NURSING6320 ORTHOPEDIC EXAM
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Question:
The axioscapular group of muscles include which one of the following?
Supraspinatus
Trapezius Correct
Subscapularis
Pectoralis major
Explanation:
The axioscapular group attaches the trunk to the scapula and includes the trapezius,
rhomboids, serratus anterior, and levator scapulae. The scapulohumeral group of
muscles extends from the scapula to the humerus and includes the muscles inserting
directly on the humerus. This group includes the supraspinatus, infraspinatus, teres
minor, and subscapularis. The axiohumeral muscle group attaches the trunk to the
humerus and includes the pectoralis major and minor, and the latissimus dorsi.
Question:
An example of a cartilaginous joint would be the:
vertebral bodies of the spine. Correct
skull.
shoulder.
knee.
Explanation:
Vertebral bodies of the spine and the pubic symphysis of the pelvis are examples of
cartilaginous joints. Examples of synovial joints include the shoulder, knee, hip, wrist,
distal radioulnar, elbow, and carpals. The skull is an example of the fibrous joint.
Question:
The part of the ulna that forms the outer prominence of the elbow is referred to as the:
olecranon bursa.
olecranon fossa.
olecranon process. Correct
olecranon.
Explanation:
The part of the ulna that forms the outer prominence of the elbow is referred to as the
olecranon process. This process fits into the fossa of the humerus when the arm is
extended.
Question:
To assess muscle tone in the legs, support the patient's thigh with one hand, grasp the
foot with the other, and:
extend the patient's feet.
flex and extend the patient's knee and ankle on each side. Correct
have the patient try to lift the foot.
, feel for jerkiness in the calf.
Explanation:
To assess muscle tone in the legs, support the patient's thigh with one hand, grasp the
foot with the other, and flex and extend the patient's knee and ankle on each side
noting for any resistance to the movements.
Question:
When grading muscle strength, a grade of three would indicate:
no muscular contraction detected.
barely detectable trace of contraction.
active movement of the body part with gravity eliminated.
active movement against gravity. Correct
Explanation:
A grade of three would indicate active movement against gravity. Zero muscular
strength would indicate no muscular contraction was noted on exam. A grade of one
indicates a barely detectable trace of contraction noted on exam. For active movement
of the body part with gravity eliminated, a grade of two would be noted.
Question:
Joints in which bones have intervening layers of fibrous tissue or cartilage holding the
bones together are referred to as:
cartilaginous joints.
synovial joints.
fibrous joints. Correct
extra-articular joints.
Explanation:
Fibrous joints, such as the sutures of the skull, have intervening layers of fibrous tissue
or cartilage holding the bones together. The bones are almost in direct contact and do
not allow movement. Cartilaginous joints, such as those between vertebrae and the
symphysis pubis, are slightly movable. In these joints, fibrocartilaginous discs separate
the bony surfaces. Joints in which bones do not touch each other, and the joint
articulations are freely moveable (within the limits surrounding ligaments) are called
synovial joints. Extra-articular refers to the structures of selected regions of the joint
and types of movement.
Question:
Passive flexion, varus stress, and external rotation of the lower leg evaluates the:
medial meniscus. Correct
lateral meniscus.
lateral collateral ligament (LCL).
posterior cruciate ligament (PCL).
Explanation:
Passive flexion, varus stress, and external rotation of the lower leg evaluates the medial
meniscus.
,Question:
When examining the knee, the presence of a palpable fluid wave with the returning fluid
wave into the suprapatellar pouch is noted. This positive sign for effusion of the knee is
known as the:
balloon sign. Correct
bulge sign.
balloting sign.
McMurray's sign.
Explanation:
A positive balloon sign for effusion in the knee is the presence of a palpable fluid wave
with a returning fluid wave into suprapatellar pouch. When examining the knee, a fluid
wave on the medial side between the patella and the femur is noted. This positive sign
for effusion is known as the bulge sign. Balloting of the patella is tested by compressing
the suprapatellar pouch and pushing the patella sharply against the femur. If fluid
returns to the suprapatellar pouch, then an effusion of the knee is diagnosed.
McMurray's test checks for tears in the medial meniscus.
Question:
The Abduction (or Valgus) Stress Test is a maneuver used to assess the function of the:
Achilles tendon.
medial meniscus.
medial collateral ligament (MCL). Correct
lateral collateral ligament (LCL).
Explanation:
The Abduction (or Valgus) Stress Test is a maneuver that evaluates the function of the
medial collateral ligament. To perform this test, place the knee in thirty degrees of
flexion. While stabilizing the knee, abduct the ankle. If the knee joint abducts greater
than the uninjured knee, the test is positive. This is suggestive of a medical collateral
ligament tear.
Question:
The dorsiflexors muscles in the foot include the:
posterior tibial muscle.
gastrocnemius.
toe flexors.
toe extensors. Correct
Explanation:
The dorsiflexors in the foot include the anterior tibial muscles and the toe extensors.
Question:
Thenar atrophy suggests:
an ulnar nerve disorder.
a median nerve disorder. Correct
a radial nerve disorder.
a superficial branch of the radial nerve.
, Explanation:
Thenar atrophy suggests a median nerve disorder such as carpal tunnel syndrome.
This is evidenced by muscle wasting in the palm of the hand.
Question:
Pouches of synovial fluid that cushion the movement of tendons and muscles over bone
or other joint structures are referred to as:
synovial joints.
bursae. Correct
joint capsule.
synovial membrane.
Explanation:
Pouches of synovial fluid that cushion the movement of tendons and muscles over
bone or other joint structures are referred to as bursae. (Bursae is plural. Bursa is
singular).
Question:
A patient experienced a neck injury yesterday and presents to the nurse practitioner
with aching paracervical pain and stiffness. Other complaints include dizziness, malaise,
and fatigue. These findings may be associated with:
mechanical neck pain.
mechanical neck pain with whiplash. Correct
cervical radiculopathy.
cervical myelopathy.
Explanation:
In patients with mechanical neck pain with whiplash, the paracervical pain and stiffness
begins the day after injury and may be accompanied by occipital headaches, dizziness,
and malaise. Mechanical neck pain is described as aching pain in the cervical
paraspinal muscles and ligaments with associated muscle spasm, stiffness, and
tightness in the upper back and shoulder, lasting up to 6 weeks. With cervical
radiculopathy, nerve root compression is the etiology. Symptoms may include sharp
burning or tingling pain in the neck and one arm with associated paresthesias. In
cervical myelopathy, cervical cord compression, the neck pain is associated with
bilateral weakness and paresthesias in both upper and lower extremities.
Question:
Women who wear high-heeled shoes with narrow toe boxes are at risk of developing all
of the following forefoot abnormalities except:
hallux valgus.
metatarsalgia.
Achilles tendinitis. Correct
Morton's neuroma.
Explanation:
Women who wear high-heeled shoes with narrow toe boxes are at risk of developing
hallux valgus, metatarsalgia, and Morton's neuroma. Achilles tendinitis more commonly
occurs in runners and affects the posterior foot as opposed to the forefoot.