PATHO CH 51

Inflammation of the sacs that overlie bony prominences is called a. epicondylitis. b. arthritis. c. tendinitis. d. bursitis.

ANS: D Bursitis is inflammation of the bursal sacs that protect the skin over bony protuberances. Epicondylitis is inflammation of an epicondyle. Arthritis is inflammation of one or more joints. Tendinitis is inflammation of a tendon.

The pathophysiology of osteomalacia involves a. increased osteoclast activity. b. collagen breakdown in the bone matrix. c. crowding of cells in the osteoid. d. inadequate mineralization in the osteoid

ANS: D Osteomalacia is characterized by inadequate or delayed mineralization in the osteoid. Osteomalacia does not involve increased osteoclast activity, collagen breakdown in the bone matrix, or crowding of cells in the osteoid.

A fracture in which bone breaks into two or more fragments is referred to as a. comminuted. b. open. c. greenstick. d. stress.

ANS: A A fracture in which the bone breaks into two or more fragments is called a comminuted fracture. Open fractures, greenstick fractures, and stress fractures do not involve two or more bone fragments.

A patient diagnosed with diabetes, smokes a pack of cigarettes daily and eats very few green leafy vegetables. After experiencing a fractured toe, this patient is at risk for a. delayed healing. b. malunion. c. nonunion. d. dysunion.

ANS: A Fracture healing that does occur but takes longer than expected is called delayed healing. The situation is not an example of malunion or nonunion. Dysunion is not a term used to describe healing complications.

. What type of fracture generally occurs in children? a. Greenstick b. Stress c. Nightstick d. Colles

ANS: A Greenstick fractures occur most often in the growing bones of children. Stress fractures can occur at any age. Nightstick and Colles fractures occur most often in adults.

The most common source of osteomyelitis is a. an infection that migrates via the bloodstream. b. direct invasion from a fracture. c. surgical contamination. d. a joint prosthesis.

ANS: A Hematogenous osteomyelitis (via the blood stream) is the most common type of osteomyelitis. Direct invasion of infection from a fracture, infection of a bone resulting from surgical contamination, and a joint prosthesis are not the most common sources of osteomyelitis

The most common type of osteomyelitis is a. hematogenous. b. contiguous focus. c. Brodie abscess. d. direct invasion.

ANS: A Hematogenous osteomyelitis is the most common type of osteomyelitis. Contiguous focus osteomyelitis is not the most common type. Brodie abscess is when an infection becomes enclosed by fibrotic tissue. Osteomyelitis may be caused by a direct invasion of organisms into the bone, but this is not the most common cause

Healing of a fractured bone with a poor alignment is called a. malunion. b. nonunion. c. disunion. d. delayed union.

ANS: A Malunion is a complication that occurs when the bone fails to align correctly during the healing process. Nonunion and delayed union are different complications of bone healing. Disunion is not the term used for fracture healing with poor alignment

Muscular dystrophy includes a number of muscle disorders that are a. genetically transmitted. b. easily prevented and managed. c. autoimmune in nature. d. demyelinating focused

ANS: A Muscular dystrophy includes a number of muscle disorders that are genetically transmitted. Muscular dystrophy is not easily prevented or managed. It is not an autoimmune disease or a demyelinating disease.

Which disorder usually causes skeletal pain and involves significant bone demineralization from vitamin D deficiency? a. Osteomalacia b. Osteopenia c. Osteomyelitis d. Osteoporosis

ANS: A Osteomalacia is inadequate mineralization of bone tissue, most commonly caused by vitamin D deficiency, and it usually causes skeletal pain. Osteopenia, osteomyelitis, and osteoporosis are not caused by vitamin D deficiency.

Pain with passive stretching of a muscle is indicative of a. noncontractile tissue injury. b. contractile tissue injury. c. vascular insufficiency. d. skeletal muscle damage.

ANS: A Pain with passive stretching of a muscle is indicative of noncontractile tissue injury. Pain with passive stretching of a muscle is not an indication of a contractile tissue injury, vascular insufficiency, or skeletal muscle damage.

The disease that is similar to osteomalacia and occurs in growing children is a. rickets. b. osteosarcoma. c. Paget disease. d. osteopenia.

ANS: A Rickets is similar to osteomalacia in that it is caused by vitamin D deficiency and leads to soft, deformable bones. Rickets occurs in growing children. Osteosarcoma, Paget disease, and osteopenia are not similar to osteomalacia

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

ANS: A Subluxation is partial dislocation of a joint. Subjugation, sublimation, and dislocation are not the terms for partial loss of contact of articular surfaces.

A unique characteristic feature of fibromyalgia is the presence of a. tender point pain. b. head pain. c. contractures. d. muscle atrophy

ANS: A Tender point pain is a unique characteristic feature of fibromyalgia. Headache, contractures, and muscle atrophy are not unique characteristic features of fibromyalgia

Following a bone fracture, the most likely event to occur is a. development of a blood clot beneath the periosteum. b. leukocyte infiltration into bone tissue. c. blood vessel growth at the fracture site. d. migration of osteoblasts to the fracture site.

ANS: A The first step in bone healing is hematoma formation. Leukocyte infiltration into bone tissue, blood vessel growth at the fracture site, and migration of osteoblasts to the fracture site are not the first steps in bone healing.

. The most common site affected in Paget's disease is the a. lower spine. b. skull. c. pelvis. d. joints.

ANS: A The lower spine is the most common site affected in Paget's disease. The skull and pelvis are affected, but are not the most common sites. Joints are not affected in Paget's disease.

Characteristics of scoliosis include (Select all that apply.) a. involvement of lateral curvature of the spine. b. increase during periods of rapid growth. c. more common in boys. d. identifiable by uneven shoulders or scapular prominence. e. possibility of leading to respiratory complications.

ANS: A, B, D, E Scoliosis involves a lateral curvature of the spine that increases during times of rapid growth. It is evidenced by uneven shoulders or scapular prominence. If severe and untreated, it can lead to respiratory and other complications in later age. Scoliosis is more common in girls.

Manifestations of fibromyalgia often include (Select all that apply.) a. generalized pain. b. sensitivity to heat. c. headaches. d. fatigue. e. sleep disturbance.

ANS: A, C, D, E Common manifestations of fibromyalgia include generalized pain, headaches, fatigue, and difficulty sleeping. Sensitivity to cold (not heat) is common.

. Anticholinesterase inhibitors may be used to manage a. muscular dystrophy. b. myasthenia gravis. c. fibromyalgia. d. rheumatoid arthritis

ANS: B Anticholinesterase inhibitors may be used to manage myasthenia gravis. Anticholinesterase agents are not used to manage muscular dystrophy, fibromyalgia, or rheumatoid arthritis.

Compartment syndrome occurs secondary to a. bone infarction. b. soft-tissue damage. c. muscle necrosis. d. breakdown of RBCs.

ANS: B Compartment syndrome occurs because of severe soft-tissue damage. Bone infarction and the breakdown of RBCs do not cause compartment syndrome. Muscle necrosis does not cause compartment syndrome, but can result from it.

Complete healing of a bone fracture occurs when a. no movement of the break is detectable. b. the callus has been completely replaced with mature bone. c. the fracture site and surrounding soft tissue are pain free. d. a cast is no longer required to stabilize the break.

ANS: B Complete healing of a bone fracture occurs when the callus has been completely replaced with mature bone. A lack of detectable movement of the break does not indicate that the fracture is healed. Even when a bone fracture is healed, pain at the fracture site and surrounding soft tissue may be present. The patient may progress from a cast to a splint, sling, or brace as the bone fracture continues to heal.

A risk factor for osteoporosis is a. endometriosis. b. early menopause. c. late menopause. d. ovarian cysts.

ANS: B Early menopause and late menarche are risk factors for osteoporosis. Endometriosis, late menopause, and ovarian cysts are not risk factors for osteoporosis

n older women, osteoporosis is thought to be primarily because of a. dietary inadequacies. b. estrogen deficiency. c. malabsorption syndrome. d. inactivity

ANS: B In older women, osteoporosis is thought to be primarily because of estrogen deficiency. Although dietary inadequacies and inactivity play roles, the primary cause of osteoporosis in older women is thought to be because of estrogen deficiency. Malabsorption is not the primary cause of osteoporosis in older women.

Most muscle strains are caused by a. a tear in an adjoining tendon. b. abnormal muscle contraction. c. muscle asymmetry. d. bleeding into the muscle.

ANS: B Most muscle strains are caused by abnormal muscle contraction. A muscle strain can be caused by a tear in the muscle. A tendon strain can be as a result of a tear in the tendon. Muscle asymmetry is not the cause of muscle strains. Muscle strains are not caused by bleeding into the muscle.

Bone healing may be impaired by a. excessive vitamin C. b. nicotine use. c. a high-protein diet. d. immobilization.

ANS: B Nicotine can delay bone healing. Vitamin C, protein, and immobilization are necessary for bone healing

Paget's disease is characterized by a. overactivity of osteoblasts leading to multiple bone tumors. b. excessive bone resorption followed by excessive formation of fragile bone. c. inflammatory disorder resulting in fusion of spine joints. d. failure of resorption by osteoclasts resulting in hard bones.

ANS: B Paget's disease is characterized by excessive bone resorption followed by excessive formation of fragile bone. Overactivity of osteoblasts that lead to multiple bone tumors is not the cause of Paget's disease. Paget's disease is not characterized by the fusion of spine joints. Fragile bone, not hard bone, is a characteristic of Paget's disease.

. Assessment of an extremity six hours after surgical alignment and casting demonstrates pulselessness and pallor. The priority action to take is to a. increase the administration his pain medication. b. initiate action to have the cast split or removed. c. note the increase in pain in his chart, and recheck the extremity in 30 minutes. d. elevate the extremity to relieve swelling.

ANS: B The priority action is to have the cast split or removed because these are signs of compartment syndrome and emergent decompression is needed. While increasing pain medication may be appropriate, it is not the priority action. It is not the priority action to note pain increases in the chart. In compartment syndrome, extremity is not to be elevated above the heart, as that may lower venous pressure and slow arterial perfusion.

The complication which is not likely to result from a compound, transverse fracture of the tibia and fibula is a. bone infection. b. fat emboli. c. air embolus. d. compartment syndrome.

ANS: C Air embolus is not likely to occur secondary to this fracture. Bone infection is likely, because it is an open fracture. Fat emboli are likely because the fracture is in a long bone. Compartment syndrome is likely because of the extent of soft-tissue injury

A malignant bone-forming tumor is referred to as a(n) a. rhabdosarcoma. b. liposarcoma. c. osteosarcoma. d. chondrosarcoma.

ANS: C An osteosarcoma is a malignant bone-forming tumor. Rhabdo- refers to skeletal muscle. Lipo- refers to fat. Chondro- refers to cartilage

Myasthenia gravis is an autoimmune disease in which a. neuronal demyelination disrupts nerve transmission. b. muscles become increasingly bulky but weakened. c. acetylcholine receptors are destroyed or dysfunctional. d. acetylcholine release from motor neurons is disrupted

ANS: C Myasthenia gravis is an autoimmune disease in which acetylcholine receptors are destroyed or dysfunctional. Multiple sclerosis is an autoimmune disease in which neuronal demyelination disrupts nerve transmission. Muscles become weak, but not bulky, in myasthenia gravis. Acetylcholine receptors are destroyed or dysfunction in myasthenia gravis

A bone disorder that results from insufficient vitamin D is referred to as a. rickets. b. osteoporosis. c. osteomalacia. d. subluxation.

ANS: C Osteomalacia is caused by vitamin D deficiency in adults. Rickets is caused by vitamin D deficiency in children. Osteoporosis is related to decreased estrogen. Subluxation refers to a bone displacement.

. The disorders characterized by softening and then enlargement of bones is referred to as a. osteomyelitis. b. osteoporosis. c. Paget disease. d. rickets.

ANS: C Paget disease is characterized by excessive bone resorption and formation, causing fractures and deformities. Osteomyelitis, osteoporosis, and rickets do not involve softening and then enlargement of bones

The most common symptom of multiple myeloma is a. pathologic fracture. b. fever. c. bone pain. d. osteomyelitis.

ANS: C The most common symptom of multiple myeloma is bone pain. Although pathologic fractures occur in multiple myeloma, bone pain is the most common symptom. Fever and osteomyelitis are not common in multiple myeloma.

The person at highest risk of a greenstick fracture from falling off a tall ladder is age a. 68. b. 44. c. 8. d. 23.

ANS: C Greenstick fractures occur primarily in children. The adults are not at high risk for greenstick fracture.

People who have osteoporosis are at risk for a. rhabdomyolysis. b. osteomyelitis. c. osteomalacia. d. bone fractures.

ANS: D Osteoporosis weakens the bone structure and increases the risk of bone fractures. Rhabdomyolysis, osteomyelitis, and osteomalacia are completely different conditions.

Pain in fibromyalgia involves a. muscle inflammation. b. autoimmune destruction of muscle tissue. c. nerve inflammation. d. changes in pain transmission in the spinal cord.

ANS: D Pain in fibromyalgia involves changes in pain transmission in the spinal cord that are called central sensitization. Muscle inflammation, nerve inflammation, and autoimmune destruction of muscle tissue do not cause the pain in fibromyalgia

Rickets is characterized by soft, weak bones resulting from a deficiency of a. calcium. b. estrogen. c. phosphate. d. vitamin D

ANS: D Rickets is characterized by soft, weak bones resulting from vitamin D deficiency. Rickets is not caused by poor calcium intake or phosphate deficiency. Estrogen deficiency is related to osteoporosis, not rickets.

A compound, transverse fracture is best described as a bone that is a. broken in two or more pieces. b. cracked but not completely separated. c. broken along the long axis. d. broken and protruding through the skin

ANS: D The type of fracture described is broken and protruding through the skin. A comminuted fracture is one that is broken in two or more pieces. An incomplete fracture is cracked but not completely separated. A longitudinal fracture is broken along the long axis.