Chapter 6 Test

Test A

Each multiple choice question counts 1 point.

The Honor Code, as always, is in force. All students are expected to comply.

Identify the parts of the bone1. Bone marrow

2. Diaphysis

3. Blood vessels

4. Osteocyte

5. Spongy bone

6. Haversian canal

7. Compact bone

A

B

C D

E A

B

Identify the Skeleton Sections

8. Cranium

9Appendicular

10. Axial

A

B

C

Match the cell to its’ function

11. Cells responsible for endochondral ossification

12. Grow pattern of bone in which matrix is laid down on the surface

13. Area of long bones where cartilage cells are replaced by bone cells

14. The appearance of this line signals the end of bone growth

15. Area where bone growth takes place

a. Chondrocytes

b. Appositional growth

c. Epiphyseal line

d. Diaphysis

e. Epiphyseal plate

Match the parts of the diagram

16. Haversian canal

17. Canaliculus

18. Volkmann’s canal

19. Osteon/Haversian system

A

C

DB

Tiny lines

20. The picture at the right shows the type of material that originally makes up embryonic “bone”. What tissue is this?

a. osseous

b. epithelial

c. hyaline cartilage

d. fibrocartilage

21. Which of the following is NOT a function of the skeleton?

a. movement

b. protection

c. support

d. respiration

22. In bone formation, a deficiency of growth hormone will cause

a. Inadequate calcification of bone

b. Decreased osteoclast activity

c. Decreased proliferation of the epiphyseal plate cartilage

d. Increased osteoclast activity

23. A fracture in the shaft of a bone would be a break in the

a. Epiphysis

b. Metaphysis

c. Diaphysis

d. Articular cartilage

24. The structure of bone suits the function. Which of the following bones is adapted to withstand stress?

a. Spongy bone

b. Irregular bone

c. Compact bone

d. Sharpey’s fibers

25. The cell responsible for secreting the matrix of bone is the

a. Osteocyte

b. Osteoblast

c. Osteoclast

d. chrondrocyte

26. Spongy bones are made up of a framework called:

a. Osteons

b. Lamellar bone

c. Trabeculae

d. Osseous lamellae

27. Factors in preventing or delaying osteoporosis include

a. Drinking fluoridated water

b. Decreasing weight bearing activity

c. Increasing dietary Vitamin C

d. Decreasing exposure to the sun

28. The covering of the bone marked “A” at right called the

a. Endosteum

b. Metasteum

c. Volkman canal

d. Periosteum

A

29. Which hormone increases osteoclast activity to release more calcium ions into the bloodstream?

a. Calcitoninb. Thyroxinec. Parathyroid hormoned. Estrogen

30. Vertebrae are considered _____bones

a. Long

b. Flat

c. Short

d. Irregular

31. Cartilage grows two ways – appositional and interstitial. Appositional growth is

a. Growth at the epiphyseal plate

b. The secretion of new matrix against existing cartilage

c. Along the edges only

d. The lengthening of hyaline cartilage

32. Children go through growth “spurts” but the most dramatic occurs in puberty. Which sex hormone increases osteoblast activity during puberty?

a. Testosteroneb. Estrogenc. Progesterond. Estradiol

33. Ricketts, or soft bone disorder, is caused by a lack of osteoblast activity due to the inability of the body to uptake calcium. Which vitamin is necessary for calcium uptake?

a. Vitamin Ab. Vitamin Bc. Vitamin Cd. Vitamin D

34. Bone growth during infancy and youth is exclusively through

a. Interstitial growth of the epiphyseal plate

b. The secretion of bone matrix into the medullary cavity

c. Differentiation of osteoclasts

d. Calcification of the matrix

35 In some cases the epiphyseal plate of the long bones of children closes too early. What might be the cause?

a. Overproduction of thyroid hormone

b. Elevated levels of sex hormone

c. Too much Vitamin D in the diet

d. Osteoblast activity exceeds osteoclast activity

36. A patient comes to the emergency room complaining of anxiety, depression, muscle stiffness, profuse diaphoresis, and extremely dry skin. You take his blood pressure, which his 55/45 (very low!). You order a chemistry panel, complete blood count, and urine tests. His blood calcium is 7.5 mg/dl! Your patient has

a. Hypercalcemia

b. Hypocalcemia

c. Isocalcemia

37. Yellow bone marrow contains a large percentage of

a. Fat

b. Bone-forming cells

c. Elastic tissue

d. Periosteum

38. Cranial bones develop

a. from cartilage models

b. within fibrous membranes

c. from a tendon

d. within osseous membranes

39.What kind of tissue is the forerunner of long bones in the embryo?

a. Elastic connective tissue

b. Dense fibrous connective tissue

c. Fibrocartilage

d. Hyaline cartilage

Match the term to the part

40. Trochanter

41. Epicondyle

42. Tuberosity

A B

C

More matching

43. Crest

44. Foramen

45. Facet

46. Groove

A

B

C

D

(holes)

47. Select the correct statement concerning the location of blood-forming tissue.

a. There is blood-forming marrow in most long bones of an adult

b. The sternum is a good source of blood-forming tissue

c. There is blood-forming marrow in most short bones of adults

d. Blood-forming tissue is found in the skull and pelvic bones only

48. The “bones” in an embryo begin to form around

a. 15 to 20 days after conception

b. 30 to 39 days after conception

c. 41 to 44 days after conception

d. 50 to 60 days after conception

49. The term given to the formation of “true” bone in the models is called

a. Chondroficationb. Ossificationc. Osteoblastificationd. Chondroblasticification

50. Which of the following IS NOT a factor involved in bone formation or remodeling?

a. Vitamin D

b. Sex hormones

c. Exercise

d. Lack of growth hormone

51. Bone lamellae grow in “spirals”. These spirals are referred to as

a. Osteoids

b. Osteocytes

c. Osteoplaca

d. Osteomalacia

52. The small “tubes” joining one osteocyte lacunae to the others is called a

a. Trabeculae

b. Canaliculi

c. Haversian canals

d. Volkmann’s canals

Identify the hormone to the gland it is synthesized in:

53. PTH

54. Calcitonin ThyroidA

B

55. The function of calcitonin is toa. Suppress osteoblasts to stop bone

formationb. Suppress osteoclasts to decrease bone

breakdownc. Suppress chondrocytes from forming new

bone after fracturesd. Increase osteocyte formation

56. One of the following IS NOT an effect of PTH. What is it?

a. Increased numbers of calcium-absorbing protein channels are formed on intestinal cells

b. Vitamin D is activated in the kidneyc. Calcium is released from bonesd. All are effects of PTH!

57. Osteoporosis is caused by

a. Too little calcium in the diet

b. Too little estrogen in the bloodstream

c. Too little Vitamin D

d. All of the above

58. True or False – Men are as likely to suffer from osteoporosis as women as they age.

A. true

B. false

59. How do SERMS help to rebuild bone?

a. They add biphosphonate crystals to the bones

b. They activate estrogen receptors on osteoclasts

c. They increase the amount of estrogen

d. None of the above

60. Mrs. X, a 58 year old female, comes to you for help. She complains that her head and face are “growing” and she is developing constant backaches. A radiographic scintillation Xray indicates that she has what disease or disorder?

a. Osteoarthritisb. Marfan’s Syndromec. Paget’s Diseased. Cushing’s Disease

61. Wolff’s Law is concerned with

a. Vertical growth of bones being dependent on age

b. The thickness and shape of a bone being dependent on stresses placed on it

c. The function of bone being dependent on shape

d. The diameter of bone being dependent on the ratio of osteoblasts to osteoclasts

62. What fills in the space between the osteon lamellae?

a. Interstitial lamellae

b. Interstitial fluid

c. Incomplete lamellae

d. None of these

63. In the epiphyseal plate the cartilage grows

a. From the diaphysis to the epiphysis

b. From the epiphysis to the diaphysis

c. From the edges inward

d. In a circular fashion

64. Osteogenesis is the process of

a. Bone healing

b. Bone remodeling

c. Bone formation

d. Bone formation and bone remodeling

65. Fill in B.

66. Which of the following enzymes is responsible for laying down hydroxyapatite crystals on bone matrix?

a. Alkaline phosphatase

b. Creatine phosphatase

c. Thyroxinase

d. Acidic phosphatase

67. Fill in B.

Essay Questions

1. Each question has a total value of 5 points.

Everyone must answer questions 1 and 5.

2. Then select one other question to answer.

3. You may also answer one more question for extra credit. Please mark the extra credit question with an asterisk.

Essay Question 1You are a doctor working for “Doctors without Borders”, an international health care organization that goes to poor or troubled countries to help those in need. During your tour of Iraq, a 34 year-old woman comes to you complaining of extreme fatigue. She is currently nursing a 2 month old infant, and is followed by two more children. You note in the charts that she is wearing the traditional burka. Her vital signs (blood pressure, temperature) seem fine. You provide her with food, and tell her to get more sleep.

A week later she is brought in on a stretcher with a broken hip which occurred after she tripped over a rock and fell down. You draw blood, check her calcium levels and Vitamin D, and find that they are very low.

You are explaining this to the patient so you cannot use medical jargon. a. What is your diagnosis and why? b. What has caused this problem? c. Be very specific in your answer as to the physiology of this disorder!

Essay 2

If your elderly patient’s blood calcium level is normal, does that mean that the patient does not have osteoporosis? Explain why.

Essay 3

Explain why swimming is not generally recommended as an exercise to increase osteoblast activity, whereas a good hour’s walk each and every day would be.

Essay 4

When does prevention of osteoporosis start and why?

Essay 5

Johnny fractured the lower third of his right tibia in a skiing accident. The soft tissues in the area were severely damaged and their surgical removal was necessary. After prolonged immobilization, it was found that Johnny was healing poorly. The explanation offered by the orthopedic surgeon was that vascularization of the fracture site was still inadequate and good healing was absolutely dependent upon an adequate blood supply. Describe how a long bone receives it blood supply and trace the path of nutrient delivery to the osteocytes.

Essay 6Mr. L is a 45 year old who is in fairly good shape. He is

5’11”, weighs 195, and attends the gym at least 4 times per week. He also jogs three times per week. He admits to eating fast food more often than “good food”. He also tells you that his 7 year old son, Jeb, was back on his feet and running around after being in a cast for 6 weeks.

You are talking to Mr. L in the E.R. as you set his leg after he trod on a rock, slipped and twisted his leg, falling hard and breaking his tibial diaphysis while jogging. He will need to be in a cast and on crutches.

What factors are working against Mr. L’s having as speedy a recovery as his son Jeb? List these factors, and give a reasonable time you can safely tell Mr. L when he will be able to resume jogging