1. in the Absence of a Contrast Medium, the X Ray Is Best Suited for Viewing Bone. However

Chapter 11

1.  In the absence of a contrast medium, the X ray is best suited for viewing bone. However, an MRI scan would allow the physician to examine the soft tissues (muscle and connective tissue) as well as the bones that make up the shoulder joint.

2.  While training prior to the season, Jason deliberately designs his workout program to prevent overuse. However, once the season starts, Jason does not feel he is progressing adequately, so he increases the intensity and duration of his workouts and omits the strength training in order to concentrate on pitching. This results in overuse and injury to the right rotator cuff.

3.  The droop of the right shoulder, lack of free movement of the right arm, decreased muscle strength in the right arm rotator cuff muscles, decreased range of motion, and guarding of the right shoulder all suggest that the rotator cuff is injured. Additionally, pitchers are predisposed to rotator cuff injuries because the pitching motion involves circumduction of the shoulder joint, which puts stress on the rotator cuff.

4.  The muscles of the rotator cuff are the infraspinatus, supraspinatus, subscapularis, and teres minor.

5.  The right subscapular nerve and/or the right axillary nerve would be suspected because they are the nerves that innervate the muscles of the rotator cuff.

6.  (c) The physical therapist is testing the strength of the quadriceps femoris.

7.  The physician suspects that Adam has myositis, specifically dermatomyositis. He will ask Adam questions in an attempt to rule out trichinosis or polymyositis. To rule out trichinosis, which can be caused by consuming undercooked pork or wild game, the physician may ask Adam about his recent diet. A muscle biopsy would aid the diagnosis of dermatomyositis by revealing atrophied muscle fascicles and inflammatory cells surrounding the blood vessels supplying the muscle.

8.  The muscles most likely to be affected are the levator palpebrae muscles, which raise the upper eyelid. These muscles are innervated by the oculomotor nerve.

9.  (a) Dark, reddish-brown urine would indicate myoglobinuria, which can lead to renal failure if left untreated. Muscle atrophy or muscle contractures (answers b and c) would develop much later.

10.  Muscle pain and stiffness occur in trichinosis because the Trichinella larvae have migrated to and encysted in the muscle. This destroys muscle tissue and leads to stiffness and pain upon use.