NR509 Musculoskeletal Exam Questions With
Accurate Answers 2025\2026 A+ Grade
synovial joints
- accurate answers-freely movable joints
ex. knee, shoulder
cartilaginous joints
- accurate answers-allow only slight movement and consist of bones
connected entirely by cartilage
ex. vertebral bodies of the spine, symphysis pubis
Fibrous joints
- accurate answers-Immovable
ex: skull sutures
Synovial Joint Anatomy
- accurate answers-Articular cartilage lines the bone surface, changes in shape
in response to pressure or load
Synovial cavity - cushions joint movement
Synovial membrane -secretes synovial fluid
synovial fluid - lubrication and nutrition to articular cartilage
Joint capsule strengthened and sometimes continuous with ligaments
types of synovial joints
- accurate answers-Spheroidal (ball & socket) - wide ROM ex shoulder hip
Hinge - flat/planar (flex, extend) ex foot, elbow, knee, TMJ
Condylar - Metacarpals and metatarsals
Bursae
- accurate answers-flattened fibrous sacs lined w/synovial membrane,
contains synovial fluid; common where things rub together (skin to bone or
tendons/muscles on bone, ligaments, tendons or other muscles)
Articular structures include:
- accurate answers-joint capsule, articular cartilage, synovium, synovial fluid,
intra-articular ligaments, juxta-articular bone
,Extraarticular structures include
- accurate answers-periarticular ligaments, tendons, bursae, muscle, fascia,
non-articular bone, nerves, and overlying skin
Pathology of articular structures typically involves
- accurate answers-swelling, tenderness, crepitus, instability, 'locking' or
deformity and limits BOTH active & passive ROM
Pathology involving extra-articular structures ...
- accurate answers-Rarely causes intraarticular joint swelling, instability or
joint deformity, typically involves 'point or focal tenderness' in regions
adjacent to joint articular structures
ONLY ACTIVE ROM LIMITED, passive intact
Considerations for monoarticular pain
- accurate answers-Injury, monoarticular arthritis
OR
extraarticular causes such as tendinitis, bursitis or soft tissue injury
Considerations for oligoarticular (pauciarticular pain)
- accurate answers-consider infection from gonorrhea or rheumatic fever,
connective tissue disease and OA
Polyarthritis possible causes
- accurate answers-Viral, inflammatory from RA, SLE, or psoriasis
inflammatory joint disorders - Rest vs activity
- accurate answers-Rest tends to worsen the pain, where as activity tends to
improve the pain
Ex. RA, psoriatic arthritis, SLE, goat, ankylosing spondylitis
mechanical joint disorders - Rest vs activity
- accurate answers-Activity tends to increase the pain and stiffness, and rest
improves symptoms
Ex: OA, low back disorders, tendinitis
, Extra-articular pain occurs in ...
- accurate answers-inflammation of bursae (bursitis), tendons (tendinitis), or
tendon sheaths (tenosynovitis) as well as in sprains from stretching or tearing
of ligaments.
Differentials for LBP on the midline
- accurate answers-musculoligamentous injury, disc herniation, degenerative
disc disease (DDD), degenerative disease of the facet joints of spine, vertebral
fracture or collapse; and rarely, spinal cord metastases or epidural abscess
Differentials for LBP off of the midline
- accurate answers-muscle strain, myofascial pain (trigger points), sacroiliitis,
greater trochanteric pain syndrome, and hip arthritis
also consider renal conditions like pyelonephritis or stones
cauda equina syndrome
- accurate answers-Due to S2-S4 midline disc herniation or tumor if there is
bowel or bladder dysfunction, especially with saddle anesthesia or perineal
numbness.
serious condition where the terminal portion of the spinal cord is compressed.
If left untreated, it can lead to permanent loss of bowel/bladder function as
well as lower extremity paralysis.
Immediate imaging and surgical intervention needed
Red flags for LBP from underlying systemic disease
- accurate answers-Age <20 or >50
H/o cancer
unexplained weight loss, fever, or decline in general health
pain lasting > 1 mo or not responding to tx
pain at night or present at rest
h/o IV drug use, addiction, or immunosuppression
presence of active infection or HIV infection
long term steroid therapy
saddle anesthesia
bladder or bowel incontinence
Accurate Answers 2025\2026 A+ Grade
synovial joints
- accurate answers-freely movable joints
ex. knee, shoulder
cartilaginous joints
- accurate answers-allow only slight movement and consist of bones
connected entirely by cartilage
ex. vertebral bodies of the spine, symphysis pubis
Fibrous joints
- accurate answers-Immovable
ex: skull sutures
Synovial Joint Anatomy
- accurate answers-Articular cartilage lines the bone surface, changes in shape
in response to pressure or load
Synovial cavity - cushions joint movement
Synovial membrane -secretes synovial fluid
synovial fluid - lubrication and nutrition to articular cartilage
Joint capsule strengthened and sometimes continuous with ligaments
types of synovial joints
- accurate answers-Spheroidal (ball & socket) - wide ROM ex shoulder hip
Hinge - flat/planar (flex, extend) ex foot, elbow, knee, TMJ
Condylar - Metacarpals and metatarsals
Bursae
- accurate answers-flattened fibrous sacs lined w/synovial membrane,
contains synovial fluid; common where things rub together (skin to bone or
tendons/muscles on bone, ligaments, tendons or other muscles)
Articular structures include:
- accurate answers-joint capsule, articular cartilage, synovium, synovial fluid,
intra-articular ligaments, juxta-articular bone
,Extraarticular structures include
- accurate answers-periarticular ligaments, tendons, bursae, muscle, fascia,
non-articular bone, nerves, and overlying skin
Pathology of articular structures typically involves
- accurate answers-swelling, tenderness, crepitus, instability, 'locking' or
deformity and limits BOTH active & passive ROM
Pathology involving extra-articular structures ...
- accurate answers-Rarely causes intraarticular joint swelling, instability or
joint deformity, typically involves 'point or focal tenderness' in regions
adjacent to joint articular structures
ONLY ACTIVE ROM LIMITED, passive intact
Considerations for monoarticular pain
- accurate answers-Injury, monoarticular arthritis
OR
extraarticular causes such as tendinitis, bursitis or soft tissue injury
Considerations for oligoarticular (pauciarticular pain)
- accurate answers-consider infection from gonorrhea or rheumatic fever,
connective tissue disease and OA
Polyarthritis possible causes
- accurate answers-Viral, inflammatory from RA, SLE, or psoriasis
inflammatory joint disorders - Rest vs activity
- accurate answers-Rest tends to worsen the pain, where as activity tends to
improve the pain
Ex. RA, psoriatic arthritis, SLE, goat, ankylosing spondylitis
mechanical joint disorders - Rest vs activity
- accurate answers-Activity tends to increase the pain and stiffness, and rest
improves symptoms
Ex: OA, low back disorders, tendinitis
, Extra-articular pain occurs in ...
- accurate answers-inflammation of bursae (bursitis), tendons (tendinitis), or
tendon sheaths (tenosynovitis) as well as in sprains from stretching or tearing
of ligaments.
Differentials for LBP on the midline
- accurate answers-musculoligamentous injury, disc herniation, degenerative
disc disease (DDD), degenerative disease of the facet joints of spine, vertebral
fracture or collapse; and rarely, spinal cord metastases or epidural abscess
Differentials for LBP off of the midline
- accurate answers-muscle strain, myofascial pain (trigger points), sacroiliitis,
greater trochanteric pain syndrome, and hip arthritis
also consider renal conditions like pyelonephritis or stones
cauda equina syndrome
- accurate answers-Due to S2-S4 midline disc herniation or tumor if there is
bowel or bladder dysfunction, especially with saddle anesthesia or perineal
numbness.
serious condition where the terminal portion of the spinal cord is compressed.
If left untreated, it can lead to permanent loss of bowel/bladder function as
well as lower extremity paralysis.
Immediate imaging and surgical intervention needed
Red flags for LBP from underlying systemic disease
- accurate answers-Age <20 or >50
H/o cancer
unexplained weight loss, fever, or decline in general health
pain lasting > 1 mo or not responding to tx
pain at night or present at rest
h/o IV drug use, addiction, or immunosuppression
presence of active infection or HIV infection
long term steroid therapy
saddle anesthesia
bladder or bowel incontinence
