Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
Porth's Pathophysiology, Concepts of Altered Health States 9th Edition by Sheila Grossman-Carol Mattson Porth
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Chapter 58- Disorders of Musculoskeletal Function
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | Which of the following is an aspect of the bone growth and development that occurs during the first two decades of life? | |
| A) | Most bone abnormalities can be traced to anomalies in the embryonic stage of development. | |
| B) | The physiological effects of in utero positioning normally remain into late adolescence. | |
| C) | Cartilage cells at the metaphyseal end of the bone plate are replaced by bone cells. | |
| D) | Bone length increases through childhood, while bone diameter remains static. | |
| Ans: | C | |
| Feedback: | ||
| During development, the mature and enlarged cartilage cells at the metaphyseal end of the plate become metabolically inactive and are replaced by bone cells. This process allows bone growth to proceed without changing the shape of the bone or causing disruption of the articular cartilage. Abnormalities linked to the embryonic stage of development are uncommon, and the physiological effects of in utero positioning resolve by 3 to 4 years. Both length and diameter of bones increase during development. | ||
| 2. | A female toddler has been diagnosed with toeing-in (metatarsus adductus). What teaching should the pediatrician provide to the parents of the child about her diagnosis? | |
| A) | “She will likely walk later than most children, but it will resolve itself with time.” | |
| B) | “We’ll likely need to start putting the first of a series of casts on her legs quite soon.” | |
| C) | “The best time to perform the surgery that’s needed will be at age 3 or 4.” | |
| D) | “While there’s no effective treatment for her toeing-in, most children learn to accommodate the problem and walk independently.” | |
| Ans: | B | |
| Feedback: | ||
| Toeing-in, regardless of staging, requires some form of intervention, most commonly braces or casts. Treatment is not noted to include surgery, and spontaneous resolution is not common. | ||
| 3. | When a 4-year-old boy stands erect with his medial malleoli touching, the distance between his knees is 2 inches. What is the child’s most likely diagnosis and treatment? | |
| A) | Genu varum, which can be treated by bracing | |
| B) | Flatfoot, which will require orthopedic shoes | |
| C) | Genu valgum necessitating a series of surgeries | |
| D) | Femoral torsion, which will spontaneously resolve before puberty | |
| Ans: | A | |
| Feedback: | ||
| Genu varum, or bowlegs, can be treated by bracing. The child’s stance is not indicative of flatfoot, genu valgum, or femoral torsion. | ||
| 4. | Following genetic testing and a thorough history from the child’s mother and father, a 5-month-old boy has been diagnosed with osteogenesis imperfecta. What teaching point should the care team provide to the mother and father? | |
| A) | “His skeleton is prone to breakage, and we’ll begin hormone therapy to treat this.” | |
| B) | “His hips are extremely susceptible to dislocation, so rough play is out of the question.” | |
| C) | “You’ll need to commit to calcium supplementation for the duration of his development.” | |
| D) | “You’ll need to be very careful to avoid causing fractures to his fragile bones.” | |
| Ans: | D | |
| Feedback: | ||
| There is no definitive treatment for correction of the defective collagen synthesis that is characteristic of osteogenesis imperfecta, and prevention and treatment of fractures are important. Hip dislocation is not a common manifestation, and neither hormone therapy nor calcium supplements are useful in treatment. | ||
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