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Question 7221

Topic: Biomechanics & Biomaterials

In the context of tissue biomechanics, the viscoelastic property of load relaxation is defined as:

. Increasing deformation over time under a constant load
. Decreasing stress over time under a constant deformation
. Energy loss dissipated as heat during cyclic loading
. Increased stiffness proportional to faster loading rates
. Permanent deformation remaining after load removal

Correct Answer & Explanation

. Increasing deformation over time under a constant load


Explanation

Load (or stress) relaxation is the phenomenon where the stress within a material decreases over time while it is held at a constant strain. Creep, conversely, is increasing deformation under a constant load.

Question 7222

Topic: Biology, Genetics & Bone Healing

What is the most abundant structural protein in the extracellular matrix of bone, constituting roughly 90% of its organic matrix?

. Osteocalcin
. Type II collagen
. Type I collagen
. Aggrecan
. Osteopontin

Correct Answer & Explanation

. Osteocalcin


Explanation

Type I collagen forms a triple helix and makes up about 90% of the organic matrix of bone, providing significant tensile strength. Osteocalcin and osteopontin are noncollagenous proteins involved in mineralization.

Question 7223

Topic: 1. General Principles & Basic Science

In normal articular cartilage, which zone has the highest concentration of water and collagen fibers oriented parallel to the joint surface?

. Superficial (tangential) zone
. Middle (transitional) zone
. Deep (radial) zone
. Tidemark
. Calcified zone

Correct Answer & Explanation

. Superficial (tangential) zone


Explanation

The superficial zone contains the highest water content and has collagen fibers aligned parallel to the joint surface to resist shear stress. The deep zone features vertical fibers to resist compressive forces.

Question 7224

Topic: 1. General Principles & Basic Science

Which of the following alterations to a cortical screw design most significantly increases its pull-out strength in bone?

. Decreasing the outer diameter
. Increasing the inner root diameter
. Decreasing the thread pitch
. Increasing the thread pitch
. Decreasing the length of engagement

Correct Answer & Explanation

. Decreasing the outer diameter


Explanation

Screw pull-out strength is directly proportional to outer diameter and length of engagement, and inversely proportional to thread pitch. Decreasing thread pitch increases the number of threads engaged per unit of length, enhancing pull-out strength.

Question 7225

Topic: Biomechanics & Biomaterials

On a stress-strain curve for a ligament, the initial 'toe region' represents which of the following physiological events?

. Microscopic failure of collagen fibers
. Macroscopic failure of the ligament
. Uncrimping of collagen fibers
. Plastic deformation
. Viscoelastic creep

Correct Answer & Explanation

. Microscopic failure of collagen fibers


Explanation

The toe region of the stress-strain curve represents the initial unfolding or 'uncrimping' of the wavy collagen fibers under low strain. Once uncrimped, the ligament enters the linear elastic region where stress becomes proportional to strain.

Question 7226

Topic: Biology, Genetics & Bone Healing

Which of the following molecules acts as a decoy receptor to bind RANKL, thereby inhibiting osteoclast differentiation and bone resorption?

. Macrophage colony-stimulating factor (M-CSF)
. Osteoprotegerin (OPG)
. Interleukin-1 (IL-1)
. Transforming growth factor-beta (TGF-beta)
. Calcitonin

Correct Answer & Explanation

. Macrophage colony-stimulating factor (M-CSF)


Explanation

Osteoprotegerin (OPG) is produced by osteoblasts and binds to RANKL as a decoy receptor. This interaction prevents RANKL from binding to RANK on osteoclast precursors, effectively inhibiting osteoclastogenesis and bone resorption.

Question 7227

Topic: 1. General Principles & Basic Science

Which structural layer of a peripheral nerve is the primary barrier to the diffusion of foreign substances and maintains the blood-nerve barrier?

. Epineurium
. Perineurium
. Endoneurium
. Schwann cell membrane
. Axolemma

Correct Answer & Explanation

. Epineurium


Explanation

The perineurium surrounds fascicles of nerve fibers and functions as the primary blood-nerve barrier. It provides significant tensile strength to the nerve and protects axons from foreign substances.

Question 7228

Topic: Biomechanics & Biomaterials

Which of the following orthopedic implant materials has a modulus of elasticity most closely resembling that of normal cortical bone?

. Stainless steel
. Cobalt-chromium alloy
. Titanium alloy
. Tantalum
. Polymethylmethacrylate (PMMA)

Correct Answer & Explanation

. Stainless steel


Explanation

Titanium alloy has a modulus of elasticity (roughly 110 GPa) closer to that of cortical bone (15-20 GPa) compared to stainless steel (200 GPa) and cobalt-chromium (220 GPa). This closer match helps minimize stress shielding.

Question 7229

Topic: Biology, Genetics & Bone Healing

Rigid plate fixation of a transverse radial shaft fracture with absolute stability primarily heals through which of the following processes?

. Endochondral ossification
. Intramembranous ossification
. Primary bone healing via cutting cones
. Secondary healing with hard callus formation
. Chondrogenesis followed by osteogenesis

Correct Answer & Explanation

. Endochondral ossification


Explanation

Absolute stability achieved through rigid internal fixation prevents micromotion and leads to primary (direct) bone healing. This process bypasses callus formation and relies on Haversian remodeling via cutting cones traversing the fracture site.

Question 7230

Topic: Biomechanics & Biomaterials

A patient undergoing gradual clubfoot correction with serial casting relies on a specific viscoelastic property of soft tissues. The progressive elongation of these contracted tissues under a constant load over time is best described as:

. Stress relaxation
. Creep
. Hysteresis
. Fatigue failure
. Isotropic behavior

Correct Answer & Explanation

. Stress relaxation


Explanation

Creep is the progressive deformation (elongation) of a viscoelastic material when subjected to a constant load over time. In contrast, stress relaxation refers to the decrease in stress over time when the material is held at a constant deformation.

Question 7231

Topic: 1. General Principles & Basic Science

Which type of joint lubrication relies primarily on a thin layer of fluid generated by the sliding motion and deformation of articular surfaces under load?

. Boundary lubrication
. Elastohydrodynamic lubrication
. Weeping lubrication
. Boosted lubrication
. Hydrostatic lubrication

Correct Answer & Explanation

. Boundary lubrication


Explanation

Elastohydrodynamic lubrication occurs when a fluid film separates sliding joint surfaces, facilitated by the elastic deformation of articular cartilage under dynamic loads. Boundary lubrication operates primarily during static loading or extreme loads, relying on surface molecules like lubricin.

Question 7232

Topic: Physiology & Rehabilitation

During the normal human gait cycle, which muscle group undergoes an eccentric contraction during the initial contact (heel strike) to loading response phase to prevent foot slap?

. Plantar flexors
. Dorsiflexors
. Quadriceps
. Hamstrings
. Hip abductors

Correct Answer & Explanation

. Plantar flexors


Explanation

The ankle dorsiflexors, primarily the tibialis anterior, contract eccentrically after heel strike to lower the foot smoothly to the ground. A failure of this mechanism results in an audible foot slap.

Question 7233

Topic: 1. General Principles & Basic Science

Which of the following biochemical changes is most characteristic of the physiological aging process of the intervertebral disc?

. Increase in water content of the nucleus pulposus
. Increase in the chondroitin sulfate to keratin sulfate ratio
. Decrease in total proteoglycan content
. Decrease in collagen cross-linking
. Shift from type I to type II collagen in the annulus fibrosus

Correct Answer & Explanation

. Increase in water content of the nucleus pulposus


Explanation

As the intervertebral disc ages, it undergoes a decrease in total proteoglycan content, a decline in water content, and a reduction in the ratio of chondroitin sulfate to keratin sulfate. This leads to diminished ability of the nucleus pulposus to absorb compressive loads.

Question 7234

Topic: Biology, Genetics & Bone Healing

Parathyroid hormone (PTH) helps regulate serum calcium levels. Which of the following mechanisms is NOT a direct action of PTH?

. Increasing osteoclast activity via RANKL stimulation
. Increasing renal tubular reabsorption of calcium
. Decreasing renal tubular reabsorption of phosphate
. Stimulating 1-alpha-hydroxylase activity in the kidney
. Directly stimulating intestinal absorption of calcium

Correct Answer & Explanation

. Increasing osteoclast activity via RANKL stimulation


Explanation

PTH does not directly stimulate the intestinal absorption of calcium. Instead, it promotes intestinal calcium absorption indirectly by upregulating 1-alpha-hydroxylase in the kidneys, which converts 25-hydroxyvitamin D to its active form, 1,25-dihydroxyvitamin D.

Question 7235

Topic: Biology, Genetics & Bone Healing

Which of the following markers is essential for the differentiation of macrophages into osteoclasts?

. Runx2
. SOX9
. RANKL
. Osteoprotegerin
. Sclerostin

Correct Answer & Explanation

. Runx2


Explanation

RANKL binds to the RANK receptor on osteoclast precursors to stimulate their differentiation into mature osteoclasts. Runx2 is a transcription factor for osteoblasts, while SOX9 is essential for chondrocytes.

Question 7236

Topic: Biomechanics & Biomaterials

In the context of viscoelastic materials, what term describes the progressive deformation of a material over time when subjected to a constant load?

. Stress relaxation
. Creep
. Hysteresis
. Fatigue failure
. Strain rate dependency

Correct Answer & Explanation

. Stress relaxation


Explanation

Creep refers to the time-dependent progressive deformation of a material under a constant load. Stress relaxation describes a decrease in stress over time when the material is held at a constant deformation.

Question 7237

Topic: Biology, Genetics & Bone Healing

Which type of bone healing is primarily characterized by the formation of a fracture callus and occurs under conditions of relative stability?

. Intramembranous ossification
. Primary bone healing
. Endochondral ossification
. Cutting cone remodeling
. Appositional bone growth

Correct Answer & Explanation

. Intramembranous ossification


Explanation

Secondary bone healing via a fracture callus primarily involves endochondral ossification, where a cartilage intermediate forms before being replaced by bone. This process occurs when relative stability (some micromotion) is present.

Question 7238

Topic: 1. General Principles & Basic Science

Which type of collagen is the primary structural component of normal articular cartilage?

. Type I
. Type II
. Type III
. Type IV
. Type X

Correct Answer & Explanation

. Type I


Explanation

Normal hyaline articular cartilage is primarily composed of Type II collagen, which provides the matrix with its essential tensile strength. Type X collagen is found in the calcified cartilage zone.

Question 7239

Topic: Biomechanics & Biomaterials

When comparing titanium alloys to stainless steel for use in orthopedic implants, titanium primarily exhibits:

. Higher modulus of elasticity
. Greater stress shielding
. Lower modulus of elasticity
. Increased risk of galvanic corrosion when paired with identical metals
. Reduced biocompatibility

Correct Answer & Explanation

. Higher modulus of elasticity


Explanation

Titanium has a lower modulus of elasticity compared to stainless steel, making it biomechanically closer to cortical bone. This reduces the effect of stress shielding compared to stiffer metals.

Question 7240

Topic: 1. General Principles & Basic Science

Which mechanism of joint lubrication operates primarily under high loads and low sliding speeds, utilizing a thin layer of surface-active molecules like lubricin on the articular surface?

. Hydrodynamic lubrication
. Elastohydrodynamic lubrication
. Boundary lubrication
. Weeping lubrication
. Squeeze-film lubrication

Correct Answer & Explanation

. Hydrodynamic lubrication


Explanation

Boundary lubrication relies on molecules such as lubricin and hyaluronic acid to prevent direct cartilage-to-cartilage contact under high loads and low speeds. Fluid-film mechanisms, like hydrodynamic lubrication, operate at higher speeds.