Human Anatomy and Physiology : Help with Evaluation Methods for Muscles, Ligaments, Tendons

Study concepts, example questions & explanations for Human Anatomy and Physiology

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Example Questions

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Example Question #1491 : Human Anatomy And Physiology

Compartment syndrome is a condition in which pressures around skeletal muscles rise to a level that cuts off blood flow and compresses nerves around the muscles. A 66-year old woman is involved in a high-speed motor vehicle collision and presents with a left femoral shaft fracture. After fixing her bone with an intramedullary rod, the patient is taken to the recovery room. Upon waking she complains of intense pain in her left thigh as well as sensory deficits in the anterior portion of the same thigh. You diagnose her with compartment syndrome and suspect that a nerve is being compromised.

If left untreated, what action do you expect the patient will not be able to perform?

Possible Answers:

Plantar flex the ankle

Evert the foot

Flex the knee

Extend the knee

Dorsiflex the ankle

Correct answer:

Extend the knee

Explanation:

It is likely that the compartment syndrome is compromising the femoral nerve, which would result in an inability to extend the knee. We need to know that the femoral nerve runs close to the femur in the anterior compartment of the thigh. The high compartment pressures have cut off blood supply and compromised the femoral nerve, as evidenced by sensory deficits in the anterior thigh.

The femoral nerve arises from L2-L4 in the lumbar plexus and innervates the quadriceps muscles, which serve to extend the knee.

Flexion of the knee is accomplished by the hamstring muscles, which are supplied by common peroneal and tibial nerves. Eversion of the foot is a function of the peroneus longus and brevis, innervated by the superficial peroneal nerve. Plantar flexion is accomplished by the tibialis anterior, supplied by the deep peroneal nerve. Dorsiflexion is by the tibialis posterior, supplied by the tibial nerve.

Example Question #1492 : Human Anatomy And Physiology

Which of the following would indicate damage to the posterior cruciate ligament?

Possible Answers:

Anterior displacement of the tibia relative to the femur

Enlargement of the femoral epicondyles

Posterior displacement of the tibia relative to the femur

Enlargement of the tibial tuberocity

A positive anterior drawer test

Correct answer:

Posterior displacement of the tibia relative to the femur

Explanation:

The posterior cruciate ligament (PCL) is a large ligament located in the center of the knee behind the anterior cruciate ligament. The primary role of the PCL is to provide stability and prevent posterior deviation of the tibia relative to the femur. A posterior drawer test or tibial sag test can be used to assess PCL injury or damage.

In contrast, the anterior cruciate ligament (ACL) prevent anterior deviation of the tibia relative to the femur. Damage to the ACL can be assessed with an anterior drawer test.

Example Question #1493 : Human Anatomy And Physiology

What are the boundaries that define the axilla?

Possible Answers:

Pectoralis major, deltoid, humerus, scapula, trapezius

Deltoid, biceps brachii, supraspinatus, serratus anterior, teres major

Pectoralis major, latissimus dorsi, teres major, humerus, serratus anterior, subscapularis

Clavicle, pectoralis major, supraspinatus, latissimus dorsi, humerus, serratus anterior

Deltoid, Pectoralis major, latissimus dorsi, clavicle, subscapularis

Correct answer:

Pectoralis major, latissimus dorsi, teres major, humerus, serratus anterior, subscapularis

Explanation:

The axilla is an important area housing a large region of the brachial plexus. It is located between the rib cage, scapula, and humerus. More specifically, it is bounded by:

  • The pectoralis major muscle anteriorly
  • The latissimus dorsi, teres major, and subscapularis muscles posteriorly
  • The shaft of the humerus laterally
  • The serratus anterior and rib cage medially

The clavicle, supraspinatus, deltoid, and biceps brachii all lie outside of the axilla region. 

Example Question #1494 : Human Anatomy And Physiology

A positive pivot-shift test of the knee, even after a successful anterior cruciate ligament (ACL) reconstruction suggests lack of structural integrity of what ligament?

Possible Answers:

Anterolateral ligament (ALL)

Arcuate popliteal ligament

Tibial collateral ligament

Posterior cruciate ligament (PCL)

Fibular collateral ligament

Correct answer:

Anterolateral ligament (ALL)

Explanation:

Although it's function has only recently been described, surgical literature suggests that the anterolateral ligament functions to provide additional rotary stability to the knee. Because of this, some patients who have had an ACL reconstruction, but not an ALL reconstruction, will demonstrate a positive pivot-shift sign, a sign of knee rotational instability upon flexion of the tibia at the knee during medial rotation.

Example Question #1495 : Human Anatomy And Physiology

While testing a patient with shoulder pain, you find that he has a positive anterior slide and positive crank tests. Based on these results, what pathology is the most likely cause of his symptoms?

Possible Answers:

Acromioclavicular ligament sprain

Teres minor tendon tear

Glenoid labrum tear

Clavicle fracture

Subscapularis tendon tear

Correct answer:

Glenoid labrum tear

Explanation:

The anterior slide and crank tests are tests for tears of the glenoid labrum. The following are common tests, with varying diagnostic value, for the other pathologies listed: O'Brien's test (acromioclavicular ligament injury), horn blower's sign (teres minor tear), lift off sign (subscapularis tear), and olecranon-manubrium-percussion test (clavicle fracture).

Example Question #1496 : Human Anatomy And Physiology

A patient comes to you complaining of hip pain. After preforming your exam, you suspect she has avulsed her sartorius from its origin. You order some diagnostic imaging to confirm your diagnosis.

Based on these suspicions, you would expect imaging to show injury to which bony prominence?

Possible Answers:

Anterior inferior iliac spine (AIIS)

Ischial ramus

Anterior superior iliac spine (ASIS)

Tibial tuberosity

Ischial tuberosity

Correct answer:

Anterior superior iliac spine (ASIS)

Explanation:

The origin of the sartorius Anterior superior iliac spine (ASIS). Accordingly, if the sartorius avulsed from its origin, we would suspect damage to this bony prominence.

Example Question #1497 : Human Anatomy And Physiology

Your patient’s x-ray shows a “Terry Thomas/David Letterman” sign. This finding suggests injury to which structure?

Possible Answers:

Triangular fibrocartilage complex

Radial collateral ligament of the wrist

Ulnar collateral ligament of the wrist

Anterior talofibular ligament

Scahpolunate ligament

Correct answer:

Scahpolunate ligament

Explanation:

The "Terry Thomas/David Letterman" sign is specific to the articulations of the wrist, and involves injury to the scapholunate ligament. When this ligament is damaged, the scaphoid and lunate drift apart, creating a gap on x-rays reminiscent of  the gap in Terry Thomas'/David Letterman's front teeth.

Example Question #1 : Help With Evaluation Methods For Muscles, Ligaments, Tendons

A patient comes to you complaining of knee pain, after playing soccer two days ago. He states that he felt a “pop” and that he is reluctant to bear weight on his injured knee.

Which of the following findings would make you think he injured his anterior cruciate ligament (ACL)?

Possible Answers:

Positive Lachman’s test

Positive Thessaly test

Positive McMurray’s test

Positive valgus stress test

Positive sag sign

Correct answer:

Positive Lachman’s test

Explanation:

Lachman's test has good diagnostic value for ACL tears. The McMurray's and Thessaly tests have mixed diagnostic value, and test for meniscus injuries, the valgus stress tests is a test for tibial collateral ligament injury, and the sag sign tests for posterior cruciate ligament (PCL) injury.

Example Question #2 : Help With Evaluation Methods For Muscles, Ligaments, Tendons

which test would be used to determine an anterior cruciate ligament (ACL) rupture?

Possible Answers:

Godfrey's (90-90)

Posterior drawer

McMurray's

Quadriceps active test

Lachman's

Correct answer:

Lachman's

Explanation:

A Lachman's test requires the clinician to apply an anterior force on the tibia, looking for an end-feel (or resistance created by the ACL). Godfrey's (90-90), posterior drawer and quadriceps active test all test for a rupture, or sprain of the posterior cruciate ligament (PCL). McMurray's tests for meniscal tear.

Example Question #3 : Help With Evaluation Methods For Muscles, Ligaments, Tendons

Which structure(s) would have a tensile force applied with hyperflexion of the knee?

Possible Answers:

Iliotibial band (ITB) and medial collateral ligament (MCL)

Medial collateral ligament (MCL)

Lateral collateral ligament (LCL)

Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)

Medial collateral ligament (MCL) & lateral collateral ligament (LCL)

Correct answer:

Anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL)

Explanation:

The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) are both affected with hyperflexion of the knee, as these two ligaments are located deep inside the knee capsule, and prevent anterior and posterior sheering forces. If this action occurred with enough force, these structures would be injured. The sedial collateral ligament (MCL) and lateral collateral ligament (LCL) would be injured with a valgus or varus force, both with occur in the coronal plane. The iliotibial band (ITB) and and medial collateral ligament (MCL) would require multiplaner forces in order to be injured. 

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