Module 16: Alterations of Musculoskeletal Function

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Which cells have the capability of dissolving bone tissue and releasing the stored calcium into the bloodstream?

A) Osteoblasts
B) Osteoclasts
C) Osteocytes
D) Osteoids

B) Osteoclasts

Spongy (cancellous) bone is found in which of the following locations?

A) Diaphysis of long bones
B) Epiphysis of long bones
C) Cortical bone areas
D) All of the above

B) Epiphysis of long bones

The component(s) of the bone matrix that gives bone compressive strength is (are):

A) collagen.
B) glycoproteins.
C) the periosteum.
D) hydroxyapatite.

D) hydroxyapatite.

Which of the following molecules form the crystalline structure of hydroxyapatite?

A) Calcium and magnesium
B) Phosphate and calcium
C) Albumin and phosphate
D) Magnesium and hydrogen

B) Phosphate and calcium

Which of the following structures is present in spongy bone and absent in compact bone?

A) Trabeculae
B) Lacunae
C) Lamellae
D) Haversian canals

A) Trabeculae

Which of the following bones belongs to the appendicular skeleton?

A) Sternum
B) Sacrum
C) Mandible
D) Ilium

D) Ilium

In children, growth in long bones primarily takes place at the:

A) ends of the epiphyses.
B) middle of the diaphysis.
C) medullary cavity.
D) epiphyseal plate.

D) epiphyseal plate.

Phase 1 of the bone remodeling cycle involves:

A) secondary bone formation.
B) bone cell activation.
C) bone tissue resorption.
D) trabeculae configuration.

B) bone cell activation.

Which muscle delivers the power stroke during the cross-bridge cycle of muscle contraction?

A) Calcium
B) Myosin
C) Actin
D) Tropomyosin

B) Myosin

Which molecule prevents a muscle contraction from occurring when the muscle is at rest?

A) Troponin
B) Calcium
C) Actin
D) Myosin

A) Troponin

Which of the following are both types of fibrous joints?

A) Sutures and syndesmoses
B) Symphyses and synchondroses
C) Gomphoses and symphyses
D) Diarthroses and amphiarthroses

A) Sutures and syndesmoses

The main energy source or fuel for skeletal muscle contraction is:

A) calcium.
B) albumin.
C) ATP.
D) actin.

C) ATP.

The epimysium, perimysium, and endomysium in the body of a skeletal muscle are made of:

A) thin sheets of cartilage.
B) simple epithelial tissue.
C) stratified epithelial tissue.
D) fascia.

D) fascia.

Which structure is the contractile subunit of the myofibril in a skeletal muscle cell?

A) Sarcoplasmic reticulum
B) Sarcomere
C) Myosin
D) Motor end plate

B) Sarcomere

Which of the following ions is released from the sarcoplasmic reticulum to initiate a muscle contraction?

A) Sodium
B) Potassium
C) Magnesium
D) Calcium

D) Calcium

A bone breaks in a place where there was pre-existing disease. What type of fracture is being described?

A) Transchondral
B) Pathological
C) Stress
D) Fatigue

B) Pathological

All of the following events occur following a bone fracture except:

A) development of a blood clot beneath the periosteum.
B) leukocyte infiltration into bone tissue.
C) blood vessel growth at the fracture site.
D) an increase in the number of osteoclasts at the fracture site.

D) an increase in the number of osteoclasts at the fracture site.

A torus fracture occurs when:

A) the injury occurs at the epiphyseal growth plate.
B) the cortex of the bone buckles.
C) the spongy bone is damaged without affecting the cortical bone.
D) a long bone splinters into many fragments.

B) the cortex of the bone buckles.

A fracture in which the bone breaks into two or more fragments is termed a(n):

A) comminuted fracture.
B) open fracture.
C) greenstick fracture.
D) occult fracture.

A) comminuted fracture.

Which of the following fractures involves fragmentation of the articular cartilage and generally occurs in adolescents?

A) Greenstick
B) Stress
C) Transchondral
D) Insufficiency

C) Transchondral

Which of the following pairs of symptoms is likely to manifest following a femoral fracture?

A) Chest pain and shortness of breath
B) Low blood glucose and seizures
C) Pain and swelling in the thigh
D) Limb paralysis and referred pain

C) Pain and swelling in the thigh

Complications that can occur as a fractured bone heals include all of the following except:

A) malunion.
B) nonunion.
C) disunion.
D) delayed union.

C) disunion.

Which of the following substances prevent proper bone healing?

A) Vitamins C and E
B) Alcohol and nicotine
C) High-protein diet
D) Dehydration

B) Alcohol and nicotine

A tear in a tendon is commonly known as a:

A) fracture.
B) sprain.
C) strain.
D) subluxation.

C) strain.

Inflammation of a tendon where it attaches to the bone at its origin is called:

A) epicondylitis.
B) arthritis.
C) delta lesions.
D) bursitis.

A) epicondylitis.

A partial tear of a ligament is called a:

A) first-degree strain.
B) second-degree strain.
C) first-degree sprain.
D) second-degree sprain.

B) second-degree strain.

An avulsion occurs when:

A) the synovial capsule is torn.
B) the body of a ligament is torn.
C) a tendon is torn off its bony attachment.
D) a tendon becomes inflamed.

C) a tendon is torn off its bony attachment.

The displacement of two bones in which the articular surfaces partially lose contact with each other is called:

A) subluxation.
B) subjugation.
C) sublimation.
D) dislocation.

A) subluxation.

Patients with osteoporosis are at risk for which of the following problems?

A) Rhabdomyolysis
B) Osteomyelitis
C) Osteomalacia
D) Pathologic bone fractures

D) Pathologic bone fractures

Factors contributing to the development of osteoporosis in older women include:

A) decreased estrogen levels.
B) increased androgen levels.
C) excessive dietary calcium.
D) strenuous exercise.

A) decreased estrogen levels.

Known causes of osteoporosis include all of the following except:

A) family history.
B) late menopause.
C) smoking.
D) anorexia.

B) late menopause.

The best screening test for osteoporosis is:

A) an x-ray.
B) a bone biopsy.
C) a dual energy x-ray absorptiometry (DEXA) scan.
D) a thorough physical exam.

C) a dual energy x-ray absorptiometry (DEXA) scan.

Which of the following disorders presents with significant bone demineralization from a vitamin D deficiency and usually results in skeletal pain?

A) Osteomalacia
B) Osteopenia
C) Osteomyelitis
D) Osteoporosis

A) Osteomalacia

In osteomyelitis, the area of necrotic bone at the site of the infection is called the:

A) periosteum.
B) involucrum.
C) drainage tract.
D) sequestrum.

D) sequestrum.

The pathophysiology of osteomalacia involves:

A) increased osteoclast activity.
B) collagen breakdown in the bone matrix.
C) crowding of cells in the osteoid.
D) abnormal calcium crystallization.

D) abnormal calcium crystallization.

Which of the following diseases is characterized by osteomalacia in the growing bones of children?

A) Rickets
B) Osteosarcoma
C) Paget disease
D) Rhabdomyoma

A) Rickets

Which of the following disorders in characterized by enlargement and softening of the bones?

A) Osteomyelitis
B) Osteoporosis
C) Paget disease
D) Rickets

C) Paget disease

The cause of most cases of endogenous osteomyelitis is (are):

A) fungal skin infection.
B) viral pneumonia.
C) parasitic infection of the gastrointestinal tract.
D) blood-borne bacteria.

D) blood-borne bacteria.

Which of the following musculoskeletal tumors usually forms in the bone marrow?

A) Rhabdosarcoma
B) Liposarcoma
C) Osteosarcoma
D) Chondrosarcoma

C) Osteosarcoma

Which of the following cancers involves the proliferation of plasma cells in the bone marrow, causing skeletal pain?

A) Myeloma
B) Leukemia
C) Lymphoma
D) Osteosarcoma

A) Myeloma

The chief pathologic feature of degenerative joint disease is:

A) stress fractures of the epiphysis.
B) loss of synovial fluid.
C) degeneration of articular cartilage.
D) thinning of the joint capsule.

C) degeneration of articular cartilage.

Risk factors for osteoarthritis include all of the following except:

A) low calcium intake.
B) older age.
C) obesity.
D) orthopedic injury.

A) low calcium intake.

The primary manifestation of osteoarthritis is:

A) joint fusion.
B) joint pain.
C) hypermobility of joints.
D) contractures.

B) joint pain.

Rheumatoid arthritis results from joint inflammation caused by:

A) bacterial infection.
B) trauma.
C) autoimmune injury.
D) congenital hypermobility.

C) autoimmune injury.

Synovial joint problems in rheumatoid arthritis are due to which of the following pathologies?

A) Articular cartilage is lost through enzymatic breakdown.
B) Free radicals attach to the synovial membrane and articular cartilage.
C) Neutrophils and inflammatory cytokines cause damage to articular cartilage.
D) Cysts develop in the subchondral bone and create fissures in the articular cartilage.

A) Articular cartilage is lost through enzymatic breakdown.

In addition to joint pain, rheumatoid arthritis often manifests with which of the following systemic symptoms?

A) Fever
B) Malaise
C) Lymphadenopathy
D) All of the above

D) All of the above

Ankylosing spondylitis results in:

A) vertebral joint fusion.
B) instability of synovial joints.
C) costal cartilage degeneration.
D) temporomandibular joint degeneration.

A) vertebral joint fusion.

Pain and inflammation associated with gout are caused by crystallization of _____ in the tissues.

A) amino acid
B) uric acid
C) ketones
D) hyaluronic acid

B) uric acid

The final stage of gout, characterized by crystalline deposits in cartilage, synovial membranes, and soft tissue, is called:

A) tophaceous gout.
B) monarticular arthritis.
C) complicated gout.
D) asymptomatic hyperuricemia.

A) tophaceous gout.

Episodes of gout are often triggered by all of the following factors except:

A) alcohol.
B) drugs.
C) high-fat diet.
D) trauma.

C) high-fat diet.

Individuals with gout are 1000 times more likely to develop which of the following problems?

A) Coronary artery disease
B) Osteoarthritis
C) Contractures
D) Renal stones

D) Renal stones

A characteristic feature of fibromyalgia is:

A) trigger point pain.
B) headache.
C) permanent shortening of muscles.
D) muscle atrophy.

A) trigger point pain.

Pain in fibromyalgia is attributed to:

A) inflammation.
B) autoimmune destruction of muscle tissue.
C) decrease in pain tolerance.
D) increased levels of peripheral neurotransmitters.

C) decrease in pain tolerance.

Severe muscle trauma from crush injuries can result in which of the following complications?

A) Myotonia
B) Rhabdomyolysis
C) Myocarditis
D) Fibromyalgia

B) Rhabdomyolysis

Myoglobinuria (rhabdomyolysis) can result in failure of which of the following organs?

A) Liver
B) Lungs
C) Kidneys
D) Pancreas

C) Kidneys

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