1. Ortho Exam 1

  1. Movement through the median-Sagittal plane would occur around the

    B. x axis, also called the transverse, horizontal, coronal or frontal axi
  2. Movement through the frontal-coronal plane would occur around the

    B. z axis, also called the sagittal axis
  3. Movement through the transverse-horizontal plane would occur around the

    A. y axis, also called the longitudinal axis and vertical axis.
  4. In the shoulder, where would the axis of rotation be located?

    D. In the head of the humerus. the axis is usually located through the convex member of the joint. This is one of the reason the glide will always be opposite the osteokinematic movements of a joint when moving the convex member.
  5. A saddle joint has ___ degrees of freedom

    D. saddle joints have 3 degrees of freedom in which the can move. Flx/ext, abd/add, rotation
  6. Which plane and axis does scapular protraction occur in?
    a. transverse/z axis
    b. transverse/x axis
    c transverse/y axis
    c. transverse/y axis
  7. Which plane does scapular elevation occur in?

    C. Frontal plane
  8. Which motions are involved with spinal rotation-side bending?

    A. Spinal rotation-side bending is what we call a coupled motion. It involves both the rotation and flexion motion.
  9. When amb. the head produces what type of motion?

    • B. This motion is considered a curvilinear translatory motion. Translatory motions may also be linear.
    • Translation means that all the parts of a rigid object move parallel to and in the
    • same direction oas every other body part. Can be curvilinear or linear.
  10. Elbow flexion and extension is an example of

    E. It is a hinge joint going through rotary motion
  11. Flexion of the bicep is an example of

    A. active internal force, Passive internal would be caused by tension in connective tissue; e.g., a contracture
  12. A body is in static equilibrium when

    D. when the velocity is zero. The body is in dynamic equilibrium when the velocity is constant the and acceleration is zero
  13. Work (W)
    a. W=F*V
    b. W=Torque
    c. W=F/time
    d. W=F*d
    d. work + force times distance
  14. Power

    • A. work/time
    • or we could say F*d/t
  15. Calf raises in closed chain is an example of

    B. This case is similar to a wheel barrow. If you are doing an open chain movement, this motion will be a 1st class lever.
  16. What does kinematics mean?

    B. kinematics is the study of motion. Kinetics is the study of the relationship between forces that produce motion. To remember think, Kinetic is like kinetic energy and deals with force
  17. In homogenous objects, the COG is in the middle and the COM is constant T/F
    T. They will remain the same since the object won't move.
  18. Males have a lower COG than females. T/F
    False. Males actually have a slightly hight center of gravity than females.
  19. Pt. s/p for arthroscopic surgery to correct bone chips in the humero-ulna joint. These chips would be an example of.

    A. mechanical block. they could also be called joint mice. A contracture is the adhesion of connective tissue. Effusion is swelling that limits the ROM. Lack of musculotendinous flexibity would have to do with scar tissue, deconditioning, posture, tension and emotion.
  20. You work our hard for a year and find your forearm flexion ROM has
    decreased, there is no pathological reason and sensation is normal. What
    may explain this decrease?

    • B. Muscle or adipose bulk
    • Due to increase bicep, the ROM has decrease. There is no pain. The
    • tricep is not stuck in spasm and there is no limiting cutaneous scar
    • tissue.
  21. Pt. had skin torn of of their arm. What is the turn over rate for skin?

    B. 1-7 skin is one of the tissues with the quickest turnover.
  22. Pt. tore their hamstring while sprinting. What is the turn over rate for muscle tissue?

    B. 50 days. Muscle turn over rate is about 50 days. It is fairly quick.
  23. Patient tore their ACL, after surgery, how long can the expect before the tissue is completely turned over?

    A. 300-500 Ligemnts have a long turnover rate. This is why recovering from ligament injuries is so tough.
  24. Patient ruptures the achiles tendon, what is the turn over time?

    B. 50-100 days tendons are slightly long than muscle, but not as long as ligaments in their turnover rate
  25. Pt. tore their ACL. what type of collagen fibers did they tear?

    C. Type I. Ligaments are composed primarily of type I collagen fibers
  26. Pt. has a tear in the hyaline cartilage of her knee, what type of collagen fiber is involved?

    A. type II Hyaline is primarily type II collagen. Type II is thinner and has less tensile strength. However it tends to be more smooth which works well for allowing movement between the bones of joints.
  27. Elastin is a type of fiber that has more give to elongation and more elasticity, in gaining these characteristics it losses

    D. Elastin type fibers sacrifice tensile strength and stiffness for elasticity and elongation properties
  28. T/F The primary cells in ligemants, tendons and other supporting CT are
    fibroblasts, while the primary cells in hyaline cartilage and
    fibrocartilage are chondrocytes.
    • True.
    • The cartilage tissues involved with movements tend to have more
    • fibroblast while the cartilage tissue involved with contact tend to have
    • more chondrocytes.
  29. Collagen fibers and stiffness, but what is the material that helps to keep them resiliant?

    E. Ground substance, interstitial fluid, and matrix are used interchangably.
  30. What is the matrix composed of?

    • D.
    • GAG's attract water and cause the collagen to be spaced evenly. Proteoglycans help compose GAG's
  31. Pt. Has been immobile for a few weeks and decrease activity with the right
    knee. What will happen inside of the hyaline cartilage?
    • The
    • GAG activity will decrease, GAG’s may not be lost, but the will be
    • repressed. Since the GAG’s are the molecules that attract water, water
    • levels will decrease. With less water the tissue is not inflated and is
    • less effective in absorbing shock. Water will decrease the space
    • between the collagen fiber and you will get cross-linking and adhesions.
    • To improve this condition you must maintain mobility.
  32. The following connective tissue contains GAG’s within their ground substance.
    a. Fibrous
    b. cartilagenous
    c. Bone
    e. a and b
    e. Bone doesn't have GAG's it has hydroxyapatite
  33. These fibers pierce deep into the bone tissue and help to anchor periosteum to the bone.

    B. b. sharpey’s fibers. They pierce deep and help to anchor the periosteum and also help anchor tendons and ligaments.
  34. Bone is 2/3 crystal, therefor is posses the properties of crystal. When compressed a bone will

    B. When compressed bone creates a negative charge which does result in bone growth. This is called the Piezoelectric effect. When traction of tension is applied the bone produces a positive charge.
  35. T/F Torsion, shear, stiffness, compression, and tension are all mechanical properties of bone.
  36. What is occuring when a stress fracture happens?

    D. osteoclastic function is greater that osteoblastic. Muscle can put stress on the bone and cause it to need to be removed and repaired. When this happens at to quick a rate, stress fractures may occur.
  37. T/F Following a stress fracture, one can return to activity as soon as their pain threshhold allows them.
    True. Return to activity is dependent on the pain the patient feels.
  38. When a bone is broken and the proximal end of the distal half is more
    proximal than the distal end of the proximal half we call it

    A. overriding
  39. According to Saltar’s classifications, a bone with a fraction going straight through the epiphyseal plate is called a
    a. Type I b. Type II
    c. Type III d. Type IV
    e. Type V f. Type VI g. Type VII
    Type I
  40. According to Saltar’s classifications, a bone with a fraction going through the
    epiphyseal plate then through the epiphysis is called a
    a. Type I b. Type II c. Type III d. Type IV
    e. Type V f. Type VI g. Type VII
    c. type III (this will disrupt the growth and require surgical fixation)
  41. According to Saltar’s classifications, a bone with a fraction going through the
    epiphyseal plate then through the metaphysis is called a
    a. Type I b. Type II c. Type III d. Type IV
    e. Type V f. Type VI g. Type VII
    b. a type II.
  42. According to Saltar’s classifications, a bone with a fraction going through the
    epiphysis, the epiphyseal plate then through the metaphysis is called a
    a. Type I b. Type II c. Type III d. Type IV
    e. Type V f. Type VI g. Type VII
    d. Type IV (this will disrupt the growth and require surgical fixation)
  43. According to Saltar’s classifications, a bone is compressed at the epiphyseal plate, this is called a
    a. Type I b. Type II c. Type III
    d. Type IV e. Type V f. Type VI g. Type VII
    e. Type V (this will disrupt the growth)
  44. According to Saltar’s classifications, a bone developes a osseus bridge at one end of the epiphyseal plate, this is called a
    a. Type I b. Type II c. Type III d. Type IV
    e. Type V f. Type VI g. Type VII
    f. Type VI
  45. Inbalance of osteoblastic activity relative to osteoclastic acitivty may result in which abnormality?

    A. osteo petrosis.Osteogenesis imperfect looks like swiss cheese in that it becomes very poreousMyositis ossificans is a heterotrophic boney formation. Bone growth in muscleOA is a mechanical wear and tear problemRA is an immune reactionRickets is the inability of the bone to solidify mineral content in the matrix causeing buckling.
  46. Cartilage is largely avascular, alymphatic and aneural. This is a result of

    C. The relatively small vascularity The lack of vascularity contributes to these qualities.
  47. How does the cartilage receive most of its nourishment?

    C. Synovial fluid is absorbed into the tissue and delivers WB and other nutrients.
  48. With hyaline cartilage damage, sometimes doctors will perform a microfacture surgery. What is the purpose of this surgery?

    • A. The point is to induce bleeding into the cartilage. The bleeding will
    • help the cartilage to repair as fibrocartilage and later be remodeled
    • into hyaline cartilage.
  49. Where do we typically find fibrocartilage?

    E. these are all areas that will contain fibrocartilage
  50. Aside from blood, this is the most pervasive tissue in the body.

    B. loose fibrous connective tissue which forms the fascia the is just under the skin, around the muscles and around the organs.
  51. Pt. sprained their left lateral collateral ligament. Which type of tissue has been damaged?

    A. A collateral ligament would be dense fibrous tissue, but it would be the organized type, which also makes up tendons, and aponeurosis. There are two types of dense fibrous connective tissue, the organized and unorganized. The unorganized forms joint capsules.
  52. The stress strain curve is based a upon the mechincal of behavior of soft tissues. This property is called.

    • B. viscoelasticity. A tissue that is viscoelastic will under go stretch
    • as it is strained. It will mover through the different phase of the
    • stress strain curve.
  53. As you are stretching a patient, energy escapes in the form of heat rather
    than all of it being conserved as elastic strain energy. The causes the
    relaxation phase to be longer than the stretching phase. As a result,
    the material does not immediate return to it’s immediate dimensions.
    This response is called

  54. While stretching a patients hamstrings, you continously apply a constant
    force, slowly over time you gain ROM. This is an example of

  55. You are stretching a pt. hamstrings. You hold their leg at the same degree
    over a period of time. As time increase the amount of force required to
    keep her leg decrease. This is an example of

  56. T/F Tissue with more collagen fibers will require more force to achieve elastic and plastic regions in the stress strain curve.
    T. The collagen is less condusive to stretching therefor it will require more force. This will result in a more verticle curve.
  57. The following therapies are based around fascial concepts

  58. What is the function of fascia?

  59. What is the function of fascia?

  60. Fibrous joints have

    • B.
    • (two bones bound by a fibrous disc would we a cartilagenous joint)
  61. Cartilagenous joints have

    • A.
    • (like IVD, SC joint, pubic symphysis)
  62. Synovial joints have

  63. The carpal bones do not move around an axis, this makes them an example of

    • D.
    • (glinding joints are also called plane joints and sliding joints)
  64. The elbow moves along one plane and axis and has strong collateral ligaments making it an example of

    • D.
    • (b is the most correct answer, the reason synovial is not the best answer is because the collateral ligaments don't make the joint a synovial joint and that is what the stem as asking for. Hyaluronic acid is found in synovial fluid. Hydroxyapatite is the matrix material for bones)
  65. MCP joints are an example of

    • D.
    • (trochoid is a pivot joint, ginglymus is a hinge joint, so it is either condyloid of ellipsoid. Condyloid has the concave on the distal end. The MCP joint is therefore a condyloid joint)
  66. The radiocarpal joint is an example of a

    • C.
    • (ginglymus=hinge, trochoid=pivot, ellipsoid has the convex end on the distal part of the joint)
  67. The 1st CMC joint is an example of

    • C.
    • (The CMC joint refers to the 1st and is a saddle joint or a sellar joint because each surface has a concave and convex shape which also allows for 3 degrees of movemnet in this case, but normaly a sellar joint is said to have 2 degrees of freedon. May also be called an unmodified sellar joint)
  68. Synovial membrane

    • E.
    • (synovial membrane does regulate entry into the cavity and line the sheaths of tendons. The membrane has lost of macrophages that can mobilize and enter the synovial fluid very quickly)
  69. Synovial fluid is pale yellow and is pushed into cartilage in a sponge-like
    fashion. It also helps reduce friction in joints due to.

    • C.
    • (hyaluronic acid is a large constituent of synovial fluid. Glycoproteins help to form GAG's but aren't directly what helps reduce the friction)
  70. Hyaline cartilage is usually damaged by OA therefor is less capable of
    absorbing shock, but it is the main articular cartilage for
    friction-free movement. What type of collagen is it composed of?

    • B.
    • (Type one is for the more rigid type of cartilage like the ligaments tendons and joint capsules. Type A is the fastest type of motor nerve, it is highly myelinated and innervates extrafusal muscle, alpha 120 m/s , and also has beta 70m/s and gamma40m/s)
  71. This part up the joint helps to guide normal movement in many directions (omnidirectional)

    • D.
    • (the joint capsule functions to guide movement in all directions. The joint capsule is made of dense unorganized fibrous tissue and of type I collagen fibers. Collateral ligaments typically help in just on plane.)
  72. This part of the joint contributes to the proprioceotive feedback, has pain
    and mechanoreceptors and forms a layer that keeps foreign objects
    outside of the joint.

  73. The labrum is an example of interarticular fibrocartilage that

    • C.
    • (the labrum actually increase stability in the joit. It also increases congruency between joints by deeping the socket that the convex end fits into, it also helps create the negative pressure in the joint that improves stability through the process called, atmospheric pressure)
  74. The articular ends of the bones in the knee fit together fairly tightly. This is an example of

  75. The joint capsule, labrum, ligaments and menisci are examples of

  76. Musculotendinous units are examples of

  77. The weight of an individual that causes the joints ends to approximate is an example of

  78. The air tight chamber within a joint capsule contributes the the stability of the joint via

  79. Joints can be classied under the sellar classification. The to main types are

    • C.
    • (ellipsoid is when the convex is distal condyloid is when the concave is distal)
  80. Under the sellar classification, ball and socket joints are considered

    • B.
    • (ball and socket retain all 3 degrees of movement making them unmodified)
  81. The 1st CMC joint is an example of

    • A.
    • (CMC is a saddle joint and maintains the 2 degrees of movement consistant to a true sellar joint)
  82. The MCP joint is an example of
    a. modified sellar
    b. modified ovoid
    c. unmodified sellar
    d. unmodified ovoid
    • b
    • (the MCP is ovoid but only has 2 degrees of movement)
  83. The elbow is an example of a

    • C.
    • (the elbow has some sellar shape to it, but only has 1 degree of motion that is significant)
  84. When treating a shoulder, the plane of treatment would be

    • B.
    • (a sounds pretty good, but just remember that the plane is relative to the concave surface and so the makes b the most correct answer)
  85. “Slop” is another word for

    • B.
    • This reffers to accesory motions in the joint
  86. This tissue withing the skeletal muscle is responsible for the stretch-strain curve response.

    C. The non-contractile connective tissue within the skeletal muscle is responsible for the viscoelasticity (which allows for slow deformation and presents with imperfect recovery) of muscle.
  87. The ability to stretch (upto to 1/2 times beyond its resting length)

    D. Extensibility. Viscoelasticity is the ability of the muscle to slowly deform with an imperfect recovery. Elasticity is the ability of a tissue to return back to its original length. Viscosity is muscles resistance to change.
  88. The ability to respond to chemical, electrical, and mechanical stimuli

    A. Irritability. Conductive is incorrect because muscle doesn’t conduct.
  89. This molecule reacts with calcium to begin the actin-myosin interaction

    • A. troponin. Tropomyosin is the structure the guards the binding sites of the actin
    • to prevent intereaction. Z disc is the ine where actin attach.
  90. What surrounds the muscle fibers?

  91. What surrounds the muscle fasciculus?

  92. What surrounds the muscle belly?

  93. Slow twitch muscle is

    C. Fast twitch is described by d.
  94. Slow twitch muscle fiber is

    A. Fast is desribed by c.
  95. Slow twitch muscle

    D. Fast is described by b.
  96. Slow twitch muscle

    C. Fast is described by d.
  97. Which of the following is not characteristic of slow twitch fibers?

    C. Slow twitch muscle atrophies rather quickly. Atrophy also occurs quicker when the muscle is fight in a shortened position.
  98. Which of the following is not characteristic of fast twitch fibers?

    C. Slow twitch as relatively lower mitochondria counts than do dlow twitch muscle fibers. This is why it depelets its energy quickly.
  99. Which of the following is not characteristic of fast twitch muscle fibers?

    C. Fast twitch is slow to atrophy, but also takes longer than the slow twitch to recover.
  100. Which is not a true of type IIA and type IIX

    D. IIX reaches its peak tension the quickest.
  101. T/F ROM is dependent on the length of the muscle fibers.
  102. What are the four common shapes of muscle from the notes?

    D. Rhombencephalon is from neuro and is developes into the metencephalon and the myelencephalon. Falciform is the ligament from the liver that attaches it to the anterior abdominal cavity.
  103. Which are the two categories of long muscles?

  104. T/F In general penne muscles create greater maximal force than fusiform muscle of similar size
    • F. Penne is a type of paste that goes great with alfredo sauce. Pennate
    • muscles do creat great maximal force the fusiform of similar size.
  105. Which is and example of Unipennate muscles?

    B. posterior tibialis, flexr policis longus is too. Quad. fem is bi-pennate, so is the gastroc. Sartorius, semi membranousus and rectus ab. are a strap muscles. Deltoid is multipennate.
  106. Which of the muscles would create the most power

    D. the larger the cross section, the greater the contractile protein available to generate force. This is why oblique muscles can create powerful movements with limmited ROM
  107. T/F Pennate have the greatest potential to create the greatest amount of tension
    T. This is because there is a direct relationship between x-sectional area and muscle tension.
  108. Hypertrophy in humans is typically not caused by

    D. in human’s hyperplasia is disregarded for practical purposes
  109. Since hypertrophy usually takes 4-6 weeks, the initial strength gains experienced when first training are primarily due to

    B. Neuromuscular intergration recruits MU that have not been active. It also coordinates the contraction of MU to create great force generations. Neuromuscular integration is usually experienced in the first 2-3 sessions and upto 3-4 weeks. This is the period before hypertrophy when the nervous system is recruiting and coordinating MU to handle the new work loads.
  110. T/F Joint effusion can cause muscle inhibition.
  111. What do we call a lack of nerve supply to a muscle?
  112. A motor unit is

  113. Muscle spindle fibers are

    B. Muscle spinal fibers are connective tissue sacs with in extrafusal muscle which attach to the connective tissue of the extrafusal fibers. The sacs house intrafusal fibers (nuclear bags and chains) which pickup the sensory of the movement of muscle and report to the reflexs and CNS.
  114. Which region of the intrafusal fibers is contractile?

    C. The polar regions are contractile and adjust to reset the nuclear sacs and chains. The polar region is innervated by type II sensory and Gamma motor nerves.
  115. The nuclear bag fibers are

  116. Which is not characteristic of nuclear bags?

    D. it is the nuclear chain that detects the over all change in position. The chain also has Ia nerves on it.
  117. What nerves are found in the intrafusal muscles?

  118. Which of the following in not a function of the gamma motor funciton?

    C. The nuclear bag contains no contractile tissues. It is only receptive tissue that is sensitive to pressure induced upon it by the contraction of relaxation of the polar ends.
  119. Which is not a characteristic of the GTO?

    C. The GTO do not cause motor contraction. They have no motor control. The GTO give feedback on the tension being placed on the muscle but do not record positioning.
  120. 1. In which of the following ways do you create the greatest tension within the muscle in the rectus femoris?

    C. Fast hip extension movement, just look at the graph in your notes (force-velocity curve). (This question was Dr. Wallman approved in class)
  121. A patient comes in with a separated symphysis pubis. The injured joint is an example of:

    A. The joints with cartilagenous discs are cartilagenous joints. Fibrous joint would be like inferior tib/fib, syndesmosis.
  122. Ginglymus joint : Uniaxial

    B. A spheroidoal joints is a ball and socket joint. So it would be triaxial.
  123. T/F Periosteum is avascular.
  124. All of the following are components of a synovial membrane EXCEPT:

    C. There is some research that indicates the synovial membranes have pain receptors in them, but the lack the nerve endings for proprioceptive feedback as far as I am aware. The joint capsule is most involved in proprioception.
  125. A friend likes to crack her knuckles. She asks you what the “pop” is.
    The best answer in terms of joint stability components is:

  126. All of the following are examples of static stabilizers EXCEPT:

    C. Muscle is considered a dynamic stabilizer due to its properties, extensibility, irritability, contractility
  127. An example of an unmodified oviod:

    A. spheroidal joint. An unmidified oviod is one the retains the ability to moves in 3 degrees such as a spheroidal or ball and socket joint.
  128. Which is true about the treatment plane:

    D. The treatment plane is parallel to the concave surface.
  129. A patient is unable to perform shoulder adduction. You should mobilize the patient with a/an:

  130. Articular surfaces are out of their normal articular relationship:___________
    Dislocation. Subluxed is similar, but with a subluxation, the articular surface is partial in contact even though it is out of position.
Card Set
1. Ortho Exam 1
UNLV DPT 741 - Ortho Exam 1