CMT Musculoskeletal Anatomy & Pathophysiology 3 — Questions and Answers
Question 1: Which bony landmark serves as the attachment site for the Achilles tendon?
- Navicular tuberosity
- Sustentaculum tali
- Calcaneal tuberosity (Correct answer)
- Lateral malleolus
Correct answer: Calcaneal tuberosity
The Achilles tendon (calcaneal tendon) inserts onto the posterior aspect of the calcaneal tuberosity.
Question 2: Spinal stenosis most commonly causes which symptom pattern?
- Unilateral radiculopathy that worsens with rest
- Neurogenic claudication relieved by lumbar flexion (Correct answer)
- Bilateral arm weakness independent of posture
- Sharp stabbing pain that improves with extension
Correct answer: Neurogenic claudication relieved by lumbar flexion
Neurogenic claudication from lumbar stenosis is classically relieved by forward flexion (e.g., leaning on a shopping cart) because flexion opens the spinal canal.
Question 3: The iliotibial band (ITB) originates primarily from the:
- Anterior superior iliac spine only
- Tensor fascia latae and gluteus maximus (Correct answer)
- Ischial tuberosity and pubic ramus
- Greater trochanter of the femur
Correct answer: Tensor fascia latae and gluteus maximus
The ITB is the thickened lateral fascia of the thigh, formed by contributions from the tensor fascia latae and the superior fibers of gluteus maximus.
Question 4: Which phase of tissue healing is characterized by collagen remodeling and scar maturation?
- Hemostasis phase
- Inflammatory phase
- Proliferative phase
- Remodeling phase (Correct answer)
Correct answer: Remodeling phase
The remodeling phase (weeks to years) involves reorganization of collagen fibers along lines of stress to improve tensile strength.
Question 5: The Q-angle is measured between the line of pull of the quadriceps and the:
- Patellar tendon to the tibial tubercle (Correct answer)
- Femoral neck and the tibial shaft
- Medial joint line and the ACL
- Hip flexion axis and the ankle mortise
Correct answer: Patellar tendon to the tibial tubercle
The Q-angle is formed by a line from the ASIS to the patella center and a line from the patella center to the tibial tubercle.
Question 6: Which muscle group is primarily responsible for lumbar extension and is commonly hypertonic in individuals with anterior pelvic tilt?
- Rectus abdominis
- Iliopsoas
- Erector spinae (Correct answer)
- Multifidus only
Correct answer: Erector spinae
The erector spinae group (iliocostalis, longissimus, spinalis) extends the lumbar spine and is typically overactive with anterior pelvic tilt.
Question 7: Rheumatoid arthritis preferentially affects which joint compartments of the hand?
- Distal interphalangeal (DIP) joints
- Metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints (Correct answer)
- Carpometacarpal (CMC) joints only
- Wrist extensors and DIP joints
Correct answer: Metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints
Rheumatoid arthritis classically involves the MCP and PIP joints bilaterally, sparing the DIP joints — the opposite pattern from osteoarthritis.
CMT Musculoskeletal Anatomy & Pathophysiology 3
Which bony landmark serves as the attachment site for the Achilles tendon?