Physical Diagnosis: The MSK Exam

Which joints are frequently moving articulations that are enclosed by a capsule of fibrous articular cartilage?

a.Synarthroses

b.Synchondroses

c.Amphiarthroses

d.Synovial

d.Synovial

Fluid that lubricates articular cavities is called:

a.blood.

b.synovial fluid.

c.mucus.

d.cerumen.

b.synovial fluid.

Joints are held together by:

a.tendons.

b.ligaments.

c.muscles.

d.cartilage.

b.ligaments.

Bones are attached to muscles by:

a.tendons.

b.ligaments.

c.muscles.

d.cartilage.

a.tendons.

An increase in muscle tone is known as:

a.crepitus.

b.effusion.

c.spasticity.

d.atrophy.

c.spasticity.

The type of joint that has the widest range of motion in all planes is the:

a.ball-and-socket.

b.condyloid.

c.gliding.

d.saddle.

a.ball-and-socket.

Spinal vertebrae are separated from each other by:

a.bursae.

b.tendons.

c.disks.

d.ligaments.

c.disks.

The glenohumeral joint is the other name for the:

a.elbow.

b.shoulder.

c.wrist.

d.scapula.

b.shoulder.

The joint where the humerus, radius, and ulna articulate is the:

a.wrist.

b.elbow.

c.shoulder.

d.clavicle.

b.elbow.

The articulation of the radius and carpal bones is the:

a.wrist.

b.elbow.

c.shoulder.

d.clavicle.

a.wrist.

The cruciate ligaments of the knee provide for:

a.anterior and posterior stability.

b.medial and lateral stability.

c.movement on one plane.

d.pivoting and rotation.

a.anterior and posterior stability.

Medial and lateral surfaces of the tibiotalar joint are protected by:

a.bursae.

b.tendons.

c.muscles.

d.ligaments.

d.ligaments.

The suprapatellar bursa separates the patella, quadriceps tendon, and muscle from the:

a.tibia.

b.fibula.

c.femur.

d.pelvis.

c.femur.

The tibia, fibula, and talus articulate to form the:

a.ankle.

b.knee.

c.hip.

d.pelvis.

a.ankle.

Long bones in children have growth plates known as:

a.epiphyses.

b.epicondyles.

c.synovium.

d.fossae.

a.epiphyses.

The elasticity of pelvic ligaments and softening of cartilage in a pregnant woman are the result of:

a.decreased mineral deposition.

b.increased hormone secretion.

c.uterine enlargement.

d.gait changes.

b.increased hormone secretion.

Skeletal changes in older adults are the result of:

a.increased bone deposition.

b.increased bone resorption.

c.decreased bone deposition.

d.decreased bone resorption.

b.increased bone resorption.

The family history for a patient with joint pain should include information about siblings with:

a.trauma to the skeletal system.

b.chronic atopic dermatitis.

c.genetic disorders.

d.obesity

c.genetic disorders.

Risk factors for sports-related injuries include:

a.competing in colder climates.

b.previous fracture.

c.history of recent weight loss.

d.failure to warm up before activity.

d.failure to warm up before activity.

Light skin and thin body habitus are risk factors for:

a.rheumatoid arthritis.

b.osteoarthritis.

c.congenital bony defects.

d.osteoporosis.

d.osteoporosis.

Inquiry about nocturnal muscle spasms would be most significant when taking the musculoskeletal history of:

a.adolescents.

b.infants.

c.older adults.

d.middle-age adults.

c.older adults.

The musculoskeletal examination should begin when:

a.the patient enters the examination room.

b.during the collection of subjective data.

c.when height is measured.

d.when joint mobility is assessed.

a.the patient enters the examination room.

Pain, disease of the muscle, or damage to the motor neuron may all cause:

a.bony hypertrophy.

b.muscle crepitus.

c.muscle hypertrophy.

d.muscle wasting.

d.muscle wasting.

Fasciculation occurs after injury to a muscle's:

a.venous return.

b.motor neuron.

c.strength.

d.tendon.

b.motor neuron.

The physical assessment technique most frequently used to assess joint symmetry is:

a.inspection.

b.palpation.

c.percussion.

d.the use of joint calipers.

a.inspection.

A goniometer is used to assess:

a.bone maturity.

b.joint proportions.

c.range of motion.

d.muscle strength.

c.range of motion.

When palpating joints, crepitus may occur when:

a.irregular bony surfaces rub together.

b.supporting muscles are excessively spastic.

c.joints are excessively lax.

d.there is excess fluid within the synovial membrane.

a.irregular bony surfaces rub together.

The temporomandibular joint is palpated:

a.under the mandible, anterior to the sternocleidomastoid muscle.

b.above the mandible at midline.

c.anterior to the tragus.

d.at the mastoid process.

c.anterior to the tragus.

The temporalis and masseter muscles are evaluated by:

a.having the patient shrug their shoulders.

b.having the patient clench their teeth.

c.asking the patient to fully extend their neck.

d.passively opening the patient's jaw.

b.having the patient clench their teeth.

The strength of the trapezius muscle is evaluated by having the patient:

a.clench her or his teeth during muscle palpation.

b.push her or his head against the examiner's hand.

c.straighten her or his leg with examiner opposition.

d.uncross her or his legs with examiner resistance.

b.push her or his head against the examiner's hand.

Expected normal findings during the inspection of spinal alignment include:

a.asymmetric skin folds at the neck.

b.slight right-sided scapular elevation.

c.concave lumbar curve.

d.the head positioned superiorly to the gluteal cleft.

d.the head positioned superiorly to the gluteal cleft.

A common finding in markedly obese patients and pregnant women is:

a.kyphosis.

b.lordosis.

c.paraphimosis.

d.scoliosis.

b.lordosis.

A wheelchair-dependent older woman would most likely develop skin breakdown at:

a.C7.

b.the iliac crests.

c.L4.

d.the gibbus.

d.the gibbus.

When the patient flexes forward at the waist, which spinal observation would lead you to suspect scoliosis?

a.Prominent lumbar hump

b.Prominent cervical concave curve

c.Lateral curvature of the spine

d.Restricted ability to flex at the hips

c.Lateral curvature of the spine

When a patient abducts an arm and the ipsilateral scapula becomes more prominent (winged), this usually means that:

a.there has been an injury to the nerve of the anterior serratus muscle.

b.one of the clavicles has been fractured.

c.there is a unilateral trapezius muscle separation.

d.one shoulder is dislocated.

a.there has been an injury to the nerve of the anterior serratus muscle.

When the shoulder contour is asymmetric and one shoulder has hollows in the rounding contour, you would suspect:

a.kyphosis.

b.fractured scapula.

c.a dislocated shoulder.

d.muscle wasting.

c.a dislocated shoulder.

Ulnar deviation and swan neck deformities are characteristic of:

a.rheumatoid arthritis.

b.osteoarthritis.

c.osteoporosis.

d.congenital defects.

a.rheumatoid arthritis.

A finding that is indicative of osteoarthritis is (are):

a.swan neck deformities.

b.Bouchard nodes.

c.ganglions.

d.Heberden nodes.

d.Heberden nodes.

Carpal tunnel syndrome would result in:

a.a negative Tinel sign.

b.a negative Phalen test.

c.reduced abduction of the thumb.

d.palm tingling.

c.reduced abduction of the thumb.

Excessive hyperextension of the knee with weight bearing may indicate:

a.advanced joint degeneration.

b.gout.

c.rotation of the Achilles tendon.

d.weakness of the quadriceps muscle.

d.weakness of the quadriceps muscle.

Arm length is measured from the acromion process through the:

a.olecranon joint to the carpal thumb hinge.

b.olecranon process to the distal ulnar prominence.

c.proximal radial prominence to the distal joint.

d.proximal ulnar joint to the middle fingertip.

b.olecranon process to the distal ulnar prominence.

A positive straight leg raise test usually indicates:

a.leg length discrepancy.

b.improperly conditioned muscles.

c.lumbar nerve root irritation.

d.hip bursitis.

c.lumbar nerve root irritation.

The Thomas test is used to detect:

a.hip dislocation.

b.unstable sacroiliac joints.

c.knee instability.

d.flexion contractures of the hip.

d.flexion contractures of the hip.

Which one of the following techniques is used to detect a torn meniscus?

a.Drawer test

b.McMurray test

c.Thomas test

d.Trendelenburg test

b.McMurray test

When performing the McMurray test, the examiner should place the patient in a supine position with a hand on the patient's completely flexed knee and the foot flat on the table at the buttocks, and then:

a.grasp and evert the foot and extend the knee.

b.grasp and invert the foot and rotate the knee.

c.apply valgus stress with the foot planted.

d.apply varus stress with the foot planted.

a.grasp and evert the foot and extend the knee. Turn the ankle outward while applying a valgus stress and then extend the knee.

Which technique is performed at every infant's examination during the first year of life to detect hip dislocation?

a.Ballottement maneuver

b.Barlow-Ortolani maneuver

c.Range of motion

d.Thomas McMurray assessment

b.Barlow-Ortolani maneuver

You note that a child has a positive Gower sign. You know that this indicates generalized:

a.arthropathy.

b.muscle weakness.

c.bursitis.

d.muscle hypertrophy.

b.muscle weakness.

A 3-year-old is brought to the clinic complaining of a painful right elbow. He is holding his right arm slightly flexed and pronated and refuses to move it. The mother states that symptoms started right after his older brother had been swinging him around by his arms. This presentation supports a diagnosis of:

a.radial head subluxation.

b.femoral anteversion.

c.carpal tunnel syndrome.

d.osteomyelitis.

a.radial head subluxation.

What temporary disorder may be experienced by pregnant women during the third trimester because of fluid retention?

a.Carpal tunnel syndrome

b.Osteitis deformans

c.Radial head subluxation

d.Talipes equinovarus

a.Carpal tunnel syndrome

A red, hot, swollen joint in a 40-year-old man should lead you to suspect:

a.trauma.

b.bursitis.

c.gout.

d.cellulitis.

c.gout.

An adult with bowed tibias and a shortened thorax may have:

a.ankylosing spondylitis.

b.Paget disease.

c.rheumatoid arthritis.

d.Sprengel deformity.

b.Paget disease.

In contrast to the patient with rheumatoid arthritis (RA), the osteoarthritis patient typically exhibits:

a.pain most pronounced after periods of rest.

b.depression.

c.sudden onset.

d.less weakness and fatigue.

d.less weakness and fatigue.

Term infants normally resist:

a.ankle dorsiflexion.

b.McMurray test.

c.forefoot adduction.

d.knee extension.

d.knee extension.

A 7-year-old child who begins to limp and complains of persistent hip pain may have:

a.congenital hip dislocation.

b.Dupuytren contracture.

c.Legg-Calvé-Perthes disease.

d.osteoarthritis.

c.Legg-Calvé-Perthes disease.

Dupuytren contracture affects the:

a.hip flexor muscle.

b.rotator cuff.

c.carpal tunnel.

d.palmar fascia.

d.palmar fascia.

A dowager hump is:

a.the hallmark of osteoporosis.

b.pathognomic of scoliosis.

c.indicative of tendonitis.

d.characteristic of rickets.

a.the hallmark of osteoporosis.

A tingling sensation radiating from the wrist to the hand on striking the median nerve is a positive _____ sign

Tinel

Anterior cruciate ligament integrity is assessed via the _________ test.

Lachman

During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee, you should initially perform the __________ test.

Valgus stress

The elbow joint that allows for flexion and extension in one plane represents a type of _____ joint.

Hinge

The most mobile vertebrae are the _______________ vertebrae.

Cervical

The ___________ test is a maneuver to detect weak hip abductor muscles

Trendelenburg

The _________ or hip extension test is used to detect inflammation of the nerve root at the L1, L2, L3, and sometimes L4 level.

Femoral stretch test

__________ is used to determine the presence of excess fluid or an effusion in the knee

Ballottment

The anterior and posterior ______ is used to identify instability of the anterior and posterior cruciate ligament.

Drawer test

Tests performed to assess shoulder rotator cuff impingement or tear:

Neer test and Hawkins test

Which muscle is most often involved in a rotator cuff tear?

Supraspinatus

What is the most common congenital foot deformity?

metatarsus adductus

What disease results in avascular necrosis of the femoral head?

Legg-Calvé-Perthes