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Religious of the Virgin Mary

St. Joseph Home Rehabilitation Center


May 2011

Quiz #2 – Chapters 5 and 6: The Thorax and Chest Wall; Temporomandibular


Joint

Instructions:
• Use BLACK ink only!
• No erasures and/or any superimpositions.
• Answers should be written in CAPITAL LETTERS ONLY!

I.Multiple Choice
Choose the letter of the best answer.
1. The thoracic vertebrae is/are _____
a. Least mobile c. both a and b
b. Most stable section of the vertebral column d. none of the above
2. The XS (xiphisternal) joint is a _____ articulating the body of the sternum with the
xiphoid process.
a. Diarthrosis c. Plane synovial
b. Synchondrosis d. Synarthrosis
3. What ligament is included in the articulation of ribs 2 to 10 and lies within the capsule
and tethers the head of the rib to the annulus that lies between the demifacets?
a. Interosseous ligament c. Inferior ligament
b. Stellate ligament d. none of the above
4. Some authors refer this joint as the “symphysis sterni”.
a. Costotransverse joint c. Manubriosternal joint
b. Xiphisternal joint d. Chondrosternal joint
5. Ribs 1 to 10 articulates with the vertebral column by these two synovial joints:
a. Manubriosternal and Costovertebral joints c. Chondrosternal and Xiphisternal
b. Interchondral and Costotransverse joints d. Costovertebral and
Costotransverse
6. “Bucket-handle motion” is movement of the lower ribs towards ___ and ____.
a. Upward and medially c. Downward and laterally
b. Upward and laterally d. Inferiorly and medially
7. The following are true of the respiratory muscles, except:
a. They must contract rhythmically and continuously throughout life
b. The control of these muscles is solely voluntary
c. They must primarily work against elastic (chest wall and lungs) and airway resistive
loads, rather than against the gravitational forces encountered by most other
skeletal muscles
d. A and B
e. All of the above
f. None of the above
8. What muscle attaches to the 12th rib and acts as a stabilizer for the diaphragm as the
diaphragm eccentrically contracts during phonation?
a. Quadratus Lumborum c. Transversus Thoracis
b. Internal Intercostals d. Levatores Costarum
9. The following are false about the diaphragm, except:
a. The diaphragm is elliptical and domed with its costal fibers running vertically
b. As the diaphragm contracts during inspiration, the shortening of the muscle fibers
decreases the length of the apposed diaphragm with a descent of the dome of the
diaphragm
c. The crural portion of the diaphragm has a less direct inspiratory effect on the lower
rib cage than the costal portion
d. B and C
e. All the above
f. None of the above
10.What is the major function of the abdominals with respect to ventilation?
a. Actively increasing intra-abdominal pressure c. Assist in forced expiration
b. Limits ventilation increase during exercise d. All of the above
11.In pregnancy, tidal volumes are ______.
a. Decreased c. Remains unchanged
b. Increased d. Varies
12.In the TMJ, what type of joint is formed by the condyle and the inferior surface of the
disk?
a. Hinge joint c. Amphiarthrodial e. NOTA
b. Ginglymus d. Both a and b
13.The following is/are true of the TMJ, except:
a. The lower joint of TM joint is a gliding or amphiarthrodial joint.
b. Each TM joint is formed by the condyle of the mandible, the articular eminence of
the temporal bone, and articular disk that is interposed between the two.
c. The surfaces of the TMJ are covered by dense collagenous tissue that may have
some chondroblasts in it, thereby allowing it to be considered fibrocartilage.
d. All of the above
e. None of the above
14.What is the normal mouth opening?
a. 11 to 25 mm c. 40 to 50 mm
b. 35 to 40 mm d. 25 to 30 mm
15.The amount of mouth opening is considered to be normal if ___ PIP joints can be placed
between the central front incisors.
a. Two c. Four
b. Three d. None of the above
16.What ligament serves to suspend the mandible and to check the mandible from
excessive forward translation?
a. Capsular ligament c. Stylomandibular ligament
b. Sphenomandibular ligament d. Temporomandibular ligament
17.The following is/are false about mandibular protrusion and retrusion, except:
a. Rotation occurs in the TMJ during protrusion.
b. Protrusion and retrusion occurs when all points of the mandible move forward the
same amount.
c. During protrusion, the anterior attachments of the disk stretch to 9 mm to allow the
motion to occur.
d. The capsular ligament limits motion by becoming taut, the retrodiskal tissue limits
movement by occupying the space into which the condyle would move during
retrusion.
e. All of the above
f. None of the above
18.What is the normal amount of lateral excursion of the TMJ?
a. 7 mm c. 6 mm
b. 9 mm d. 8 mm
19.What is the primary muscle responsible for mandibular depression?
a. Masseter c. Digastric
b. Temporalis d. Lateral Pterygoid
20.This position refers to, when the teeth are in firm approximation?
a. Maximal intercuspation c. Both a and b
b. Occlusal position d. NOTA
21.This refers to when a patient who has an anteriorly dislocated disk will have an audible
click from the TMJ on opening and a second when the mouth is closing?
a. Jaw locking c. Crepitus
b. Reciprocal click d. Bruxism
22.This serves to limit the forward motion of the disk during rotation and translation?
a. Inferior retrodiskal lamina c. Capsular ligament
b. Bilaminar retrodiskal pad d. Stylomandibular ligament
23.These muscles are responsible for mandibular retraction, except:
a. Digastric c. Temporalis
b. Suprahyoid muscles d. Masseter
24.What is the normal adult dentition?
a. 33 teeth c. 30 teeth
b. 32 teeth d. 31 teeth
25.What two muscles, when combined, deviates the mandible to the left?
a. Right Medial Pterygoid and Left Temporalis c. Left Lateral Pterygoid and
Left Temporalis
b. Left Medial Pterygoid and Right Lateral Pterygoid d. Right Lateral Pterygoid
and Left Temporalis

II. Identification:
1. This muscle depresses and fixes the ribs to provide adequate diaphragmatic muscle
tension during ventilation.
2. Portion of the diaphragm that is directly apposed to the inner wall of the lower rib cage.
3. This is called as the movement of the lower ribs upwards and laterally.
4. This is where the Temporalis muscle attaches to.
5. Part of the TMJ that serves as a tether on the disk, limiting forward translation, but does
not assist with repositioning the disk during mouth closing.
6. This action is obtained through bilateral action of the posterior fibers of the temporalis
muscles with assistance from the digastrics and suprahyoid muscles.
7. Other term used to refer to Manubriosternal joint.
8. This muscle appears to always be active during expiration below functional residual
capacity or below a normal tidal expiration and has also further been shown to be
active during quiet expiration in older subjects in standing.
9. Primary muscle for inspiration
10.Major manifestation of this disease is air trapping with hyperinflation of the lungs.

III. Enumeration:
1-3 Give 3 muscles responsible for mandibular elevation
4-5 Give at least 2 advantages of the biconcave shape of the TMJ’s disk

--- Good luck!!! ---


Jewel Ricci Tan, PTRP

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