Musculoskeletal online multiple choice questions and answers-7 Weakness of which muscle would correlate with compression of the T1 nerve root? Scoliosis can be classified as structural or functional. Which one of the following is not characteristic of structural scoliosis?

141. Mallet finger is:
     A) A rupture of the terminal extensor tendon of the distal phalanx
     B) Identified by a loss of active extension of the proximal interphalangeal (PIP) joint of the
     finger
     C) Caused by forced extension of the distal phalangeal joint
     D) Occurs more commonly in ice hockey than in basketball or baseball players
142. Weakness of which muscle would correlate with compression of the T1 nerve root?
     A) Abductor digiti minimi (ADM)/interossei
     B) Extensor carpi radialis (ECR)
     C) Triceps brachii
     D) Flexor digitorum profundus (FDP)
143. Scoliosis can be classifi ed as structural or functional. Which one of the following is not characteristic of structural scoliosis?
     A) Most cases are idiopathic
     B) It is reversible
     C) Subtypes of structural scoliosis include idiopathic
     D) Subtypes of structural scoliosis include congenital or acquired
144. Shoulder flexion involves the use of all of the following muscles except:
     A) Anterior deltoid
     B) Biceps brachii
     C) Coracobrachialis
     D) Teres major
145. What diagnostic test is used to diagnose complex regional pain syndrome (CRPS) in the upper limb?
     A) Somatosensory evoked potentials (SSEP)
     B) Stellate ganglion block
     C) Lumbar vertebral ganglion block
     D) Erythrocyte sedimentation rate
146. What is the Stimson technique?
     A) A provocative maneuver to test for glenohumeral instability
     B) Gravity-assisted technique to reduce an anterior shoulder dislocation
     C) A two-person technique to reduce an anterior shoulder dislocation, using a sheet under
     the axilla by one person and manual traction by the other person
     D) A test for inferior shoulder laxity
147. What is Panner’s disease?
     A) Osteochondritis dessicans of the trochlea
     B) Traumatic elbow dislocation
     C) Median nerve compression at the elbow by lacertus fibrosis
     D) Epiphyseal aseptic necrosis of the capitellum
148. L2 nerve root compression would cause which of the following reflex abnormalities?
     A) Patellar tendon
     B) Cremasteric
     C) Cross adductor
     D) Achilles tendon
149. Where is the most common site of injury to the spinal accessory nerve?
     A) At the foramen magnum where it passes before entering the jugular foramen
     B) At the jugular foramen
     C) At the cervical root level
     D) In the posterior cervical triangle
150. What is the physical exam to test for cervical spine radiculopathy that places the patient in passive lateral flexion and extends the neck, followed by compression of the head?
     A) Spurling’s maneuver
     B) Lhermitte sign
     C) Hoffman’s sign
     D) Neck distraction test
151. Motions of the hip in Patrick’s test are:
     A) Flexion, adduction, and internal rotation
     B) Flexion, adduction, external rotation, and extension
     C) Flexion, abduction, internal rotation, and extension
     D) Flexion, abduction, external rotation, and extension
152. Which muscles would most commonly be affected by a nerve injury after an anterior shoulder
     dislocation?
     A) Deltoid and teres minor
     B) Supraspinatus and infraspinatus
     C) Rhomboids
     D) Biceps and Supraspinatus
153. In heat exhaustion:
     A) The patient needs to be hyperthermic to be diagnosed
     B) There are known chronic and long-lasting effects
     C) The cardiovascular system fails to respond to increased workload due to heat
     D) It is considered a medical emergency
154. A hip pointer injury is a direct blow to the pelvic brim or hip causing:
     A) Hip dislocation
     B) Contusion of soft tissues and underlying bone of the hip
     C) Hip or femur fracture
     D) Avascular necrosis of the hip
155. What is a Rockwood type II acromioclavicular (AC) joint injury?
     A) Sprain of the AC and coracoacromial (CC) ligaments
     B) Torn CC ligament and intact AC ligament
     C) Torn AC ligament and sprained CC ligament
     D) Torn AC and CC ligaments
156. All of the following muscles are involved in shoulder adduction, except:
     A) Pectoralis major
     B) Teres major
     C) Coracobrachialis
     D) Biceps brachii
157. Hyperextension injury of the metatarsalphalangeal joint of the great toe is called:
     A) Turf toe
     B) Lisfranc injury
     C) Plantar fasciitis
     D) Hallux rigidus
158. All the following are benefits of ice in the treatment of acute tendinitis except:
     A) Local vasoconstriction
     B) Decreased metabolic rate
     C) Decreased swelling
     D) Local vasodilatation
159. Most common site of Morton’s neuroma is:
     A) The first intermetatarsal space
     B) The second intermetatarsal space
     C) The third intermetatarsal space
     D) The fourth intermetatarsal space
160. Among the rotator cuff muscles, a tear primarily occurs in which of the following:
     A) Supraspinatus
     B) Infraspinatus
     C) Teres minor
     D) Subscapularis

Musculoskeletal online multiple choice questions and answers-7 Answer Online Multiple choice Question

141. A) Mallet finger is a rupture of the terminal extensor tendon of the distal phalanx causing loss of active extension of the distal interphalangeal joint. It is usually caused by forced flexion of the distal phalangeal joint as can occur when a ball hits the end of the finger. It occurs most commonly in sports like basketball or baseball.
142. A) Compression of the T1 nerve root would result in weakness of the ADM/interossei. Compression of C6 and C7 nerve roots would result in weakness of the extensor carpi radialis and triceps, respectively. Compression of the C8 nerve roots would result in weakness of the flexor digitorum profundus.
143. B) Structural scoliosis is not reversible. Subtypes include idiopathic, congenital, or acquired. Idiopathic scoliosis accounts for 80% of structural scoliosis.
144. C) Shoulder flexion involves the use of the anterior deltoid, pectoralis major, biceps brachii, and coracobrachialis.
145. B) CRPS is a condition characterized as a chronic pain syndrome due to dysfunction in the central and peripheral nervous systems. It presents with changes in skin color and temperature and is accompanied by intense burning pain symptoms and sensitivity. The stellate ganglion block is a sympathetic block used primarily to diagnose and treat symptoms of CRPS. Such blocks are usually performed by a pain specialist and may result in complete or partial pain relief. An adequate block may result in a temporary Horner’s syndrome. Sympathetic blocks performed for the lower extremities are called lumbar sympathetic blocks.
146. B) In the Stimson’s technique, the patient with an anterior shoulder dislocation is placed prone on the stretcher with the dislocated arm hanging off the edge of the bed. A 5- to 15-lb. weight is attached to the distal arm so that it is not touching the floor. The physician places their thumb on the patient’s acromion and using fingers of the same hand places them over the humeral head. As the patient’s muscles gradually relax, the provider gently pushes the humeral head caudally until it reduces. Choice (C) describes another type of technique different from Stimson’s.
147. D) Panner’s disease is usually seen in young boys aged 5 to 12 years. It is felt to be due to an interruption in the blood supply to the epiphysis resulting in initial resorption followed by eventual remodeling of the epiphysis. This condition most commonly occurs in the dominant arm and is found to be due to chronic repetitive trauma, hereditary factors, and certain endocrine disorders.
148. B) L2 nerve root compression would result in cremasteric reflex abnormalities. The cremaster muscle receives innervation via the genitofemoral nerve (L1 and L2). Patellar tendon and Achilles tendon reflexes would be present in L3/L4 and S1 nerve root compressions, respectively. Cross-adductor reflex is a withdrawal reflex on one side, with an inhibitory response on the contralateral side to maintain balance—for example, stepping on a nail would result in flexion of the affected limb and extension of the contralateral limb.
149. D) The spinal accessory nerve is most commonly injured in the posterior cervical triangle. This will result in isolated trapezius muscle weakness. The mechanism of injury may be stretch or external compression or after surgical procedure (ie, cervical lymph node biopsy). A lesion in this region will spare the sternocleidomastoid of the affected side. Mild scapular winging may also be observed with shoulder abduction (lateral winging).
150. A) Spurling’s maneuver is a highly specific, but not a sensitive test for cervical radiculopathy. Lhermitte’s sign is rapid passive cervical flexion while the patient is seated, which causes a shock sensation. Hoffman’s sign signifies an upper motor neuron insult.
151. D) Patrick’s test is a provocative maneuver to assess for sacroiliac joint dysfunction as well as hip joint pathology by flexion, abduction, external rotation, and extension of the hip joint (hence it is also called the FABERE test). FAIR test (flexion, adduction, and internal rotation) is a provocative test for piriformis syndrome.
152. A) The axillary nerve is most commonly injured in an anterior shoulder dislocation. The axillary nerve innervates the deltoid and teres minor. Supraspinatus and infraspinatus are innervated by suprascapular nerve. The suprascapular nerve is rarely associated with glenohumeral dislocation, but can be injured from repetitive traction trauma. The rhomboids are innervated by the dorsal scapular nerve.
153. C) Heat exhaustion is due to failure of the cardiovascular system to respond to an increased workload secondary to heat. Heat stroke is considered a medical emergency (when the rectal core temperature is greater than 39°C). Heat stroke can cause organ damage. Heat stroke can occur because of endogenous heat production, and does not necessarily occur only in warm environments. The treatment is immediate cooling.
154. B) Hip pointers are seen in contact sports such as football and hockey, and are usually seen at the greater trochanter and iliac crest. There can be hematoma formation but there is usually focal tenderness. Patients should have full range of motion of the hip. X-rays should be considered if there is severe pain with passive range of motion.
155. C) The Rockwood classification system is used to describe AC joint injuries. Type I is mild injury with intact AC and CC ligaments. Type II is a complete tear of the AC ligament and intact CC ligament. Type III to VI each describe complete disruption of both AC and CC ligaments with varying degrees of dislocation of the clavicle. In type III injuries, the clavicle is displaced superiorly, whereas in type IV the clavicle is displaced superiorly and posteriorly into the trapezius. In type V injuries, the clavicle is displaced superiorly with more than 100% increase in the coracoclavicular interspace. In type VI, the clavicle is displaced inferiorly below the acromion or coracoid process.
156. D) The biceps brachii is not involved in shoulder adduction. In addition to the pectoralis major, teres major, and coracobrachialis, shoulder adduction involves the latissimus dorsi, infraspinatus, anterior and posterior deltoid, and the long head of the triceps.
157. A) Turf toe is associated with metatarsophalangeal joint pain that worsens with weight bearing. It can be exacerbated by turf fi elds which have stiff surfaces.
158. D) Ice is used more frequently in the acute stages of inflammation, particularly during the first 24 to 48 hours. It is a very effective anti-inflammatory modality. Benefits of ice include vasoconstriction, decreased swelling, and relief of pain and muscle spasm.
159. C) Morton’s neuroma is a benign neuroma of an intermetatarsal plantar nerve, and most commonly affects the third intermetatarsal space (between the third and fourth metatarsal bones).
160. A) The supraspinatus is the primary muscle implicated in rotator cuff tears. The supraspinatus tendon has a poor blood supply and is susceptible to chronic subacromial impingement—a mechanism which is rarely seen in people younger than 40 years of age

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