Deck 5: Musculoskeletal System: Structure, Function, and Evaluation

Question 1

You are doing an orthopedic evaluation on a 13-month-old child. The parents are concerned that the child isn't walking. Select the finding that is atypical in a 13-month-old child.

A) The child has no visible longitudinal arch in standing (flat feet).
B) The child has a 3-degree hip flexion contracture.
C) The child has genu valgum.
D) The child has a straight lateral border of the foot.

Answer 1

C
Explanation: Children at this age have genu valgum.

Question 2

A full-term, typically developing neonate will have which following range of motion?

A) Limitations in hip flexion and elbow flexion and excessive plantar flexion
B) Limitations in hip extension and elbow extension and excessive plantar flexion
C) Limitations in plantar flexion and excessive hip flexion and elbow extension
D) Limitations in hip extension and elbow extension and excessive dorsiflexion

Answer 2

D
Explanation: Babies are born with physiological flexion, which limits hip and elbow extension. Babies are also born with more than normal dorsiflexion range and less than normal plantar flexion. These situations occur due to the compression of the fetus in the uterus.

Question 3

It is common to see the most significant genu valgum posture (knock-kneed) in children around ______year(s) of age.

A) 1
B) 19
C) 4
D) 12

Answer 3

C
Explanation: Knee posture starts in genu varum at birth, moves into genu valgum around age 4, and then moves into a more neutral alignment.

Question 4

It is typical for a 24-month old to have a hip flexion contracture of about 10 degrees.

Question 5

The clavicle, mandible, and facial and cranial flat bones develop directly in vascularized mesenchyme through a process called

A) endochondral ossification.
B) mesodermal outgrowth.
C) differentiating chondroblasts.
D) intramembranous ossification.

Question 6

Cadence is

A) highest in adolescence.
B) very high in 1-year-old walkers.
C) highest in toddlers.
D) stable during maturation of gait.

Question 7

Variability in joint angle or kinematic patterns during gait is most common in

A) young independent walkers.
B) toddlers.
C) adolescents.
D) running.

Question 8

When performing the hip prone extension test, you should

A) stabilize the pelvis prior to measuring.
B) allow the "non-testing" foot to rest gently on the floor.
C) position the child with one hip on the edge of the plinth and the other securely on the plinth.
D) test both sides at the same time.

Question 9

Measuring a child's thigh-foot angle gives you an indication of the amount of

A) twisting of the long axis of the tibia (version).
B) hamstring limitation.
C) genu valgum.
D) metatarsus adductus.

Question 10

Select the factor(s) that contributes to neonatal hip instability.

A) Synovial viscosity
B) High neck shaft angle of inclination
C) 30 degrees of retrotorsion
D) Spherical femoral head

Question 11

Select the correct definition(s):

A) Antetorsion is a posterior rotation through the long axis of the femur.
B) Retrotorsion results in a posterior rotation of the neck of the femur in relation to the acetabulum.
C) Anteversion refers to the position of the head of the femur relative to its position in the acetabulum.
D) Retroversion places the leg into external rotation.

Question 12

Reciprocal arm swing

A) starts to emerge at age 4 years.
B) is correlated with decreased base of support.
C) is common with hand high guard.
D) is common in early walkers.

Question 13

The spine of a newborn infant is initially in a

A) scolotic position.
B) kyphotic position.
C) straight position.
D) lordotic position.

Question 14

Cartilage provides the initial prenatal structure for the development of bone.

Question 15

To estimate the amount of metatarsus adductus present, you should draw a line that bisects the child's metatarsals and then draw a second line that is perpendicular to this line and bisects the calcaneus.

Question 16

A tape measure is a more accurate method to measure an actual leg length discrepancy than the block method.

Question 17

After initial development, bone shape can be changed through a process called

A) metaphysis.
B) calcification.
C) ossification.
D) modeling.

Question 18

The kinematics of a child's gait are generally mature by which age?

A) 2 years
B) 4 years
C) 7 years
D) 9 years

Question 19

A flexible flat foot in a typically developing 3 -year-old is a concerning finding and should be referred to an orthopedic physician for further evaluation.