Fundamental Orthopedic Management For The Physical Therapist Assistant 4th Edition By Robert – Test Bank

Chapter 11: Cartilage Healing

MULTIPLE CHOICE

1. Which of the following terms is defined as the intrinsic cartilage repair?
a. Chondromalacia
b. Chondrogenesis
c. Hydrophilic
d. Angiogenesis

ANS: B
Proper rehabilitation techniques are based on the foundation of intrinsic cartilage repair (chondrogenesis), time necessary for healing, and extrinsic reparative interventions.

REF: P. 185

2. Which of the following terms is defined as softening of hyaline cartilage?
a. Chondromalacia
b. Chondrogenesis
c. Hydrophilic
d. Angiogenesis

ANS: A
Osteoarthritis, chondromalacia (softening of hyaline cartilage), meniscal lesions, labral tears, and many other cartilage pathologies are common problems the physical therapist assistant sees clinically.

REF: P. 185

3. Which cartilage zone is composed of calcified cartilage made up mainly of cells, cartilage, matrix, and inorganic salts?
a. Superficial
b. Middle/transitional
c. Deep
d. Deepest

ANS: D
The zone of calcified cartilage is the deepest zone that separates cartilage tissue from subchondral bone. This small distinct layer is composed mainly of cells, cartilage, matrix, and inorganic salts.

REF: P. 186

4. Which cartilage zone is composed of water and parallel, highly organized collagen fibrils?
a. Superficial
b. Middle/transitional
c. Deep
d. Deepest

ANS: A
The superficial zone of articular cartilage is composed of water and parallel, highly organized collagen fibrils with very limited concentration of proteoglycans.

REF: P. 185

5. Which type of collagen is the majority of articular cartilage composed of?
a. Type I
b. Type II
c. Type V
d. Type VI

ANS: B
Collagen represents more than 50% of the entire dry weight of articular cartilage. The vast majority of collagen in articular cartilage is type II; however, the extracellular matrix also contains types V, VI, IV, X, and XL.

REF: P. 186

6. Why is it difficult to impossible for articular cartilage to heal itself?
a. Articular cartilage has the wrong type of collagen to stimulate its own healing
b. Articular cartilage is an avascular cartilage that produces a limited vascular inflammatory response
c. The vascular inflammatory response overwhelms the articular cartilage and prevents intrinsic healing
d. None of the above

ANS: B
Articular cartilage is a nonhomogeneous and avascular structure that lacks the ability to stimulate, regulate, or organize intrinsic repair. Without an intense vascular response to injury, articular cartilage cannot form a fibrin scaffold or mobilize cells in order to repair the defect.

REF: P. 186

7. How does cartilage receive its nutrients?
a. Through normal joint motion causing fluid movement and through diffusion or convection
b. Through the normal blood supply to the knee
c. From the blood supply to the synovial fluid
d. Through the cartilage artery

ANS: A
Articular cartilage is permeable and the synovial fluid provides the necessary nutrients through diffusion and convection. Normal joint motion is needed to maintain the cartilage integrity and nutrition of hyaline cartilage.

REF: P. 187

8. What is the effect of immobilization on cartilage?
a. There is no effect of immobilization on cartilage
b. Immobilization encourages cartilage to heal and repair itself
c. Immobilization has profound negative effects on cartilage healing
d. None of the above

ANS: C
The removal of normal physiologic loading, unloading, and joint motion have profoundly negative effects on the biochemical and mechanical characteristics of articular cartilage. The significance of articular cartilage atrophy and degeneration is related to the magnitude and duration of immobilization.

REF: P. 187

9. Which of the following is NOT a cause of cartilage erosion?
a. Trauma
b. Infection
c. Shearing loads
d. Immobilization
e. Continuous passive motion (CPM)

ANS: E
All of the items listed can cause cartilage erosion except CPM.

REF: P. 188

10. Why do superficial articular cartilage defects not heal as well as deeper cartilage injuries?
a. They lack the blood vessels needed to deliver the cells in the inflammatory response
b. Superficial defects are not as serious and therefore do not have the strong inflammatory response deeper injuries receive
c. Superficial defects do heal as well as deeper cartilage injuries
d. Chondrocytes adhere to the superficial defects better than the deeper injuries

ANS: A
Superficial articular cartilage defects do not heal as well as deeper injuries because they injuries do not stimulate the inflammatory response. These superficial injuries lack vascularization.

REF: P. 188