Musculoskeletal online multiple choice questions and answers-6 The most common cause of collapse in a marathon runner after crossing the finish line is, Boxer’s fractures involve a fracture of which metacarpal bone?
- The most common cause of collapse in a marathon runner after crossing the finish line is:
A) Benign exercise–associated collapse
B) Cardiac arrest
C) Heat stroke
D) Hypoglycemia - Boxer’s fractures involve a fracture of which metacarpal bone?
A) First metacarpal
B) Second metacarpal
C) Third metacarpal
D) Fifth metacarpal - An Achilles tendon injury is most likely to occur with what action?
A) Sudden pivoting
B) Internal rotation of the ankle
C) Abruptly starting a sprint
D) Walking uphill - What is not true about hip fractures?
A) Females are more likely than males to sustain a hip fracture
B) Most common underlying cause is weakened bone from metastatic disease
C) Approximately 25% of patients over age 50 years with hip fractures die within 1 year
D) About 50% of hip fracture patients require some form of assistive device - All of the following are true about iliopsoas bursitis and tendonitis except:
A) Condition may cause snapping hip syndrome with flexion
B) Pain is elicited with hip extension
C) Pain is usually noted deep in the groin and radiates to the front of hip
D) Refers to a stretch, tear, or complete rupture of the iliopsoas muscle and tendon where the
tendon attaches to the femur - When compared to paraplegic patients who were nonathletes, paraplegic patients who participated in sports had:
A) More hospital admissions
B) More pressure sores
C) More susceptibility to infections
D) More success in avoiding major medical complications - What physical exam maneuver is used to detect biceps tendonitis?
A) Hawkins’ test
B) Neer’s test
C) Speed’s test
D) Empty can test - Which nerve is susceptible to injury with humeral shaft fractures?
A) Radial nerve
B) Axillary nerve
C) Ulnar nerve
D) Median nerve - Rehabilitation in patients with patellofemoral syndrome is focused on strengthening of which
muscle?
A) Vastus lateralis
B) Rectus femoris
C) Vastus medialis obliquus (VMO)
D) Vastus intermedius - How do you measure for leg length discrepancy?
A) Anterior superior iliac spine (ASIS) to lateral malleolus
B) Posterior superior iliac spine (PSIS) to lateral malleolus
C) ASIS to medial malleolus
D) PSIS to medial malleolus - Weakness of which muscle would correlate with compression of the C5 nerve root?
A) Biceps brachii
B) Extensor carpi radialis (ECR)
C) Triceps brachii
D) Flexor digitorum profundus (FDP) - Scaphoid fractures can be ruled out if the patient:
A) Reports falling with an outstretched hand
B) Complains of pain over the anatomical snuff box
C) Has negative initial x-rays
D) Has point tenderness localized to the ulnar aspect of the wrist - Which is not a characteristic of plantar fasciitis?
A) Affects females more than males
B) Tenderness over lateral aspect of the heel
C) Pain is worse in the morning
D) Heel spurs may contribute to the etiology - What is the most common type of hip fracture?
A) Femoral neck
B) Intracapsular
C) Intertrochanteric
D) Subtrochanteric - Which of the following is false about hip dislocation?
A) The most common type is anterior hip dislocation
B) Sciatic nerve may be stretched or compressed during posterior hip dislocations
C) Femoral nerve may be injured during anterior hip dislocation
D) Motor vehicle accidents are the most common cause of hip dislocations - Evaluation of scoliosis involves the Adam’s test (forward bending test) and measuring the Cobb
angle using a posterior-anterior (PA) radiograph, which measures:
A) The angle formed at the intersection between the horizontal line drawn along the iliac
crest and a line drawn along the superior end plate of the vertebra tilted the most at the
top of the curve
B) The angle formed at the intersection between a line drawn along the superior endplate
of the vertebra tilted the most at the top of the curve, and a similar line drawn along the
inferior endplate of the vertebra tilted the most at the bottom of the curve
C) The angle formed at the intersection between a line drawn along the superior endplate of
the vertebra tilted the most at the top of the curve, and a similar line drawn bisecting the
center of the curve
D) The angle formed at the intersection between a line drawn along the inferior endplate of
the vertebra tilted the most at the bottom of the curve, and a similar line drawn bisecting
the center of the curve - What is the function of the flexor digitorum profundis (FDP) muscles?
A) Flexes at the distal interphalangeal (DIP) joint
B) Flexes at the proximal interphalangeal (PIP) joint
C) Flexes at the metacarpophalangeal (MCP) joint
D) Flexes at the wrist - Hypertrophic cardiomyopathy is an autosomal dominant hereditary condition in which the
patient has a defect in:
A) Dystrophin protein
B) Sarcomere contractile proteins
C) Mitochondria
D) Tau protein - What is plica syndrome of the knee?
A) Knee pain caused by a duplicated meniscus
B) Knee pain and weakness caused by an inflamed synovial structure in rheumatoid arthritis patients
C) Knee pain and weakness caused by a synovial fold in femorotibial joint
D) An extension or a vestigial structure of the protective synovial capsule of the knee
becomes irritated or inflamed causing anterior knee pain and weakness - If a patient is supine with knees flexed to 90° and feet flat on the table, how will it be determined
if the right femur is longer than the left?
A) Left knee is higher than the right
B) Right knee is higher than the left
C) Left knee is anterior to the right
D) Right knee is anterior to the left
Musculoskeletal online multiple choice questions and answers-6 Answer Online Multiple choice Question
- A) Benign exercise–associated collapse is due to a form of orthostatic hypotension. When the patient stops running, venous blood pools to the lower extremities and the patient becomes hypotensive, which can cause them to collapse. It can be prevented by having the athlete continue to walk/jog to maintain the muscular venous pumping after the marathon.
- D) Boxer’s fractures involve a fracture of the fifth metacarpal and are the most common fractures occurring in the metacarpals. They usually occur after the patient strikes a hard object with a closed fist. Treatment typically involves closed reduction and casting.
- C) The Achilles tendon attaches the gastrocnemius to the heel. As the muscle shortens, the tendon plantarflexes the foot. An acute injury occurs when a healthy tendon is subjected to a sudden, unexpected force, such as pushing off for a sprint or landing from a jump.
- B) The most common cause of hip fractures is osteoporosis. In the vast majority of cases, a hip fracture is a fragility fracture owing to a fall or minor trauma in someone with weakened, osteoporotic bone. They are classified as intracapsular, which includes femoral head and neck fractures, or extracapsular, which includes trochanteric, intertrochanteric, and subtrochanteric fractures. The location of the fracture and the amount of angulation and comminution play integral roles in the overall morbidity of the patient, as does the preexisting physical condition of the individual. The other options are all true.
- B) Pain is elicited with hip flexion. The acute injury often involves eccentric contraction of the iliopsoas muscle or rapid flexion against extension force/resistance, but may less commonly result from direct trauma. The overuse phenomenon may occur in any activity resulting in repeated hip flexion or external rotation of the femur.
- D) Paraplegic athletes were shown to have fewer hospitalizations, fewer pressure sores, and were less susceptible to infections. There is an increase in athletic opportunities for patients with impairments—there has been a rise in participants in the Paralympic games.
- C) Speed’s test is performed by asking the patient to anteriorly flex the shoulder against resistance while the elbow is extended. Hawkins’ and Neer’s both test for rotator cuff impingement. Empty can test is used to detect supraspinatus tendinopathy. Image source: Araim RJ, Aghalar MR, Weiss LD. Neuromuscular Quick Pocket Reference. New York, NY:
- A) Up to 18% of humeral shaft fractures are associated with radial nerve injury, particularly if the fracture occurs at the junction between the middle and distal 1/3 of the shaft. The axillary nerve is the most commonly injured nerve with more proximal humerus fractures (ie, surgical neck fractures).
- C) The VMO is a dynamic medial stabilizer which helps maintain proper patellar tracking during extension of the knee.
- C) To assess for a leg length discrepancy, measure from the anterior superior iliac spine to the medial malleolus. Leg length discrepancies of less than 1/2 in. do not need correction.
- A) Compression of the C5 nerve root will result in weakness of the biceps brachii. Compression of C6 and C7 nerve roots would result in weakness of the extensor carpi radialis and triceps, respectively. Compression of C8 and T1 nerve roots would result in weakness of flexor digitorum profundus and abductor digitiminimi (ADM)/interossei, respectively.
- D) Scaphoid fractures are the most common carpal bone fractures. They often occur due to a fall on an outstretched hand. Snuff box tenderness may be noted. If initial plain fi lms are negative, then wrist should be immobilized and fi lms repeated in approximately 2 weeks. There is a high incidence of nonunion and avascular necrosis.
- B) Tenderness usually occurs over the medial aspect of the heel in plantar fasciitis.
- C) An intertrochanteric hip fracture occurs three to four inches from the hip joint. This type of fracture does not interrupt the blood supply to the bone and may be easier to repair.
- A) The most common type of hip dislocation is posterior (90%).
- B) If the Cobb angle exceeds 50° to 60°, abnormalities in pulmonary function tests may appear. Treatments are based on the degree of curvature: 1° to 20°—observation; 20° to 40°—bracing; greater than 40°—evaluation for surgery.
- A) The FDP muscle’s origin is at the anterior ulna and interosseous membrane. The insertion is the distal phalanx of the index, middle, ring, and small fingers. Its main action is flexion of the DIP joint of the fingers. The FDP is innervated by the anterior interosseous nerve from the median nerve (index and middle fingers) as well as the ulnar nerve (ring and small finger).
- B) This defect leads to increased ventricular muscle mass but not an increase in ventricular cavity size. Hypertrophic cardiomyopathy leads to a net reduction in inner ventricular cavity size because of the hypertrophied muscle. Dystrophin abnormalities are seen in Duchenne muscular dystrophy. Tau proteins are affected in Alzheimer’s disease.
- D) The knee plica is considered a vestigial structure because of remnant embryological tissue that compartmentalizes the knee during fetal development. This horseshoe-shaped structure can become irritated or inflamed, which causes anterior knee pain and weakness, known as the plica syndrome.
- D) If one knee projects further anteriorly in the position described, then that femur is longer. In this case, the right knee will be anterior to the left. If one knee is higher than the other, that tibia is longer.
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