SAER 2005 Flashcards
An overhead athlete with shoulder pain is found to have shoulder posterior capsule tightness. A
biomechanical consequence of this tightness is
(a) posterior displacement of the humeral head relative to the glenoid when the shoulder is
flexing.
(b) glenohumeral internal rotation deficit with range of motion less than 15° from neutral.
(c) impingement of the humeral head onto the superior glenoid labrum when the shoulder is
abducted less than 90°.
(d) posterior tilting of the scapula in the static position and with shoulder abduction.
(b) A tight posterior capsule is a common phenomenon in overhead athletes. Often rotator cuff
tendinopathy results from impingement and scapular dyskinesis. Glenohumeral internal rotation
deficit (GIRD) defined as internal rotation less than 15° or a greater than 25° side to side difference,
is due to tight posterior capsule, teres minor, and infraspinatus. Further, Matsen and Harriman
showed that a tight posterior capsule drives the humeral head anteriorly when flexing the shoulder,
thus predisposing to further impingement at the coracoacromial arch. Scapular dyskinesis, due to
weak scapular stabilizer muscle weakness, is typically in a position of anterior tilting rather than
posterior tilting.
According to the Consortium for Spinal Cord Medicine’s Clinical Practice Guidelines for the
Prevention of Thromboembolism in Spinal Cord Injury, individuals with motor complete (ASIA A
or B) spinal cord injury should receive
(a) warfarin (Coumadin), international normalized ratio target: 2–3.
(b) low-molecular-weight heparin or adjusted-dose unfractionated heparin.
(c) inferior vena cava filter.
(d) unfractionated heparin, 5000 units every 12 hours.
(b) Clinical practice guidelines for spinal cord injury (SCI) have been established for the prevention of
thromboembolism. Anticoagulant prophylaxis either with low-molecular-weight heparin or
adjusted-dose unfractionated heparin should be initiated within 72 hours after SCI. Inferior vena
cava filter placement is indicated in SCI patients who have failed to respond to or have
contraindications to anticoagulation. Filter placement is not considered a substitute for
thromboprophylaxis.
A patient with multiple myeloma presents with a new pathologic fracture of the superior pubic
ramus. Computed tomography scans and plain radiographs fail to reveal additional myelomatous
involvement of the pelvic ring. When consulted regarding weight-bearing recommendations you
advise
(a) bed rest.
(b) non-weight bearing on ipsilateral lower extremity.
(c) weight bearing as tolerated.
(d) toe touch weight bearing until surgical stabilization.
(c) Pathologic fractures of the pelvis that do not involve the acetabulum are generally treated
nonsurgically. Patients may bear weight as tolerated. Aggressive analgesic management may be
required. Mechanical insufficiency of the acetabulum can only be managed surgically.
The purpose of the Health Insurance Portability and Accountability Act (HIPAA) is to
(a) ensure that a patient’s medical record is available only to health care providers as directed by
the patient.
(b) make sure that only qualified physicians have access to a patient’s medical record.
(c) allow a lawyer access to a medical record only if litigation is pending.
(d) allow only the treating physician to know the patient’s diagnosis.
(a) The purpose of the Health Insurance Portability and Accountability Act (HIPAA) is to ensure that a
patient’s medical record remains private. A non-treating physician, lawyer, insurance company,
etc. can have access so long as the patient directs it, with written authorization. There are no
stipulations about a physician’s qualifications with regards to medical information access.
Which statement is TRUE about volume conduction as it relates to electrophysiologic studies?
(a) Volume conduction is the transmission of an electrical potential through intracellular tissue.
(b) Volume conducted potentials produce a biphasic waveform as an advancing action potential
approaches and then passes beneath a recording electrode.
(c) The negative peak of a recorded waveform represents the time that the action potential is
beneath the active electrode.
(d) Volume conducted near field potential amplitudes does not characteristically depend on the
distance between the recording electrode and the source.
(c) The characteristics of volume conducted near field responses are dependent on the distance from
the recording electrode and the electrical source. The responses represent intracellular events
transmitted through extracellular fluid and tissue. They usually produce a triphasic waveform and
the negative phase is that time during which the advancing wave is directly underneath the
recording electrode.
Which exercise creates the least stress of the rotator cuff musculature?
(a) Arms in the scapula plane in internal rotation with weights
(b) Arms in the scapula plane in external rotation with weights
(c) Prone horizontal shoulder abduction in external rotation
(d) Quadruped push-up
(d) The quadruped push-up is a closed kinetic chain (CKC) exercise. CKC exercises are the least
demanding of the rotator cuff exercises. The axial load with CKC exercises effectively reduces the
weight of the arm (ie, load). CKC promote muscle co-activation needed for functional tasks.
Which diagnosis is associated with an increased risk of post-traumatic hydrocephalus?
(a) Diffuse axonal injury
(b) Subdural hematoma
(c) Epidural hematoma
(d) Subarachnoid hemorrhage
(d) Hydrocephalus is a well-recognized complication of subarachnoid hemorrhage. The fundamental
abnormality in post-traumatic hydrocephalus is an imbalance in the production and absorption of
cerebral spinal fluid (CSF). As the blood in the subarachnoid space obstructs the arachnoid villi it
impairs absorption of CSF, thus causing hydrocephalus
Amputation rather than limb salvage is recommended for the surgical management of high-grade sarcomas involving the
(a) humerus.
(b) distal tibia.
(c) ilium.
(d) distal femur.
(b) Limb salvage is almost always preferred for the upper extremity because of the disability associated
with upper extremity amputation. Amputation is generally preferred for malignancies of the distal
leg and foot in order to ensure adequate tumor resection and because of the excellent functional
status of transtibial amputees. Limb salvage is also preferred for sarcomas of the pelvis and thigh.
The Americans with Disabilities Act (ADA) was passed in order to
(a) require employers to hire individuals with disabilities.
(b) protect individuals with disabilities from having to work.
(c) ensure that the pay of workers with disabilities is equal to that of nondisabled workers.
(d) ensure that workers with disabilities have equal access in the work environment.
(d) The Americans with Disabilities Act (ADA) provides that workers with disabilities be offered equal
access in the work environment. The Act requires the employer to provide accessible environment
for the workers. Dimensions for doorways, hallways, ramps and elevator lifts are specified to allow
2 of 11
wheelchair access. The ADA does not make stipulations with regards to pay, or that an employer is
forced to hire a disabled worker. The ADA does not make any determinations regarding a disabled
person’s ability to work.
Which statement is TRUE about F-wave and H-reflex responses?
(a) They both are obtained with supramaximal stimulation.
(b) F waves can only be obtained from posterior tibial and median nerves.
(c) They both involve conduction along motor and sensory fibers.
(d) They both can be helpful in the diagnosis of S1 radiculopathy.
(d) The F-wave response is a pure motor response that is obtained with supramaximal stimulation and
can be obtained from any motor nerve in an adult. The H reflex is usually obtained with
submaximal stimulation and involves both sensory and motor fibers. Tibial and peroneal nerve F
waves can be abnormal in L5–S1 radiculopathies and tibial nerve H reflex can be abnormal in S1
radiculopathies.
The Gross Motor Functional Measure (GMFM) is designed to measure
(a) motor changes over time.
(b) quality of motor performance.
(c) achievement of motor milestones.
(d) only walking, running, and jumping ability.
(a) The Gross Motor Functional Measure (GMFM) evaluates motor changes over time in children with
cerebral palsy. It includes activities in prone and supine positions, rolling, sitting, crawling,
kneeling, standing, walking, running, and jumping. It does not measure the quality of motor
performance.
What is the major factor limiting ambulation in Duchenne muscular dystrophy?
(a) Joint contracture
(b) Weakness
(c) Scoliosis
(d) Restrictive lung disease
(b) Weakness, not contracture formation, is the major cause of loss of ambulation in Duchenne’s muscular
dystrophy. Contracture formation may actually assist with ambulation.
A 25-year-old man with L5 complete paraplegia is admitted to your rehabilitation service 2 weeks
after his injury. On admission you note that he is tolerating an oral diet but has not produced a
bowel movement for 6 days. At this point, you recommend
(a) oxybutynin (Ditropan) 3 times a day.
(b) a contact irritant suppository with digital stimulation daily.
(c) manual removal of stool from the rectum 1–2 times daily.
(d) nasogastric decompression for a presumed ileus.
(c) Individuals with lower lumbar and sacral level injuries usually experience areflexic bowel function.
The use of suppositories are usually not useful in these individuals, because of the absence of spinal
reflex activity. Manual evacuation is often required for an effective bowel program in a lower
motor neuron injury. Anticholinergic medications may lead to constipation.
A 35-year-old female tennis player and data entry clerk presents with a 6-week history of lateral
elbow pain. Which factor is promoting her injury?
(a) Her strong scapular stabilizer muscle strength
(b) Her leading with the shoulder when performing the backhand tennis stroke
(c) Her keyboard being placed at too high a level at work
(d) Her tennis racquet string tension being recently increased from a low to a moderate string
tension.
(c) This patient has lateral epicondylitis or so-called tennis elbow. Weak scapular stabilizer muscle
strength may cause decreased force production through the elbow, thus causing more force and load
through the elbow. Leading with the elbow during the backhand stroke can cause an increased load
on the wrist extensor muscles. Keyboards placed too high or too low may cause lateral
epicondylitis. Racquet string tension should be adjusted to mild to moderate tension (52 to 55
pounds if stringing machine is properly calibrated) in a normal (non-oversized) racquet. A racquet
strung to less than 30 pounds will require the tennis player to use more force. This may, in turn,
cause increased grip pressures and wrist extensor overuse
What is the most common primary malignant tumor of the brain in adults?
(a) Medulloblastoma
(b) Meningioma
(c) Glioblastoma multiform
(d) Ependymoblastoma
(c) More than 90% of the primary malignant tumors of the brain in adults are high-grade astrocytomas
and, of these, the most common is glioblastoma multiform. Meningiomas are tumors that occur in
the membranes that cover and protect the brain and spinal cord (the meninges). Meningiomas
usually grow slowly. Medulloblastomas are almost always found in children or young adults.
Ependymoblastomas are rare cancers that usually occur in children.
A 19-year-old man with Charcot-Marie-Tooth disease has begun falling frequently and you note 2/5
bilateral ankle dorsiflexion strength. He ambulates with a steppage gait pattern. You would recommend
which of the following?
(a) Knee-ankle-foot orthosis
(b) Ankle-foot orthosis
(c) High top shoes with rocker bottom
(d) Supramalleolar orthosis
(b) Persons with Charcot-Marie-Tooth (CMT) disease typically have dorsiflexion weakness and require
ankle-foot orthoses. Supramalleolar orthoses will not provide enough support to compensate for the
weakness in dorsiflexion. A rocker bottom shoe would not be an appropriate option. Patients with
CMT disease generally have functional (grade 4/5) strength in their quadriceps, thus a knee-ankle-foot
orthosis is not indicated
An 8-year-old boy presents with an insidious onset of diffuse right elbow pain. Physical
examination reveals loss of full right-elbow extension. Radiographs reveal bone fragment
contiguous with the capitellum. Your advice to the patient and his parents is
(a) reassurance that this condition is self-limiting.
(b) referral to an orthopedic surgeon for surgery.
(c) start a weight-training program of his upper body.
(d) short-arm casting of the elbow for 4 to 6 weeks.
(a) This patient likely has Panner’s disease, or developmental osteochondrosis of the capitellum. This
is a self-limiting condition that does not need surgery or casting. Weight-training in children
should not be commenced until, at least, reaching puberty.
What is the most likely diagnosis in a 45-year-old man with a rash over the upper and lower eyelids
who complains of insidious onset of difficulty getting out of a chair and ascending stairs?
(a) Inclusion body myositis
(b) Ankylosing spondylitis
(c) Dermatomyositis
(d) Guillain-Barré syndrome
(c) Individuals with dermatomyositis commonly present with slowly progressive proximal weakness. A
heliotrope rash affecting the eyelids occurs in 30% to 60 % of patients with dermatomyositis.
Inclusion body myositis primarily affects upper extremities distally and occurs in the older
population. Ankylosing spondylitis and Guillain-barré syndrome would not present in the fashion
described.
A 68-year-old man with diabetes-related peripheral neuropathy presents with a painful forefoot.
Physical examination reveals a pes cavus foot with hammertoe deformity. Your initial recommendation
is
(a) surgical referral for correction of deformity.
(b) physical therapy focusing on plantar fascia lengthening and intrinsic foot muscle strengthening.
(c) custom-made, total-contact foot orthotic with a built-up arch and metatarsal bar.
(d) botulinum toxin injection of the foot intrinsic muscles.
(c) A well built, custom foot orthotic with a built-up arch and metatarsal bar will support and help correct
the foot deformity. Due to the patient’s insensate skin, the orthosis must be custom fit with even
pressure distribution. The skin should be checked daily for pressure areas. Although corrective foot
surgery may improve function, the initial treatment should be an orthosis. In addition to the built-up
arch, the metatarsal bar is needed to help relieve the hammertoe deformity.
In preparation for discharge from your rehabilitation unit, an individual with T12 ASIA A
paraplegia requests information regarding access to a home with 5 steps. You suggest a ramp that,
for every 1 inch in elevation, should have a length of
(a) 12 inches.
(b) 8 inches.
(c) 16 inches.
(d) 24 inches.
(a) Ramps must have a 12-inch length for every 1-inch rise in elevation. This ratio is a minimum
requirement. A ramp must often be longer for an individual with a higher level spinal cord injury to
be able to independently navigate it. When space allows, a longer, less steeply inclined ramp is
preferable.
Which adjuvant analgesic medication acts at ion channels to stabilize neuronal cell membranes?
(a) Gabapentin (Neurontin)
(b) Amitriptyline (Elavil)
(c) Clonidine (Catapres)
(d) Baclofen (Lioresal)
(a) Gabapentin’s therapeutic effects are mediated by binding to a calcium ion channel located on
neuronal cell membranes. It may also have GABA agonistic properties, but this remain equivocal
What percentage of American children with myelomeningocele requires a shunt to manage hydrocephalus? (a) 10–20 (b) 25–50 (c) 60–70 (d) 80–90
(d) Seventy-five percent of lesions in spina bifida cystica (myelomeningocele) affect the lumbosacral
spine. Ninety percent of children with spina bifida have hydrocephalus that requires a shunt for
management.
What does the acronym SACH stand for?
(a) Simple amputation, cadence heel
(b) Single axis, carbon heel
(c) Standard adult, control heel
(d) Solid ankle, cushion heel
(d) SACH is an acronym for solid ankle, cushion heel. The SACH foot has a cushioned heel that
compresses during heel strike, stimulating plantar flexion, and has a rigid anterior keel to roll over
during late stance. It is light, durable, and inexpensive, and is the orthosis most often prescribed for
juvenile and geriatric amputees.
A 20-year-old female long-distance runner presents with a l-week history of worsening lateral hip
pain. Magnetic resonance imaging reveals bone edema at the lateral aspect of the femoral neck,
without evidence of a fracture line or cortical break. What is the next step in management?
(a) Relative rest for 4 weeks
(b) Refer to orthopedic surgeon for surgical evaluation
(c) Order a triple-phase bone scan to determine acuity of the injury
(d) Physical therapy with closed kinetic chain exercise emphasis
(b) Femoral neck stress fractures are serious injuries. Stress fractures may occur without a cortical
break. Stress fractures of the medial side of the femoral neck, the “compression” side, can be
treated with a weight-bearing restriction for 6 weeks or longer including no running or high impact
activities. Stress fractures on the lateral side of the femoral neck, the “tension” side, warrants
strong surgical consideration because of the poor healing capability at that location.
A 45-year-old man complains of wrist, thumb, and elbow pain and swelling after being on a highprotein
diet for 12 weeks. Aspiration of the elbow reveals negatively birefringent intracellular
crystals on microscopic examination. What would you expect to see on radiographs of his hands
and wrists?
(a) Distal interphalangeal joint osteophytes
(b) Pencil-in-cup deformity
(c) Juxtarticular osteopenia
(d) Joint erosion with sclerotic borders
(d) This patient has gout, and radiographs of the hands and wrists would likely demonstrate joint
erosions with sclerotic borders. The finding in option (b) describes psoriatic arthritis. Juxtarticular
osteopenia may be a finding on radiographic studies in patients with rheumatoid arthritis. Distal
interphalangeal joint osteophytes are characteristic of osteoarthritis.
What is the primary underlying cause of the restrictive lung disorders that are common in many neuromuscular disorders? (a) Recurrent pneumonia (b) Prolonged wheelchair use (c) Respiratory muscle weakness (d) Intrinsic lung damage
(c) Respiratory impairment in neuromuscular disease is due to weakness of the diaphragm, chest, and
abdominal musculature. The other listed factors have not been shown to play a significant role.
The term maximum medical improvement (MMI) indicates that
(a) no deterioration of the condition is expected to occur.
(b) no further treatment for the condition is required.
(c) no further treatment is reasonably expected to improve the condition.
(d) physician and patient agree that the condition has stabilized.
(c) Maximum medical improvement (MMI) is a term used by a physician to indicate that he/she has
determined that no further significant recovery of a condition is anticipated to occur. Resolution of
the condition may or may not occur. Determining MMI does not indicate that no treatment is
indicated.
A 60-year-old woman with diabetes and hypertension complains of right foot swelling and mild
discomfort on ambulation. There is no history of trauma. Examination demonstrates decreased
sensation in the foot and a plantar ulcer. There is no sinus tarsi tenderness and no ankle instability.
What is the most likely diagnosis?
(a) Charcot’s joint
(b) Lateral ankle sprain
(c) Tarsal tunnel syndrome
(d) Plantar fasciitis
(a) Charcot’s joints often present as painless swelling in patients with diabetes. Other illnesses
associated with Charcot’s joint include tabes dorsalis and syringomyelia.
You are told by a physical therapist that your patient with acute C5 ASIA A tetraplegia is having
difficulty breathing, but only when sitting upright. Appropriate lab tests and radiologic studies are
unremarkable. To address the patient’s breathing difficulty, you suggest
(a) bilateral above-knee compression stockings.
(b) a tilt table program.
(c) intermittent positive pressure breathing treatments.
(d) the use of an abdominal binder.
(d) In the acute complete tetraplegic patient there is a lack of abdominal muscle tone. An abdominal
binder can help because when the patient using it sits upright the abdominal contents are pulled
caudally and also are pushed inward. This action pushes up on the diaphragm and allows it to start
in a position of mechanical advantage when inhaling while upright. Compression stockings and tilt
table programs can be useful for a decrease in blood pressure that accompanies upright posture.
Orthostatic hypotension is associated with lightheadedness, dizziness, nausea, syncope. Intermittent
positive pressure breathing can be useful to decrease atelectasis.
The surgical transplant service requests physical therapy recommendations for a patient beginning
to reject a single lung transplant. In addition to pursed lip and diaphragmatic breathing,
recommendations should include
(a) a focus on passive stretching and isometrics.
(b) telemetry monitoring while out of bed.
(c) an aerobic exercise program.
(d) minimizing of supplemental oxygen.
(c) During rejection, lung transplant patients should perform basic breathing exercises. They can
continue to perform aerobic exercise as tolerated with oxygen supplementation
A 9-year-old girl with C5 ASIA A spinal cord injury sustained 2 years ago is evaluated for upper
extremity splinting. Which statement regarding this scenario is TRUE?
(a) A resting hand splint should be prescribed for daytime use to preserve function.
(b) A wrist extension splint would be contraindicated for daytime use because it would interfere
with function.
(c) A mobile arm support or balanced forearm orthosis could be prescribed to make self-feeding
possible.
(d) A short hand splint should be prescribed to strengthen wrist extensor muscles.
(c) A mobile arm support or balanced forearm orthosis would enable the child with C5 ASIA A spinal cord injury (SCI) and weak arm muscles to move the arm through useful active range of motion and to position the hand for function. In patients with C5 SCI, these orthoses are typically combined with wrist extension splints or a universal or palmar cuff for feeding. A resting hand splint may be used at night to improve or maintain range of motion, but would interfere with daytime function. A short hand splint would not strengthen wrist extensor muscles, but may be useful to improve function.
Which structure is NOT part of the pain pathway for rapid transmission of immediate pain?
(a) Rexus lamina 2,3
(b) Lissauer’s tract
(c) C fibers
(d) Periaqueductal gray matter
(c) C fibers are unmyelinated fibers that modulate slow pain (“second pain”) rather than acute pain.
“First pain” is mediated by A-delta nociceptors and is brief and localized.
A 26-year-old woman is admitted to the inpatient rehabilitation unit following a traumatic brain
injury. She is confused, inappropriate, agitated, and requires a padded floor bed. What is her
Rancho Los Amigos level?
(a) IV
(b) V
(c) VI
(d) VII
(a) The Rancho Los Amigos level IV applies to persons who are confused and agitated. The need of a
padded floor bed indicates that the patient is restless and agitated.
with axial grinding of the first carpometacarpal joints as well as Heberden and Bouchard nodes in
the hands. What is an appropriate initial treatment?
(a) Resting wrist splints in neutral
(b) Thumb spica splints
(c) Compression gloves
(d) Buddy taping the digits
(b) The carpometacarpal joint is a common location for osteoarthritis in the upper extremity. While
cumbersome, a thumb spica splint will often alleviate the pain. The other options listed would not
be considered appropriate initial treatment options
Which statement about workers’ compensation cases is TRUE?
(a) The most recent publication of the American Medical Association guidelines for disability
are used uniformly in every state.
(b) Parameters that guide entry to evaluation and treatment are unique to each state.
(c) States require subspecialty board certification for physicians who practice industrial
medicine.
(d) Most states allow injured workers to choose the physician who manages their care.
(b) Guidelines for worker entry and treatment under workers’ compensation law are determined by
each state. The published American Medical Association guidelines are useful tool in determining
disability. Because each state determines which edition of the publication is used, its application is
not uniform nationwide. Not all states require subspecialty certification required of a physician
wishing to practice industrial medicine. In some states the employer chooses the physician to treat
the injured worker.
Which compound muscle action potential (CMAP) finding is the most compatible with myasthenia
gravis?
(a) A 15% decrement in the amplitude between the 1st and 4th responses with repetitive
stimulation at 3 hertz
(b) A low amplitude response with supramaximal stimulation of the ulnar nerve and pick-up over
the hypothenar muscles
(c) A 100% increase in the amplitude with stimulation of the spinal accessory nerve and pick-up
over the trapezius muscle immediately post exercise
(d) A 50% increment in the amplitude between the 1st and 4th responses with repetitive
stimulation at 30 hertz
(a) In myasthenia gravis there is a decrement in the amplitude and area of the compound muscle action
potential (CMAP) with stimulation at low frequencies (2–3Hz). Stimulation at high rates of 20–
50Hz can result in pseudofacilitation with correction of the amplitude decrement in normal subjects
as well as patients with neuromuscular junction disorders. A 100% or greater increase in the
amplitude of the post exercise CMAP is usually associated with a presynaptic neuromuscular
junction disorder such as Lambert-Eaton myasthenic syndrome (LEMS). Small CMAPs on routine
nerve conduction studies are more characteristic of LEMS than of myasthenia gravis
Which muscle is primarily responsible for clearance of the leg during swing phase?
(a) Iliopsoas
(b) Hamstrings
(c) Quadriceps
(d) Tibialis anterior
(d) Midswing is the continuation of the passive pendulum action of the leg. Foot clearance is
maintained by activity of the tibialis anterior
A 70-year-old man with severe bilateral knee osteoarthritis states that over the counter nonsteroidal
anti-inflammatory drugs and aceteminophen are not controlling his knee pain. He inquires about a
more potent anti-inflammatory medication he saw on a television commercial. Once treatment has
been initiated, which recommendation would be most appropriate?
(a) Check kidney function and a hematocrit for anemia every 6 months.
(b) Start concomitant anti-hypertensives if the patient develops high blood pressure.
(c) Switch to a cyclooxygenase-2 inhibitor if the patient is on aspirin for cardioprotective effects.
(d) Start concomitant proton pump inhibitor or histamine H2-receptor antagonists.
(a) Older patients on nonsteroidal anti-inflammatory drugs are at a high risk for medication-induced
side effects. Kidney function and gastrointestinal (GI) bleeds (causing anemia) should be
monitored every 6 months. The purported gastroproctective effects of cyclooxygenase-2 inhibitors
may be lost with concomitant aspirin use. Gastritis side effects, especially in the elderly, should be
worked up for a GI bleed prior to instituting histamine H2-receptor antagonists or a proton pump
inhibitor.
The mechanism of action of a phenol nerve block is
(a) reduction of calcium release from the sarcoplasmic reticulum.
(b) agonist action at alpha-adrenergic receptor sites.
(c) denaturation of protein in myelin sheaths and axons.
(d) inhibiton of presynaptic acetylcholine release.
(c) Phenol acts as a neurolytic agent that denatures protein in myelin sheaths and axons. Dantrolene
sodium (Dantrium) reduces calcium release from the sarcoplasmic reticulum. Tizanidine (Zanaflex)
is an alpha-2 agonist. Botulinum toxin (Botox) inhibits acetylcholine release.
Which agent acts on osteoblasts to increase bone formation?
(a) Calcium
(b) Calcitonin
(c) Vitamin D
(d) Estrogen
(c) Bone remodeling has 5 phases; activation, resorption, reversal, formation, quiescence. Vitamin D
will increase this process and acts on the osteoblasts, whereas the other choices act on the
osteoclasts to stabilize bone.
