Muskulo Skeleton System
Muskulo Skeleton System
MUSCULO – SKELTON
Axial (80)
Bone:-
25% Water, 25% Organic substance and cell, 50% inorganic substance.
1 diaphysis, 2 epiphysis.
In diaphysis compact bone with center medullary canal.
In canal yellow bone marrow is present.
Bone covering layer periosteum .
Bone development consist 2 process
Secreation by osteoblast.
Calcificaton.
Main variety:-
Long bone (increase length, decrease width) femur, humerus, radio-ulna.
Short bone (equal length-width) cube shape, carpal- tarsal.
Flat bone (thin. large area for musde) cranium. sternum, scapula.
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MUSCULO-SKELTON SYSTEM
Irregular (Complex) vertebrae, hip, facial.
Sesamoid (sead like) patella.
THE SKULL
(22)
CRANIUM FACIAL
(8) (14)
CRANIUM:-
1. Frontal :- Roof of orbital cavity, contain sinus, supra orbital Foramen present.
2. Parietal :- pair and contain sutures .
3. Temporal: - have 2 process - Anterior (zygomatic)
- Posterior (mastoid)
Form temporo- mondibular joint.
1 styloid process For voice- box attach ment.
Have petrous portion in which auditory canal present.
4. Occipital :- Foramen magnum present inferiorly connect with medulla oblongata and cord.
Form atlanto- occipital joint.
5. Sphenoid:- Triangular, leaf, butterfly shape contain sinus.
Form base/ Floor and connect to all other.
Hollow space called sellaturcica.
Optic Foramen present.
6. Ethamoid:- Anteriar to sphenoid posterior to nose.
Anterior portion of cranial floor.
Form Medial orbit wall.
Superior to nasel septum.
Side of nasel cavity.
Cribiform/ prepandicular plate make roof of nasel cavity.
FACE:-
1. Nasel bone : Small, flat, rectangular Form nasel bridge.
2. Lacrimal : Smallest in face, thin Finger Nail size.
3. Palatine : L shape and Form posterior part of hard palate.
4. Inferior conche : Inferior to ethamid, pyramid like.
5. Vomar : Single, triangular, Form inferior of septum.
6. Maxillae : Upper jaw bone articulate with every facial bone except mandible.
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MUSCULO-SKELTON SYSTEM
Make hard palate that seprate nasel, from oral cavity.
7. Zygomatic : Cheek bone, attach to maseter muscle, connect to temporal.
8. Mandible : Lower jaw bone. Largest, strongest, only movable.
Form temporo- mandibular(TM) joint.
TM joint syndrome : popping noise when chewing, Earpain.
HYOID BONE :-
Single U shape. No articulation with anyone.
At anterior neck between mandible/ larynx.
VERTEBRAL COLUM:-
Male 71 c.m. (28’’), Female 61 c.m. (24’’)
Formula is C5 T12 L5 S1 (5) C1(4), total 26
Curve - Convex (cervical, Lumber)
- Concave (thorasic, sacral)
Inter Vertebral Disc - Outer Annulus Fibrous
- Inner Nucleus pulpossus.
Typical vertebra:-
Body (thick, disc shape)
Arch (2 short process pedicle)
Process (7)
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MUSCULO-SKELTON SYSTEM
Cervical (1 to7):-
1st Atlas (Atlanto- occipital:yes)
2nd Axis (Atlanto-axial : no)
7th vertebra prominence
Thorasic (T1-T12):-
T1-T10 :- Articulate with ribs(vertebra-castla)
T11-T12:- Articulate transverse process with ribs
Lumber (L1-L5):-
Largest, strongest, five unfused bone.
Sacrum (1To 5):-
Triangular
Cocyx:-
C1 to C4 Fusion, tail like.
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MUSCULO-SKELTON SYSTEM
THORAX/CHEST:-
Ribs:-
12 PAIR
From 1 to 7 increase in length then decrease.
1to 7 (true)-sterno-costal then costovertebral joint.
8 to 10 (False)- indirectly attachment with vertebra by mean of costal cartilage
11 to 12(Floating)- not attached
Space between ribs Inter Costal space (ICS).
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MUSCULO-SKELTON SYSTEM
APPENDICULAR SKELTON
MEAN-HANG FUNCTION IS MOVEMENT
PECTORAL GIRDLE/SHOULDER:-
Two in number.
Anterior in clavicle and posterior scapula (shoulder blade)
Clavicle connect with sternum (sterno-clavicular)
Scapula:-
Clavicle (Acromino - Clavicular)
Humerus (Gleno - Humeral)
Clavicle is collar bane, beauty bone, s shape, single One Horizontal bone -:
Medially sterna
Laterally Acromial
MUSCULO-SKELTON
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MUSCULO-SKELTON SYSTEM
SCAPULA:-
Shoulder Blade, triangular, 2nd - 7th rib level, Form post thorax.
UPPER, LIMB:-
(1) HUMERUS:-
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MUSCULO-SKELTON SYSTEM
Largest/longest in upper limb
Proximal with glenoid cavity
Distal with radius-ulna (Elbow)
Surgical neck below head obove shaft
Capitulum for radius
Trochlear for Ulna
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MUSCULO-SKELTON SYSTEM
(3) CARPAL/WRIST:-
(4)MATA-CARPAL/PALM:-
5 in Number
Carpo- metacarpal and metacarpo- phalengeal joint.
Boxer fracture at 5th metacarpal (liltle finger).
(5) PHALANGES:-
Total 14 finger 4x3= 12
Thumb 1x2=2
Inter phalengeal joint.
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MUSCULO-SKELTON SYSTEM
LOWER LIMB:-
(1) FEMUR-
Thigh bone
Longest/largest/heaviest
More fracture in neck
(2) PATELLA -
Knee cap
sesamoid type
triangular
Anterior to knee joint
patella femoral joint
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MUSCULO-SKELTON SYSTEM
TIBIA
Flute, shine bone
Front part of leg
Proximal end with femur(tibio-femoral)
Proximal end with fibula(tibia- fibular proximal)
Distal end with fibulashaft articulation (interosseous membrane)
FIBULA:-
Parellal and lateral to tibia
Smaller then tibia
Does not articulate with femur
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MUSCULO-SKELTON SYSTEM
(4) TARSAL/ANKLE
Talus (ankle bone) connect to tibia-fibula.
Calcaneus (heel) largest, strongest
Nevicular (little boat)
Cueniform I,II,III (medial-lateral)
Cuboid (cube shape)
Connected by inter-tarsel joint
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MUSCULO-SKELTON SYSTEM
JOINTS
Arthrology - Joint study
Kinesiology - Motion study
Arthrosis - Point of contact
Classification:-
(1) Presence or absence of synovial cavity
(2) Type of connective tissue
Fibrous (no cavity, bone connected by fibrous tissue)
Cartilagenous (no cavity, connected by hyaline/fibro cartilage)
Synovial (yes cavity with articular cartilage 2 capsule)
(3) MOVMENT BASED
Synarthrosis (immovable)
Amphiarthrosis (slight movable)
Diarthrosis (Free movable)
Discription:-
A- FIBROUS JOINT
SUTURE SYNDESMOSIS INTEROSSEOUS
Between skull bane band or ligament Membrane of dense irregular tissue
In child movable more dense irregular Slight move
- In adult nonmove tibio-fibular Radio-ulna
B- CARTILAGENOUS
SYNCHONDROSIS SYMPHYSIS
Hyaline cartilage connection Fibro cartilage connection
Pubic symphysis, intervertebral
Between maubrium and body of sternum
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MUSCULO-SKELTON SYSTEM
C-SYNOVIAL
(1) PLANE:-
Articulate surface flat/slight curve, biaxial-triaxial, movment, intercorporaltarsel, sterno-
clavicular
(2) HINGE:-
Convex of 1st connect into concave of 2nd, door open closing, 1 fix another move, move around -
axis.Uniaxial, knee – elboul
(3 ) PIVOT:-
Pointed surface 1st connect to ring shape 2nd onlyRotation uniaxial radio – ulnar atlanto– axial.
(4) CONDY LOIDAL:-
Ovale projection of 1st into ovale depression of 2nd biaxial ulrist joint.
(5) SADDLE:-
1st bone saddle shape 2nd sit into saddle biaxialCircumduction, carporometacarpal.
(6) BOLL and Socket:-
Ball shape 1st cup shape 2ndtriaxial shoulder hip joint.
SYNOVIAL JOINT:-
MOVEMENT:-
1. Gliding (flat bone)
2. Angular (Flexion,extension,abduction,adduction,circumduction)
3. Rotation (medial- lateral)
4. Special
(elevation-depression da/ks mij&uhps)
(protrection-retraction xnZu vkxs&ihNs)
(Inversion-eversion iSj vanj&ckgj)
(supination-pronation, planter-dorsiflexion)
AXIAL SKELTAN JOINT:-
Suture (non movable fibrous)
Atlanto occipital (synovial, diarthrosis)
Atlanto axial (Synovial ) diarthrosis
Intervertebral
Body (cartilagenaus, amphiarthrosis)
Arch (synovial, diarthrosis)
APPENDICULAR-SKELTON JOINT:-
Synovial Diarthrosis:-
(Sterno-clavicular, acromio-clavicular, Radio-ulnar,wrist, sacro-iliac, Metacarpo
metatarsophalengealgnter, Phalangeal tarso metatarsalGntercarpel (plain and saddke,
diarthrosis)
Intercarpel (Plain and saddle, diarthrosis)
Carpo- symphsis (plain and saddle,diarthrosis)
Pubic-symphysis (cartilaginous, amphiarthrosis)
Tibio- fibular
Proximal (synovial, syndesmosis)
Distal (fibrous, amphiarthrosis)
Inter-tarsal (plain and saddle,diarthrosis)
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MUSCULO-SKELTON SYSTEM
MUSCLE
Importent variety
Skelton (striated, voluntry)
Cardiac (striated, involuntry)
Smooth (nonstriated, involuntary)
Basic fuction include movment, position, storage, heat
Basic properties
Electrical excitement
Contractility
Extansibility
Elasticity
Basic structure have 3 surrounding lagers :-
Epimyseum – iwjh muscle ds ckgj
Perimyseum - 10 ls 100 muscle fiber ds bundle fascicle dks doj djus okyh
Endomyseum - cover each muscle fiber from bundle.
Each muscle have artery and vein and neuron called Somaticmotor.
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MUSCULO-SKELTON SYSTEM
Microscopic Anatomy of Muscle Fiber:-
Diameter 10-100 mm, length 10c.m.(4 inch)
Each fiber contain cell k/s sarcomere.
Sarcolema is outer covering of sarcomere.
Sarcoplasm present within sarcolema.
Protein in sarcoplasm is myglobin.
Mypfibril is thread like structure present in sarcoplasm.
Myofibril is contractile orgen.
Fluid filled sac around myofibrill known as sarcoplasmic reticulum.
In myofibrill protein structure are present called as Myofilament:-
THICK (Actin)
THIN (myosin)
Sarcomere is functional unit of myofibril.
Dense protein within sarcomere have disc which seprate I and next sarcomere.
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MUSCULO-SKELTON SYSTEM
MUSCLE PROTEIN:-
Contractile (Actin/myosin)-generate force
Regulatory (troponin/tropomyosin)- on-off regulation.
Structural (titin, actisin, myomesin, dystropin)
MUSCLE METABOLISM:-
(i) Creatine phosphate (in resting, more ATP)
(ii) Anarobic (ATP production without oxygen)
(iii)Aerobic (ATP produetion need oxygen)
MUSCLE TONE:-
Hypo Hyper
Spasticity (Increase tone, Increase reflex)
Rigidity (Increase tone, no reflex)
Contrection
Isometric (Equal length with change in tone)
Isotonic (Equal tension with change in length)
(Concentric) Eccentric
(↓se angel) (↑se Angle)
MUSCLE SPECIAL:-
40% of total body weight.
200 muscle are used in making one step.
Muscle are Fix in-Number from birth to death.
Cardiac muscle never tired.
Shortest/Smallest/Weakest – Stepedius (Ear).
2nd smallest – Erectarpilli (HAIR).
Longest – Sartorius / tailor.
Largest/thickest – gluteus maximus (buttock).
Strongest – messetar (tcM+k).
Swimmer/Widest/Broadest – Lattismusdorsi.
Deepest – Adductor (Group in thigh).
Boxer muscle – Serrator (palm).
Eye blink – Levatorpalpebri/ orbicularis.
Smile – Zygomatic.
Biceps Flexion, tricep’s extension.
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MUSCULO-SKELTON SYSTEM
BODY MUSCLE:-
In Humen body 639 muscle.
Usual Origion proximal, insertion distal.
Body of muscle belly.
Face
Occipito – Frontalis (surprised look)
Mouth
Orbicularis oris (kissing speech)
Buccinator (whistle,blow suck)
Neek
Platusma (depress mandible)
Orbit/Eyebrow
Orbicularis occuli (close eye)
Mastigation
Masseter (close mouth)
Temporalis (elevate mandible)
Tongue movement
Genioglossus, styloglossus.
Hypoglossus, palatoglossus
Neck Movement
Sterno- cleido- mastoidal
Breathing
Diaphragm
External- internal intercostals
Eye ball
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MUSCULO-SKELTON SYSTEM
Swallowing Suprahyoid
Infra hyoid
Abdominal visera (Six pack)
Internal oblique
External Oblique
Ractusabdominus
Transverse abdominus
Quadratuslumborum.
Pelvic Floor
LevatorAni (ileo-ischio-pubococcygeus)
Thorax
Anterior (subclavius, pectoralis Minor, serratous)Posterior (Trapezius, rhomboid, Levator)
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MUSCULO SKELTON DISORDERS
I. INJURIES
1. SPRAIN/STRAIN:-
Sprain is ligament tear without bone dislocation; common site is ankle and wrist.
Strain is tear in muscle and tendon, site is back and leg muscle.
Degree include
I. (Injury then in Flammarion)
II. (Partial Tear)
III. (Complete Tear)
Problem include pain, swelling, decrease movement in sprain and no movement in strain.
Diagnose by CT, MRI, Arthroscopy.
Management follow Hot/cold, NSAIDS, Muscle relaxant,
RICE-REST- R
ICE APPLICATION –I
COMPRESSION BY CRAP/WRAP BANDAGE-C
ELEVATION OF PART-E
2. Rotator Cuff Injury:-
Rotator cuff is group of muscle that originate from scapula and insert in humerus involve- (i)
deltoid (ii) Trapezius (iii) Pectoralis major
Strain or tear in rotator cuff commonly in baseball players, volleyball, sweimmer due to
shoulder movement involve circumduction.
Mostly seen in supra-spinatus tendon of rotator cuff.
In rotator cuff “SITS”
S- Supra spinatus
I- Infra spinatus
T- Teres minor
S- Sub Scapularis
Drop arm test is unability to perform abduction.
Intervention involve NSAIDS physiotherapy
3. DISLOCATION:-
Dislocation is ligament injury leads to displacement, Separating articular surface.
Subluxation is incomplete joint surface displacement, force disrupt soft tissue.
Intervention includes pain relief, joint support, protection, open-close reduction.
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MUSCULO SKELTON DISORDERS
4. DISC HERNIATION:-
Nucleus Pulposus of disc protrude into annulus cause nerve compresses.
More common in lumbar region
CERVICAL:-
At the level of C5-C6, C6-C7
Pain radiate to arm, shoulder, hand, scapula.
Intervention includes bed rest, immobilize with collar, heat cervical traction, log-roll
position.
LUMBER:-
L4-L5, L5-S1 Mainly
Lower back spasm radiate to hip and downward.
Intervention include hard mattress, heat, sidelying with hip-knee flexion, maintain back
straight.
Analgesic, Relaxant, Steroid.
Surgical approach:-
Diskectomy- Disc Removal
Diskectomy with fusion- Fusion with graft
Laminectomy- removal of Lamina to relieve pressure.
Lominotomy- Lamina division
Edoscopic by laser
Maintain knee-chest postion.
II. FRACTURE
1. FRACTURE:-
(FRACTURE LIST ACCORDING TO NATURE)
Simple, closed – Skin is intact
Open compound – Skin not intact, soft tissue injury and infection.
Comminuted- Crush, bone break in piece.
Complete- 2 part separation
Compression- Fractured bone Compress by other.
Depressed- Piece of bone depressed into organ.
Green stick- 1st side break, 2nd side bent,
Impacted- Part of fractured bone move to another bone.
Incomplete- Fracture lines not extend fully at transverse width of bone.
Oblique- Fracture line across the axis of bone.
Pathological- due to disease process or by infection.
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MUSCULO SKELTON DISORDERS
Spiral- Circular fracture, occur in twisting.
Transverse- Straight across, break in perpendicular.
SPECIFIC NAME:-
Monteggia Fracture – Proximal ulnar fracture.
Galeggizer Fracture- Distal radius.
Colles Fracture- distal radius with dorsal tilt.
Smith Fracture- Distal radius with ventral tilt.
Binet Fracture- 1stMetacarpel
Boxer Fracture- 5th metacarpal
Bumper- lateral tibia condyle
Pott- Medial/lateral condyle of tibia
Jufferson- Atlus
Hangmen- Axis
Manifestation includes pain, tenderness, swelling, decrease movement and function, edema,
bruising, neural-muscular impairment.
Management
Concurrent Surgical
Rice
Cast Reduction Arthroplasty
Traction
Open Close THR TKR
(Hip) (Knee)
Fixation
Reduction
(Restore Proper Alignment)
Close Open
Non- Surgical, Manual Invasive, Surgical
Under anesthesia Fixator are used
After it use cast
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MUSCULO SKELTON DISORDERS
Fixation
Internal External
Screw, Plate, Pin, road, Use of external frame
Remove fractured bone Attachment of pins
Replace by prosthetic More freedom then traction
Immediate bone strength In massive trauma
Traction:-
Application of pulling force with counter- traction.
Reduce and immobilize the fracture
Ensure weight hang freely without floor touching
Skin traction apply by using elastic bandages adhesive and slings.
Ideally 10% of body weight is calculated.
Variety of traction include:-
Cervical: Chin pad placement who attach with traction 30o-40o head elevation required.
Bucks: applied over lower limb with elevated foot end.
Russell’s: Useful in femur shaft fracture, horizontal force on tibia- fibula, vertical at knee.
Pelvic: Used in lower back-HIP pain, traction belt and weight used.
Dunlop: Horizontal traction in humours fracture vertical to maintain forearm.
Balanced suspensions are used with-traction, in semi-fowler position.
CAST:-
Plaster of paris, caso4- ½ H2O.
Cast is circumferential best method
Slab is unilateral multilayer (12-16) in initial stage.
Extremity elevation with turning 1-2 houriy.
Clean dry and monitoring of infection.
Access for circulation impairment.
Impairment Indicatars:-
Pain Swelling
Tingling Numbness, Coolness
Discolouration diminished pulse
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MUSCULO SKELTON DISORDERS
Complication in fracture:-
Fat embolism:
Originate in bone marrow released into blood within 48 to 72 hours.
Patient may develop restlessness, hypoxemia, tachycardia, dyspnoea, hypotension.
Notify- Oxygen-IV-Vital-intubate.
Compartment Syndrome:-
Fascia Surround group make compartment Composed of artry, vein, nerve,
Pressure in one compartment decrease blood supply, induce ischemia, neural-vascular impairment.
B. Rheumatoid Arthritis
Result from auto-immune reaction (auto-antibody)
Symptom involve:-
Main affected Joint are interphalengeal wrist
Pain, Swelling, tenderness, stiffness.
Deformity and decrease ROM
Soft feeling joint.
Diagnose by increase ESR. X-Ray tissue biopsy.
Blood test for rheumatoid factor
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MUSCULO SKELTON DISORDERS
Synovectomy (Removal)
Surgical Approach Arthrodesis (Bony fusion of joint)
Athroplasty (Replacement)
D. Gouty Arthritis:-
Disorder of purine metabolism in which plasma uric acid increase that will deposit into joint
cause pain, swelling inflammation.
Abnormal/Excessive Breaking of urine- due to increase activity of xanthine oxidase (XOA) or
dehydroginase.
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MUSCULO SKELTON DISORDERS
XAO- Convert Hypoxanthine Xanthine Uric acid.
Uric Acid
In joint Tophy (Mainely in feet/toes)
In kindey stone
Type:-
Primary (Direct Purine metabolism )
Secoundry (Excess URIC acid by other disease)
Phase involve asymptomatic, acute, intermittent, chronic.
Tophi are hard, irregular nodules in skin due to deposition of sodium Urate.
Intervention involve:-
Steroids, NSAIDS, XAO inhibitor (Allopurinol)
Colchicines and uricosurics (Probenacid, sulfinpurozone)
Increase water, low purine diet, alkaline ash.
In acute gout (NSAID/colochisine/steroid)
In chronic gout (UricoSuric/ Allopurinol)
IV. METABOLIC BONE DISEASE
1. OSTEOPOROSIS:-
Metabolic disorder characterized by bone demineralization loss of calcium, phosphorus lead to
fragility and fracture.
Result of increase absorption, decrease deposition.
Etio- Pathogenasis involve:-
Excess calcium loss by urine, faeces, sweat.
80% women after menopause.
In Men due to decrease level of testosterone.
Decrease calcium intake
In male- female hormone depletion is primary cause.
Secondaryto steroid, alcohol, malnutrition, history, age.
Main festation involve asymptomatic, pain, kyphosis, pathological fracture, decrease height.
Diagnose by X-Ray, BMD.
Dietry treated by increase calcium, vitamin D, Vitc,
Drugs involve (i) Biphosphonate
(ii) Estrogen receptor modulator
(iii) HRT
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MUSCULO SKELTON DISORDERS
2. Paget Disease:-
Also Called osteitis deformens, cotton wool spot found in latter stage.
Result from excessive break and formation of bone.
Patho- Physiology involve
Osteoclast proliferation - increase reabsorption decrease - deposition, Weak new bone osteoblast
compensate-OsteolysisSe decrease Mineralization – Hollow cavity – pagetic bone.
Manifestation invole:-
Increase alkaline phosphate
Weak, pain, fracture. Arthritis, deformity.
Nerve compression due to enlargement.
Associated condition is stone and neuropathy.
Medication involve:-
Biphosphonate ( decrease osteoclast)
Etidronate/Pamidronate disodium.
Calcitonin.
3. Osteomalacia
Bone softening – due to impaired bone metabolism- Decrease, Calcuium, phosphate, vitamin D,
Assess by bone pain, muscle weakness, gait problem, hypocalcaemia.
10000 I.U./ W.K. vitamin D
Vitamin D + Calcium
V. MUSCULAR DYSTROPHY
Group of disorder due to mutation of gene result in progressive degeneration of muscles groups.
1. Duchenee:-
Most common variety, affected gene carried on long X chromosome.
Mutation in dystrophine gene a protein present in sarcolema.
Less severe variety is becker (Death 40Yr) and more severe is duchenne (Death 20-25
yr)
Gower’s sign manifested when patient use hand four walking.
Supportive prednisolone may give to improve muscle strength.
2. FSHD:-
Fasico Scapulo Humeral Muscular Dystrophy
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MUSCULO SKELTON DISORDERS
Mutation of chromosome No.04
Autosomal dominant condition
Usual symptom during 10-26 year, more in men.
Manage by prednisolone, physical therapy, surgery walking aids.
3. Myotonic Dystrophy:-
Chronic, slow progressive, highly variable, autosomal multisystem disease.
Muscle are weak and slow to relax after contraction.
Defected gene located on chromosome no 19.
VI. OTHERS DISORDERS
1. Vertebral colum Abnormality:-
Scoliosis: Most common, lateral banding, usually in thorax.
Kyphosis: Increase thorasic curve, hunchback, comman in female with osteoporosis.
Lordosis: Increase lumbar curve, hollow back as in pregnancy, obesity.
Intervention: neruro-Muscular assessment, medic alert braclet, antimyesthamic
2. CARPAL TUNNEL:-
Compression of medial nerve mostly by hamete bone.
Manifestation include muscle weakness, sharp pain, numbness- tingling- paresthesia in lateral 3
½ finger.
Cause includes inflamed tendon, fluid retention, excercise, trauma, and repeated activities.
Examination done by:-
Phalen test: Wrist Flexion for 1 min, Numbness in hand show positive test.
Tinel sign: Tapping carpel ligament with hammer, numbness in palm show positive test.
Durken test: compress median nerve for 30 secound, numbness in finger show positive
test.
NSAIDS, Splint, Steroid, Surgery involve cut down of flexor reticulum.
3. Osteo-Myelitis
Infection, inflammation of bone marrow.
Pyogenic infection by s. Aureus/Enterobactor/Salmonella.
Non Pyogenic by mycobacterium cause vertebral infection (Pott disease)
In child affect metaphyseal plate
In adult affect vertebra and pelvis.
Route of entry is blood, contagious, trauma, penetration.
Main diagnose by WBC, MRI.
Antibiotic recommendation.
Gurjar Ki Thadi, Opp. Metro Pillar No. 67, New Sanganer Road, Jaipur. Mob. No. 7426955591, 7426955593 30
MUSCULO SKELTON DISORDERS
4. Crush Syndrome:-
Crushing accident’s like war, accident , disaster, long surgery result in muscle necrosis.
Crush injury
Ischemia (Compartment)
Muscle Necrosis
Gurjar Ki Thadi, Opp. Metro Pillar No. 67, New Sanganer Road, Jaipur. Mob. No. 7426955591, 7426955593 31
MUSCULO SKELTON DISORDERS
C. 3 Point:-
Orthopaedic gait when total body weight depends upon single normal extremity.
1st use both crutch and affected extremity forward and at last weight bearing extremity.
D. Swing to:-
Patient with strong arm and foot muscle.
First place both crutches forward after that both extremities.
Extremities remain behind crutches.
E. Swing Through:-
Fastest Gait
Same as swing to except extremities make a advance step.
Extrimities are advanced to crutches.
On Holding crutch elbow make an angle of 150- 250
Gurjar Ki Thadi, Opp. Metro Pillar No. 67, New Sanganer Road, Jaipur. Mob. No. 7426955591, 7426955593 32
MCQs
Q.1 Human skeleton is made of a total of ? Q.16 Sella Turcica is a part of :
(a) 201 bones (b) 206 bones (a) Ethmoid (b) Parietal
(c) 198 bones (d) 105 bones (c) Palatine (d) Sphenoid
Q.2 Spinal column has Vertebrae : Q.17 The longest and strongest bone of the
(a) 12 (b) 20 human body is :
(c) 25 (d) 33 (a) Humerus (b) Tibia
Q.3 Longest bone of the human body is : (c) Radius (d) Femur
(a) Femur (b) Humerus Q.18 Joints of skull are known as :
(c) Tibia (d) Fibula (a) Suture joints
Q.4 What is the correct equation of vertebral (b) Cartilaginous joints
column? (c) Synovial joints
(a) C7T12L5S5C4 (d) All of the above
(b) C7T12L5S4C4 Q.19 Osteochondroma is related to :
(c) C9T10L3S,C1 (a) Muscle (b) Heart
(d) None (c) Bones (d) Lungs
Q.5 Total number of vertebrae into human body; Q.20 Thoracic region of vertebral column contain
(a) 30 (b) 33 how many bones :
(c) 22 (d) 44 (a) 5 (b) 7
Q.6 Skull consists of : (c) 9 (d) 12
(a) 14 Bones (b) 22 Bones Q.21 Which carpal bone most commonly
(c) 12 Bones (d) 8 Bones fractured ?
Q.7 Lateral curvature of the spine is called is : (a) Lunate (b) Pisiform
(a) Kyphosis (c) Scaphoid (d) Hamate
(b) Lordosis Q.22 Haversian canal situated into :
(c) Scoliosis (a) Bone (b) Brain
(d) Pectus excavatum (c) Lungs (d) Kidney
Q.8 Abnormal lateral deviation of vertebral Q.23 In human body, the leg bones are :
column is : (a) Humerus and Femur
(a) Lordosis (b) Fibula and Tibia
(b) Kyphosis (c) Fibula and Ulna
(c) Scoliosis (d) Tibia and Radius
(d) Osteoporosis Q.24 Identify the hip bone from the following :
Q.9 Goniometer is used to assess : (a) Femur
(a) Auditory acuity (b) Humerus
(b) Muscle strength (c) Innominate
(c) Range of motion of joints (d) Sacrum
(d) Visual acuity Q.25 Potts fracture is the fracture of : N.
Q.10 Areas where two or more sutures meet are : (a) Spine (b) Ribs
(a) Sutures (b) Fontanelle (c) Ankle (d) Femur
(c) Vaul (d) Segregated Q.26 Fractures of the distal radius is called:
Q.11 Which of the following bone has a shape (a) Hume fracture
like that of a bat ? (b) Monteggia fracture
(a) Ethmoid bone (b) Sphenoid bone (c) Galeazzi fracture
(c) Temporal bone (d) Parietal bone (d) Colles' fracture
Q.12 The smallest bone of human body is : Q.27 Colle's fracture referred to the injury of :
(a) Stapes (b) Phalanges (a) Shoulder joint (b) Knee joint
(c) Metacarpals (d) Xiphisternum (c) Wrist joint (d) Elbow joint
Q.13 Which of the following is not part of the Q.28 The radius is located :
axial skeleton ? (a) In the upper part of the arm
(a) Femur (b) Sternum (b) On the thumb side of the lower arm
(c) Mandible (d) Sacrum (c) On the little finger side of the lower arm
Q.14 All the following are types of bones except : (d) At the shoulder arm
(a) Long bones (b) Short bones Q.29 Which bone is the largest bone in human
(c) Flat bones (d) Regular bones body :
Q.15 At which point humerus joins scapula : (a) Femur (b) Humerus
(a) Acetabulum (b) Glenoid (c) Tibia (d) Radius
(c) Popliteal fossa (d) Coronoid fossa
Gurjar Ki Thadi, opp. Metro Pillar No. 67 New Sanganer Road, Jaipur. Mb. 7426955591, 7426955593 33
MCQs
Q.30 Tibia is expanded at lower end and offers Q.39 Commonest type of fracture seen in children
bearing surface to which bone ? is :
(a) Calcaneus (b) Femur (a) Colley's fracture
(c) Talus (d) Fibula (b) Pott's fracture
Q.31 Which of the following actions would a (c) Greenstick fracture
technician give priority in the emergency (d) Pathological fracture
care of a patient who had compound Q.40 All of the following are types of fractures
fracture of the femur ? except:
(a) Splint the leg in its present position (a) Simple (b) Impacted
(b) Place the leg in neutral alignment (c) Lacerated (d) Complicated
(c) Irrigate the wound with normal saline Q.41 Nursing assessment for neurovascular status
(d) Apph -essure directly over the wound of the extremity with a cast include the
Q.32 A fracture in which the broken end of bone following Answer
comes out through the skin is known as : (a) Pallor
(a) Simple (b) Range of motion
(b) Comminuted (c) Paresthesia
(c) Compound (d) Pain
(d) Impacted Q.42 The surgical procedure done to relieve
Q.33 A patient has fractured hip, is placed in pressure in compartment syndrome is :
Buck's traction. The purpose of Buck's (a) Open reduction with internal fixation
traction is to : (ORIF)
(a) Prevent contractures (b) Meniscectomy
(b) Promote circulation (c) Fasciotomy
(c) Conserve body energy (d) Arthroplasty
(d) Maintain body alignment Q.43 Which nursing intervention is appropriate
Q.34 Most common fracture into children : for a client with skeletal traction?
(a) Greenstick fracture (a) Prone positioning
(b) Potts fracture (b) Intermittent weights
(c) Colles' fracture (c) Pin care
(d) Pathological fracture (d) 5 pound weight
Q.35 The instruments used in plaster work are : Q.44 While nursing the patient with skeletal
(a) Plaster knife traction all the following should be kept in
(b) Plaster saw, plaster bender mind except:
(c) Plaster shears (a) Remove the weight while changing the
(d) All of these position
Q.36 Splints are rigid structure used to : (b) Maintain the accuracy of weight
(a) Support a broken bone (c) Ensure that weight does not touch the
(b) To give protection to part of the body floor
(c) To correct deformity (d) Remove the weight if required without
(d) All of these causing jerk
Q.37 The nurse can best prevent foot drops for Q.45 Which of the following symptoms are
the bed rest client by the use of- considered signs of a fracture?
(a) Traction (a) Tingling, coolness, loss of pulses
(b) Splint (b) Loss of sensation, redness, coolness
(c) Cradle (c) Coolness, redness, new site of pain
(d) Railing (d) Redness, warmth, pain at the site of
Q.38 To prevent foot drop in a leg with a cast, injury
which of the following interventions is an Q.46 The symptoms associated with the type of
appropriate? fracture would probably be :
(a) Encourage bed rest (a) Shock, pain and adduction with hip and
(b) Support the foot with 45 degree of knee
flexion (b) Pain, external rotation and lengthening
(c) Support the foot with 90 degree of of the extremity
flexion (c) Pain, external rotation and shortening of
(d) Place a stocking on the foot to provide the extremity
warmth (d) Shock, internal rotation and shortening
of the extremity
Gurjar Ki Thadi, opp. Metro Pillar No. 67 New Sanganer Road, Jaipur. Mb. 7426955591, 7426955593 34
MCQs
Q.47 Gallows traction is used for : (BSF Staff Nurse 2015 )
(a) Fracture shaft of femur Q.55 Osteoporosis is disease of :
(b) Fracture neck of femur (a) Skin (b) Bones
(c) Fracture humerus (c) Brain (d) Muscles
(d) Fracture tibia Q.56 Osteoporosis is caused by deficiency of :
Q.48 After a long leg cast is removed, the male (a) Vitamin-A (b) Vitamin-B
client should : (c) Vitamin-C (d) Vitamin-D
(a) Cleanse the leg by scrubbing with a brisk Q.57 Which of the following are factors
motion contribution osteoporosis?
(b) Put leg through full range of motion (a) Hypothyroidism
twice daily (b) End stage renal disease
(c) Report any discomfort or stiffness to the (c) Cushing's Disease
physician (d) Diabetes
(d) Elevate the leg when sitting from long Q.58 All of the following are potentially
periods of time modifiable I factors for osteoporosis except;
Q.49 Which fracture or dislocation into an infant (a) Anorexia nervosa
gives Allis' sign : (b) Chronically low intake of calcium and
(a) Head of femur vitamin
(b) Developmental dysplasia of hip (c) Chronically low intake of vitamins C
(c) Dislocation of femoral head and B6
(d) All of above (d) Excessive alcohol consumption
Q.50 Main cause of fracture into female after Q.59 Complication of osteoporosis :
menopause : (a) Pathological fracture
(a) Hormone imbalance (b) Growth retardation
(b) Osteoporosis (c) Infection
(c) Both A and B (d) Muscular dysfunction
(d) None of above Q.60 After menopause in women the chances of
Q.51 Which of the following is a relevant clinical her developing osteoporosis increase
feature in a patient with fracture of neck of because of :
femur? (a) Decrease in oestrogen levels
(a) Abduction with internal rotation (b) Increase in oestrogen levels
(b) Abduction with external rotation (c) Decrease in LH levels
(c) Shortening of the affected extremity with (d) Decrease in FSH levels .
external rotation Q.61 Meaning of osteomyelitis means :
(d) Lengthening of the affected extremity (a) Severe pyogenic infection of bone
with internal rotation surroundings
Q.52 A child with femur fracture temporarily (b) Infection of eye
placed into skin traction. During assessment (c) Inflammation of bones
nurse note the absent dorsalis pedal pulse in (d) None of these
left foot. What wo be initial action taken by Q.62 Osteomyelitis most commonly results from
nurse : which of the following mechanisms?
(a) Administer pain killer (a) Immune suppression (b) IV drug
(b) Release the traction (c) Surgery (d) Trauma
(c) Inform the doctor immediately Q.63 Deep fascia which covers the thigh is called
(d) Apply hot bottle to affected leg as :
Q.53 Elderly people have a high incidence of (a) Fascia lata (b) Darto's fascia
fracture because of : (c) Scarpa's fascia (d) Campere's fascia
(a) Carelessness Q.64 End of two bones is connected by :
(b) Fragility of bone (a) Muscles (b) Tendons
(c) Sedentary existence (c) Ligament (d) Cartilage
(d) Rheumatoid diseases Q.65 The fibrous tissue connecting bone to bone
Q.54 The type of fracture which occurs is called :
commonly children is : (a) Cartilage (b) Tendon
(a) Colle's fracture (c) Muscle (d) Ligament
(b) Green stick fracture Q.66 The ligaments join :
(c) Pathologic fracture (a) Muscle to muscle (b) Bone to bone
(d) None of these (c) Muscle to bone (d) None of these
Gurjar Ki Thadi, opp. Metro Pillar No. 67 New Sanganer Road, Jaipur. Mb. 7426955591, 7426955593 35
MCQs
Q.67 The position used to assess the extension of Q.79 The level of uric acid increases :
hip joint is : (a) In arthritis
(a) Supine (b) Prone (b) In gout
(c) Sitting (d) Dorsal recumbent (c) In myocardial infarction
Q.68 ……………is a ball and socket joint : (d) None of the above
(a) Hip joint (b) Elbow joint Q.80 What is Gout'
(c) Knee joint (d) None of these (a) A degenerative &scram
Q.69 Example of ball and socket joint is : (b) A vascular disorder
(a) Elbow (b) Hip joint (c) A renal disorder
(c) Thumb and fingers (d) A metabolic disorder
(d) Between wrist bones Q.81 Gout is a :
Q.70 For assessing range of joint movement the (a) Degenerative disorder
nurse will ask the patient to move away (b) Psychological disorder
from the body evaluating the movement of : (c) Neurological disorder
(a) Flexion (b) Extension (d) Metabolic disorder
(c) Abduction (d) Adduction Q.82 Most frequently and severely involved
Q.71 Bending of head towards chest is : joints in rheumatoid arthritis are :
(a) Flexion (b) Extension (a) Knees (b) Elbows
(c) Abduction (d) Supination (c) Interphalangeal (d) Sacroiliac
Q.72 Hip joint and shoulder joint are : Q.83 Allopurinol drug is used in the treatment of
(a) Saddle joint disease is :
(b) Ball and socket joint (a) Gouty arthritis
(c) Plane joint (b) Fracture
(d) Hinge joint (c) Spondylitis
Q.73 The client is being assessed for range-of- (d) Osteoporosis
joint movement. You ask the client to move Q.84 Which increased level cause gout?
the arm away from the body, evaluating the (a) Urea
movement of : (b) Uric acid
(a) Flexion (b) Extension (c) Ammonia
(c) Abduction (d) Adduction (d) Bile pigment
Q.74 Which muscle does not belong to hip joint? Q.85 A patient with gout should follow which
(a) Psoas Muscle (b) Gluteal Muscle type of diet
(c) Lliacu Muscle (d) Triceps Muscle (a) Potassium modified diet
Q.75 Meaning of articulation is : (b) Renal diet
(a) Joint of two muscles (c) Low purine diet
(b) Joint of two nerves (d) High calcium diet
(c) Joint of two bones RUHS Post B.Sc. NSG Entrance 2015
(d) Joint of two arteries Q.86 A nurse is caring for an old lady with
Q.76 Which of the following muscles do not form osteoarthritis and all the following facts are
muscles of mastication? true regarding osteoarthritis EXCEPT?
(a) Masseter (a) Crepitus
(b) Temporalis (b) Tophi
(c) Pterygoideus lateralis (c) Subcutaneous nodules
(d) Deltoid (d) Pain on moving the joint
Q.77 Pain, redness, warmth and swelling of knee Q.87 Which joint movement is restricted in a
joint in a patient indicates : patient with pericapsulitis of shoulder?
(a) Infection (b) Inflammation (a) Adduction
(c) Thrombosis (d) Degeneration (b) Abduction
Q.78 An old woman complains of pain. The nurse (c) Flexion
noticed that the knee is reddened, warm to (d) Extension
touch and swollen. The interpretation of Q.88 Which of the following is the modifiable
these signs and symptoms are likely related risk factor of osteoarthritis?
to : (a) Overweight
(a) Infection (b) Increasing age
(b) Thrombophlebitis (c) Previous joint damage
(c) Inflammation (d) Genetic susceptibilty
(d) Degenerative disease
Gurjar Ki Thadi, opp. Metro Pillar No. 67 New Sanganer Road, Jaipur. Mb. 7426955591, 7426955593 36
MCQs
Q.89 In case of a patient with paraplegia, in order (d) All of the above
to prevent contractures of the joints of lower (AIIMS Staff Nurse, 2016)
extremities, which of the following is NOT Q.98 Decreased bone density is called
relevant? as…………..
(a) Hourly change of position. (a) Osteoporosis
(b) Using supportive devices to maintain (b) Osteomalacia
alignment. (c) Osteoarthritis
(c) Provide instructions for active exercise. (d) Rheumatoid arthritis
(d) Perform passive range-of-motion (AIIMS Staff Nurse, 2016)
exercise several times daily. Q.99 Most common sign of osteoarthritis
Q.90 In case of a patient with rheumatoid is……………..
arthritis, which of the following laboratory (a) Joint stiffness
test result to be reviewed? (b) Weakness improved in the evening
(a) Pancreatic lipase (c) Pain
(b) Bence-Jones Protein (d) Swelling
(c) Antinuclear antibody (AIIMS Staff Nurse, 2016)
(d) Alkaline Phosphatase
Q.91 Skeletal muscles under microscope have Q.100 Bow leg and wide wrist are the
cross-striations formed by dark and light characteristic of
bands. The dark bands are formed by the (a) Rickets (b) Osteomalacia
protein________________ (c) Polio (d) CDS
(a) Mysium (b) Myosin (AIIMS Staff Nurse, 2016)
(c) Actin (d) Coronin Q.101 Bow leg and wide wrist are the
(ESIC Delhi, 2016) characteristic of
Q.92 New growth in the bone marrow (a) Rickets (b) Osteomalacia
is_________ (c) Polio (d) CDS
(a) Osteoma (b) Myeloma (AIIMS Staff Nurse, 2016)
(c) Odontoma (d) Myoma Q.102 The part of the bone that enters into the
(ESIC Delhi, 2016) formation of a joint is called:-
Q.93 An opening in the bone through which (a) Articulating surface
blood vessels, nerves, and ligaments pass is (b) Bony sinus
called_____________: (c) Condyl
(a) Fossae (b) Sulcus (d) Facet
(c) Antrum (d) Foramen (AIIMS Raipur Staff Nurse, 2017)
(ESIC Delhi, 2016) Q.103 The repair and reconstruction of the joint is
Q.94 New growth in the bone marrow called:-
is________: (a) Arthrodesis (b) Arthrotomy
(a) Osteoma (b) Myoma (c) Arthroplasty (d) Amputation
(c) Myeloma (d) Odontoma (AIIMS Raipur Staff Nurse, 2017)
(ESIC Staff Nurse, 2016) Q.104 A strong weight bearing synovial joints with
Q.95 Skeletal muscles under microscope have irregular elevations and depressions that
cross-striations formed by dark and light produce interlocking of the bones is called:-
bands. The dark bands are formed by the (a) Vestigeal tail
protein________________ (b) Symphysism pubis
(a) Myosin (b) Mysium (c) Sacroiliac joints
(c) Coronin (d) Actin (d) Sacrococygeal joint
(ESIC Staff Nurse, 2016) (AIIMS Raipur Staff Nurse, 2017)
Q.96 All among the following are long bones, Q.105 Which of the following is known as bone
EXCEPT forming cells?
(a) Scapula (b) Tibia (a) Fibrinoblasts (b) Osteocytes
(c) Femur (d) Fibula (c) Osteoclasts (d) Osteoblasts
(ESIC Staff Nurse, 2016) (AIIMS Raipur Staff Nurse, 2017)
Q.97 Normal response to plantar reflex in adult Q.106 Which comfort device is used to prevent
is:- foot drop?
(a) Extention (a) Bed cradle (b) Foot board
(b) Flexion (c) Sand bag (d) Pillow
(c) Babinski response (AIIMS Raipur Staff Nurse, 2017)
Gurjar Ki Thadi, opp. Metro Pillar No. 67 New Sanganer Road, Jaipur. Mb. 7426955591, 7426955593 37
MCQs
Q.107 Which of the following is NOT a long (AIIMS Bhubaneswar Staff Nurse, 2018)
bone? Q.116 ‘Knee Joint’ is the example of which of the
(a) Humerus (b) Stemum following joints?
(c) Tibia (d) Ulnar (a) Ball and socket joint
(AIIMS Raipur Staff Nurse, 2017) (b) Hinge joint
Q.108 Which among the following is the correct (c) Pivot joint
full form of MRI? (d) Saddle joint
(a) Magnetic Resonance Imaging (AIIMS Bhopal Staff Nurse Gr.2, 2018)
(b) Muscular Repeating Impulse Q.117 The long head of Biceps Brachii muscles
(c) Microscopic Result investigation arised from which of the following?
(d) Mobile Radiation Intercom (a) Supraglenoid tubercle of scapula
(Recruitment Tutor-Nursing, 2016) (b) Infraglenoid tubercle of scapula
Q.109 Polymyalgia rheumatic is associated (c) Coracoids process of scapula
with________. (d) Lateral epicondyle of humerus
(a) Raised cretinine kinase (AIIMS Bhopal Staff Nurse Gr.2, 2018)
(b) Increased alkaline phosphatase Q.118 Gleno-humeral joint is also called:
(c) Sudden loss of vision in one eye (a) Shoulder joint (b) Knee joint
(d) Erythematic nodosum (c) Elbow joint (d) Hip joint
(Recruitment Tutor-Nursing, 2016) (AIIMS Bhopal Staff Nurse Gr.2, 2018)
Q.110 The bone which is also known as ‘knee cap’ Q.119 The largest synovial joint in the body is:
(a) Tibia (b) Fibula (a) The knee joint
(c) Femur (d) Patella (b) The shoulder joints
(RUHS B.Sc. Nursing Exam., 2017) (c) The ankle joint
Q.111 Reduction of bone density leading to (d) The wrist joints
increased susceptibility to fracture is (AIIMS BHUBANESWAR 2019)
(a) Osteomalcia (b) Paget’s Disease Q.120 All of the following are sesamoid bone:-
(c) Osteoarthritis (d) Osteoporosis (a) Patella (b) Fabella
(RUHS B.Sc. Nursing Exam., 2017) (c) Calcaneum (d) Cyamella
Q.112 Which of the following is correct regarding (AIIMS New Delhi 2019)
tendon Q.121 Which of the following is an example of
(a) It connect bone to muscle Hinge joint?
(b) It possible strength to muscle (a) Wrist joint (b) Radioulnar joint
(c) It lubricate joints with synovial fluid (c) Shoulder joint (d) Elbow joint
(d) It relieve friction between moving parts (AIIMS Raipur Shift I 2019)
(RUHS B.Sc. Nursing Exam., 2017) Q.122 Which is the longest bone in the human
Q.113 Which of the following is a classic body?
symptoms of systemic lupus erythematosus (a) Patella (b) Tibia
(SLE)? (c) Femur (d) Fibula
(a) Fatigue and fever (AIIMS Raipur Shift I 2019)
(b) Weight loss Q.123 The function of pectoralis major muscle is:
(c) Shortness of breath (a) Flexion of elbow
(d) Superficial lesions over the cheeks and nose (b) Adduction of arm
(RUHS B.Sc. Nursing Exam., 2017) (c) Extension of elbow
Q.114 A client has his leg immobilized in a long (d) Abduction of arm
leg cast. Which of the following (AIIMS Bhopal Shift II 2018)
assessments would indicate the early Q.124 Gleno-humeral joint is also called:-
beginning of circulatory impairment? (a) Shoulder joint (b) Elbow joint
(a) Inability to move toes (c) Knee joint (d) Hip joint
(AIIMS Bhopal Shift II 2018)
(b) Cyanosis of toes
Q.125 Elevated levels of antistreptolysin O are
(c) Complaints of cast tightness
seen in:
(d) Tingling of toes
(a) Subacute endocarditis
(RUHS B.Sc. Nursing Exam., 2017)
(b) Ventricular septal defect
Q.115 ckDlj dh ekalis’kh ¼ckWDllZ ely½ ______ gSA
(c) Rheumatic fever
(a) czSfd;ksjsfM;kfyl
(d) Cardiomyopathy
(b) ckblsIl czSdkbZ (AIIMS Bhopal Shift II 2018)
(c)MsYVkWbM
(d) fljSVl ,aVhfj;j
Gurjar Ki Thadi, opp. Metro Pillar No. 67 New Sanganer Road, Jaipur. Mb. 7426955591, 7426955593 38
MCQs
Q.126 An example for sesamoid bone is: Q.132 Type of Fracture shown in the image is:-
(a) Patella (b) Ribs
(c) Carpals (d) Sternum
(AIIMS Manglagiri Grade 2018)
Q.127 Among the following, the bone that belongs
to the axial skeleton is:
(a) Humerus (b) Patella
(c) Hyoid (d) Tarsals
(ESIC Shift I 2019)
Q.128 In rheumatoid arthritis, during the acute
phase the values which are significant
are_________
(a) ESR and C reactive Protein (CRP)
elevation
(b) RFT elevation (renal Function Test) (a) Greenstick fracture
(c) CBC elevation (Complete Blood Count) (b) Comminuted fracture
(d) LFT elevation (Liver Function Test) (c) Linear fracture
(ESIC Shift II 2019) (d) Oblique displaced fracture
Q.129 Which is the process of recording the (Safdarjung 2019)
electrical potential of skeletal muscles and Q.133 Which of the following is paired correctly
nerves supplying them by inserting small with its description about skeletal fracture?
needle electrodes into the muscles? (a) An avulsion fracture: A fracture that
(a) ECG (b) EMG extracts a part of bone from the ligament or
(c) ECT (d) EEG tendon
(Railway Recruitment Board Shift I 2019) (b) A greenstick fracture: This bends the
Q.130 What is the name of the muscle that extends bone but does not lead to a fracture
from the sphenoid bone to the mandible? (c) A complete fracture: The fractured bone
(a) Trapezius pierces to the skin surface through the skin
(b) Sternocleidomastoid (d) A pathological fracture: A fracture that
(c) Pterygoid occurs due to some physical trauma
(d) Masseter (GMCH 2019)
(Railway Recruitment Board Shift III 2019) Q.134 Which action by the nurse in charge is
Q.131 Name of this Fossa? essential when cleaning the area around a
Jackson-Pratt wound drain?
(a) Cleaning from the center outward in a
circular motion.
(b) Cleaning from periphery towards center
in circular motion.
(c) Cleaning briskly around the site from
left to right
(d) Cleaning briskly around the site from
right to left
(GMCH 2019)
Gurjar Ki Thadi, opp. Metro Pillar No. 67 New Sanganer Road, Jaipur. Mb. 7426955591, 7426955593 39
MCQs
1 B 2 D 3 A 4 A 5 B 6 B 7 C 8 C 9 C 10 B
11 B 12 A 13 A 14 D 15 B 16 D 17 D 18 A 19 C 20 D
21 C 22 B 23 B 24 C 25 C 26 C 27 C 28 B 29 A 30 C
31 A 32 C 33 D 34 A 35 D 36 D 37 B 38 C 39 C 40 C
41 B 42 C 43 C 44 A 45 D 46 C 47 A 48 D 49 D 50 C
51 C 52 C 53 B 54 B 55 B 56 D 57 A 58 C 59 A 60 A
61 C 62 D 63 A 64 C 65 D 66 B 67 D 68 A 69 B 70 C
71 A 72 A 73 C 74 D 75 C 76 D 77 B 78 C 79 B 80 D
81 D 82 C 83 A 84 B 85 C 86 B 87 B 88 A 89 C 90 C
91 B 92 B 93 D 94 C 95 A 96 A 97 B 98 A 99 A 100 A
101 A 102 A 103 C 104 C 105 D 106 B 107 B 108 A 109 B 110 D
111 D 112 A 113 D 114 D 115 D 116 B 117 A 118 A 119 A 120 A
121 D 122 C 123 B 124 A 125 C 126 A 127 C 128 A 129 B 130 B
131 C 132 B 133 A 134 A
Gurjar Ki Thadi, opp. Metro Pillar No. 67 New Sanganer Road, Jaipur. Mb. 7426955591, 7426955593 40