Brunnstrom Clinical Kinesiology 6th Edition

Houglum Bertoti

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Brunnstrom Clinical Kinesiology 6th Edition Houglum Bertoti

Chapter 6: Elbow and Forearm Complex

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. The elbow complex consists of ______ joint(s) and is surrounded by ________
capsule(s).

a. two; one

b. three; one

c. two; two

d. three; two

____ 2. Most of the motion at the elbow comes from this joint:

a. proximal radioulnar

b. distal radioulnar

c. humeroradial

d. humeroulnar

____ 3. Classically the elbow is considered to have ______ degree(s) of freedom.

a. one

b. two

c. three

d. four
____ 4. Motion at the elbow takes place primarily in the _______ plane about a(n) _______
axis.

a. sagittal; medial-lateral

b. sagittal; anterior-posterior

c. frontal; medial-lateral

d. frontal; anterior-posterior

____ 5. The elbow relies mainly on this for stability:

a. active restraints

b. passive restraints

c. bony geometry

d. negative intra-articular pressure

____ 6. On average, there is _________° of motion (extension to flexion) at the elbow.

a. 80

b. 105

c. 120

d. 145
____ 7. The normal end feel for elbow extension range of motion is:

a. firm

b. soft tissue approximation

c. bone to bone

d. springy

____ 8. In very thin individuals it is possible the end feel for elbow flexion to be bone to bone
due to the ____________ process articulating with the ____________ fossa.

a. coronoid; coronoid

b. coronoid; olecranon

c. olecranon; olecranon

d. olecranon; coronoid

____ 9. The closed pack position of the proximal radioulnar joint is:

a. full flexion

b. full extension

c. mid-flexion with neutral supination-pronation

d. either full supination or pronation

____ 10. Full elbow flexion necessitates that all of the following tissues have normal
length/mobility except the:

a. posterior capsule

b. anterior fibers of the medial collateral ligament

c. ulnar nerve

d. one joint elbow extensors

____ 11. During open kinetic chain elbow extension, the ________ radial head moves
_________ on the capitulum.

a. concave; anteriorly

b. concave; posteriorly

c. convex; anteriorly

d. convex; posteriorly

____ 12. During closed kinetic chain elbow flexion, the capitulum rolls __________ and glides
___________.

a. anterior; anterior

b. anterior; posterior

c. posterior; anterior

d. posterior; posterior
____ 13. In the humeroradial resting position, the radial head is located:

a. anterior to the capitulum

b. posterior to the capitulum

c. medial to the capitulum

d. in full contact with the capitulum

____ 14. The carrying angle is most pronounced with the glenohumeral joint ___________
rotated and forearm _____________.

a. medially; pronated

b. medially; supinated

c. laterally; pronated

d. laterally; supinated

____ 15. The medial collateral ligament of the elbow provides stabilization in the ________
plane.

a. sagittal

b. frontal

c. transverse

d. horizontal

____ 16. Supination and pronation occur in the ___________ plane about a(n) _________ axis.
a. sagittal; medial-lateral

b. frontal; anterior-posterior

c. transverse; superior-inferior

d. coronal; anterior-posterior

____ 17. The normal end feel for supination range of motion is:

a. firm

b. bone to bone

c. soft tissue approximation

d. springy

____ 18. What type of joint is the proximal radioulnar joint is classified as?

a. Ginglymus

b. Trochoid

c. Condyloid

d. Pivot

____ 19. During open kinetic chain supination at the distal radioulnar joint, the radius rolls
________ and slides ________.

a. anterior; anterior
b. anterior; posterior

c. posterior; posterior

d. posterior; anterior

____ 20. The radioulnar joints primarily rely on _________ for stability?

a. bony geometry

b. active and passive soft tissue restraints

c. negative intra-articular pressure

d. load creating compression and hence stability of joints

____ 21. The interosseous membrane between the radius and ulna serves to perform all of the
following functions except:

a. transmit forces from the radius to the ulna

b. transmit forces from the ulna to the radius

c. serve as an attachment site for local musculature

d. increase stability of the radioulnar joints

____ 22. The undersurface of the annular ligament is lined with?

a. Hyaline cartilage

b. Fibrocartilage
c. Elastic cartilage

d. Calcified cartilage

____ 23. The quadrate ligament provides stability at which joint?

a. Humeroulnar

b. Humeroradial

c. Proximal radioulnar

d. Distal radioulnar

____ 24. The oblique cord becomes taut with:

a. elbow flexion

b. elbow extension

c. forearm pronation

d. forearm supination

____ 25. Of the following, which muscle is capable of producing elbow flexion?

a. Long head of the triceps

b. Pronator teres

c. Pronator quadratus
d. Anconeus

____ 26. The elbow flexor group is innervated by each of the following peripheral nerves
except by the __________ nerve

a. median

b. ulnar

c. radial

d. musculocutaneous

____ 27. Which elbow flexor muscle is unaffected by forearm and shoulder position?

a. Biceps brachii, short head

b. Biceps brachii, long head

c. Brachioradialis

d. Brachialis

____ 28. Of the following, which elbow flexor is recruited in all tasks requiring elbow flexion?

a. Biceps brachii, short head

b. Biceps brachii, long head

c. Brachioradialis

d. Brachialis
True/False

Indicate whether the statement is true or false.

____ 29. Because the trochlea is located more distal than the capitulum, a valgus carrying
angle is created.

____ 30. In the anatomical position, the elbow joint axis is strictly aligned with the coronal
plane.

____ 31. Compared with the shoulder and wrist, the accessory motions at the elbow are
substantial.

____ 32. A gunstock deformity is associated with cubital varus.

____ 33. The carrying angle increases when moving from elbow extension to flexion.

____ 34. The majority of supination and pronation occurs at the distal radioulnar joint.

____ 35. The supinator muscle is thought to act in isolation to perform slow supination tasks
near elbow extension.

____ 36. When an individual makes a tight fist, the biceps and triceps act to stabilize the
elbow.
____ 37. During most functional motions, bi-articular muscles become active insufficient.

____ 38. Regardless of angle, the supinator is capable of producing more supination torque
than the biceps brachii.

____ 39. The pronator teres contributes more to pronation torque compared with the pronator
quadrates.

____ 40. Typically, the anconeus initiates elbow extension.

Chapter 6: Elbow and Forearm Complex

Answer Section

MULTIPLE CHOICE

1. ANS: B PTS: 1

2. ANS: D PTS: 1

3. ANS: A PTS: 1

4. ANS: A PTS: 1
5. ANS: C PTS: 1

6. ANS: D PTS: 1

7. ANS: C PTS: 1

8. ANS: A PTS: 1

9. ANS: D PTS: 1

10. ANS: B PTS: 1

11. ANS: A PTS: 1

12. ANS: B PTS: 1

13. ANS: B PTS: 1

14. ANS: D PTS: 1

15. ANS: B PTS: 1

16. ANS: C PTS: 1

17. ANS: A PTS: 1

18. ANS: D PTS: 1

19. ANS: C PTS: 1

20. ANS: B PTS: 1

21. ANS: B PTS: 1

22. ANS: A PTS: 1

23. ANS: C PTS: 1

24. ANS: D PTS: 1

25. ANS: B PTS: 1

26. ANS: B PTS: 1

27. ANS: D PTS: 1

 28. ANS: D PTS: 1

TRUE/FALSE

29. ANS: T PTS: 1

30. ANS: F PTS: 1

31. ANS: F PTS: 1

32. ANS: T PTS: 1

33. ANS: F PTS: 1

34. ANS: F PTS: 1

35. ANS: T PTS: 1

36. ANS: T PTS: 1

37. ANS: F PTS: 1

38. ANS: F PTS: 1

 39. ANS: T PTS: 1

40. ANS: T PTS: 1

Chapter 7: Wrist and Hand

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. The primary bone of the wrist is the:

a. radius

b. ulna

c. scaphoid

d. lunate

____ 2. Lister’s tubercle provides a pulley for the:

a. flexor pollicis longus

b. flexor pollicis brevis

c. extensor pollicis longus

d. extensor pollicis brevis

____ 3. The axis for radial and ulnar deviation passes through this carpal bone:

a. scaphoid

b. lunate

c. hamate

d. capitates

____ 4. Which carpal bone is most commonly fractured?

a. Scaphoid

b. Lunate

c. Hamate

d. Capitates

____ 5. Blood supply to the scaphoid proceeds primarily in a ___________ fashion.

a. proximal to distal

b. distal to proximal

c. lateral to medial

d. medial to lateral

____ 6. Which carpal bone is most commonly dislocated?

a. Scaphoid

b. Lunate

c. Hamate

d. Capitates

____ 7. The wrist is often classified as a __________ joint.

a. ginglymus

b. plane or gliding

c. condyloid

d. elliptical

____ 8. The wrist has _______ degree(s) of angular freedom.

a. one

b. two

c. three

d. four

____ 9. During open kinetic chain wrist extension, the proximal row of carpal bones roll
___________ and glide ___________.

a. volarly; volarly
b. dorsally; volarly

c. volarly; dorsally

d. dorsally; dorsally

____ 10. During closed kinetic chain wrist extension, the distal radius rolls ___________ and
glides ____________.

a. volarly; volarly

b. dorsally; volarly

c. volarly; dorsally

d. dorsally; dorsally

____ 11. The palm of the hand has a concave appearance because:

a. the flexor muscles are stronger than the extensors

b. the extensor muscles are stronger than the flexors

c. of the arches formed by the carpal bones and ligaments

d. of the tightness of the superficial fascia on the volar aspect of the hand

____ 12. The __________ carpometacarpal (CMC) joint has the least amount of motion in the
sagittal plane

a. first
b. second

c. third

d. fourth

____ 13. The first CMC joint of the thumb is considered to be a(n) _______ joint.

a. ball and socket

b. saddle

c. condyloid

d. ellipsoid

____ 14. During abduction of the first CMC joint, the first metacarpal rolls _______ and glides
_______ on the trapezium.

a. volarly; volarly

b. dorsally; volarly

c. volarly; dorsally

d. dorsally; dorsally

____ 15. The metacarpophalangeal (MCP) joints (2–5) possess ______ degree(s) of angular
freedom.

a. one
b. two

c. three

d. four

____ 16. MCP joint motion (2–5) includes:

a. flexion/extension and medial/lateral rotation

b. medial/lateral rotation and abduction/adduction

c. abduction/adduction and flexion/extension

d. flexion/extension and opposition

____ 17. Approximately ____% of the metacarpal heads are covered with articular cartilage.

a. 25

b. 50

c. 75

d. 100

____ 18. The interphalangeal (IP) joints of the hand possess ______ degree(s) of angular
freedom.

a. one

b. two
c. three

d. four

____ 19. To stretch the oblique retinacular ligament, the proximal interphalangeal (PIP) joint
should be ________, whereas the distal interphalangeal (DIP) joint is either actively or passively
__________.

a. flexed; flexed

b. flexed; extended

c. extended; flexed

d. extended; extended

____ 20. Because there are no ligaments between these two carpal bones, a substantial amount
of motion exists:

a. scaphoid and lunate

b. lunate and capitate

c. capitate and scaphoid

d. lunate and triquetrum

____ 21. The fibrocartilaginous disc, which is part of the triangular fibrocartilage complex of
the wrist, is located between the:

a. radius and ulna

b. radius and proximal row of carpal bones

c. ulna and proximal row of carpal bones

d. proximal and distal rows of carpal bones

____ 22. How many tendons pass through the carpal tunnel?

a. 6

b. 7

c. 8

d. 9

____ 23. When the elbow is flexed a minimum of 15°, the wrist extensors are situated
_______________ to the elbow axis and therefore are capable of _____________ the elbow.

a. anterior; flexing

b. posterior; flexing

c. anterior; extending

d. posterior; extending

____ 24. The extensor carpi ulnaris and flexor carpi ulnaris work as ______________ to
perform ulnar deviation.

a. agonists
b. antagonists

c. synergists

d. These muscles do not ulnarly deviate the wrist.

____ 25. In the frontal plane, the abductor pollicis longus is __________ to the axis of rotation
and therefore is capable of assisting with ________________.

a. medial; radial deviation

b. medial; ulnar deviation

c. lateral; radial deviation

d. lateral; ulnar deviation

____ 26. Which muscle flexes the IP joint of the thumb?

a. Flexor pollicis brevis

b. Flexor pollicis longus

c. Flexor digitorum superficialis

d. Flexor digitorum profundus

____ 27. The lumbricals function to ______________ the MCP joints and ____________ the
PIP joints.

a. flex; flex
b. flex; extend

c. extend; flex

d. extend; extend

____ 28. Mallet finger results from disruption of the ___________ tendon at the _________
joint.

a. extensor communis; DIP

b. extensor communis; PIP

c. flexor digitorum profundus; DIP

d. flexor digitorum profundus; PIP

____ 29. The normal end feel for radial deviation or abduction is:

a. firm-capsular

b. empty

c. soft tissue approximation

d. hard-bony

____ 30. The most stable position of the wrist is full:

a. radial deviation

b. ulnar deviation
c. extension

d. flexion

____ 31. The PIP joints exhibit approximately __________° of motion.

a. 30

b. 60

c. 90

d. 120

____ 32. Patients with C6 tetraplegia grasp objects:

a. by actively flexing their digits

b. by actively extending their wrists

c. particularly well if they have their wrist flexors stretched regularly

d. are unable to grasp objects

____ 33. Which type of grip is most commonly used when picking up and holding objects for
use?

a. Three prong chuck

b. Tip prehension

c. Lateral prehension
d. Power grip

____ 34. Which type of grip is recommended to pick up objects for patients with upper motor
neuron lesions to minimize the likelihood of spasticity?

a. Three prong chuck

b. Tip prehension

c. Lateral prehension

d. Power grip

True/False

Indicate whether the statement is true or false.

____ 35. The first two digits provide the hand with gross or strength manipulation.

____ 36. The hand has multiple functions including prehension, providing afferent information
to the CNS as well as assisting in expression and nonverbal communication.

____ 37. The radius is in direct contact with the carpal bones.

____ 38. The ulna is in direct contact with the carpal bones.

____ 39. The loose packed position of the MCP joints is 90° of flexion.
____ 40. The extensor digitorum participates in wrist extension only when the fingers are
simultaneously extended.

____ 41. The cruciate pulleys prevent bowstringing of the long finger flexors.

____ 42. All power grips incorporate use of the thumb.

____ 43. In precision grips, the thumb is typically abducted and positioned to oppose the
fingers.

____ 44. The wrist extensors play a vital role in stabilizing the wrist when an individual makes
a fist.

____ 45. As it relates to flexion of the MCP joints, the internal moment arm of the palmar
interossei is greater than that of the lumbricals.

____ 46. The intrinsic muscles of the hand actively function to perform light or easy closure of
the fingers.

____ 47. Abduction at the MCP joints naturally occurs when the hand is rapidly opened,
fingers fully extended.

Chapter 7: Wrist and Hand

Answer Section
MULTIPLE CHOICE

1. ANS: A PTS: 1

2. ANS: C PTS: 1

3. ANS: D PTS: 1

4. ANS: A PTS: 1

5. ANS: B PTS: 1

6. ANS: B PTS: 1

7. ANS: C PTS: 1

8. ANS: B PTS: 1

9. ANS: B PTS: 1

10. ANS: D PTS: 1

11. ANS: C PTS: 1

12. ANS: C PTS: 1

13. ANS: B PTS: 1

14. ANS: C PTS: 1

15. ANS: B PTS: 1

16. ANS: C PTS: 1

17. ANS: C PTS: 1

18. ANS: A PTS: 1

19. ANS: C PTS: 1

20. ANS: B PTS: 1

21. ANS: C PTS: 1

22. ANS: D PTS: 1

23. ANS: A PTS: 1

24. ANS: C PTS: 1

25. ANS: C PTS: 1

26. ANS: B PTS: 1

27. ANS: B PTS: 1

28. ANS: A PTS: 1

29. ANS: D PTS: 1

30. ANS: C PTS: 1

31. ANS: D PTS: 1

32. ANS: B PTS: 1

33. ANS: A PTS: 1

 34. ANS: C PTS: 1

TRUE/FALSE

35. ANS: F PTS: 1

36. ANS: T PTS: 1

37. ANS: T PTS: 1

38. ANS: F PTS: 1

39. ANS: F PTS: 1

40. ANS: T PTS: 1

41. ANS: T PTS: 1

42. ANS: F PTS: 1

43. ANS: T PTS: 1

44. ANS: T PTS: 1

45. ANS: F PTS: 1

46. ANS: F PTS: 1

47. ANS: T PTS: 1