ONC: Orthopedic Nursing Study Cards
Correct Questions & Answers!!
Lachman Test- what is it, and how do we position for test. - ANSWERBest indicator
of anterior cruciate ligament (ACL) injury
Done to detect the presence of an ACL tear
Position the patient supine with knee at 200 to 300 of flexion. The leg should also be
slightly externally rotated.
Use one hand to stabilize the femur while moving the proximal tibia anteriorly.
Musculoskeletal System- Major Parts: - ANSWERBones: 206 in adults; inorganic
salts with collagen fiber framework.
Joints: Collective term that includes relevant ligaments and tendons.
Muscles
Ligaments
Tendons
Musculoskeletal System- Purposes - ANSWERCalcium and other mineral storage
Form and shape of the body
Movement of the body
Organ protection
Hematopoiesis
Bone shapes- Long - ANSWERFound in extremities.
Examples: Femur, tibia, humerus
Bone shapes- Short - ANSWERFound in feet and hands
Examples: Tarsal and carpal bones (e.g. metacarpals, metatarsals)
Bone shapes- Flat - ANSWERFound in the skull (frontal/parietal bones)
Found in the ribs, scapulae, sternum, ilium, and pubis
Bone shapes- Irregular - ANSWERFound in the spine (vertebrae)
Found in the skull (mandible, sphenoid, etc.)
Bone Structure- cortical/compact - ANSWERNetworks (haversian systems) of
interconnecting canals
Canals (canaliculi) contain capillaries and provide nutrients and fluids to bone and
connect all the lacunae.
Contains lamellae (layers) and lacunae (small openings between lamellae)
Lacunae holds osteocytes (bone cells)
Bone Structure-
Cancellous/spongy/trabecular - ANSWERTrabeculae: Thin plates form interior
meshwork
Random directional placement give structural support.
,Inorganic mineral salts enable bones to flex and withstand a certain amount of
compression.
Bone growth- osteoclasts - ANSWERPhagocytic cells
Digest older weak bone
Bone growth- osteoblasts - ANSWERInner and outer surfaces of bones
Produce the osteoid (bone matrix)
Fill in sections cleared of old bone by osteoclasts
Eventually become mature bone cells (osteocytes)
Bone growth- Pediatric bone growth - ANSWEREpiphyseal plate: Cartilage layer
between diaphysis and epiphysis of long bones.
Epiphyseal line: in adults after the plate has become ossified.
Remodeling in the plate promotes longitudinal growth until the plates close at some
point in adolescence.
Substances needed for bone growth - ANSWERCalcium, phosphate, vitamin D
Small amounts of Na, Mg, and potassium carbonate
Alkaline phosphatase (alk phos)
Parathyroid hormone breaks down bone and works against growth.
High Serum Alk Phos Differential Diagnoses - ANSWERBone metastases (increased
osteoblast activity)
Paget's disease (increased osteoblast activity)
Biliary obstruction
Excess vitamin D
Hyperparathyroidism
Joint Classification by structure-
1. Fibrous (synarthroses)
2. Cartilaginous (amphiarthroses)
3. Synovial (diarthroses) - ANSWER1. Mostly stability, very little movement; skull
sutures
2. Limited movement; intravertebral joints
3. Greatest movement; limb joints. Articular cartilage covers ends of synovial joint
bones. Held together by articular (fibrous) capsule and surrounded by ligaments,
tendons, and muscles as stabilizers. Synovial membranes beneath the articular
capsules secrete synovial fluid.
Joint Classification by function-
1. Angular functions
2. Circular functions - ANSWER1. Flexion, extension, hyperextension, abduction,
adduction
2. Rotation, pronation, supination
Muscles-
1. Muscle fibers
2. Myofibrils
3. Fascia - ANSWER1. Long muscle cells
, 2. Threads of protein that separate muscle fibers
3. Fibrous tissue sheaths that hold muscle fibers together in bundles
Types of Muscular Contractions
1. Isotonic
2. Isometric - ANSWER1. Increased tension with shortening of fiber length
2. Increased tension; no change in fiber length
Muscle contraction pathway - ANSWERMotor neurons-> myoneural junctions-> Y
ATP and acetylcholine released-> sarcoplasmic reticulum releases calcium-> muscle
contraction
Muscle Classifications- Voluntary activity - ANSWERControlled by somatic nervous
system that promotes movement based on purposeful thoughts (walking, grasping)
or reactive thoughts (reflexes)
Ex: Skeletal muscles
Muscle Classifications- Involuntary activity - ANSWERControlled by autonomic
nervous system (ANS), which comprises the sympathetic and parasympathetic
system (SNS and PNS)
Ex: Cardiac muscle, visceral muscles
Types of muscles-
1. Striated
2. Nonstriated
3. Cardiac - ANSWER1. Striped appearance found in skeletal muscles
2. Smooth muscles that move internal organ contents through the body
3. Smooth muscles that comprise the walls of the heart
Grading Muscle Strength-
1. Zero
2. Trace
3. Poor - ANSWER1. Paralysis without visible or palpable muscle contractions. NO
ROM exhibited.
2. Palpable contractions without joint movement. no ROM exhibited.
3. Contraction moves joint only without gravity forces. Full ROM possible
Grading Muscle Strength-
1. Fair
2. Good
3. Normal - ANSWER1. Contraction moves joint only against gravity forces. Full
ROM likely.
2. Contraction moves joint against gravity and some resistance. Full ROM present.
3. Contraction moves joint against full resistance. Full ROM present.
Tendons - ANSWERFibrous cords
Attach skeletal muscles to bones
Point of origin: Generally, the proximal end; least movable
Point of insertion: Generally, the distal end; most movable
Correct Questions & Answers!!
Lachman Test- what is it, and how do we position for test. - ANSWERBest indicator
of anterior cruciate ligament (ACL) injury
Done to detect the presence of an ACL tear
Position the patient supine with knee at 200 to 300 of flexion. The leg should also be
slightly externally rotated.
Use one hand to stabilize the femur while moving the proximal tibia anteriorly.
Musculoskeletal System- Major Parts: - ANSWERBones: 206 in adults; inorganic
salts with collagen fiber framework.
Joints: Collective term that includes relevant ligaments and tendons.
Muscles
Ligaments
Tendons
Musculoskeletal System- Purposes - ANSWERCalcium and other mineral storage
Form and shape of the body
Movement of the body
Organ protection
Hematopoiesis
Bone shapes- Long - ANSWERFound in extremities.
Examples: Femur, tibia, humerus
Bone shapes- Short - ANSWERFound in feet and hands
Examples: Tarsal and carpal bones (e.g. metacarpals, metatarsals)
Bone shapes- Flat - ANSWERFound in the skull (frontal/parietal bones)
Found in the ribs, scapulae, sternum, ilium, and pubis
Bone shapes- Irregular - ANSWERFound in the spine (vertebrae)
Found in the skull (mandible, sphenoid, etc.)
Bone Structure- cortical/compact - ANSWERNetworks (haversian systems) of
interconnecting canals
Canals (canaliculi) contain capillaries and provide nutrients and fluids to bone and
connect all the lacunae.
Contains lamellae (layers) and lacunae (small openings between lamellae)
Lacunae holds osteocytes (bone cells)
Bone Structure-
Cancellous/spongy/trabecular - ANSWERTrabeculae: Thin plates form interior
meshwork
Random directional placement give structural support.
,Inorganic mineral salts enable bones to flex and withstand a certain amount of
compression.
Bone growth- osteoclasts - ANSWERPhagocytic cells
Digest older weak bone
Bone growth- osteoblasts - ANSWERInner and outer surfaces of bones
Produce the osteoid (bone matrix)
Fill in sections cleared of old bone by osteoclasts
Eventually become mature bone cells (osteocytes)
Bone growth- Pediatric bone growth - ANSWEREpiphyseal plate: Cartilage layer
between diaphysis and epiphysis of long bones.
Epiphyseal line: in adults after the plate has become ossified.
Remodeling in the plate promotes longitudinal growth until the plates close at some
point in adolescence.
Substances needed for bone growth - ANSWERCalcium, phosphate, vitamin D
Small amounts of Na, Mg, and potassium carbonate
Alkaline phosphatase (alk phos)
Parathyroid hormone breaks down bone and works against growth.
High Serum Alk Phos Differential Diagnoses - ANSWERBone metastases (increased
osteoblast activity)
Paget's disease (increased osteoblast activity)
Biliary obstruction
Excess vitamin D
Hyperparathyroidism
Joint Classification by structure-
1. Fibrous (synarthroses)
2. Cartilaginous (amphiarthroses)
3. Synovial (diarthroses) - ANSWER1. Mostly stability, very little movement; skull
sutures
2. Limited movement; intravertebral joints
3. Greatest movement; limb joints. Articular cartilage covers ends of synovial joint
bones. Held together by articular (fibrous) capsule and surrounded by ligaments,
tendons, and muscles as stabilizers. Synovial membranes beneath the articular
capsules secrete synovial fluid.
Joint Classification by function-
1. Angular functions
2. Circular functions - ANSWER1. Flexion, extension, hyperextension, abduction,
adduction
2. Rotation, pronation, supination
Muscles-
1. Muscle fibers
2. Myofibrils
3. Fascia - ANSWER1. Long muscle cells
, 2. Threads of protein that separate muscle fibers
3. Fibrous tissue sheaths that hold muscle fibers together in bundles
Types of Muscular Contractions
1. Isotonic
2. Isometric - ANSWER1. Increased tension with shortening of fiber length
2. Increased tension; no change in fiber length
Muscle contraction pathway - ANSWERMotor neurons-> myoneural junctions-> Y
ATP and acetylcholine released-> sarcoplasmic reticulum releases calcium-> muscle
contraction
Muscle Classifications- Voluntary activity - ANSWERControlled by somatic nervous
system that promotes movement based on purposeful thoughts (walking, grasping)
or reactive thoughts (reflexes)
Ex: Skeletal muscles
Muscle Classifications- Involuntary activity - ANSWERControlled by autonomic
nervous system (ANS), which comprises the sympathetic and parasympathetic
system (SNS and PNS)
Ex: Cardiac muscle, visceral muscles
Types of muscles-
1. Striated
2. Nonstriated
3. Cardiac - ANSWER1. Striped appearance found in skeletal muscles
2. Smooth muscles that move internal organ contents through the body
3. Smooth muscles that comprise the walls of the heart
Grading Muscle Strength-
1. Zero
2. Trace
3. Poor - ANSWER1. Paralysis without visible or palpable muscle contractions. NO
ROM exhibited.
2. Palpable contractions without joint movement. no ROM exhibited.
3. Contraction moves joint only without gravity forces. Full ROM possible
Grading Muscle Strength-
1. Fair
2. Good
3. Normal - ANSWER1. Contraction moves joint only against gravity forces. Full
ROM likely.
2. Contraction moves joint against gravity and some resistance. Full ROM present.
3. Contraction moves joint against full resistance. Full ROM present.
Tendons - ANSWERFibrous cords
Attach skeletal muscles to bones
Point of origin: Generally, the proximal end; least movable
Point of insertion: Generally, the distal end; most movable
