Musculoskeletal Flashcards
1
Q
The musculoskeletal system consists of the body’s bones, joints, and muscles
A)true
B)false
A
.A
2
Q
1) for support to stand erect and
(2) for movement. The musculoskeletal system also functions
(3) to encase and pro/ec/thc inner vital organs (e.g., brain, spinal cord, heart), (
4) to prorluce the red blood cells in the bone marrow (hematopoiesis), and
(5) as a reservoir for storage of essential minerals, such as calcium and phosphorus in the bones.
A
Musculoskeletal system
3
Q
. It has 206 bones, which support the body like the posts and beams of a building.
A)true
B)false
A
.A
4
Q
Bone and cartilage are specialized forms of connective tissue. Bone is hard, rigid, and very dense. Its cells are continually turning over and remodeling.
The joint (or articulation) is the place of union of two or more bones. Joints are the functional units of the musculoskeletal system because they permit the mobility needed for activities of daily living
A
.
5
Q
In nonsynovial joints, the bones are united by fibrous tissue or cartilage and are immovable (e.g., the sutures in the skull) or only slightly movable (e.g., the vertebrae).
Synovial joints are freely movable because they have bones that are separated from each other and are enclosed in a joint cavity
A
.
6
Q
Just like grease on gears, synovial fluid allows sliding of opposing surfaces, and this sliding permits movement.
A
.
7
Q
is avascular; it receives nourishment from synovial fluid that circulates during joint movement. It is a very stable connective tissue with a slow cell turnover. It has a tough, firm consistency, yet is flexible. This cartilage cushions the bones and gives a smooth surface to facilitate movement.
A)cartilage
B)joint
C)muscles
A
Cartilage
8
Q
The joint is surrounded by a fibrous capsule and is supported by ligaments.
A
.
9
Q
are fibrous bands running directly from one bone to another that strengthen the joint and help prevent movement in undesirable directions
A)ligament
B)joint
C)both a and b
A
Ligament
10
Q
is an enclosed sac filled with viscous synovial fluid, much like a joint. Are located in areas of potential friction and help muscles and tendons glide smoothly over bone.
A)bursa
B)ligament
C)muscles
A
Bursa
11
Q
Muscles account for 40% to 50% of the body’s weight.
A)true
B)false
A
.true
12
Q
When they contract, they produce movement
A)muscles
B)joints
C)both a and b
A
Muscles
13
Q
Muscles are of three types: skeletal, smooth, and cardiac
A)true
B)false
A
.true
14
Q
Each skeletal muscle is composed of bundles of muscle fibers, or fasciculi.
The skeletal muscle is attached to bone by a tendon-a strong fibrous cord.
A)true
B)false
A
.
15
Q
The temporomandibular joint (TMJ) is the articulation of the mandible and the temporal bone
A)true
B)false, the joint articulates with the mandible and sphenoid bone
A
.true
16
Q
You can feel it in the depression anterior to the tragus of the ear.
A)temporalmandibular joint
B)mandible joint
A
Temporalmandibular joint
17
Q
The TMJ permits jaw function for speaking and chewing
A)temporalmandibular joint
B)mandible
A
Temporalmandibular. Joint
18
Q
The joint allows three motions: (l) hinge action to open and close the jaws; (2) gliding action for protrusion and retraction; and (3) gliding for side-to-side movement of the lower jaw
A)temporalmandibular joint
B)mandible
A
Temporalmandibular joint
19
Q
The vertebrae are 33 connecting bones stacked in a vertical column
A)true
B)false
A
Ture
20
Q
Humans have 7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 3 or 4 coccygeal vertebrae.
A)true
B)false
A
True
21
Q
SPINE
A
.
22
Q
The spinous processes of C7 and Tl are prominent at the base of the neck.
A)true
B)false
A
.true
23
Q
The inferior angle of the scapula normally is at the level of the interspace between T7 and T8
A)true
B)false
A
.true
24
Q
An imaginary line connecting the highest point on each iliac crest crosses L4.
A)true
B)false
A
.true
25
An imaginary line joining the two symmetric dimples that overlie the posterior superior iliac spines crosses the sacrum
A)true
B)false
.true
26
A lateral view shows that the vertebral column has four curves (a double-S-shape)
A)true
B)false
.true
27
1.cervical and lumbar curves are concave (inward or anterior), and
2.the thoracic and sacrococcygeal curves are convex
A)true
B)true for the first one
C)false
D)true for the second one
.true
28
The intervertebral disks are elastic fibrocartilaginous plates that constitute one fourth of the length of the column
A)true
B)false
True
29
```
Each disk center has a_____________ made of soft, semifluid, mucoid material that has the consistency of toothpaste in the young adult.
A)nucleus pulposus
B)spinal nucleus
C)nucleus spine
D)all the above
```
Nucleus pulposus
30
The disks cushion the spine like a shock absorber and help it move
A)intervertebral disk
B)intercostal disk
C)all the above
Intervertebral disk
31
The disk then can rupture and the nucleus pulposus can herniate out of the vertebral column, compressing on the spinal nerves and causing pajn
A)true
B)false
True
32
SHOULDER
.
33
The glenohumeral joint is the articulation of the humerus with the glenoid fossa of the scapula
A)true
B)false
True
34
The joint is enclosed by a group of four powerful muscles and tendons that support and stabilize it. Together these are called the rotator cuff of the shoulder.
A)shoulder
B)hip
C)both a and b
Shoulder
35
```
The large subacromial bursa helps during abduction of the arm, so that the greater tubercle of the humerus moves easily under the acromion process of the scapula
A)shoulder
B)subacromial bursa
C)both a and b
D)clavicle
```
Subacromial bursa
36
The scapula and the clavicle connect to form the shoulder girdle.
A)true
B)false
True
37
You can feel the bump of the scapula's acromion process at the very top of the shoulder
A)true
B)false
True
38
The next bump is the greater tubercle of the humerus a few centimeters down and laterally, and from that the coracoid process of the scapula is a few centimeters medially
A)true
B)false
True
39
ELBOW
.
40
The elbow joint contains the three bony articulations of the humerus, radius, and ulna of the forearm
A)true
B)false
True
41
```
Its hinge action moves the forearm (radius and ulna) on one plane, a!Jowing flexion and extension. The olecranon bursa lies between the olecranon process and the skin
A)shoulder
B)elbow
C)hip
D)wrist
```
Elbow
42
The sensitive ulnar nerve runs between the olecranon process and the medial epicondyle.
A)true
B)false
True
43
The radius and ulna articulate with each other at two radioulnar joints, one at the elbow and one at the wrist These move together to permit pronation and supination of the hand and forearm.
A)true
B)false
True
44
WRIST AND CARPALS
.
45
Of the body's 206 bones, over half are in the hands and feet.
A)true
B)false
True
46
Its condyloid action permits movement in two planes at right angles: flexion and extension, and side-to-side deviation.
A)true
B)false
True
47
The midcarpal joint is the articulation between the two parallel rows of carpal bones. It allows flexion, extension, and some rotation. The metacarpophalangeal and the interphalangeal joints permit finger flexion and extension. The flexor tendons of the wrist and hand are enclosed in synovial sheaths.
A)true
B)false
True
48
HIP
.
49
The hip joint is the articulation between the acetabulum and the head of the femur
A)true
B)false
.
50
Palpation of these bony landmarks will guide your examination. You can feel the entire iliac crest, from the anterior superior iliac spine to the posterior. The isd1ial tuberosity lies under the gluteus maximus muscle and is palpable when the hip is flexed. The greater trochanter of the femur is normally the width of the person's palm below the iliac crest and halfway between the anterior superior iliac spine and the ischial tuberosity. Feel it when the person is standing, in a flat depression on the upper lateral side of the thigh.
A)true
B)false
C)ball and socket joint
True
51
KNEE
.
52
The knee joint is the articulation of three bones-the femur, the tibia, and the patella (kneecap)-in one common articular cavity
A)true
B)false
True
53
```
The knee joint is the articulation of three bones
A)the femur, the tibia, and the patella
B)knee cap
C)femur, tibia and the fibula
D)femur, tibia and knee
```
A fumur tibia and patella
54
```
lt is the largest joint in the body and is complex
A)shoulder
B)knee
C)hip
D)all the above
```
Knee
55
Two wedge-shaped cartilages, called the medial and lateral menisci
A)cushion the tibia and femur.
B)balance the femur
C)both a and b
A
56
The cruciate ligaments (not shown) crisscross within the knee;
A) they give anterior and posterior stability and help control rotation.
B)aide in the contraction of the knee
C) both a and b
A
57
prepatellar bursa, lies between the patella and the skin
A)true
B)false
True
58
Landmarks of the knee joint start with the large quadriceps muscle, which you can feel on your anterior and lateral thigh
A)true
B)false
True
59
ANKLE AND FOOT
.
60
The ankle, or tibiotalar joint, is the articulation of the tibia, fibula, and talus
A)true
B)false
True
61
It is a hinge joint, limited to flexion (dorsiflexion) and extension (plantar flexion) on one plane.
A)true
B)false
TURE
62
Landmarks are two bony prominences on either sidethe medial malleolus and the lateral malleolus.
A)true
B)false
True
63
The subtalar joint permits inversion and eversion of the foot
A)true
B)false
True
64
DEVELOPMENTAL COMPETENCE
.
65
Infants and Children
.
66
By 3 months' gestation, the fetus has formed a "scale model" of the skeleton that is made up of cartilage.
A)true
B)false
True
67
Bone growth continues after birth-rapidly during infancy and then steadily during childhood-until adolescence, when both boys and girls undergo a rapid growth spurt.
A)true
B)false
True
68
growth spurt. Long bones grow in two dimensions.
A)false
B)true
True
69
. Lengthening occurs at the epiphyses, or growth plates. These specialized growth centers are transverse disks located at the ends of long bone. Any trauma or infection at this location puts the growing child at risk for bone deformity. This longitudinal growth continues until closure of the epiphyses; the last closure occurs at about age 20 years.
A)true
B)false
True
70
At birth, the spine has a single
A)C-shaped curve
B)S-shaped curve
C)both a and b
C shaped curve
71
At 3 to 4 months, raising the baby's head from prone position develops the anterior curve in the cervical neck region
A)true
B)false
TURE
72
From 1 year to 18 months, standing erect develops the anterior curve in the lumbar region.
A)true
B)false
True
73
growth is marked during the adolescent growth spurt
A)true
B)false
True
74
muscles respond to increased secretion of growth hormone, to adrenal androgens, and in boys, to further stimulation by testosterone.
A)true
B)false
True
75
This is due to genetic programming, nutrition, and exercise
A)lifestyles
B)Muscles vary in size and strength in different people
C)African Americans have more muscle
Muscles vary in size and strength in different people.
76
The Pregnant Woman
.
77
Increased levels of circulating hormones (estrogen, relaxin from the corpus luteum, and corticosteroids) cause increased mobility in the joints.
A)true
B)false
True
78
```
Increased mobility in the sacroiliac, sacrococcygeal, and symphysis pubis joints in the pelvis contributes to the noticeable changes in maternal posture.
A)true
B)the pregnant women
C)both a and b
D)flase
```
Both a and b
79
The most characteristic change is progressive lordosis, which compensates for the enlarging fetus; otherwise, the center of balance would shift forward.
A)the pregnant women
B)false
C)young adult
The pregnant women
80
Anterior flexion of the neck and slumping of the shoulder girdle are other postural changes that compensate for the lordosis.
A)the pregnant woman
B)teen mom
C)both a and b
The pregnant women
81
```
These upper back changes may put pressure on the ulnar and median nerves during the __________ trimester. Nerve pressure creates aching, numbness, and weakness in the upper extremities in some women
A)1
B)3
C)2
D)all the above
```
3
82
The Aging Adult
.
83
Bone remodeling is a cyclic process of bone resorption and deposition. The balance favors deposition until skeletal maturity at 25 to 35 years when bones mass reaches its peak.
A)true
B)false
25-35bone reaches its max
84
After age 40, loss of bone matrix (resorption) occurs more rapidly than new bone formation. The net effect is a gradual loss of
bone density, or osteoporosis.
A)true
B)flase
Bone starts breaking down at age 40
85
women have more bone loss than men because for 5 years after menopause, the lack of estrogen leads to accelerated bone loss.
A)true
B)false
True
86
Postural changes are evident with aging, and decreased height is the most noticeable.
A)true
B)false
True
87
Long bones do not shorten with age.
A)true
B)flase
True
88
Decreased height in the aging adult is due to?
A)shortening of the vertebral column. caused by loss of water content and thinning of the intervertebral disks and by a decrease in the height of individual vertebrae from osteoporosis.
B)shortening of long bones
Decreased height is due to shortening of the vertebral column. This is caused by loss of water content and thinning of the intervertebral disks and by a decrease in the height of individual vertebrae from osteoporosis.
A
89
Both men and women can expect a progressive decrease in height beginning at age 40 years in males and age 43 years in females, although this is not significant until age 60 years
A)true
B)false
True
90
A greater decrease occurs in the 70s and 80s as a result of osteoporotic collapse of the vertebrae The result is a shortening of the trunk and long extremities. Other postural changes are kyphosis, a backward head tilt to compensate for the kyphosis, and a slight flexion of hips and knees.
A)true
B)false
True
91
Usually, men and women gain weight in their 40s and 50s.
A)true
B)false
True
92
```
They begin to lose fat in the face and deposit it in abdomen and hips.
A)the aging adult
B)aging women
C)aging men
D)none
```
A
93
In the 80s and 90s, fat further decreases in the periphery, which is especially noticeable in the forearms and apparent over the abdomen and hips.
A)true
B)flase
True
94
Loss of subcutaneous fat leaves bony prominences more marked (e.g., tips of vertebrae, ribs, iliac crests) and body hollows deeper (e.g., cheeks, axillae).
A)pregnant woman
B)the aging adult
C)both a and b
B the aging adult
95
; a sedentary lifestyle hastens musculoskeletal changes of aging
A)false
B)true
True
96
However, physical exercise increases skeletal mass and helps prevent or delay osteoporosis. Physical activity delays or prevents bone loss in postmenopausal women in a dose-dependent manner. Fast walking is the best prevention for osteoporosis; the faster the pace, the higher the preventive effect on the risk for hip fracture.
A)true
B)false
True
97
The other positive effects of physical activity are improving muscle strength to prevent falls, balance and posture control, decrease in back pain, increase in quality of life, and prevention of cardiovascular disease, cancer, and depression.
A)true
B)false
True.
98
CULTURE AND GENETICS
.
99
African-American adults have a decreased risk for fracture when compared with white adults, and Hispanic women have a decreased risk for fractures than white women have.
A)true
B)false
True
100
African-American and Hispanic children have shown significantly higher bone strength than white children.This is due to structural properties-greater bone density at specific bone sites in African-American and Hispanic children.
A)true
B)false
True
101
greater bone mass and bone mineral density (BMD) among AfricanAmerican men than among their white counterparts.
A)true
B)false
True
102
Younger Hispanic men had similar bone strength as African Americans, but older Hispanic men had more rapid loss of BMD and strength. The increased bone strength helps explain fracture risk.
A)false
B)true
True
103
In the spine, women of all races gained BMD up to 30 to 33 years of age.3 But at the femoral neck in Lhe hip joint, BMD peaked earlier among white women years) than among African Americans (2 l years) and Hispanics (20 years)
A)true
B)flase
True
104
SUBJECTIVE DATA
.
105
```
Joints Pain Stiffness Swelling, heat, redness Limitation of movement, Muscles Pain (cramps) Weakness, Bones Pain Deformity,Trauma (fractures, sprains, dislocations), Functional assessment (activities of daily living [ADLs]),Self-care behaviors
Are all.?
A)objective data
B)subjective data
C)both a and b
```
Subjective data
106
• Any problems with your joints? Any pain?
A)Joint pain and loss of function are the most common musculoskeletal concerns that prompt a person to seek care.
B)no
A
107
Location: Which joints? On one side or both sides?
A)tender
B)Rheumatoid arthritis (RA) involves symmetric joints; other musculoskeletal illnesses involve isolated or unilateral joints.
B
108
Quality: What does the pain feel like: aching, stiff, sharp or dull, shooting? Severity: How strong is the pain?
A)Exquisitely inflammation. tender with acute
B)free of pain
A
109
Timing: What time of day does the pain occur? How long does it last? How often does it occur?
A)RA pain is worse in morning when arising; osteoarthritis is worse later in the day; tendinitis is worse in morning, improves during the day.
B)arthritis
A
110
RA pain is worse in morning when arising;
A)true
B)false
True
111
osteoarthritis is worse later in the day;
A)true
B)false
True
112
tendinitis is worse in morning, improves during the day.
A)true
B)flase
C)worse at day improves at morning
True
113
Is the pain aggravated by movement, rest, position, weather? Is the pain relieved by rest, medications, application of heat or ice?
A)Movement increases most joint pain except in RA, in which movement decreases pain.
B)call the doctor
A
114
Is the pain associated with chills, fever, recent sore throat, trauma, repetitive activity?
A)Joint pain 10 to 14 days after an untreated strep throat suggests rheumatic fever. joint injury occurs from trauma, repetitive motion.
B) flase
A
115
Joint pain 10 to 14 days after an untreated strep throat suggests rheumatic fever. joint injury occurs from trauma, repetitive motion.
A)true
B)flase
True
116
Any stiffness in your joints?
A)RA stiffness occurs in morning and after rest periods.
B)false
A
117
Any swelling, heat, redness in the joints? The nurse would expect
A)pain
B)acute inflammation
C)none
BSuggests acute inflammation
118
Any limitation of movement in any joint? Which joint? The nurse would suspect?
A)Decreased ROM may be due to joint injury to cartilage or capsule or to muscle contracture
B)Increase in ROM may be due to joint flexibility
A
119
Any problems in the muscles, such as any pain or cramping? Which muscles? The nurse would suspect which of the following?
A)Myalgia
B)arthalgia
C)both a and b
Myalgia is usually felt as cramping or aching. A
120
If in calf muscles: Is the pain with walking? Does it go away with rest? The nurse would suspect, which the following?
A)Suggests intermittent claudication
B)Suggests myalgia
A
121
Are your muscle aches associated with fever, chills, the "flu"? The nurse knows that?
A)Viral illness often includes myalgia
B)Weakness may involve musculoskeletal or neurologic systems
A
122
Any weakness in muscles? The nurse knows too suspect which abnormal finding, in what two two system?
A)Weakness may involve musculoskeletal or neurologic systems
B)atrophy
A
123
```
Do the muscles look smaller there? What term describes this.
A)atrophy
B)diminishing
C)building
D)catabolism
```
A
124
Any bone pain? Is the pain affected by movement? The knows that which of the following statements might be answered to the question?
A)Fracture causes sharp pain that increases with movement. Other bone pain usually feels "dull" and "deep" and is unrelated to movement.
B)Functional assessment screens the safety of independent living, the need for home health services, and quality of life
A
125
Functional assessment screens the safety of independent living, the need for home health services, and quality of life?
A)true
B)flase
True
126
-Bathing-getting in and out of the tub, turning faucets?
-Toileting-urinating, moving bowels, able to get self on/off toilet, wipe self? •
-Dressing-doing buttons, zipper, fasten opening behind neck, pulling dress or sweater over head, pulling up pants, tying shoes, getting shoes that fit?
-Grooming-shaving, brushing teeth, brushing or fixing hair, applying makeup?
-Eating-preparing meals, pouring liquids, cutting up foods, bringing food to mouth, drinking? •
-Mobility-walking, walking up or down stairs, getting in/out of bed, getting out of house?
-Communicating-talking, using phone, writing?
All of the following are relevant to helping the nurse figure out what assessment on the patient?
A)complete assessment
B)functional assessment
C)ADL
B functional assessment
127
any repetitive motion or chronic stress to joints, the nurse will?
A)Assess risk for back pain or carpal tunnel syndrome.
B)look for books
C)perform hand hygiene
A
128
If person has chronic disability or crippling illness: the nurse ask, How has your illness affected you, by doing this the nurse will asses for?
A)Self-esteem disturbance, Loss of independence
B) Body image disturbance, Role performance disturbance
C) Social isolation
D)all the above
D
129
Additional History for Infants and Children
.
130
Were you told about any trauma to infant during labor and delivery? Did the baby come head first? Was there a need for forceps? The nurse will be asking these questions because?
A)Traumatic delivery increases risk for fractures, (e.g., humerus, clavicle).
B)for the mom to feel safe
A
131
Did the baby need resuscitation? The nurse ask because?
A)Period of anoxia may result in hypotonia of muscles.
B)hypotension
C)both a and b
A
132
Additional History for Adolescents
.
133
Involved in any sports at school or after school? How frequently (times per week)? The nurse ask this question for adolescents group too?
A)Assess safety of sport for child. Note if child's height and weight are adequate for the particular sport (e.g., football).
B)to assess vitals
A
134
Use of safety equipment and presence of adult supervision decrease risk for sports injuries?
A)true
B)false
True
135
Lack of adequate warm-up increases -risk for sports injury.
A)true
B)false
True
136
```
Students may not report injury or pain for fear of limiting participation in sport. In which age group?
A)adolescents
B)preschool
C)young adults
D)older adults
E)infants
```
A
137
Additional History for the Aging Adult
.
138
Use what assessment on the aging adult to elicit any loss of function, self-care deficit, or safety risk that may occur as a process of aging or musculoskeletal illness.
A)complete assessment
B)functional assessment
C)both of none of the above
.
139
OBJECTIVE DATA
.
140
A screening musculoskeletal examination suffices for most people? The nurse does which of the following?
A) Inspection and palpation of joints integrated with each body region
B)Observation of ROM as person proceeds through motions described earlier
C) Age-specific screening measures, such as Ortolani sign for infants or scoliosis screening for adolescents
D)all the above
D
141
During the assessment the nurse should?
A)Support each joint at rest. Muscles must be soft and relaxed to assess the joints under them accurately.
B) Take care when examining any inflamed area where rough manipulation could cause pain and muscle spasm. To avoid this, use firm support, gentle movement, and gentle return to a relaxed state
C)both a and b
D)a and second part of b
C
142
Presence of swelling is significant and signals joint irritation.
A)true
B)false
True
143
Swelling may be excess joint fluid (effusion), thickening of the synovial lining, inflammation of surrounding soft tissue (bursae, tendons), or bony enlargement.
A)true
B)flase
True
144
(complete loss of contact between the two bones in a joint)
A)dislocation
B)subluxation
C)contracture
A
145
(two bones in a joint stay in contact but their alignment is off);
A)subluxation
B)contracture
C)ankylosis
A
146
(shortening of a muscle leading to limited ROM of in a joint)
A)contracture
B)ankylosis
C)none
A
147
or ankylosis (stiffness or fixation of a joint).
A)subluxation
B)contracture
C)ankylosis
C
148
The nurse Palpates each joint, including its skin for temperature, its muscles, bony articulations, and area of joint capsule, an abnormal finding would be?
A)Warmth and tenderness that signal inflammation.
B) warmth and normal
A
149
The synovial membrane normally is not palpable. A small amount of fluid is present in the normal joint, but y.it is not palpable.
A)true
B)flase
True
150
The synovial membrane, When thickened, it feels .
A) "doughy" or "boggy."
B) "hard" or "painful"
A
151
Palpable fluid is abnormal. Because fluid is contained in an enclosed sac, if you push on one side of the sac, the fluid will shift and cause a visible bulging on another side.
A)false
B)true
B
152
What is the most sensitive sign of joint disease.
A)Limitation in ROM
B)Increase in ROM
A
153
Articular disease (Inside the joint capsule [e.g., arthritis) produces swelling and tenderness around the whole joint, and it limits all planes of ROM in both active and passive motion.
A) articular disease
B)Extra-articular
A
154
(injury to a specific tendon, ligament, nerve) produces swelling and tenderness to that one spot in the joint and affects only certain planes of ROM, especially during active (voluntary) motion
A)articular disease
B)extra-articular disease
B
155
Do not confuse crepitation with the normal discrete "crack" heard as a tendon or ligament slips over bone during motion, such as when you do a knee bend.
A)true
B)false
A
156
is an audible and palpable crunching or grating that accompanies movement. It occurs when the articular surfaces in the joints are roughened, as with rheumatoid arthritis?
A)crepitation
B)dislocation
C)both a and b
A
157
Test the strength of the prime mover muscle groups for each joint.Muscle strength should be equal bilaterally and should fully resist your opposing force.
A)true
B)false
A
158
5 Full ROM against gravity, full 100 Normal resistance
4 Full ROM against gravity, some 75 Good resistance
3 Full ROM with gravity 50 Fair
2 Full ROM with gravity eliminated 25 Poor (passive motion
1 Slight contraction 10 Trace 0 No contraction 0 Zero
Muscle testing know it
159
TEMPOROMANDIBULAR JOINT
.
160
Swelling looks like a round bulge over the joint, although it must be moderate or marked to be visible.
A)true
B)false
True
161
Crepitus and pain occur with temporomandibular joint dysfunction
A)true
B)false
True
162
Instructions to Person and Motion and Expected Range
.
163
Open mouth maximally.
A)Normal is 3 to 6 cm, or three fingers inserted sideways.
B)Normal is 1 to 9 cm, or three fingers inserted sideways.
C)Normal is 2 to 4 cm, or three fingers inserted sideways.
Normal is 3 to 6 cm, or three fingers inserted sideways. A
164
Partially open mouth, protrude lower jaw, and move it side to side.
A)Lateral motion. Normal extent is 1 to 2 cm
B)Lateral motion. Normal extent is .5 to 2 m
C)both a and b
ALateral motion. Normal extent is 1 to 2 cm
165
Lateral motion may be lost earlier and more significantly than vertical.
A)in the TMJ
B) in the mandible
A
166
Stick out lower jaw.
A)Protrude without deviation.
B)Protrude without rotation.
C)Protrude without both a and b
A
167
CERVICAL SPINE
.
168
The spine should be straight and the head erect.
A)false
B)true
True
169
Palpate the spinous processes and the sternomastoid, trapezius, and paravertebral muscles. They should feel firm, with no muscle spasm or tenderness.
A)true
B)flase
True
170
Abnormal findings of the cervical spine the nurse would find?(select all that apply)
A) Head tilted to one side.
B)Asymmetry of muscles.
C)Tenderness and hard muscles with muscle spasm.
D)head straight forward
A,B,C
171
Instructions to Person and Motion and Expected Range of cervical spine
.
172
Touch chin to chest. Normal finding?
A)Flexion of 45 degrees
B)Flexion of 90 degrees
C)Flexion of 30 degrees
A
173
Lift the chin toward the ceiling. Normal finding?
A)Hyperextension of 45 degrees.
B)Hyperextension of 90 degrees.
C)Hyperextension of 55 degrees.
C
174
Touch each ear toward the corresponding shoulder. Do not lift up the shoulder. Normal finding?
A)Lateral bending of 40 degrees
B)Lateral bending of 50 degrees
C)Lateral bending of 70 degrees
A
175
Turn the chin toward each shoulder. Normal finding?
A)Rotation of 70 degrees
B)Rotation of 90 degrees
C)Rotation of 180 degrees
A
176
The person normally can maintain flexion against your full resistance. This also tests the integrity of cranial nerve Xl (spinal). Abnormal findings would be?
A)The person cannot hold flexion.
B)The person can hold flexion
A
177
Shoulder
.
178
Check the size and contour of the joint, and compare shoulders for equality of bony landmarks. Normally, no redness, muscular atrophy, deformity, or swelling is present.
A)true
B)false
True
179
Check the anterior aspect of the joint capsule and the subacromial bursa for abnormal swelling.
A)true
B)false
True
180
Dislocated shoulder
A)loses the normal rounded shape and looks flattened laterally
B)gains the normal rounded shape and looks flattened laterally
True a
181
Swelling of a shoulder is best seen?
A) anteriorly. Considerable fluid must be present to cause a visible distention because the capsule normally is so loose.
B) posterily. Considerable fluid must be present to cause a visible distention because the capsule normally is so loose
A
182
Be aware that shoulder pain may be from local causes or it may be referred pain from a hiatal hernia or a cardiac or pleural condition, which could be potentially serious.
A) true
B)false
True
183
Swelling of subacromial bursa
A)is localized under deltoid muscle and may be accentuated when the person tries to abduct the arm
B)localized under trapezes muscle and may be accentuated when the person tries to abduct the arm
A)
184
The nurse is aware that, Pain from a local cause is reproducible during the examination by palpation or motion?
A)false
B)true
True B
185
Start at the clavicle and methodically explore the acromioclavicular joint, scapula, greater tubercle of the humerus, area of the subacromial bursa, the biceps groove, and the anterior aspect of the glenohumeral joint. Palpate the pyramid-shaped axilla; no adenopathy or masses should be present.
A)false
B) true
True b
186
Abnormal findings of the shoulder would be?
A)Hard muscles with muscle spasm.
B) Tenderness or pain.
C)both a and b
C
187
Instructions to Person and Motion and Expected Range of the shoulder
.
188
With arms at sides and elbows extended, move both arms forward and up in wide vertical arcs and then move them back. Normal finding?
A)Forward flexion of 180 degrees. Hyperextension up to 50 degrees
B)Forward flexion of 200 degrees. Hyperextension up to 50 degrees
C)Forward flexion of 90 degrees. Hyperextension up to 50 degrees
D) all the above
AForward flexion of 180 degrees. Hyperextension up to 50 degrees
189
Rotate arms internally behind back, place back of hands as high as possible toward the scapulae. Normal finding?
A)Rotate arms internally behind back, place back of hands as high as possible toward the scapulae
B)Rotate arms externally behind back, place back of hands as high as possible toward the scapulae
C)both a and b
A
190
With arms at sides and elbows extended, raise both arms in wide arcs in the corona] plane. Touch palms together above head. Normal finding?
A)Abduction of 180 degrees. Adduction of 30 degrees
B)Abduction of 180 degrees. Adduction of 60 degrees
C)Abduction of 90 degrees. Adduction of 50 degrees
D)Abduction of 180 degrees. Adduction of 50 degrees
Abduction of 180 degrees. Adduction of 50 degrees D
191
Touch both hands behi.nd the head with elbows flexed and rotated posteriorly. Normal finding?
A)Touch both hands behind the head with elbows flexed and rotated posteriorly.
B)Touch one hand behind the head with elbows flexed and rotated posteriorly.
A
192
Rotator cuff lesions may cause limited ROM, pain, and muscle spasm during abduction, whereas forward flexion stays fairly normal.
A)true
B)flase
True
193
The shoulder shrug also tests the integrity of cranial nerve ________ the spinal accessory.
A)11
B)12
C)6
A
194
. Elbow
.
195
Check the olecranon bursa and the normally present hollows on either side of the olecranon process for abnormal swelling.
A) true
B) false
True
196
Subluxation of the elbow shows the forearm dislocated?
A) anteriorly
B) posteriorly.
BSubluxation of the elbow shows the forearm dislocated posteriorly.
197
Swelling and redness of olecranon bursa are localized and easy to observe because of the close proximity of the bursa to skin
A)true
B)false
True
198
Effusion or synovial thickening shows first as a bulge or fullness in groove on either side of the olecranon process, and it occurs with
A) gouty arthritis.
B) gout elbowitis
C)both a and b
A
199
Palpate with the elbow flexed about 70 degrees and as relaxed as possible.Use your left hand to support the person's left forearm, and palpate the extensor surface of the elbow-the olecranon process and the medial and lateral epicondyles of humerus-with your right thumb and fingers.
A)true
B) flase
True
200
Epicondyles, head of radius, and tendons are common sites of inflammation and local tenderness, or "tennis elbow."
A)true
B)false
True
201
With your thumb in the lateral groove and your index and middle fingers in the mectial groove, palpate either side of the olecranon process using varying pressure. Normally, present tissues and fat pads feel fairly solid. Check for any synovial thickening, swelling, nodules, or tenderness.
A)true
B)flase
True
202
Abnormal finding in the elbow would be?
A)Soft, boggy, or fluctuant swelling in both grooves occurs with synovial thickening or effusion
B)Hard, swelling, or fluctuant swelling in both grooves occurs with synovial thickening or effusion
ASoft, boggy, or fluctuant swelling in both grooves occurs with synovial thickening or effusion
203
Subcutaneous nodules are raised, firm, and nontender, and overlying skin moves freely. Common sites are
A)in the olecranon bursa and along extensor surface of the ulna. These nodules occur with RA
B) in the radial bursa and along extensor surface of the ulna.
A
204
lnstructions to Person and Motion and Expected Range of the elbow
.
205
Bend and straighten the elbow, normal finding?
A)Flexion of 150 to 160 degrees; extension at 0. Some healthy people lack 5 to l0 degrees of full extension, and others have 5 to 10 degrees of hyperextension.
B)none
A
206
Movement of 90 degrees in pronation and supination, normal finding?
A)Hold the hand midway; then touch front and back sides of hand to table
B) halfway and touch back to front sides of hand to table
A
207
Wrist and Hand
.
208
The normal functional position of the hand shows the wrist in slight extension. This way, the fingers can flex efficiently and the thumb can oppose them for grip and manipulation. The fingers lie straight in the same axis as the forearm. Normally, no swelling or redness, deformity, or nodules are present.
A)true
B)flase
True
209
Abnormal findings of the wristband hand would be?(select all that apply)
A)Subluxation (partial dislocation) of wrist.
B)Ulnar deviation; fingers list to ulnar side.
C)Dupuytren contracture; flexion contracture of finger(
D)Swan-neck or boutonniere deformity in fingers
E)Atrophy of the thenar eminence
A,b,c,d,e
210
Use your thumb and index finger in a pinching motion to palpate the sides of the interphalangeal joints (Fig. 22-25). Normally, no synovial thickening, tenderness, warmth, or nodules are present. But in a abnormal finding the nurse would suspect to which finding?
A)Heberden and Bouchard nodules are hard and nontender and occur with osteoarthritis
B)Heberden
C)Bouchard nodules
D)osteoarthritis
A
211
Instructions to Person and Motion and Expected Range of wrist and hand
.
212
Bend the hand up at the wrist.normal finding?
A)Hyperextension of 70 degrees (Fig. 22-26, A).
B) Palmar flexion of 90 degrees. Flexion of 90 degrees. Hyperextension of 30 degrees (Fig. 22-26, B).
C) Ulnar deviation of 50 to 60 degrees, and radial deviation of 20 degrees (Fig. 22-26, C).
D)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally (Fig. 22-26, D, E)
A
213
Bend hand down at the wrist. Normal finding?
A)Palmar flexion of 90 degrees.
B)Flexion of 90 degrees. Hyperextension of 30 degrees (Fig. 22-26, B).
C)Ulnar deviation of 50 to 60 degrees, and radial deviation of 20 degrees (Fig. 22-26, C).
D)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally (Fig. 22-26, D, E)
A
214
Bend the fingers up and down at metacarpophalangeal joints. Normal finding?
A)Flexion of 90 degrees. Hyperextension of 30 degrees
B)Ulnar deviation of 50 to 60 degrees, and radial deviation of 20 degrees (Fig. 22-26, C).
C)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally (Fig. 22-26, D, E)
A
215
With palms flat on table, turn them outward and in.normal finding?
A)Ulnar deviation of 50 to 60 degrees, and radial deviation of 20 degrees (Fig. 22-26, C).
B)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally (Fig. 22-26, D, E)
A
216
Spread fingers apart; make a fist. Normal finding?
A)Abduction of 20 degrees; fist tight. The responses should be equal bilaterally.
B)Hyperextension of 70 degrees
A
217
Touch the thumb to each finger and to the base of little finger. Normal finding?
A)The person is able to perform, and the responses are equal bilaterally
B)The person is able to perform, and the responses are equal unilaterally
A
218
For muscle testing, position the person's forearm supinated (palm up) and resting on a table (Fig. 22-27). Stabilize by holding your hand at the person's midforearm. Ask the person to flex the wrist against your resistance at the palm.
A)wrist
B)hand
C)both a and b
C
219
Ask the person to hold both hands back to back while flexing the wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand. The test is called?
A)Tinsel Test
B)Phalen Test.
BPhalen Test. Ask the person to hold both hands back to back while flexing the wrists 90 degrees. Acute flexion of the wrist for 60 seconds produces no symptoms in the normal hand
220
```
A patient with carpal tunnel syndrome the nurse will perform what test to conclude abnormal finding?
A) tinsel test
B) wrist test
C) hand test
D) phalen test
```
DPhalen test reproduces numbness and burning in a person with carpal tunnel syndrome
221
. Direct percussion of the location of the median nerve at the wrist produces no symptoms in the normal hand. Is what test the nurse is performing?
A)phaglen test
B)Tinel Sign
C)both a and b
Tinel Sign B In carpal tunnel syndrome, percussion of the median nerve produces burning and tingling along its distribution, which is a positive Tine! sign.
222
In carpal tunnel syndrome, percussion of the median nerve produces burning and tingling along its distribution, which is a positive Of what test?
A)tinel test
B) phaglen test
C) both a and b
In carpal tunnel syndrome, percussion of the median nerve produces burning and tingling along its distribution, which is a positive Tine! sign. A
223
Hip
.
224
Instructions to Person and Motion and Expected Range of the HIP
.
225
```
Raise each leg with knee extended. Normal finding?
A)Hip flexion of 90 degrees
B)Hip flexion of 180 degrees
C)Hip flexion of 45 degrees
D)Hip flexion of 100 degrees (F
```
A
226
Bend each knee up to the chest while keeping the other leg straight. Normal finding?
A)Hip flexion of 180degrees. The opposite thigh should remain on the table
B)Hip flexion of 120 degrees. The opposite thigh should remain on the table
C)Hip flexion of 90 degrees. The opposite thigh should remain on the table
BHip flexion of 120 degrees. The opposite thigh should remain on the table
227
Flex knee and hip to 90 degrees. Stabilize by holding the thigh with one hand and the ankle \vith the other hand. Swing the foot outward. Swing the foot inward. (Foot and thigh move in opposite directions.) normal finding?
A)Internal rotation of 40 degrees. External rotation of 45 degrees
B)Internal rotation of 30 degrees. External rotation of 45 degrees
C)Internal rotation of 15 degrees. External rotation of 30 degrees
AInternal rotation of 40 degrees. External rotation of 45 degrees
228
Swing leg laterally, then medially, with knee straight. Stabilize pelvis by pushing down on the opposite anterior superior iliac spine. Normal finding?
A)Abduction of 40 to 50 degrees. Adduction of 10 to 30 degrees
B)Abduction of 40 to 45 degrees. Adduction of 20 to 30 degrees
Abduction of 40 to 45 degrees. Adduction of 20 to 30 degrees B
229
When standing (later in examination), swing straight leg back behind body. Stabilize pelvis to eliminate exaggerated lumbar lordosis. The most efficient way is to ask person to bend over the table and to support the trunk on the table. Or the person can lie prone on the table. Normal finding?
A)Hyperextension of 15 degrees when stabilized.
B)Hyperextension of 20 degrees when stabilized.
AHyperextension of 15 degrees when stabilized.
230
Flexion flattens the lumbar spine; if this reveals a flexion deformity in the opposite hip, it represents a positive Thomas test.
A)true
B)flase
True
231
The nurse that a patient with Limited internal rotation of hip is an early and reliable sign of
A)bone disease
B)hip disease
C)both a and b
BLimited internal rotation of hip is an early and reliable sign of hip disease
232
Limitation of abduction of the hip while supine is the most common motion dysfunction found in
A)hip disease.
B)bone disease
ALimitation of abduction of the hip while supine is the most common motion dysfunction found in hip disease.
233
Knee
.
234
The person should remain supine with legs extended, although some examiners prefer the knees to be flexed and dangling for inspection. The skin normally looks smooth, with even coloring and no lesions.
A) true
B)false
True
235
```
Abnormalities of the Knee?
A)Lesions (e.g., psoriasis). Angulation deformity:
B)Genu varum {bowlegs)
C) Genu valgum (knock knees)
D)Flexion contracture
E)all the above
```
E
Abnormalities of the Knee, p. 613). Lesions (e.g., psoriasis). Angulation deformity: • Genu varum {bowlegs) (see p. 601) • Genu valgum (knock knees) • Flexion contracture
236
Genu varum
A){bowlegs)
B)(knock knees)
A
Abnormalities of the Knee, p. 613). Lesions (e.g., psoriasis). Angulation deformity: • Genu varum {bowlegs) (see p. 601) • Genu valgum (knock knees) • Flexion contracture
237
• Genu valgum
A) (knock knees)
B) {bowlegs)
A
Abnormalities of the Knee, p. 613). Lesions (e.g., psoriasis). Angulation deformity: • Genu varum {bowlegs) (see p. 601) • Genu valgum (knock knees) • Flexion contracture
238
Inspect the knee's shape and contour. Normally distinct concavities, or hollows, are present on either side of the patella. Check them for any sign of fullness or swelling. Note other locations, such as the prepatellar bursa and the suprapatellar pouch, for any abnormal swelling.
A) true
B)false
True
239
Hollows disappear; of the knee then the nursebshould know that?
A)they may bulge with synovial thickening or effusion.
B)that this is normal
C)report to the doctor
A
240
Check the quadriceps muscle in the anterior thigh for any atrophy. Because it is the prime mover of knee extension, this muscle is important for joint stability during weight-bearing?
A)true
B)False
True
241
Because it is the prime mover of knee extension, this muscle is important for joint stability during weight-bearing?
A)rectus femoris
B)quadriceps
C) hamstrings
Check the quadriceps muscle in the anterior thigh for any atrophy. Because it is the prime mover of knee extension, this muscle is important for joint stability during weight-bearing
B
242
Abnormal finding of the quadriceps muscle?
A)Atrophy occurs with disuse or chronic disorders. First, it appears in the medial part of the muscle, although it is difficult to note because the vastus medialis is relatively small.
B)Atrophy occurs with disuse or acute disorders. First, it appears in the medial part of the muscle, although it is difficult to note because the vastus medialis is relatively small.
A
Atrophy occurs with disuse or chronic disorders. First, it appears in the medial part of the muscle, although it is difficult to note because the vastus medialis is relatively small.
243
The muscles and soft tissues should feel solid, and the join t should feel smooth, with no warmth, tenderness, thickening, or nodularity.
A)true
B)flase
True
244
The joint feels Feels fluctuant or boggy with synovitis of suprapatellar pouch.
A) true
B) false
True
245
When swelling occurs at the knee joint,the nurse needs to distinguish whether it is due to?
A) soft tissue swelling or increased fluid in the joint.
B) vital signs
A
| When swelling occurs, you need to distinguish whether it is due to soft tissue swe!Ung or increased fluid in the joint.
246
For swelling in the suprapatellar pouch, the __________confirms the presence of small amounts of fluid as you try to move the fluid from one side of the joint to the other. Firmly stroke up on the medial aspect of the knee two or three times to displace any fluid (Fig. 22-32, A). Tap the lateral aspect (Fig. 22-32, B). Watch the medial side in the hollow for a distinct bulge from a fluid wave. Normally, none is present
A)phaglen test
B)tinel test
C)bulge Sign.
C
Bulge Sign. For swelling in the suprapatellar pouch, the bulge sign confirms the presence of small amounts of fluid as you try to move the fluid from one side of the joint to the other. Firmly stroke up on the medial aspect of the knee two or three times to displace any fluid (Fig. 22-32, A). Tap the lateral aspect (Fig. 22-32, B). Watch the medial side in the hollow for a distinct bulge from a fluid wave. Normally, none is present
247
A positive bulge sign occurs with?
A) no amounts of effusion, 10 to 20 mL, from fluid flowing across the joint
B)very small amounts of effusion, 4 to 8 mL, from fluid flowing across the joint
B
| The bulge sign occurs with very small amounts of effusion, 4 to 8 mL, from fluid flowing across the joint
248
This test is reliable when larger amounts of fluid are present. Use your left hand to compress the suprapatellar pouch to move any fluid into the knee joint. With your right hand, push the patella sharply against the femur. If no fluid is present, the patella is already snug against the femur?
A)Ballottement of the Patella.
B)Ballottement of the knee
C)Ballottement of the knee and femur
A
Ballottement of the Patella. This test is reliable when larger amounts of fluid are present. Use your left hand to compress the suprapatellar pouch to move any fluid into the knee joint. With your right hand, push the patella sharply against the femur. If no fluid is present, the patella is already snug against the femur (
249
Irregular bony margins occur with osteoarthritis
A)true
B)false
True
250
Check for crepitus by holding your hand on the patella as the knee is flexed and extended. Some crepitus in an otherwise asymptomatic knee is not uncommon.
A)true
B)false
True
251
Pronounced crepitus is significant, and it occurs with degenerative diseases of the knee.
A)true
B) false
True
252
Instructions to Person and Motion and Expected Range of the KNEE
.
253
Bend each knee. normal finding?
A)Flexion of 130 to 150degrees
B)Flexion of 1440 to 160degrees
AFlexion of 130 to 150 degrees
254
Extend each knee. normal finding?
A)A straight line of 0 degrees in some persons; a hyperextension of 15 degrees in others
B)A straight line of 0 degrees in some persons; a hyperextension of 20 degrees in others
AA straight line of 0 degrees in some persons; a hyperextension of 15degrees in others
255
Sudden locking-the person is unable to extend the knee fully. This usually occurs with a painful and audible "pop" or "click.
A)true
B)false
True
256
Sudden buckling, or "giving way," occurs with ligament injury, which causes weakness and instability.
A)true
B)false
True
257
Perform this test when the person has reported a history of trauma followed by locking, giving way, or local pain in the knee. Position the person supine as you stand on the affected side. Hold the heel, and flex the knee and hip. Place your other hand on the knee with fingers on the medial side. Rotate the leg in and out to loosen the joint. Externally rotate the leg, and push a valgus (inward) stress on the knee. Then slowly extend the knee. Normally, the leg extends smoothly with no pain.
A)McMurray Test.
B)pahlegen test
A
McMurray Test. Perform this test when the person has reported a history of trauma followed by locking, giving way, or local pain in the knee. Position the person supine as you stand on the affected side. Hold the heel, and flex the knee and hip. Place your other hand on the knee with fingers on the medial side. Rotate the leg in and out to loosen the joint. Externally rotate the leg, and push a valgus (inward) stress on the knee. Then slowly extend the knee. Normally, the leg extends smoothly with no pain
258
If you hear or feel a "click," McMurray test is positive for a
A)torn meniscus.
B)joint disease
C)knee disese
A
| If you hear or feel a "click," McMurray test is positive for a tom meniscus.
259
Ankle and Foot
.
260
The foot should align with the long axis of the lower leg; an imaginary line would fall from mid patella to between the first and second toes.Most feet have a longitudinal arch, although that can vary normally from "flat feet" to a high instep
A)true
B)false
A
261
The toes point straight forward and lie flat. The ankJes (malleoli) are smooth bony prominences. Normally, the skin is smooth, with even coloring and no lesions.
A)normal findings
B)abnormal findings
A normal findingss
262
In hallux valgus, the distal part of the great toe is directed
A)abnormal fiinding, toward the body midline
B) abnormal finding, away from the body midline
B
| In hallux valgus, the distal part of the great toe is directed away from the body midline
263
Support the ankJe by grasping the heel with your fingers while palpating with your thumbs.They should feel smooth and depressed, with no fullness, swelling, or tenderness.
A)normal findings of the ankle and the foot
B)abnormal finding of the ankle and the foot
A
| They should feel smooth and depressed, with no fullness, swelling, or tenderness.
264
Using a pinching motion of your thumb and forefinger, the nurse can palpate the
A)interphalangeal joints on the medial and lateral sides of the toes.
B)false the nurse can not palpate
A
265
Instructions to Person and Motion and Expected Range of the ANKLE AND FOOT
.
266
Point toes toward the floor. normal finding?
A)Plantar flexion of 45 degrees
B)Plantar flexion of 90 degrees
A
267
Point toes toward the nose.normal finding???
A)Dorsiflexion of 20 degrees
B)Dorsiflexion of 30 degrees
A
268
Turn soles of feet out, then in. (Stabilize the ankle with one hand, hold heel with the other to test the subtalar joint.) normal finding?
A)Eversion of 20 degrees. Inversion of 30 degrees
B)Eversion of 10 degrees. Inversion of 20 degrees
A
269
Flex and straighten toes. normal finding?
A)true
B)falsse
A
270
SPINE
.
271
Inspect and note whether the spine is straight
(1) by following an imaginary vertical line from the head through the spinous processes and down through the gluteal cleft and (2) by noting equal horizontal positions for the shoulders, scapulae, iliac crests, and gluteal folds and equal spaces between the arm and lateral thorax on the two sides (Fig. 22-41, A). The person's knees and feet should be aligned with the trunk and should be pointing forward.
A)true
B)false
True
272
difference in shoulder elevation and in level of scapulae and iliac crests occurs with scoliosis.
A)true
B)false
true
273
note the normal convex thoracic curve and concave lumbar curve.
A)true
B)false
true
274
An enhanced thoracic curve, or kyphosis, is common in aging people.
A)true
B)false
true
275
. A pronounced lumbar curve, or lordosis, is common in obese people.
A)true
B)false
true
276
Lateral tilting and forward bending occur with a herniated nucleus pulposus.
A)true
B)false
Ture
277
Chronic axial skeletal pain occurs with Fibromyalgia Syndrome.
A)true
B)false
true
278
Check ROM of the spine by asking the person to bend forward and touch the toes. Look for flexion of 75 to 90 degrees and smoothness and symmetry of movement.
A)true
B)false
True
279
Note that the concave lumbar curve should disappear with this motion and the back should have a single convex C-shaped curve.
A)true
B)false
true
280
If the dots fonn a slight S-shape when the person stands, a spinal curve is present.
A)true
B)false
true
281
Instructions to Person and Motion and Expected Range of the SPINE
.
282
Bend sideways. normal findings?
A)Lateral bending of 35 degrees
B)lateral bending of 45 degrees
A
283
Bend backward. normaling?
A)Hyperextension of 30 degrees.
B)hyperextension of 45 degrees
A
284
Twist shoulders To one side, then the other. normal findings?
A)Relation of 30 degrees, bilaterally
B)Relation of 40 degrees, bilaterally
A
285
These maneuvers reproduce back and leg pain and help confirm the presence of a herniated nucleus pulposus. Straight leg raising while keeping the knee extended normally produces no pain. Raise the affected leg just short of the point where it produces pain. Then dorsiflex the foot. this test is called?
A)Straight Leg Raising or Lasegue Test.
B)tienl test
A
286
A test that is positive if it reproduces sciatic pain. If lifting the affected leg reproduces sciatic pain, it confirms the presence of a herniated nucleus pulposus. the test called?
A)Lasegue test
B)phaglen test
A
Lasegue test is positive if it reproduces sciatic pain. If lifting the affected leg reproduces sciatic pain, it confirms the presence of a herniated nucleus pulposus.
287
If lifting the unaffected leg reproduces sciatic pain, it strongly suggests a herniated nucleus pulposus.
A)true
B)false
true
288
For true leg le11gth, measure between fixed points, from the anterior iliac spine to the medial malleolus, crossing the medial side of the knee (Fig. 22-45). Normally, these measurements are equal or within 1 em, indicating no true bone discrepancy.
A)true
B)false
true
289
For nppnre111 leg length, measure from a nonfixcd point (the umbilicus) to a fixed point (medial malleolus) on each leg.
A)true
B)false
true
290
True leg lengths are equal, but apparent leg lengths unequal-this condition occurs with pelvic obliquity or adduction or flexion deformity in the hip.
A)abnormal finding
B)normal finding
normal finding A
291
DEVELOPMENTAL COMPETENCE
.
292
Infants
.
293
Start with the feet and work your way up the extremities.
A)true
B)false
true
294
Often the newborn's feet are not held straight but, instead, in a varus (apart) or valgus (together) position. It is important to distinguish whether this position is flexible (and thus usually self-correctable) or fixed.
A)true
B)false
true
295
A true deformity is fixed and assumes a right angle only with forced manipulation or not at all.
A)abnormal findings
B)normal findings
A abnormal normal findings
296
Commonly, the hindfoot is in alignment with the lower leg and just the forefoot angles inward. This forefoot adduction is metatarsus ndductus. It is usually present at birth and usually resolves spontaneously by age 3 years.
A)true
B)false
true
297
Metatarsus varus
A)adduction and inversion of forefoot.
B)abduction and eversion of forefoot
A
298
Check for tibial torsion, a twisting of the tibia. Place both feet flat on the table, . and push to flex up the knees. With the patella and the tibial tubercle in a straight line, place your fingers on the malleoli. In an infant, note that a line connecting the four malleoli is parallel to the table.
A)true
B)false
true
299
More than 20 degrees of deviation; or if lateral malleolus is anterior to medial malleolus, it indicates tibial torsion.
A)true
B)false
trrue
300
Tibial torsion may originate from intrauterine positioning and then may be exacerbated at a later age by continuous sitting in a reverse tailor position, the "TV squat"
A)true
B)false
true
301
which should be done at every professional visit until the infant is l year old. With the infant supine, flex the knees holding your thumbs on the inner mid-thighs and your fingers outside on the hips touching the greater trochanters. Adduct the legs until your thumbs touch (Fig. 22-46, A). Then gently Lift and abduct, moving the knees apart and down so their lateral aspects touch the table (Fig. 22-46, B). This normally feels smooth and has no sound.
A)Ortolani maneuver,
B)phaglen test
A
302
With a dislocated hip, the head of the femur is not cupped in the acetabulum but rests posterior to it. Hip instability feels like a clunk as the head of the femur pops back into place. This is a positive Ortolani sign and warrants referral.
A)Ortolani maneuver,
B)tienl test
A
303
The Allis test also is used to check for hip dislocation by comparing leg lengths (Fig. 22-47). Place the baby's feet flat on the table and flex the knees up. Scan the tops of the knees; normally, they are at the same elevation.
A)true
B)false
true
304
is used to check for hip dislocation by comparing leg lengths (Fig. 22-47). Place the baby's feet flat on the table and flex the knees up. Scan the tops of the knees; normally, they are at the same elevation.
A)The Allis test
B)Phaglen test
AThe Allis test also is used to check for hip dislocation by comparing leg lengths (Fig. 22-47). Place the baby's feet flat on the table and flex the knees up. Scan the tops of the knees; normally, they are at the same elevation.
305
Finding one knee significantly lower than the other is a positive indication of Allis' sign and suggests hip dislocation.
A)true
B)false
A
306
Unequal gluteal folds may accompany hip dislocation after 2 to 3 months of age
A)true
B)false
trrue
307
Polydactyly is the presence of extra fingers or toes.
Syndactyly is webbing between adjacent fingers or toes
A)true
B)false
true
308
_____________ is a single palmar crease that occurs with Down syndrome, accompanied by short broad fingers, incurving of little fingers, and low-set thumbs.
A)down syndrome
B)simian crease
C)none
BA simian crease is a single palmar crease that occurs with Down syndrome, accompanied by short broad fingers, incurving of little fingers, and low-set thumbs.
309
Palpate the length of the clavicles because the clavicle is the bone most frequently fractured during birth. The clavicles should feel smooth, regular, and without crepitus. Also note equal ROM of arms during Moro's reflex.
A)true
B)false
A true Palpate the length of the clavicles because the clavicle is the bone most frequently fractured during birth. The clavicles should feel smooth, regular, and without crepitus. Also note equal ROM of arms during Moro's reflex.
310
```
what bone is most fractured during brith?
A)clavicle
B)hip bone
C)fingers and toes
D) shoulder
```
clavicle A
311
Abnormal findings will include?
A)Fractured clavicle: Note irregularity at the fracture site, crepitus, and angulation.The site has rapid callus formation with a palpable lump within a few weeks. Observe limited arm ROM and unilateral response to More's reflex.
B)hydraated
A
312
Note the normal single Ccurve of the newborn's spine.
A)true
B)false
true
313
2 months of age, the infant can lift the head while prone. This builds the concave cervical spinal curve and indicates normal forearm strength.
A)true
B)false
true
314
A tuft of hair over a dimple in the midline may indicate
A)incision
B)spina bifida
C)scoliosis
B
| A tuft of hair over a dimple in the midline may indicate spina bifida
315
small dimple in the midline anywhere from the head to the coccyx suggests
A)dermoid sinus.
B)spina bifida
A
316
A baby with normal muscle strength wedges securely between your hands.
A)true
B)false
true
317
A baby starts to slip between your hands shows weakness of the shoulder muslce?
A)true
B)false
true
318
Preschool-Age and School-Age Children -
.
319
Lordosis is marked with
A)muscular dystrophy and rickets.
B)heart pain
C)both a and b
Lordosis is marked with muscular dystrophy and rickets.
| A
320
A "bowlegged" stance (genu varum) is a lateral bowing of the legs (Fig. 22-50, A). It is present when you measure a persistent space of more than 2.5 em between the knees when the medial malleoli are together. Genu varum is normal for 1 year after the child begins walking. The child may walk with a waddling gait. This resolves with growth; no treatment is indicated
A)true
B)false
true
321
Severe bowing or unilateral bowing also occurs with?
A) rickets.
B)hypokalemia.
C)both a and b
A
322
Knock knees" (genu valgum) are present when there is more than 2.5 cm between the medial malleoli when the knees are together (Fig. 22-50, 8). It occurs normally between 2 and 3 and a half years of age. Also, treatment is not indicated.
A)true
B)false
true
323
```
Genu valgum also occurs with
A)rickets.
B)poliomyelitis.
C) syphilis.
D)all the above
```
D
324
Flatfoot (pes planus) is pronation, or turning in, of the medial side of the foot. The young child may look flatfooted because the normal longitudinal arch is concealed by a fat pad until age 3 years. When standing begins, the child takes a broad-based stance, which causes pronation. Thus pronation is common between 12 and 30 months. You can see it best from behind the child, where the medial side of the foot drops down and in.
A)true
B)false
true
325
```
Flatfoot (pes planus) is pronation, or turning in, of the medial side of the foot. The young child may look flatfooted because the normal longitudinal arch is concealed by a fat pad until age 3 years. When standing begins, the child takes a broad-based stance, which causes pronation. Thus pronation is common between 12 and 30 months. You can see it best from behind the child, where the medial side of the foot drops down and in. but an abonormal finding would be?
A)Pronation beyond 30 months
B)Pronation beyond 15 months
C)Pronation beyond 18 months
D)Pronation beyond 20 months
```
A
326
Pigeon toes, or toeing in, are demonstrated when the child tends to walk on the lateral side of the foot, and the longitudinal arch looks higher than normal. It often starts as a forefoot adduction, which usually corrects spontaneously by age 3 years, as long as the foot is flexible.
A)true
B)false
true
327
Toeing in from forefoot adduction that is fixed, or lasts beyond age 3 years.
A)pigeon toe
B)bird toed
A
328
From 1 to 2 years of age, expect a broad-based gait, with arms out for balance. Weight bearing falls on the inside of the foot.
A)true
B)false
true
329
From 3 years of age, the base narrows and the arms are closer to the sides. Inspect the shoes for spots of greatest wear to aid your judgment of the gait. Normally, the shoes wear more on the outside of the heel and the inside of the toe.
A)true
B)false
true
330
```
Limp, usually caused by
A)trauma
B)fatigue
C)hip disease
D)all the above
```
D
331
to screen progressive subluxation of the hip. Watching from behind, ask the child to stand on one leg, then the other (Fig. 22-Sl,A). Watch the buttocks and iliac crests; they should stay level when weight is shifted. Remember that you are testing the side that is bearing weight.
A)Check the Trendelenburg sign
B)Check the phaglen sign
C)both a and B
A
Check the Trendelenburg sign to screen progressive subluxation of the hip. Watching from behind, ask the child to stand on one leg, then the other (Fig. 22-Sl,A). Watch the buttocks and iliac crests; they should stay level when weight is shifted. Remember that you are testing the side that is bearing weight.
332
severe subluxation of one hip. When the child stands on the good leg, the pelvis looks level. When the child stands on the affected leg, the pelvis drops toward the "good" side and the opposite buttock falls. The hip abductors on the standing side are too weak to hold the pelvis level. the test will be positive what is the test called?
A)Trendelenburg sign
B) the test is not postive
A
333
Start with the feet and hands of the child from 2 to 6 years of age because the child is happy to show these off, and proceed through the examination described earlier.
A)True
B)False
TRUE
334
Inability to supinate the hand while the arm is flexed, together with pain in elbow, indicates subluxation of the head of the radius.
A)true
b)false
A
335
Pain or tenderness in extremities is usually caused by trauma or infection.
A)false
B)true
B true
336
Fractures are usually due to trauma and are exhibited as an inability to use the area, a deformity, or an excess motion in the involved bone with pain and crepitation.
A)true
B)false
True
337
```
Enlargement of the tibial tubercles with tenderness suggests
A) Osgood-Schlatter disease
B)hypertibal tubercles disease
C)macrotibal diseas
D)all the above
E)both a and b
```
A
338
Adolescents
.
339
Kyphosis is common during adolescence because of chronic poor posture. Be aware of the risk for sports-related injuries with the adolescent, because sports participation and competition often peak with this age-group
A)ture
B)false
true
340
Scoliosis is most apparent during the preadolescent growth spurt. Asymmetry suggests scoliosis-ribs hump up on one side as child bends forward, and with unequal landmark elevation
A)true
B)flase
true
341
The Pregnant Woman
.
342
Expected postural changes in pregnancy include progressive lordosis and, toward the third trimester, anterior cervical flexion, kyphosis, and slumped shoulders.
A)pregnant woman
B)adolescents
A
343
When the pregnancy is at term, the protuberant abdomen and the relaxed mobility in the joints create the characteristic "waddling" gait
A)true
B)false
true
344
The Aging Adult
.
345
Postural changes include a decrease in height, more apparent in the eighth and ninth decades
A)the aging adult
B)Pregnant women
a
346
Lengthening of the arm-trunk axis" describes this shortening of the trunk with comparatively long extremities.
A)the aging adult
B)young adult
C)pregnant woman
A
347
Kyphosis is common, with a backward head tilt to compensate. This creates the outline of a figure 3 when you view this older adult from the left side. Slight flexion of hips and knees is also common.
A)the aging adult
B)the pregnant woman
C)young aadut
A
348
Contour changes include a decrease of fat in the body periphery and fat deposition over the abdomen and hips. The bony prominences become more marked.
A)the pregnant women
B)the aging adult
C)young adult
B
349
ROM and muscle strength are much the same as with the younger adult, provided no musculoskeletal illnesses or arthritic changes are present.
A)true
B)false
true
350
For those with advanced aging changes, arthritic changes, or musculoskeletal disability, perform a
A)functional assessment for ADLs.
B)complete assessment for ADLs.
A
351
Instructions to Person and Common Adaptation for Aging Changes of the aging adult
.
352
Walk (with shoes on) ?
A)Shuffling pattern; swaying; arms out to help balance; broader base of support; person may watch feet.
B)false
A
353
Climb up stairs.
A)Person holds hand rail; may haul body up with it; may lead with favored (stronger) leg
B)false
A
354
Walk down stairs.
A)Holds hand rail, sometimes with both hands.
B) If the person is weak, he or she may descend sideways, lowering the weaker leg first. If the person is unsteady, he or she may watch feet
C)both a and b
C
355
Pick up object from floor.
A)Person often bends at waist instead of bending knees; holds furniture to support while bending and straightening.
B)false
A
356
Rise up from sitting in chair
A)Person uses arms to push off chair arms, upper trunk leans forward before body straightens, feet planted wide in broad base of support
B)none
.
357
Rise up from lying in bed
A)May roll to one side, push with arms to lift up torso, grab bedside table to increase leverage.
B)jump up
A
358
PROMOTING A HEAL THY LIFESTYLE: PREVENTING OSTEOPOROSIS Don't Overlook Osteoporosis!
.
359
Five Steps to Bone Health and Osteoporosis Prevention
A)diet,exercise, lifestyle,medical options and supplements
B)diet, exercise, mental health, socialecomnomics, friends
A
360
a. Drink milk. Low-fat and skim milk, nonfat yogurt, and reduced-fat cheese are healthy sources of calcium. Fortified milk products also contain vitamin D, which is needed to absorb calcium.
b. Go fish. Canned salmon and sardines that are packed with their bones are also rich in calcium. Further, oily fish such as mackerel is rich in vitamin D.
c. Eat greens with gusto. Leafy green vegetables have a lot of calcium. Rll up on broccoli, kale, Swiss chard, turnip greens, and bok choy. In addition to the calcium, you will also get the benefits of potassium and vitamin K, which help block calcium loss from bones.
d. Try soy. Soy contains calcium and plant estrogens. Try substituting soy flour for regular flour in recipes, nibbling on soybean "nuts," or drinking soy milk.
e. Limit caffeine. Caffeine causes the body to excrete calcium more readily. Caffeine is in coffee, tea, hot chocolate, and many sodas.
f. Eat onions. Although onions are not known to have any nutritive value, they appear to reduce the bone breakdown process that can lead to osteoporosis.
diet
361
About 15 minutes of sunshine a day is all that is needed to maintain a good vitamin D supply.
A)true
B)false
true
362
Avoid smoking and excessive alcohol, and seek help for depression. Smokers have twice the risk for spinal and hip fractures
a)true
B)false
true
363
fractures heal slower in smokers and are more apt to heal improperly. Too much alcohol prevents your body from absorbing calcium
A)true
B)false
A
364
loss of 1 to 2 inches is an early sign of undiagnosed vertebral fractures and osteoporosis.
A)true
B)false
True
365
```
Also, remember that other medications may contribute to bone loss. These medications include
A)corticosteroids
B)anticoagulants, thyroid supplements
C)certain anticonvulsants.
D)all the above
```
D
366
19 to 50 years: 1000 mg calcium; 200 IU vitamin D
51 to 70 years: 1200 mg calcium; 400 IU vitamin D
Older than 70 years: 1200 mg calcium; 600 IU vitamin D
supplements normss
367
Abnormalities Affecting Multiple Joints
.
368
This is a chronic, systemic inflammatory disease of joints and surrounding connective tissue. Inflammation of synovial membrane leads to thickening; then to fibrosis, which limits motion; and finally to bony ankylosis. The disorder is symmetric and bilateral and is characterized by heat, redness, swelling, and painful motion of the affected joints. Is associated with fatigue, weakness, anorexia, weight loss, low grade fever, and lymphadenopathy.
A)Rheumatoid Arthritis (RA)
B)Osteoarthritis (Degenerative Joint Disease)
C)Ankylosing Spondylitis
A
369
Chronic, progressive inflammation of spine, sacroiliac, and larger joints of the extremities, leading to bony ankylosis and deformity. A form of RA, this affects primarily men by a 10: l ratio, in late adolescence or early adulthood. Spasm of paraspinal muscles pulls spine into forward flexion, obliterating cervical and lumbar curves. Thoracic curve exaggerated into single kyphotic rounding. Also includes AeKion deformities of hips and knees.
A)Rheumatoid Arthritis (RA)
B)Osteoarthritis (Degenerative Joint Disease)
C)Ankylosing Spondylitis
C
370
Noninflammatory, localized, progressive disorder involving deterioration of articular cartilages and subchondral bone and formation of new bone (osteophytes) at joint surfaces. Aging increases incidence; nearly all adults older than 60 years have some radiographic signs of osteoarthritis. Asymmetric joint involvement commonly affects hands, knees, hjps, and lumbar and cervical segments of the spine. Affected joints have stiffness, swelling with hard, bony protuberances, pain with motion, and limitation of motion
A)Osteoporosis
B)Osteoarthritis (Degenerative Joint Disease)
C)Rheumatoid Arthritis (RA)
B
371
Decrease in skeletal bone mass occurring when rate of bone resorption is greater than that of bone formation. The weakened bone state increases risk for stress fractures, especially at wrist, hip, and vertebrae. Occurs primarily in postmenopausal white women. Osteoporosis risk also is associated with smaller height and weight, younger age at menopause, lack of physical activity, and lack of estrogen in women.
A)Osteoporosis
B)Osteoarthritis (Degenerative Joint Disease)
C)Rheumatoid Arthritis (RA)
A
372
Abnormalities of the Shoulder
.
373
Loss of muscle mass is exhibited as a lack of fuUness surrounding the deltoid muscle. also occurs from disuse, muscle tissue damage, or motor nerve damage.
A)Atrophy
B) Dislocated Shoulder
C)Joint Effusion
A
374
Swelling from excess fluid in the joint capsule, here from rheumatoid arthritis. Best observed anteriorly. Fluctuant to palpation. Considerable fluid must be present to cause a visible distention because the capsule normally is so loose.
A)Atrophy
B)Dislocated Shoulder
C)Joint Effusion
C
375
Anterior dislocation (95%) is exhibited when hunching the shoulder forward and the tip of the clavicle dislocates. It occurs with trauma involving abduction, extension, and rotation (e.g., falling on an outstretched arm or diving into a pool)
A)Atrophy
B)Dislocated Shoulder
C)Joint Effusion
B
376
Characteristic "hunched" position and limited abduction of arm. Occurs from traumatic adduction while arm is held in abduction, or from fall on shoulder, throwing, or heavy lifting. Positive drop arm test: if the arm is passively abducted at the shoulder, the person is unable to sustain the position and the arm falls to the side
A)Tear of Rotator Cuff
B)Subacromial Bursitis
C)Frozen Shoulder-Adhesive Capsulitis
A
377
Inflammation and swelling of subacromial bursa over the shoulder cause limited ROM and pain with motion. Localized swelling under deltoid muscle may increase by partial passive abduction of the arm. Caused by direct trauma, strain during sports, local or systemic inflammatory process, or repetitive motion with injury.
A)Tear of Rotator Cuff
B)Frozen Shoulder-Adhesive Capsulitis
C)Subacromial Bursitis
C
378
Fibrous tissues form in the joint capsule, causing stiffness, progressive limitation of motion, and pain. Motion limited in abduction and external rotation; unable to reach overhead. It may lead to atrophy of shoulder girdle muscles. Gradual onset; unknown cause. It is associated with prolonged bedrest or shoulder immobiJity. May resolve spontaneously.
A)Tear of Rotator Cuff
B)Frozen Shoulder-Adhesive Capsulitis
C)Subacromial Bursitis
B
379
Abnormalities of the Elbow
.
380
Large, soft knob, or "goose egg," and redness from inflammation of olecranon bursa. Localized and easy to see because bursa Lies just under skin.
A)Olecranon Bursitis
B)Gouty Arthritis
C)Subcutaneous Nodules
A
381
Joint effusion or synovial thickening, seen first as bulge or fullness in grooves on either side of olecranon process. Redness and heat can extend beyond area of synovial membrane. Soft, boggy, or fluctuant fullness to palpation. Limited extension of elbow.
A)Gouty Arthritis
B)Epicondylitis-Tennis Elbow
C)Subcutaneous Nodules
A
382
Raised, firm, no tender nodules that occur with rheumatoid arthritis. Common sites are in the olecranon bursa and along extensor surface of Arm. The skin slides freely over the nodules.
A)Subcutaneous Nodules
B)Epicondylitis-Tennis Elbow
A
383
Chronic disabling pain at lateral epicondyle of humerus, radiates down extensor surface of forearm. Pain can be located with one finger. Resisting extension of the hand will increase the pain. Occurs with activities combining excessive pronation and supination of forearm with an extended wrist (e.g., racquet sports or using a screwdriver)
A)Subcutaneous Nodules
B)Epicondylitis-Tennis Elbow
B
384
Medial epicondylitis is rarer and is due to activity of forced palmar flexion of wrist against resistance.
A)true
B)false
True
385
cystic, nontender nodule overlying a tendon sheath or joint capsule, usually on dorsum of wrist. Flexion makes it more prominent. A common benign tumor; it does not become malignant.
A)Ganglion Cyst Round,
B)Ankylosis
A
386
Wrist in extreme flexion, due to severe rheumatoid arthritis. This is a functionally useless hand because when the wrist is palmar flexed, a good deal of power is lost from the fingers and the thumb cannot oppose the fingers.
A)Ganglion Cyst Round,
B) Ankylosis
B
387
Nonarticular fracture of distal radius, with or without fracture of ulna at styloid process. Usually from a fall on an outstretched hand; occurs more often in older women. Wrist looks puffy with "silver fork" deformity, a characteristic hump when viewed from the side.
A)Colles Fracture
B)Carpal Tunnel Syndrome
A
388
Atrophy occurs from interference with motor function from compression of the median nerve inside the carpal tunnel. Caused by chronic repetitive motion; occurs between 30 and 60 years of age and is five times more common in women than in men. Symptoms of carpal tunnel syndrome include pain, burning and numbness, positive findings on Phalen test, positive indication of Tine! sign, and often atrophy of thenar muscles
A)Colles Fracture
B)Carpal Tunnel Syndrome with Atrophy of Thenar Eminence
B
389
Chronic hyperplasia of the palmar fascia causes flexion contractures of the digits, first in the 4th digit, then the 5th digit, then the 3rd digit. Note the bands that extend from the mid palm to the digits and the puckering of palmar skin. The condition occurs commonly in men older than 40 years and is usually bilateral. It occurs with diabetes, epilepsy, and alcoholic liver disease and as an inherited trait. The contracture Is painless but impairs hand function.
A)Dupuytren Contracture
B)hyperplasia
A
390
Abnormalities of the Wrist and Hand-cont'd CONDITIONS CAUSED BY CHRONIC RHEUMATOID ARTHRITIS
.
391
Flexion contracture resembles curve of a swan's neck- Note flexion contracture of metacarpophalangeal joint, then hyperextension of the proximal interphalangeal joint, and flex.ion of the distal interphalangeal joint. It occurs with chronic rheumatoid arthritis and is often accompanied by ulnar drift of the fingers
A)Swan-Neck
B)Boutonniere Deformity
A
392
the knuckle looks as if it is being pushed through a buttonhole. It is a relatively common deformity and includes flexion of proximal interphalangeal joint with compensatory hyperextension of distal interphalangeal joint.
A)Swan-Neck
B)Boutonniere Deformity
B
393
Osteoarthritis is characterized by hard, non tender nodules, 2 to 3 mm or more. These osteophytes (bony overgrowths) of the distal interphalangeal joints are called Heberde11 11ories, and those of the proximal interphalangeal joints are called Bouchard 11odes.
A)Degenerative Joint Disease, or Osteoarthritis
B)Ulnar Deviation
A
394
Drift Fingers drift to the ulnar side because of stretching of the articular capsule and muscle imbalance. Also note subluxation and swelling in the joints and muscle atrophy on the dorsa of the hands. This is caused by chronic rheumatoid arthritis.
A)Ulnar Deviation
B)Acute Rheumatoid Arthritis
A
395
Painful swelling and stiffness of joints, with fusiform or spindle-shaped swelling of the soft tissue of proximal interphalangeal joints. Fusiform swelling is usua!Jy symmetric, the hands are warm, and the veins arc engorged. The inflamed joints have a limited range of motion.
A)Acute Rheumatoid Arthritis
B)joint effusion
C)Arthritis
A
396
Extra digits are a congenital deformity, usually occurring at the fifth finger or the thumb. Surgical removal is considered for cosmetic appearance. The 6th finger shown here was not removed because it had full ROM and sensation and a normal appearance.
A)Polydactyly
B)Syndactyly
A
397
Webbed fingers are a congenital deformity, usually requiring surgical separation. The metacarpals and phalanges of the webbed fingers are different lengths, and the joints do not line up. To leave the fingers fused would thus limit their flexion and extension.
A)Syndactyly
B)polydactyl
A
398
Abnormalities of the Knee
.
399
Localized soft swelling from cyst in lateral meniscus shows at the midpoint of the anterolateral joint line. Semiflexion of the knee makes swelling more prominent.
A)Swelling of Menisci
B)arthalgia
A
400
Loss of normal hollows on either side of the patella, which are replaced by mild distention. Occurs with synovial thickening or effusion (excess Auid). Also note mild distention of the suprapatellar pouch.
A)Mild Synovitis
B)Prepatellar Bursitis
A
401
Localized swelling on anterior knee between patella and skin. A tender, fluctuant mass indicates swelling; in some cases, infection spreads to surrounding soft tissue. The condition is limited to the bursa, and the knee joint itself is not involved. Overlying skin may be red, shiny, atrophic, or coarse and thickened.
A)Osgood-Schlatter Disease
B)Prepatellar Bursitis
B
402
Painful swelling of the tibial tubercle just below the knee, probably from repeated stress on the patellar tendon. Occurs most in puberty during rapid growth and most often in males. Pain increases with kicking, running, bike riding, stair climbing, or kneeling. The condition is usually self-limited, and symptoms resolve with rest
A)Osgood-Schlatter Disease
B)Post Polio
A
403
Right leg and foot muscle atrophy as a result of childhood polio. Poliomyelitis epidemics peaked in the United States in the 1940s and 1950s. The development of the oral polio vaccine (1962) has almost eradicated the disease. However, thousands of polio survivors have this muscle atrophy.
A)Post Polio Muscle Atrophy
B)Achilles Tenosynovitis
A
404
Abnormalities of the Ankle and Foot
.
405
Inflammation of a tendon sheath near the ankle (here, the Achilles tendon) produces a superficial linear swelling and a localized tenderness along the route of the sheath. Movement of the involved tendon usually causes pain.
A)Achilles Tenosynovitis
B)Tophi with Chronic Gout Hard,
A
406
Hard, painless nodule (tophi) over metatarsophalangeal joint of first toe. Tophi are collections of sodium urate crystals due to chronic gout in and around the joint that cause extreme swelling and joint deformity. They sometimes burst with a chalky discharge.
A)Tophi with Chronic Gout
B)acute gout
A
407
Acute episode of gout usually involves first the metatarsophalangeal joint. Clinical fi ndings consist of redness, swelling, heat, and extreme tenderness. Gout is a metabolic disorder of disturbed purine metabolism, associated with elevated serum uric acid. It occurs primarily in men older than 40 years
A)Callus
B)Acute Gout
B
408
Hypertrophy of the epithelium develops because of prolonged pressure, conunonly on the plantar surface of the first metatarsal head in the haUux valgus deformity or as shown here over the bony prominences of the joints in hammertoes. The condition is not painful
A)Callus
B)Ingrown Toenail
A
409
A misnomer; the nail does not grow in, but the soft tissue grows over the nail and obliterates the groove. It occurs almost always on the great toe on the medial or lateral side. It is due to trimming the nail too short or toe-crowding in tight shoes. The area becomes infected when the nail grows and its corner penetrates the soft tissue.
A)Ingrown Toenail
B)Plantar Wart
A
410
Vascular papillomatous growth is probably due to a virus and occurs on the sole of the foot, commonly at the ball. The condition is extremely painful.
A)Plantar Wart
B)ingrown toenail
A
411
is a common deformity from rheumatoid arthritis. It is a lateral or outward deviation of the great toe with medial prominence of the head of the first metatarsal.
A)bunion
B)Hallux valgus
B
412
is the inflamed bursa that forms at the pressure point. The great toe loses power to push off while walki11g; this stresses the second and third metatarsal heads, and they develop calluses and pain. Chronic sequelae include corns, calluses, hammertoes, and joint subluxation
A)bunion
B)Claus
A
413
deformities in the 2nd, 3rd, 4Th, and 5th toes. Often associated with hailux valgus, hammertoe includes hyperextension of the metatarsophalangeal joint and flexion of the proximal interphalangeal joint.
A)hammertoe
B)bunion
A
414
(thickening of soft tissue) develop on the dorsum over the bony prominence from prolonged pressure from shoes.
A)corns
B)bunion
A
415
Abnormalities of the Spine
.
416
Scoliosis
A)Lateral curvature of thoracic and lumbar segments of the spine, usually with some rotation of involved vertebral bodies
B)none
A
417
scoliosis is flexible; it is apparent with standing and disappears with forward bending. lt may be compensatory for other abnormalities such as leg length discrepancy
A)functional
B)structural
A
418
scoliosis is fixed; the curvature shows both on standing and on bending forward. Note rib hump with forward flexion. When the person is standing, note unequal shoulder elevation, unequal scapulae, obvious curvature, and unequal hip level. At greatest risk are females 10 years of age through adolescence, during the peak of the growth spurt.
A)Structural
B)functional
A
419
The nucleus pulposus (at the center of the intervertebral disk) ruptures into the spinal canal and puts pressure on the local spinal nerve root. Usually occurs from stress, such as lifting, twisting, continuous flexion with lifting, or fall on buttocks. Occurs mostly in men 20 to 45 years of age. Lumbar herniations occur mainly in interspaces L4 to LS and LS to S I. Note: Sciatic pain, numbness, and paresthesia of involved dermatome; listing away from affected side; decreased mobility; low back tenderness; and decreased motor and sensory function in leg. Straight leg raising tests reproduce sciatic pain.
A)Herniated Nucleus Pulposus
B)scoliosis
A
420
Common Congenital or Pediatric Abnormalities
.
421
Head of the femur is displaced out of the cup-shaped acetabulum. The degree of the condition varies; subluxation may occur as stretched ligaments allow partial displacement of femoral head, and acetabular dysplasia may develop because of excessive laxity of hip joint capsule. Occurrence is I: 500 to 1: 1000 births; common in girls by 7: I ratio. Signs include limited abduction of flexed thigh, positive indications of Ortolani and Barlow signs, asymmetric s!Un creases or gluteal folds, limb length discrepancy, and positive indication of Trendelenburg sign in older children.
A)Congenital Dislocated Hip
B)Talipes Equinovarus (Clubfoot) Congenital,
A
422
Talipes Equinovarus
A) (Clubfoot)
B) pigeon toe
A
423
) Congenital, rigid, and fixed malposition of foot, including ( 1) inversion, (2) forefoot adduction, and (3) fool pointing downward (equinus). A common birth defect, with an incidence of I : 1000 to 3: 1000 live births. Males are affected twice as frequently as females.
A)Talipes Equinovarus (Clubfoot)
B)Spina Bifida
A
424
Incomplete closure of posterior part of vertebrae results in a neural tube defect. Seriousness varies from skin defect along the spine to protrusion of the sac containing meninges, spinal fluid, or malformed spinal cord. The most serious type is myelomeningocele (shown here), in which the meninges and neural tissue protrude. In these cases, the child is usually paralyzed below the level of the lesion.
A)Spina Bifida
B)Coxa Plana (Legg-Calve-Perthes Syndrome) )
A
425
Avascular necrosis of the femoral head, occurring primarily in males between 3 and 12 years of age, with peak at age 6 years. In initial inflammatory stage, interruption of blood supply to femoral epiphysis occurs, halting growth. Revascularization and healing occur later, but significant residual deformity and dysfunction may be present.
A)Coxa Plana (Legg-Calve-Perthes Syndrome)
B)Fibromyalgia Syndrome
A
426
Fibromyalgia Syndrome
.
427
Chronic disorder of unknown cause characterized by widespread musculoskeletal pain lasting 3 months or longer, associated with fatigue, insomnia, and psychosocial distress. Most patients (90%) are adult women. There are two major diagnostic criteria30: (1) pain on both sides of the body, above and below the waist, and axial skeletal pain (cervical, thoracic, lumbar spine, or anterior chest); and (2) point tenderness on digital palpation in 11 of 18 specified sites shown above. The examiner presses the thumb of the dominant hand with a force of 4 kg (same as needed to blanch or whiten the nail bed). Burden of illness is high with one third to one fourth of patients receiving disability compensation.
A)Fibromyalgia Syndrome
B)myalgia
A
428
```
Lower cervical
Second rib
Lateral epicondyle
Supraspinatus
Greater trochanter
Knee
Occipital
Trapezius
Gluteal
These are all ?
A)LOCATION OF TENDER POINTS
B) ARE NOT LOCATION OF TENDER POINTS
```
A
429
```
Summary Checklist: Musculoskeletal Examination
For each joint to be examined:
I. Inspection
Size and contour of joint
Skin color and characteristics
2. Palpation of joint area
Skin
Muscles
Bony articulations
Joint capsule
3. ROM
Active
Passive (if limitation in active ROM is present)
Measure with goniometer (if abnormality in ROM is present)
4. Muscle testing
```
True
430
EXTRA INFORAMTION
.
431
support and movement primary function
A)musculoskeletal system
B)neurological system
A
432
bone and cartilage are
A)connective tissue
B)muscles
A
433
```
function uint of the musculoskeletal system is the
A) joint
B)muscle
```
A
434
voluntary muscles are also callled
A)skeletal muscles
B)smooth muscle
A
435
growth surpts happen at adolescents age
A)true
B)false
A
436
bone lengthinng occurs at the epiphysis or growth plates
A)true
B)false
A
437
the most charccteristic postural change in pregenccy is progressive
A) lordosis
B)kyphosis
A
438
at age 40 you start losing bone mass
A)true
B)false
A
439
tmj maain focus is to assess
A) lateral and vertical
B)tmj
A
440
cervical spine main focus is to assess
A) flexion extension lateraal bending and rotation
B) forwordd flexion hyperextension internal rotation abduction adduction
A
441
shoulders main funtion is to asess for
A)forward flexion hyperextension internal rotationn abduction adduction
B)false
A
442
elbow main focus is to asses?
A)flexion extensiion pronation and supination
B)false
A
443
wrist and hands main focus is to assess
A)extension and flexionn and hyperexxtensionn and flexion unlar devation and radial deviation,adduction
B)false
A
444
to detect carpal tunnel syndrome perform what test?
A)Phalens test and asess tinel sign percusssion on the wrist
B)false
A
445
in hips main focus is to assess
A) flexion extesion internal and external rotaation abductioon aand adduction
B) false
A
446
knees main focus is to assess
A)flexion and extension
B)hyperextension
A
447
perform mcmurrays test for possible
A) meniscus tears
B)joint tears
A
448
ankeles and feet focus is assessing
A) plantar flexion and Dorsiflexion and inversion and eversion
B flexion extension lateral bending
A
449
Spine main focus is assessing
A) flexion, extension, lateral bendding and rotation
B)none
A
450
test patient on the lesegues test
A)which you have patient supine, then rise the leg and if lower back pain occurs then patient most likey have nucleus pulposus
B) false
A
451
oestoprosis is common in
A)women
B)European descent
C) both a and b
C
452
is hard, rigid, and very dense. Its cells are continually turning over and remodeling.
A)bone
B)cartilage
C)joint
A
453
The ______(or articulation) is the place of union of two or more bones.
A)bone
B)joint
C)cartilage
B
454
```
In which of the following ethnic groups has the lowest incidence of osteoporosis?
A)African Americans
B)Whites
C)Asians
D)Native Americans
```
A
455
Heberden and bouchard nodes are hard and non-tender and are associated with
A)osteoarthritis
B)rheumatoid arthritis
C)both a and b
A
456
when testing for muscle strength the examiner should
A)observe muscles for the degree of contraction when the individual lifts a heavy object
B)apply an opposing force when the individual puts a joint in flexion or extension
C)measure the degree of force that takes to overcome joint flexion or extension
D)all the above
B
457
```
the knee joint is in articulation with what three bones?
A)femur tibia fibula
B)femur tibia patella
C)femur fibula tibia
D)femur fibula patella
```
B
458
when assessing for the presence of a herniated nucleus pulposus, the examiner
A)raise each of the patients legs straight while keeping the knee extended
B)instruct the patient to bend and touch the floor
C)have the patient perform lateral flexon
A
459
crepitaton is an audible sound that is produced by?
A)roughened articular surfaces moving over each other
B)tendons and ligaments that slip over each other during motion
C)both a and b
A
460
bundles of muscle fibers that are compose of skeletal muscle are identified as
A)fasciuli
B)ligaments
C)tendons
A
461
```
the production of RBC in the bone marrow
A)hemolysis
B)hematopoiesis
C)hematopisa
D)both b and c
```
B
462
the musculoskeletal system functions as
A)protection and storage
B)storage and contol
A
463
```
Low muscle tone is called
A)hypostenia
B) hypotonia
C)hypomuscle
D)all the above
```
B
464
```
A nurse performs a test on an infant, upon results the nurse hears a click sound of an congenital dislocation of the hip. It is noted as when the hip slips into or out of the socket(acetabulum and femur). This test is called?
A)Thomas test
B)Ortolani test
C)Bulge test
D)Lasegue test
```
B
465
```
Abnormal stiffening and immobility of a joint due to fusion of bones is called?
A)ankylosis
B)effusion
C)both a and b
D) subluxation
```
A
466
```
A grading sound or sensation produced by friction between bone and cartilage or fractured parts of a bond is called?
A)crepitus
B)dislocation
C)subluxation
D)all the above
```
A
467
```
What test is used to rule out hip flexion contracture?
A)Ortolani test
B)Bulge test
C)Thomas test
D)Allis test
```
C
468
```
The patient lies on the examination table and brings one knee in the direction to the chest /flexes hip, while the other leg remains extended. This test is called?
A)Thomas test
B)Bulge test
C)Lasegue test
D)all the above
```
A
469
```
What test is used to determine the presence of fluid in the knee joint.
A)Ortolani test
B)Thomas test
C)Bulge test
D)all the above
```
C
470
When the knee "gives way" it is because of which of the best following?
A)bone injury
B)ligament injury
C)none
B
471
```
What test can the nurse perform to reveal meniscal injury on a patient?
A)Thomas test
B)Bulge test
C)Ortolani test
D)Mcmurrays test
```
D
472
```
Straight leg rise test that is to determine if the patient has an herniated disk is called?
A)Thomas test
B)Lasegue test
C)Bulge test
D)Mcmurrays test
```
B
473
```
A single transverse crease in the palm, a minor variation associated with Down syndrome?
A)simian crease
B)dermoid sinus
C)dermoid crease
D)both a and d
```
A
474
To check startle reflex and to see if the baby feels like it is falling(arms abducted, adducted and crying) is called what test?
A)Moros reflex
B)Thomas reflex
C)both a and b
A
475
```
Most common genetic background with flat feet are?
A)Asian Americans
B)Native Americans
C) Hispanic Americans
D)African Americans
```
D
476
```
Which of the following are types of connective tissue? Select all that apply.
Select all that apply:
A)Skeletal muscle
B)Tendons
C)Ligaments
D)Articulations
E)Bone
```
B,C,E
477
The musculoskeletal system is composed of skeletal muscle and five types of connective tissue: bone, cartilage, ligaments, tendons, and fascia.
A)true
B)false also skeletal muscle
A
478
A patient has rheumatoid arthritis most prominent in her hands, where she has decreased range of motion (ROM), pain, and tenderness. What is an appropriate nursing diagnosis for this patient?
Choose one of the following
A)Risk for depression related to immobility
B)Risk for falls related to degenerative joint disease
C)Risk for infection related to pain and inflammation
D)Impaired physical mobility related to reduced strength and ROM
D
479
After assessing the patient for posture and body alignment, how would the nurse document head position in relation to the spine if alignment is normal with noticeable defect?
Choose one of the following
A)The head is straight up and down in accordance with the spine
B)The head is equally distributed on the neck
C)The head is midline and aligned with the spine
D)The head is centered and in line with the backbone
C
The correct documentation would be "the trunk and head are erect with weight distributed equally on both feet. The head is midline and aligned with the spine."
480
An elderly woman fell in her bathroom and is brought to the ED. Upon examination, the nurse notices that the right leg is externally rotated. This finding is indicative of a fractured femur.
Choose one of the following
A)True
B)False
A
481
When lying supine, external rotation of the lower leg and foot indicates a fractured femur.
A)true
B)false
A
482
```
Increased lumbar curvature, which compensates for the enlarging uterus in pregnant women, is called what?
Choose one of the following
A)Kyphosis
B)Scoliosis
C)Lordosis
D)Keracytosis
```
C
483
```
A nurse has just performed the test for Allis' sign on a newborn; the result is positive. What did the nurse observe while performing this test?
Choose one of the following
A)A clicking sound is heard
B)No clicking sound is heard
C)One knee is lower than the other
D)Knees are at equal height
```
C
Rationale
The examiner tests for Allis' sign by placing the infant supine with flexed hips and knees and both feet flat on the table. A negative Allis' sign is when the knees are at equal heights. A positive Allis' sign is when one knee is lower than the other, indicating hip dysplasia. In the Barlow-Ortolani maneuver, the infant is supine with flexed knees and hips so that the heels touch the buttocks. The examiner places his or her fingers on the baby's greater trochanter of the humerus and adducts the legs, moving the knees down and laterally. This maneuver is negative when the movement is smooth, with no clicking sound. If a clicking sound is audible, the maneuver is considered a positive indication of hip dislocation.
484
A 58-year-old woman comes to the ED after falling and breaking her right hip and right wrist. She has been diagnosed with osteoporosis. The nurse is aware that Caucasian women have the lowest risk of developing problems from loss of bone density.
Choose one of the following
A)True
B)False
B
Rationale
Caucasian women have the highest risk of developing problems from loss of bone density.
485
```
Assessment of the musculoskeletal system usually proceeds from general to specific and from?
Choose one of the following
A)Head to toe
B)Right to left
C)Bottom to top
D)Anterior to posterior
```
A
486
Focused assessments may be more appropriate when the patient reports an injury to a specific area or joint.
A)true
B)false
A
487
The nurse is assessing a 68-year-old man with a new onset of dementia. The nurse is using the Morse Fall Scale; the patient's score is 63. What does this tell the nurse?
Choose one of the following
A)That the patient is at moderate risk for falling
B)That the patient is at high risk for falling
C)That the patient needs to be restrained for his own safety
D)That the patient is at low risk for falling
B
488
```
Moving a part of the body away from the midline is called?
Choose one of the following
A)Abduction
B)Adduction
C)Extension
D)Rotation
```
A
489
A patient is being discharged home from the hospital. This patient has a history of falling at home. A caregiver is not able to stay with the patient all the time. What can be done to decrease the risk for falling at the patient's home? Select all that apply.
Select all that apply:
A)Place colorful throw rugs near the exits
B)Install grab bars in the bathroom
C)Correct environmental hazards in the home
D)Make sure house hallways are well lit
E)Have the patient go to a physical therapy three times a week
B,C,D
Patients should correct environmental hazards such as slippery surfaces, uneven floors, poor lighting on stairs, loose rugs, unstable furniture, and objects on floors. The nurse can recommend installation of grab bars in restrooms for patients with poor balance. Participation in physical therapy might help patients with gait and balance problems, but the nurse cannot implement this intervention independently.
490
Bone marrow cavities serve as sites of hematopoiesis or the manufacturing of blood cells.
A)true
B)false it is hematolysis
A
491
```
A 28-year-old woman has been diagnosed with carpal tunnel syndrome. What type of working conditions may have contributed to this diagnosis?
Choose one of the following
A)Frequent repetitive movements
B)Substantial physical activity
C)Prolonged sitting
D)Heavy lifting
```
A
Some working conditions present potential risks to the musculoskeletal system. Workers required to lift heavy objects may strain and injure their backs. Jobs requiring substantial physical activity, such as construction work and fire fighting, increase the likelihood of sprains, strains, and fractures. Frequent repetitive movements may lead to misuse disorders such as carpal tunnel syndrome, pitcher's elbow, or vertebral degeneration. Musculoskeletal injuries may also occur when people sit for long periods at desks with poor ergonomic design.
492
```
How many vertebrae make up the spinal column?
Choose one of the following
A)33
B)31
C)37
D)32
```
A
493
```
The nurse is testing a patient for carpal tunnel syndrome. The patient flexes the wrists at an angle of 90° and holds the backs of the hands to each other for 60 seconds. The patient tells the nurse that he is experiencing a burning pain as a result. Which test is the nurse performing on this patient?
Choose one of the following
A)McMurray's
B)Ballottement
C)Tinel's
D)Phalen's
```
D
494
```
Loss of bone density that occurs with greatest frequency in postmenopausal women is called?
Choose one of the following
A)Kyphosis
B)Lordosis
C)Scoliosis
D)Osteoporosis
```
D
495
The nurse is examining a 77-year-old man. During the physical assessment, the patient appears to be getting fatigued. What can the nurse do to help the patient finish the assessment?
Choose one of the following
A)Halt the assessment, and finish when the patient has enough strength
B)Omit tests
C)Divide the assessment into portions
D)Rush through each activity to finish more quickly
C
Examiners should allow extra time for older adults to complete each activity. They may divide the assessment into portions if an older patient appears fatigued.
496
The hip joint is the articulation between the acetabulum and the head of the humerus.
Choose one of the following
A)True
B)False
B
497
What test does the nurse performs called when, the nurse firmly strokes up the medial aspect of the knee two or three times to displace any fluid.taps the lateral aspect.
A)bulge test
B)Thomas test
C)ballottement of the patella
A
498
Pushing the patell against the femur is called what test?
A)ballottement of the patella
B)frim-nase of the patella
A
499
```
Kock knee also called genu valgum normally occurs at what age
A)3-6
B)2-3 1/2
C)2-7
D)12 months-6
```
B
500
```
Genu varum also means Bowleg are how many more than ______ between the knees when the medial malleoli are together.
A)6.7
B)2.5
C)2
D)2.9
```
B
501
Postive test of severe subluxation of the hip is called what test
A)Trendelenburg test
B)Thomas test
C)bulge test
A
502
The patient is placed supine and the uninvolved hip and knee are placed in maximum flexion (in a knee-to-chest position). When a flexion contracture of the opposite hip is present, the thigh will spontaneously elevate, thus indicating the amount of contracture present
A) Bluge test
B) Thomas test
C) both a and b
B
503
The axial skeletal is made up of the skull and neck bones,trunk,and pelvis?
A)true
B)false
true
504
The appendicular skeletal is made up of bones of the upper and lower extremities?
A)true
B)false
true
505
joint pain is the most common condition when patient seek help?
A)true
B)false
true
506
pressure on the dorsum of the foot on bony prominence is called?
A)corns
B)callus
C)both a and b
A
507
pressure on the plantar section of the foot on bony prominence is called?
A)callus
B)Corn
C)both a and b
A
508
```
The nurse examining a patient with normal muscle strength would document the Grade_______?
A)0
B)1
C)3
D)5
```
D
509
```
The nurse is assessing a 72-y/o spinal column. Which spinal finding would be consider normal for a 72-y/o patient?
A)lordosis
B)kyphosis
C)both a and b
D)scoliosis
```
B
510
```
The nurse is trying o assess a patients risk for osteoporosis. the nurse knows that the following groups have the highest incidence of osteoporosis?select all the apply?
A)asian females
B)white males
C)American indians
D)african americans
E)postmenopasual women
F)patients who had fractures in the past
```
A,E,F
511
which statement regarding the comparison of the circumference between the right and left extremities is true?
A)measurements between the right and left sides should be identical
B)measurements differences are less than 1cm
C)measurements difference are within 2 cm
D)all the above
B
512
the nurse is assessing a patient muscle strength of the trapezius muscle. the nurse will apply resisting force while the patient?
A)shrugs her shoulders
B)moves her jaw
A
513
```
the nurse is assessing a patient using a goniometer. what is this instrument used for/?
A)muscle strength
B)range of motion
C)joint symmetry
D)length of extremity
```
B
514
which patient condition increases the risk of osteomyelitis?
A)sever osteoporosis
B)an open fracture of the radius
B
515
Gout is caused by the accumulation of uric acid in the joint?
A)true
B)false
true
516
RA is joint inflammation?
A)true
B)false
true
517
An open fracture allows the entry of microorganism into an bone?
A)osteomyelitis
B)false
A
518
the nurse is assessing a patient internal rotation of the shoulder joint. how should the nurse direct the patient?
A)place your right hand against the small of your back
B)rotate the palm of your hand up and down
C)elevate your right arm over your head
A
519
the nurse is assessing a new born hips and hears a click this means??
A)an indication of congenital hip dislocation
B)indication of spina bifida
A
520
```
a patient complain of pain and clicking in the jaw with movement. these symptoms are consistent with
A)gout in the jaw
B)TMJ syndrome
C)RA in the jaw
D)all the above
```
B
521
•Rotation:
A) moving head around central axis
B)moving body part forward, parallel to ground
C)moving body part backward, parallel to ground
A
522
•Protraction:
A)moving head around central axis
B)moving body part forward, parallel to ground
C)moving body part backward, parallel to ground
B
523
Retraction:
A) moving body part backward, parallel to ground
B) moving body part forward, parallel to ground
A
524
By 3 months fetus has formed skeleton of cartilage
A)true
B)false by 2 months
A true
525
Longitudinal growth continues until closure of epiphyses; last closure occurs about age 20
A)true
B)false
True
526
Purpose of musculoskeletal examination is to assess function for ADLs and to screen for abnormalities
A)true
B)false
True
527
ØAge-specific screening measures, such as Ortolani’s sign for what age group?
A)infants
B)adolescents
A
528
ØAge-specific screening measures, such as scoliosis for what age group.
A)adolescents
B)infants
A
529
ØPalpate contracted temporalis and masseter muscles as person clenches teeth
A)true
B)false
A
530
ØAsk person to move jaw forward and laterally against your resistance, and to open mouth against your resistance
•This tests integrity of cranial nerve V (trigeminal nerve)
A)true
B)false
A
531
•Flatfoot (pes planus): pronation, or turning in, of medial side of foot because normal longitudinal arch concealed by fat pad until age 3 years
A)true
B)false
True
532
MUSCULOSKELETAL
.
