+
• troponin
• ATP
• Ca2+

Answer 24

• Ca2+

Question 25

``` Neuromuscular transmission is: • unidirectional • bidirectional • stimulated by curare • inhibited by acetylcholine • inhibited by calcium ```

Answer 25

• Unidirectional

Question 26

Skeletal muscle contraction is terminated by which action? * removal of acetylcholine from the neuromuscular junction * removal of Ca2+ from the terminal of the motor neurone * closure of the postsynaptic nicotinic acetyl-choline receptor * decrease of sarcoplasmic Ca2+ from 10-5 M to 10-7 M * return of the dihydropyridine receptor to its resting conformation

Answer 26

• Decrease of sarcoplasmic Ca2+ from 10-5 M to 10-7 M

Question 27

Rigor mortis*: *Rigor mortis is a postmortem change resulting in the stiffening of the body muscles due to chemical changes in their myofibrils. * is due to failure of neuromuscular transmission * is due to loss of ATP * means muscle stiffness after fatigue * is an autoimmune disease * is due to loss of Ca2+

Answer 27

• Is due to loss of ATP

Question 28

According to the sliding filament mechanism of skeletal muscle contraction, during contraction: * the thick filaments stay the same size but the thin filaments shorten * the sarcomeres shorten * the thin filaments stay the same size but the thick filaments shorten * both thick and thin filaments shorten * none of the above occurs

Answer 28

• the sarcomeres shorten

Question 29

During skeletal muscle contraction: * ATP-ase activity of myosin head is inhibited * tropomyosin covers the active site of actin * attachment - detachment cycling occurs between myosin head and actin * Ca2+ needed to start contraction comes from T-tubules * Ca2+ needed to start contraction comes from extracellular fluid

Answer 29

• attachment - detachment cycling occurs between myosin head and actin

Question 30

``` Isometric contraction is characterised by: • constant tension • constant length • decrease in length • high mechanical efficiency • low tension in the muscle ```

Answer 30

• Constant length Isometric contractions are contractions in which there is no change in the length of the muscle. No joint or limb motion occurs. Isotonic contractions occur when the muscle changes length, producing limb motion. Concentric contractions occur when the muscle shortens.

Question 31

A motor unit is made up of: * all the muscle fibres within a given muscle * a motor neurone and the muscle fibres it innervates * all the neurones innervating an individual section of the body * a fascicle and a nerve * all the motor neurones innervating one muscle

Answer 31

• a motor neurone and the muscle fibres it innervates

Question 32

IV disk examination of it is outer part- - Dense regular CT - Fibrous cartilage - Dense irregular CT

Answer 32

-Fibrous cartilage

Question 33

If the patient can not ABDUCT their shoulder, what muscles are then damaged?

Answer 33

- Deltoid muscle | - Infraspinatus muscle

Question 34

The patient can't abduct the shoulder what nerve is damaged?

Answer 34

Axillary Nerve

Question 35

The patient feels shooting pain from hip to ankle --> what is the degenerative disease of the spine? (2 diseases)

Answer 35

- Spinal column disorder | - Femoral head fracture

Question 36

The football player is standing with his knee hyperextension and do a fast rotation with the second leg. Feeling a sharp pain in his knee. What is torn?

Answer 36

ACL --> Anterior cruciate ligament

Question 37

The patient can't make a fist, abduct and adduct fingers. | What nerve is damaged?

Answer 37

Ulnar nerve

Question 38

Adductor canal components are?

Answer 38

Femoral artery Femoral vein Vastus medialis Saphenous nerve

Question 39

The patient can't do eversion (process of turning inside the foot). What muscle is not functioning?

Answer 39

Anterior and posterior tibialis *Eversion of the Foot (tilting of the sole of the foot away from the midline): Performed by the fibularis brevis and fibularis longus.

Question 40

What are the components of carpal tunnel?

Answer 40

Median nerve Flexor pollicis longus Flexor digitorum profundus Flexor digitorum superfacialis

Question 41

What can cause CTS? (Carpal tunnel syndrome)

Answer 41

Long hours of work

Question 42

What is the definition of ergonomics?

Answer 42

Science of fitting a job to a person

Question 43

In the top of the pyramid what do we have?

Answer 43

Kinesiology skills

Question 44

In the bottom of the pyramid what do we have?

Answer 44

Pain

Question 45

What is the main cause of DMD in chromosomes?

Answer 45

Prevents the body from producing DYSTROPHIN*. *In skeletal and cardiac muscles, dystrophin is part of a group of proteins (a protein complex) that work together to strengthen muscle fibers and protect them from injury as muscles contract and relax.

Question 46

What type of inheritance does DMD* have?

Answer 46

X linked recessive *DMD is a rapidly progressive form of muscular dystrophy that occurs primarily in boys. It is caused by an alteration (mutation) in a gene, called the DMD gene that can be inherited in families in an X-linked recessive fashion, but it often occurs in people from families without a known family history of the condition.

Question 47

What kind of molecule attract water?

Answer 47

Proteoglycans

Question 48

The features of assessment of injured patient:

Answer 48

Deformity Asymmetry Swelling Skin rash

Question 49

What are the possible causes of pneumothorax?

Answer 49

Can be result of an injury or accident (gunshot or knife wounds to the chest, automobile accidents) or can occur due to following medical procedures whoich accidentally allows air into pleural space. High risk medical procedures include trans bronchial biopsy, pleural biopsy, thoracicentesis, chest tube placement, intracoastal needle anaesthesia and oesophagoscopy.

Question 50

What restrain limits leg extension?

Answer 50

ACL

Question 51

What are the advantages of CT vs. X-ray?

Answer 51

x- ray: + rapid, cheap, excisable, good for bone & joint evaluation. - Ionizing radiation, limited information about soft tissue. CT: + No superimposition or blurring, high contrast resolution, differentiation of soft tissue and fluid. - High dose of ionize radiation, artifacts for metal structure, bed for evaluation of soft tissue.

Question 52

What is the best examination for osteoporosis patients?

Answer 52

DEXA* *A DEXA scan is a type of medical imaging test. It uses very low levels of x-rays to measure how dense your bones are.

Question 53

What can we see in X rays of osteoporosis patient?

Answer 53

We can see decreased cortical thickness and loss of bony trabeculae in the early stages in radiography. Bones like the vertebra, long bones (proximal femur), calcaneum and tubular bones are usually looked at for evidence of osteoporosis.

Question 54

How can we detect abdominal wall bleeding?

Answer 54

Ultrasound