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Chapter 1

Anatomy and Kinesiology

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SCHUCMANN RETEST A A. Biceps D. deltoid
B. pronator teres E. rhomboids
Directions: Each of the questions or incomplete statements C. supraspinatus
below is followed by five suggested answers or completions. 13. During abduction of the arm, the infraspinatus,
Select the single BEST answers in each case. subscapularis, and teres minor muscles contract. What is
the purpose of their contraction during this movement? D
1. The term “kinesiology” refers to the study of B A. to add additional power to the action of abduction
A. muscle anatomy B. to help initiate abduction
B. movements C. to prevent uncontrolled rotation during abduction
C. ligamentous stress analysis D. to hold the humeral head in its socket
D. limb circulation E. all of the above
E. none of the above 14. Injury to the radial nerve in the spiral groove would result
2. Lordosis of the spine normally occurs in which spinal in weakness of E
area(s)? A. elbow flexion D. thumb adduction
A. cervical D. both A and C B. elbow extension E. wrist extension
B. thoracic E. all of the above C. wrist flexion
C. lumbar 15. A patient with a musculocutaneous nerve injury is still able
3. Functions of the human vertebral column include E to flex the elbow. The major muscle causing this elbow
A. protection D. both A and C flexion is the A
B. support E. all of the above A. Brachioradialis D. extensor carpi ulnaris
C. mobility B. flexor carpi ulnaris E. pectoralis major
4. The nerve that supplies cutaneous sensation to the C. pronator quadratus .
dorsum of the medial one and one-half fingers is the C 16. Which of the following muscles is not innervated by the
A. posterior antebrachial cutaneous median nerve? C
B. superficial radial A. abductor pollicis brevis
C. ulnar B. flexor pollicis longus
D. median C. medial heads of flexor digitorum profundus
E. lateral brachial cutaneous D. superficial head of flexor pollicis brevis
5. The muscle(s) that are active during the initiation of E. pronator quadratus
humeral abduction is (are) D 17. The nerve that innervates the first lumbrical muscle in the
A. supraspinatus hand is the A
B. infraspinatus A. median nerve
C. deltoid B. ulnar nerve
D. both A and C C. radial nerve
E. all of the above D. anterior interosseus nerve
6. The muscle that is active during all movements of the E. lateral cutaneous nerve of the hand (1:39)
arms is the 18. After a nerve injury, regeneration occurs proximally first
A. supraspinatus D. deltoid and then progresses distally at a rate of about 1-mm per
B. pectoralis major E. subscapularis day. Following a radial nerve injury in the axilla, which
C. pectoralis minor muscle would be the last to recover? C
7. During the mid stance phase of the gait cycle, the knee is A. long head of the triceps
normally held in which position D B. anconeus
A. five degrees of hyperextension C. extensor indicis
B. full extension D. extensor digiti minimi
C. five degree of flexion E. supinator
D. fifteen degrees of flexion 19. A bony mass is vaguely felt in the posterior midline of the
E. All of the above could be true, knee position varies neck about two fingerbreadths beneath the occipital
from person to person. protuberance. It is the
8. During the normal gait cycle, when do the hamstrings A. inferior articular process of C!
have their maximum activity? D B. spinous process of the axis
A. just after heel - strike C. spinous process of the atlas
B. just after toe - off D. spinous process of C7
C. during mid - stance E. odontoid process
D. during the end of the swing phase 20. The number of vertebrae present at birth is approximately
E. hamstrings remain inactive during normal walking A. 26 D. 36
9. The pretibial group of muscles is maximally active at which B. 29 E. 37
portion of the gait cycle? C. 33
A. toe - off 21. The number of vertebrae present in an adult is generally:
B. swing - through A
C. heel - strike A. 26 D. 36
D. foot - flat B. 29 E. 37
E. heed - rise C. 33
10. The maximum activity of the gluteus medius and minimus 22. Intervertebral discs are responsible for approximately what
muscles occurs at which point in the normal gait cycle? percentage of the total length of the vertebral column? E
A. toe off A. 5% D. 20%
B. swing through B. 10% E. 25%
C. heel strike C. 15%
D. mid - stance 23. After a compression fracture of a vertebral body, stability
E. heel - rise of the spine is maintained by which ligament? D
11. A patient presents with severe weakness of the deltoid A. ligamentum flavum
muscle and wrist extensors. Where would the lesion B. posterior longitudinal ligament
probably be located? B C. interspinous ligament
A. C6 nerve root D. anterior longitudinal ligament
B. posterior cord of the brachial plexus E. supraspinous ligament
C. C7 nerve root 24. The most common direction of disc protrusion causing
D. middle trunk of the brachial plexus neurological involvement in the lumbar area is B
E. radial nerve A. Posterior D. anterolateral
12. A patient was involved in a motorcycle accident and it is B. Posterolateral E. anterior
suspected that he may have avulsed his C5 nerve root at C. lateral
its origin. To test this impression, what is the best muscle 25. The most limited motion in the lumbar spine is C
to check electro physiologically? E A. flexion

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B. lateral bending D. just anterior to the S2 vertebra
C. rotation E. 1 cm posterior to the upper one fourth of the lemur
D. extension 36. The most important flexor of the shoulder joint is the D
E. the lumbar spine is not limited in any direction of A. coracobrachialis
movement B. biceps brachii
26. The chief motion permitted in the thoracic spine is C C. clavicular head of the pectoralis major
A. flexion D. anterior portion of the deltoid
B. rotation E. serratus anterior
C. lateral bending 37. Erb’s palsy involves injury to the upper trunk of the brachial
D. extension plexus. What is the typical posture of a limb affected by
E. the thoracic spine is virtually immobile Erb’s palsy? E
27. A patient com plains of a burning sensation in the A. extension, abduction and internal rotation
anterolateral aspect of the thigh. Dysfunction of which B. flexion, adduction, and external rotation
nerve could lead to these symptoms? A C. extension, abduction and external rotation
A. lateral femoral cutaneous D. flexion, adduction and internal rotation
B. femoral E. extension, adduction and internal rotation
C. obturator 38. Which of the following flexor muscles is not innervated by
D. genitofemoral the median nerve? B
E. ilioinguinal A. flexor carpi radialis D. flexor digitorum superficials
28. The sciatic nerve consists of two divisions (medial and B. flexor carpi ulnaris E. flexor pollicis longus
lateral) which eventually separate into distinct nerves. The C. palmaris longus
medial and lateral divisions, respectively, form the B 39. The anterior interosseus branch of the median nerve
A. femoral and obturator nerve innervates which muscles? D
B. tibial and common peroneal nerves A. flexor pollicis longus
C. obturator and femoral nerve B. pronator teres
D. common peroneal and tibial nerves C. pronator quadratus
E. obturator and tibial nerves D. both A and C
29. The subtalar joint of the foot is an articulation between the E. all of the above
A 40. Most of the power for forearm supination is supplied by
A. calcaneus bones and talus which of the following muscles? D
B. talus and navicular bone A. palmaris longus
C. calcaneus and cuboid bone B. pronator quadratus
D. tibia and talus C. supinator
E. cuboid and navicular bones D. biceps
30. The saphenous nerve supplies cutaneous sensation to the E. brachioradials
medial aspect of the leg. From which nerve does the 41. A birth injury which results in injury to the lower portion of
saphenous nerve arise? D the brachial plexus is referred to as C
A. obturator A. Bell’s palsy
B. peroneal B. Erb’s paralysis
C. sciatic C. Klumpke’s paralysis
D. femoral D. Saturday night palsy
E. the saphenous nerve arises as a direct branch from E. Tinel’s sign
the sacral plexus 42. To perform the act of opposition of the thumb, rotation must
31. The tibial nerve passes into the foot where in divides into occur at which joint? C
its terminal branches. What route does the tibial nerve A. radioulnar
follow to enter the foot? E B. Intercarpal
A. it passes along the dorsal aspect of the ankle, then into C. Carpometacarpal
the foot D. Proximal interphalangeal
B. it passes anterior to the lateral malleolus E. Distal interphalangeal
C. it passes under the flexor retinaculum and posterior to 43. The median nerve passes into the hand by B
the lateral malleolus A. passing through the pronator quadratus muscle
D. it passes anterior to the medial malleolus B. passing beneath the flexor retinaculum
E. it passes under the flexor retinaculum and posterior to C. passing through Guyon’s canal
the lateral malleolus D. piercing the intermuscular septum
32. To plantarflex the foot against a load of 100 pounds, E. none of the above
approximately how much force must be generated by the 44. The flexor digitorum profundus muscle is primarily a flexor
triceps surae muscle? D of which joints? E
A. 50 lbs. D. 200 lbs. A. metacarpophalangeal
B. 100 lbs. E. 250 lbs. B. proximal interphalangeal
C. 150 lbs. C. intercarpal
33. Injury to the deep branch of the peroneal nerve would D. radiocarpal
result in a sensory deficit to which of the following E. distal interphalangeal
locations? E 45. The lumbar plexus is occasionally injured at the point
A. medial side of the foot where it passes through a muscle. The muscle
B. lateral side of the foot causing the compression is the E
C. lateral one and one half toes A. gluteus maximus
D. medial border of the sole of the foot B. gluteus medius
E. adjacent dorsal surfaces of the first and second toes C. quadratus lumborum
34. A brachial plexus injury involving the upper portion of the D. obturator externus
plexus produces winging of the scapula. Weakness of E. psoas major
which of the following muscle would produce the winging 46. The quadriceps femoris is an important knee extensor.
observed? E Which portion of this muscle also causes hip flexion? D
A. long head of the triceps A. vastus medialis
B. supraspinatus B. vastus intermedius
C. deltoid C. vastus lateralis
D. pectoralis major D. rectus femoris
E. serratus anterior E. the vastus lateralis and vastus medialis act together to
35. The center of gravity of the human body is located D produce hip flexion
A. at the level of the T12 vertebar 47. The adductor magnus muscle is innervated by two nerves.
B. just anterior to the T6 vertebra These nerves are the D
C. at the level of the xiphoid process A. posterior branches of the obturator and femoral

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B. sciatic and anterior branches of the obturator B. supinator E. biceps
C. femoral and anterior branches of the obturator C. deltoid
D. posterior branches of the obturator and sciatic 60. The muscle which compose the triceps surae are the
E. femoral and sciatic 1. soleus
48. The “spring ligament” is thought to provide some elasticity 2. plantaris
to the arch of the foot. Another name for the “spring 3. gastrocnemius
ligament” is the E 4. flexor hallucis longus
A. long plantar ligament A. if only 1,2 and 3 are correct
B. metatarsal interosseus ligament B. if only 1 and 3 are correct
C. tarsal interosseus ligament C. if only 2 and 4 are correct
D. dorsal tarsal ligament D. if only 4 is correct
E. plantar calcaneonavicular ligament E. if all are correct
49. In the neck, the joint where the maximum amount of 61. Muscles innervated by the superficial branch of the
rotation occurs is the B peroneal nerve include the
A. altantooccipital joint D. C5/ C6 interspace 1. peroneus longus
B. atlantoaxial joint E. C6/C7 interspace 2. peroneus tertius
C. C3/C4 interspace 3. peroneus brevis
50. In the neck, the joint where the maximum amount of the 4. tibialis anterior
flexion-extension occurs is the A A. if only 1,2 and 3 are correct
A. atlantooccipital joint B. if only 1 and 3 are correct
B. atlantoaxial joint C. if only 2 and 4 are correct
C. C3/C4 interspace D. if only 4 is correct
D. C5/C6 interspace E. if all are correct
E. C6/C7 interspace 62. Muscle that participate in upward shrugging of the shoulder
51. The most limited motion in the lumbar spine is C include the
A. flexion 1. rhomboid major
B. extension 2. levator scapula
C. rotation 3. rhomboid minor
D. lateral bending 4. trapezius
E. none of the above A. if only 1,2 and 3 are correct
52. The chief muscle used for supination of the forearm with B. if only 1 and 3 are correct
the elbow fully extended is the A C. if only 2 and 4 are correct
A. supinator D. if only 4 is correct
B. brachioradialis E. if all are correct
C. biceps 63. Abduction of the shoulder is performed by which of the
D. pronator teres following muscles?
E. palmaris longus 1. infraspinatus
53. The primary support for the low back in the position of full 2. supraspinatus
forward flexion is provided by the B 3. teres minor
A. abdominal muscle 4. deltoid
B. vertebral ligaments A. if only 1,2 and 3 are correct
C. errector spinae muscle B. if only 1 and 3 are correct
D. iliotibial band C. if only 2 and 4 are correct
E. costovertebral ligaments D. if only 4 is correct
54. The shoulder joint is capable to much motion but sacrifices E. if all are correct
some stability to achieve this degree of motion. The 64. The deltoid muscle helps produce which of the following
weakest portion of the shoulder joint capsule is located D shoulder motions?
A. Anteriorly D. inferiorly 1. flexion
B. Posteriorly E. superiorly 2. extension
C. laterally 3. adduction
55. Which of the following muscle movement dislocation of the 4. abduction
shoulder in the position of full abduction E A. if only 1,2 and 3 are correct
A. supraspinatus B. if only 1 and 3 are correct
B. infraspinatus C. if only 2 and 4 are correct
C. teres minor D. if only 4 is correct
D. subscapularis E. if all are correct
E. all of the above 65. Ligaments found along the lateral aspect of the ankle joint
56. In unresisted pronation of the forearm, which muscle is the include the
prime mover? A 1. anterior talofibular
A. pronator quadratus 2. calcaneofibular
B. pronator teres 3. postenor talofibular
C. brachioradialis 4. calcaneonavicular
D. flexor carpi ulnaris A. if only 1,2 and 3 are correct
E. biceps B. if only 1 and 3 are correct
57. The primary extensor of the metacarpopphalangeal joints C. if only 2 and 4 are correct
in the hand is the A D. if only 4 is correct
A. extensor digitorum E. if all are correct
B. extensor carpi radialis longus
C. extensor carpi ulnaris Matching Type A
D. dorsal interossei muscles A. sciatic nerve
E. palmaraneorossei muscle B. peroneal nerve
58. The primary importance of the lumbrical muscles of the C. femoral nerve
hand is in B D. tibial nerve
A. flexion of the metacarpopphalangeal joints E. obturator nerve
B. extension of the interphalangeal joints
C. abduction of the fingers
D. flexion of the carpometacarpal joints 66. nerve primarily responsible for knee extension
E. flexion of the radiocarpal joint 67. nerve primarily responsible for knee flexion
59. The axillary nerve can occasionally be injured, where it 68. nerve primarily responsible for hip adduction
passes through a muscle. Which muscle would this be? D 69. nerve primarily responsible for eversion of the foot
A. pronator teres D. coracobrachialis 70. nerve primarily responsible for ankle dorsiflexion

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Chapter 1
Answers and Commentary
1. D. Kinesiology is the study of bone and joint deltoid muscle is also active during the initiation
movement and includes consideration of muscle of abduction.
function and joint mechanics. 6. D. The deltoid muscle is divided into three
2. D. The term “lordosis” describes the type of functional components: anterior, lateral, and
spinal curve normally found in the lumbar region- posterior. While one portion serves as the prime
the “arch” of the back – and in the cervical region. mover the other two portions often function as
The spinal curve found in the thoracic region is stabilizers.
referred to as a kyphosis. 7. D. During the normal gait cycle the knee is fully
3. E. The vertebral column supports the trunk, extended at both heel-strike and toe-off, but is
provides mobility for various activities, and flexed during mid-stance. An early sign of
protects the spinal cord and posterior aspects of weakness of the quadriceps is the absence of
the thoracic and abdominal regions. flexion during mid-stance.
4. C. The ulnar nerve supplies cutaneous 8. D. At the end of the swing phase of the gait
sensation to both the palmar and dorsal aspects cycle, the hamstring muscles becomes active.
of the medial one and one half fingers. They perform a lengthening contraction and help
5. D. Early kinesiologic studies reported that the decelerate the swinging leg.
supraspinatus muscle alone initiated humeral 9. C. The peak in activity of the pretibial muscles
abduction. Later studies have shown that the during heel-strike prevents the foot from slapping
down on the floor. By performing a lengthening
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contraction, the foot is gradually brought into full 22. E. In normal adults intervertebral discs
contact with the ground. contribute about 25% of the total vertebral
10. D. During the stance phase of the gait cycle, the column height. During the aging process disc
gluteus medius and gluteus minimus muscles are degeneration occurs and the disc spaces
active. These muscles function to help keep the gradually narrow. This accounts for a loss of
trunk balanced over the support leg. height in the older person.
11. D. The deltoid muscle is innervated by the C5 23. B. The broad anterior longitudinal ligament
and C6 nerve roots and by the axillary nerve, stretches form the sacrum to the occiput. Since
which is formed from the posterior cord of the compression fractures will usually involve
brachial plexus. The wrist extensors are damage to the anterior portions of the vertebral
innervated primarily by the C7 and C8 nerve bodies, hyperextension of the spine will tighten
roots and the radial nerve. The radial nerve is the anterior longitudinal ligament and help pull
also formed from the posterior cord of the the fracture fragments back into position.
brachial plexus would be the most likely site for 24. B. In the lumbar area the posterior longitudinal
the lesion. ligament narrows so that at the L5/S1 interspace,
12. E. The nerve to the rhomboid muscles--the the ligament covers only the central area of the
dorsal scapular nerve—originates directly from disc. The posterolateral areas are not covered by
the C5 nerve root. Abnormalities of the muscle in this ligament and are the most common sites of
this case would help localize the lesion to the C5 disc herniation.
nerve root. All of the other upper (and lower) 25. C. Lateral motion and flexion-extension are
extremity muscles are innervated by more than relatively free in the lumbar spine, but rotation is
one spinal nerve segment. extremely free in the lumbar spine, but rotation is
13. D. When the deltoid muscle acts alone it has a extremely limited because of the anatomical
tendency to elevate the humeral head rather than alignment of the articular facet joints.
to abduct the arm. The infraspinatus, 26. B. In the thoracic spine, flexion and extension
subscapularis, and teres minor muscles help are limited because of the orientation of the
stabilize the humeral head and permit the deltoid articular facet joints. The ribs also limit these
muscle to abduct the arm rather than elevate the motions. Lateral bending is the freest movement
humeral head. in the thoracic spine.
14. D. The radial nerve branches to the triceps 27. A. The lateral femoral cutaneous nerve is
usually arise proximally before the nerve has left occasionally compressed at or near the inguinal
the axilla. ligament. This leads to paresthesias and
15. A. The brachioradialis muscles originates dysesthesias along the anterolateral aspect of
proximally enough on the humerus and passes the thigh—an entity known clinically as meralgia
far enough in front of the elbow to be an efficient paresthetica.
elbow flexor. The muscle is most efficient when 28. D. The medial (tibial) and lateral (common
the thumb is up. peroneal) portions of the sciatic nerve separate
16. C. The lateral portion of the flexor digitorum just above the knee.
profundus muscles is innervated by the anterior 29. E. The subtalar joint is important because it
interosseous branch of the median nerve, while permits inversion and eversion of the hindfoot.
the medial portion of the muscle is innervated by 30. D. Injuries to the femoral nerve present with
the ulnar nerve. sensory deficit along the medial aspect of the leg
17. A. In the hand, the median nerve innervates the owing to saphenous nerve involvement.
first two lumbricals, the hypothenar muscles, the 31. E. The tibial nerve (or its branches) is
adductor pollicis, and the deep head of the flexor occasionally compressed as it passes under the
pollicis brevis. flexor retinaculum, giving rise to what is known as
18. C. The extensor indicis is the last muscle to be the tarsal tunnel syndrome.
innervated by the radial nerve and is therefore 32. D. The lever arm over which the triceps surae
thel ast muscle to recover following an injury to must act is rather short, and much force must
the radial nerve. therefore be generated to achieve plantar flexion.
19. B. The spinous process of C2 (the axis) can be Other muscles which pass posteriorly to the
palpated with some difficulty. Below this level the malleoli can also contribute to plantar flexion, but
spinous processes are buried by the neck these muscles have extremely short lever arms
musculature until the C6/C7 level is reached. and together can generate a force of only 5 to
20. C. Vertebrae generally found at birth include 7 15% that of triceps surae.
cervical vertebrae, 12 thoracic vertebrae, 5 33. E. The superficial branch of the peroneal nerve
lumbar vertebrae, 5 sacral vertebrae, and 3 or 4 innervates most of the dorsum of the foot, with
coccygeal vertebrae. the sensory distribution of the deep branch being
21. A. In the adult there are generally 7 cervical limited to the adjacent surfaces of the great and
vertebrae, 12 thoracic vertebrae, 5 lumbar second toes.
vertebrae, 1 sacrum, and 1 or 2 coccygeal 34. E. The long thoracic nerve originates proximally
vertebrae. from the C5, C6, and C7 nerve roots. The

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serratus anterior muscle is innervated by this 50. A. The atlantooccipital joint allows flexion and
nerve. Winging of the scapula occurs with extension, but minimal rotation or lateral bending.
serratus anterior weakness and most prominent 51. C. Minimal rotation occurs in the lumbar spine
when the arm is held in front of the body. because of the anatomical alignment of the facet
35. D. During normal relaxed standing the major joints. These joints tend to lock together when
support of the body is ligamentous. Except for the rotation is attempted.
calf muscles, the muscles are essentially inactive 52. A. With the elbow in a flexed position, the biceps
during relaxed standing. muscle is the major forearm supinator. Full elbow
36. D. In addition to being the most important extension reduces the mechanical advantage of
shoulder flexor, the anterior deltoid muscle also the biceps and causes the supinator muscle to
participates in internal rotation of the shoulder. assume the major role in forearm supination.
37. E. The muscles affected by Erb’s palsy are 53. D. During the initiation of trunk forward flexion,
those innervated by C5 and C6. Included are the the erector spinae muscles are quite active
major shoulder and elbow flexors as well as the during full forward flexion the erector spinae
shoulder abductors and external rotators. Muscle muscles relax and the primary support is
imbalance between the normally functioning ligamentous. For this reason patient should be
muscles results in the typical deformity. taught to lift with their backs.
38. B. The flexor carpi ulnaris muscles is innervated 54. D. Because the weakest portion of the shoulder
by the ulnar nerve. joint capsule is located inferiorly, the shoulder is
39. D. In addition to innervating the pronator least stable in a position of abduction.
quadratus and flexor pollicis longus muscles, the 55. E. The “rotator cuff” muscles are the primary
anterior interosseus nerve also innervates the stabilizers of the shoulder joint in the position of
lateral portion of the flexor digitorum profundus humeral abduction.
muscle. 56. A. The pronator quadratus muscle is the prime
40. D. The biceps muscle supplies most of the pronator of the forearm during both fast and slow
power for supination and is most efficient when pronation when the movement is unresisted.
the elbow is in the flexed position. 57. A. The extensor digitorum muscle is the sole
41. C. With Klumpke’s paralysis, the muscles of the extensor of the metacarpophalangeal joints.
forearm and hand are most affected. This type of 58. B. Extension of the interphalangeal joints is the
brachial plexus injury is much less common than primary function of the lumbrical muscles. These
is Erb’s palsy. muscles can aid in flexion at the
42. C. The carpometacarpal joint of the thumb is metacarpophalangeal joints only when the
quite mobile and allows abduction, adduction, interphalangeal joints are fully extended.
flexion, extension, and rotation to occur. 59. D. Other nerves can sometimes be injured
43. B. The space beneath the flexor retinaculum is where they pass through muscles. The median
called the carpal canal, and is a common site of nerve has occasionally been compressed as it
median nerve compression ( the carpal tunnel passes through the pronator teres, and the radial
syndrome) nerve as it passes through the supinator.
44. C. The flexor digitorum profundus muscle 60. A.
attaches on the distal phalanges and is primarily 61. A.
a flexor of the distal interphalangeal joints. It will 62. A.
also aid in flexion at the proximal interphalangeal 63. B.
and metacarpophalangeal joints. 64. B.
45. E. The lumbar plexus passes through the psoas 65. D.
major muscle. Hemorrhage into this muscle— 66. A. Inversion is produced by muscles passing to
which most commonly occurs in patients or around the medial border of the foot. Eversion
receiving anticoagulants—can occasionally is produced by muscles passing to or around the
cause lumbar plexus compression. lateral border of the foot.
46. D. The rectus femoris muscle attaches to the 67. E.
anterior inferior iliac spine and is the only head of 68. D.
the quadriceps to pass over the hip joint. 69. C.
47. D. The anterior fibers of the adductor magnus 70. D.
muscle receive innervation from the posterior 71. A.
branch of the obturator nerve. The more posterior 72. B.
fibers receive sciatic innervation. 73. C.
48. E. The plantar calcaneonavicular ligament forms 74. B.
a sling that functions to resist downward 75. E.
movement of the talus. 76. B.
49. B. The atlas rotates around the dens (or 77. A.
odontoid process), which projects superiorly from 78. C.
the axis or C2 vertebra. 79. A.

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80. D. Athletic injuries to the knee most often 94. A. The thoracic outlet syndrome is due to
damage the medial side. The medial meniscus, compression of the “neurovascular bundle”
by being firmly attached to the tibial collateral (brachial plexus and axillary or subclavian artery)
ligament, is relatively immobile and more prone in the thorax before the bundle enters the upper
to being torn than is the lateral meniscus, which extremity. Arteriography and electrodiagnosis
is not attached to the fibular collateral ligament. may help to make the diagnosis. Chest and
The “terrible triad”, a severe athletic injury, results cervical spine x-rays may also provide useful
in damage to the tibial collateral ligament, the information as to etiology.
medial meniscus, and the anterior cruciate 95. E. The deltoid muscle participates in most
ligament. shoulder motions because it passes anteriorly,
81. C. posteriorly, and laterally to the shoulder joint. The
82. D. anterior fibers produce flexion and internal
83. A. rotation, the posterior fibers, extension and
84. B. external rotation, and the lateral fibers, abduction.
85. B. 96. C. Earlier studies reported that the
86. D. In normal relaxed standing, ligaments supraspinatus muscle initiated shoulder
maintain the stability at the knee and hip. Since abduction, but more recent studies have shown
the center of gravity of the body passes in front of that the supraspinatus and deltoid muscles work
the ankle joint, the soleus muscle must contact to together to produce abduction.
counterbalance the natural tendency for the body 97. E. The upper portion of the trapezius muscle
to fall forward. elevates the lateral border of the scapula, while
87. B. The peroneus longus and brevis muscles are the rhomboids and levator scapulae muscles
innervated by the superficial branch of the elevate the medial border of the scapula.
peroneal nerve, while the tibialis anterior, 98. A. Costal pits (costal foveae) are situated such
extensor digitorum longus, peroneus tertius, and that each rib articulates with three of the pits—
extensor digitorum brevis are the muscles one on a transverse process, one on the upper
innervated by the deep branch of this nerve. border of a vertebral body, and one on the lower
88. B. The gastrocnemius muscle has two heads— border of the next-higher vertebral body.
one medial and one lateral. These two heads 99. C. The atlantooccipital joints are stabilized
plus the deeper soleus form the triceps surae and primarily by muscles and by the shape of the joint
attach to the calcaneus by means of the tendo itself. The joint capsule is rather weak.
calcaneus (Achilles tendon) 100. C. Variation in plexus anatomy can result in
89. C. The gluteus maximus muscle will abduct the variations in symptoms and physical findings if
limb only when the hip is flexed to 90 degrees. In pathology should occur.
other positions it causes adduction. The tensor 101. E. The sartorius muscle—the “tailor muscle”—
fasciae lata is an abductor, but is able to flexes the hip since it passes anteriorly to the hip
generate only one-fifth the combined power of joint. It attaches to the medial tibia posterior to
the gluteus medius and minimus muscles. the knee axis of motion. Its lateral attachment to
90. A. The patella provides increased quadriceps the anterior superior iliac spine allows it to be a
leverage by holding the quadriceps tendon weak abductor of the thigh.
anterior to the knee center of rotation. Rotation of 102. B. The obturator nerve supplies the major thigh
the tibia upon the femur is primarily performed by adductor muscles, with the exception of the
the knee flexor muscles. posterior portion of the adductor magnus, which
91. B. The cervical lordosis that develops prior to receives innervation from the sciatic nerve.
lumbar lordosis helps balance the head upon the 103. C. With weakness of the hip abductor muscles,
trunk. The cervical and lumbar lordoses are the pelvis will drop toward the unaffected side
secondary or compensatory spinal curvatures when weight is borne on the affected extremity.
because they develop after birth. Thoracic To help minimize this pelvic drop, many patients
kyphosis, which is present at birth, is a primary will learn to laterally bend their trunk toward the
curvature. affected side during the stance phase on that leg.
92. B. The majority of the shoulder girdle muscles 104. C. The tibia articulates with the femur and
are innervated by both the C5 and C6 spinal transmits weight to the foot. The fibula does not
nerves and the upper trunk of the brachial plexus. articulate with the femur but with the tibia distal to
Scapular movement during movements of the the knee. The peroneal nerve passes laterally
humerus permits greater motion at the shoulder around the head of the fibula; in this position the
joint. peroneal nerve is superficial and can be easily
93. C. The brachial plexus is formed by the C5-T1 injured. One type of peroneal nerve injury in this
anterior or ventral rami. The posterior posterior location is called the “crossed-leg” palsy.
portion of the plexus gives rise to the axillary, 105. E. The deltoid ligament is important in that it
radial, thoracodorsal, and subscapular nerves. helps limit eversion of the ankle.
The radially innervated muscles are primarily 106. A. With a sprained ankle the lateral ankle joint
extensors of the elbow, wrist, and fingers. ligaments are most often injured. The mechanism

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of injury is usually forceful inversion of a 114. C. When the transversospinalis muscles act
plantarflexed foot. bilaterally, the spine is extended. When these
107. C. Contraction of both sternocleidomastoid muscles are unilaterally, rotation occurs.
muscles will result in forward flexion of the head 115. C. The iliopsoas muscle is a major hip flexor. It
and neck. Unilateral contraction results in lateral can reverse its action and increase the amount of
flexion to the same side and rotation of the face lumbar lordosis. An increase in the amount of
to the opposite side Lumbar lordosis may be a factor in the production
108. C. The brachial plexus, subclavian artery, or of back pain.
both can occasionally be compressed between 116. A. The medial and lateral plantar nerves in the
the scalenus anticus and scalenus medius foot are distributed in nearly the same pattern, as
muscles. This is referred to as the scalenus are the median and ulnar nerves in the hand.
anticus syndrome—a type of thoracic outlet 117. B. The annular ligament encircles the head of
syndrome. the radius and prevents distal displacement of
109. A. Abduction at the shoulder is initiated by both this bone. The annular ligament permits rotation
the deltoid and supraspinatus muscles. External of the radial head, which is essential for forearm
rotation, which accompanies abduction, permits pronation and supination.
the greater tubercle to slide under the acromion.
110. B. The latissimus dorsi muscle functions to 118. B. The elbow joint
extend the arm and depress the shoulder, the
muscle prevents the shoulder from being
includes the humeral-radial
displaced upward by weight transmitted through and humeral-ulnar joints.
an ambulatory assistive device such as a crutch.
111. A. The subclavius muscle originates from the The elbow is strengthened
inferior surface of the clavicle and inserts on the
first rib. by muscles and by the
112. C. The capsule of the acromioclavicular joint is
rather weak and the joint surfaces are so shaped
shape of the humeral-ulnar
as to favor overriding of the acromion by the
clavicle. Most of the stability at the
articulation. The articular
acromioclavicular joint is provided by ligaments. capsule is weak and the
113. C. The dens or odontoid process projects
upward from C2 and is firmly attached to C1 by radial collateral ligament
ligaments. The dens serves as a pivot around
which the atlas rotates. attaches to the annular
ligament

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