C．a secondary ossification center forms at the ends of a 1ong bone
D．bones may form within cartilage model or within a membrane matrix
E．a cartilaginous disk remains between the primary and secondary ossification centers
until old age
39．The bones of the wrist are called the .
40．Which of the following bones is／are not part of the axial skeleton?
41．Which of the following is not true about the vertebrae?
A．They help protect the spinal cord
B．They are part of the appendicular skeleton
C．They form the dorsal backbone
D．They help form 4 curvatures of the spine
E．They are separated by intervertebral discs
42．The correct order of regions of vertebra is .
1．A1though both tympanic membranes appear normal，fluid is observed in both middle ears．The right ear also suffers a moderate hearing loss. Ear involvement in this case may best be explained by spread of infection from the tonsils via the.
A. facial canal
B. foramen ovale
C. pharyngotympanic tube
D. external auditory meatus
E. internal auditory meatus
2．A 26-year-old accountant trips over a brief case and falls onto his outstretched hand. You suspect a fracture of a carpal bone. Which of the following is most likely fractured?
3．An 18-year-old boy was suspected of having leukemia. It was decided to confirm the diagnosis by performing a bone marrow biopsy. The following statements concerning this procedure are correct except which one?
A. Red bone marrow specimens can be obtained from the sternum or the iliac crests
B. The biopsy was taken from the lower end of the tibia
C. At birth, the marrow of all bones of the body is red and hematopoietic
D. The blood-forming activity of bone marrow in many long bones gradually lessens with age, and the red marrow is gradually replaced by yellow marrow
E. By the time the person becomes adult, red marrow is restricted to the bones of the skull, the vertebral column, the thoracic cage, the girdle bones, and the head of the humerus and femur
4．During a little league game one of the players accidently struck her teammate with her bat. When the bat hit the boy' s arm there was an audible crack and the boy fell to the ground in pain. Luckily, one of the mothers watching was a physician and she rushed to the boy' s aid. Quick examination showed that the boy had a closed fracture in his upper arm. After watching him abduct and rotate the arm, she diagnosed damage to the axillary nerve. Damage to this nerve normally occurs when injury is located at the.
A. lateral epicondyle of the humerus
B. medial epicondyle of the humerus
C. anatomical neck of the humerus
D. surgical neck of the humerus
E. deltoid tuberosity of the humerus
5．A heavily built, middle-aged man running down a flight of stone steps misjudged the position of one of the steps and fell suddenly onto his buttocks. Following the fall, he complained of severe bruising of the area of the cleft between the buttocks and persistent pain in this area. The following statements concerning this patient are correct except which?
A. The lower end of the vertebral column was traumatized by the stone step
B. The coccyx can be palpated beneath the skin in the natal cleft
C. The anterior surface of the coccyx cannot be felt clinically
D. The coccyx is usually severely bruised or fractured
E. The pain is felt in the distribution of dermatomes S4 and S5
6．An elderly woman was run over by an automobile as she was crossing the road. Radiographic examination of the pelvis in the Emergency Department of the local hospital revealed a fracture of the ilium and iliac crest on the left side. The following statements about fractures of the pelvis are correct except which?
A. Fractures of the ilium have little displacement
B. Displacement is prevented by the presence of the iliacus and the gluteal muscles on the inner and outer surfaces of this bone, respectively
C. If two fractures occur in the ring forming the true pelvis, the fracture will be unstable and displacement will occur
D. Fractures of the true pelvis do not cause injury to the pelvic viscera
E. The post-vertebral and abdominal muscles are responsible for elevating the lateral part of the pelvis should two fractures occur
7．A pregnant woman visited an antenatal clinic. A vaginal examination revealed that the sacral promontory could be easily palpated and that the diagonal conjugate measured less than 10 cm. The following statements concerning this examination are correct except which?
A. Normally it is difficult or impossible to feel the sacral promontory by means of a vaginal examination
B. The normal diagonal conjugate measures about 25 cm
D. It is likely that this patient would have an obstructed labor
E. This patient was advised to have a cesarean section
8．A 26-year-old man was running across a field when he caught his right foot in a rabbit hole. As he fell, the right foot was violently rotated laterally and overeverted. On attempting to stand, he could place no weight on his right foot. On examination by a physician, the right ankle was considerably swollen, especially on the lateral side. After further examination, including a radiograph of the ankle, a diagnosis of severe fracture dislocation of the ankle joint was made. The following statements concerning this patient are correct except which?
A. This type of fracture dislocation is caused by forced external rotation and overexertion of the foot.
B. The talus is externally rotated against the lateral malleolus of the fibula, causing it to fracture.
C. The torsion effect on the lateral malleolus produces a spiral fracture.
D. The medial ligament of the ankle joint is strong and never ruptures.
E. If the talus is forced to move farther laterally and continues to rotate, the posterior inferior margin of the tibia will be sheared off.
9．Infection may spread from the nasal cavity to the meninges along the olfactory nerves. Olfactory fibers pass from the mucosa of the nasal cavity to the olfactory bulb via the.
A. semilunar hiatus
B. cribriform plate of the ethmoid bone
C. anterior and posterior ethmoidal foramina
D. sphenopalatine foramen
E. nasociliary nerve
10．A 23-year-old college student is being seen for possible sinusitis. The physician sees purulent drainage arising from the superior nasal meatus. Which of the following sinuses is likely to be infected?
1. List the bones of the skull that are paired. Which are unpaired?
2. List four types of bones based on shape and give an example of each type.
Multiple Choice Questions
1. C 2. E 3. D 4. C 5. B 6. D 7. C 8. A 9. E 10. B 11. D 12. B 13. E 14. E 15. A 16. B 17. C 18. D 19. E 20. C 21. A 22. A 23. B 24. A 25. B 26. D 27. E 28. A 29. B 30. D 31. D 32. E 33. A 34. D 35. B 36. A 37. E 38. E 39. B 40. D 41. B 42. C
1. C 2. D 3. B 4. D 5. C 6. D 7. B 8. D 9. B 10. D
1. B 2. C 3. A 4. E 5. D 6. A 7. A 8. C 9. D 10. E
True or False Questions
1. F 2. F 3. F 4. F 5. F 6. T 7. T 8. F
Explanation of Terms
1. This is a reference position that allows for the use of consistent directional terminology. All descriptions of location are made from within anatomical position. The person is standing erect, palms facing anteriorly, feet together and facing forward.
2. The sternal angle is the angle formed by the junction of the manubrium and the body of the sternum in the form of a secondary cartilaginous joint (symphysis). This is also called the manubriosternal joint or Angle of Louis. The sternal angle is a palpable clinical landmark. It marks the approximate level of the 2nd pair of costal cartilages and the level of the intervertebral disc between T4 and T5. The angle is 140 degrees.
3. The point corresponding with the posterior end of the sphenoparietal suture is named the pterion. It is situated about 3 cm behind, and a little above the level of the zygomatic process of the frontal bone. It marks the junction between four bones: parietal bone, temporal bone, sphenoid bone and frontal bone. The pterion is known as the weakest part of the skull. Clinically, the pterion is relevant because the middle meningeal artery runs beneath it, on the inner side of the skull, which is quite thin at this point.
4. When the arm is extended, with the palm facing forward or up, the bones of the humerus and forearm are not perfectly aligned. The deviation from a straight line (generally on the order of 5。-10。) occurs in the direction of the thumb, and is referred to as the carrying angle. In females the carrying angle is greater than in males. The carrying angle can influence how objects are held by individuals--those with a more extreme carrying angle may be more likely to supinate the forearm when holding objects in the hand to keep the elbow closer to the body.
5. The largest one of all fontanelles.
Location: the junction of the sagittal and coronal sutures
Size: about 4cm anteroposteriorly and 2. 5cm transversely.
The fontanelle is closed at about the middle of the second year.
6. It is a circular line, formed by the promontory of the sacrum, the anterior border of the sacrum ala, the arcuate line of ilium, the pecten pubis, the pubic crest and the upper border of the pubic symphysis. Whole pelvis is divided into a greater pelvis and a lesser pelvis by the terminal line.