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Question 1Orthopaedic anatomy, terminology, and operative report fundamentals

How many bones are typically present in the adult human skeleton?

  1. 246
  2. 186 Correct answer.
  3. 226
  4. 206

Explanation

The adult human skeleton typically contains 206 bones, divided into 80 axial and 126 appendicular bones. The count can vary slightly because of accessory sesamoid bones, but 206 is the standard reference figure.

Question 2Orthopaedic anatomy, terminology, and operative report fundamentals

In anatomical position, the palms of the hands face in which direction?

  1. Anteriorly Correct answer.
  2. Inferiorly
  3. Laterally
  4. Posteriorly

Explanation

In anatomical position the body stands upright, the face is forward, the upper limbs are at the sides, and the palms face anteriorly. This standardized orientation makes directional terms consistent.

Question 3Orthopaedic anatomy, terminology, and operative report fundamentals

The patella is best classified as which type of bone?

  1. Flat bone
  2. Irregular bone
  3. Long bone
  4. Sesamoid bone Correct answer.

Explanation

The patella is the largest sesamoid bone and develops within the quadriceps tendon. Sesamoid bones lie within tendons, where they protect the tendon and improve mechanical advantage.

Question 4Orthopaedic anatomy, terminology, and operative report fundamentals

Which muscle is part of the rotator cuff?

  1. Teres major
  2. Deltoid
  3. Supraspinatus Correct answer.
  4. Latissimus dorsi

Explanation

The rotator cuff comprises the supraspinatus, infraspinatus, teres minor, and subscapularis, remembered as SITS. The deltoid, teres major, and latissimus dorsi are shoulder movers but are not part of this cuff.

Question 5Orthopaedic anatomy, terminology, and operative report fundamentals

A sagittal plane divides the body into which portions?

  1. Anterior and posterior portions
  2. Superior and inferior portions
  3. Left and right portions Correct answer.
  4. Proximal and distal portions

Explanation

A sagittal plane runs vertically and divides the body into left and right portions. A coronal plane divides anterior from posterior, and a transverse plane divides superior from inferior.

Question 6Orthopaedic anatomy, terminology, and operative report fundamentals

Which description best defines a comminuted fracture?

  1. A break that opens through the skin
  2. One fragment driven into another fragment
  3. A fracture with more than two fragments Correct answer.
  4. A single oblique fracture line

Explanation

A comminuted fracture produces more than two bone fragments. It differs from a simple two-part fracture and often indicates a higher-energy injury.

Question 7Orthopaedic anatomy, terminology, and operative report fundamentals

Which element of an operative report states the condition confirmed or treated during surgery?

  1. Preoperative diagnosis
  2. Postoperative diagnosis Correct answer.
  3. Indications for surgery
  4. Procedure performed

Explanation

The postoperative diagnosis reflects the condition confirmed or treated at surgery and is a required element of the operative report. The preoperative diagnosis reflects the working diagnosis before surgery.

Question 8Orthopaedic anatomy, terminology, and operative report fundamentals

Which joint is a ball-and-socket joint?

  1. Hip Correct answer.
  2. Elbow
  3. Ankle
  4. Knee

Explanation

The hip is a ball-and-socket joint formed by the femoral head and acetabulum, allowing motion in multiple planes. The knee, elbow, and ankle are primarily hinge-type joints.

Question 9Orthopaedic anatomy, terminology, and operative report fundamentals

Which carpal bone is most commonly fractured?

  1. Lunate
  2. Scaphoid Correct answer.
  3. Hamate
  4. Pisiform

Explanation

The scaphoid is the most frequently fractured carpal bone, often after a fall on an outstretched hand. Its retrograde blood supply makes proximal fractures prone to nonunion.

Question 10Orthopaedic anatomy, terminology, and operative report fundamentals

The linea aspera is located on which part of the femur?

  1. Anterior surface of the femoral neck near the head
  2. Distal articular surface of the femoral condyles
  3. Posterior ridge along the femoral shaft Correct answer.
  4. Medial aspect of the greater trochanter

Explanation

The linea aspera is a prominent longitudinal ridge on the posterior surface of the femoral shaft. It serves as an attachment site for muscles and the intermuscular septa.

Question 11Orthopaedic anatomy, terminology, and operative report fundamentals

Which function is primarily attributed to the anterior cruciate ligament?

  1. Resists varus stress at the knee
  2. Prevents anterior tibial translation Correct answer.
  3. Resists valgus stress at the knee
  4. Prevents posterior tibial translation

Explanation

The ACL is the primary restraint to anterior translation of the tibia relative to the femur. The PCL restrains posterior translation, while the collateral ligaments resist varus and valgus stress.

Question 12Orthopaedic anatomy, terminology, and operative report fundamentals

A greenstick fracture is best described as which of the following?

  1. An incomplete fracture in children Correct answer.
  2. A fracture with many fragments
  3. A crushed cancellous bone
  4. A spiral fracture through a long bone

Explanation

A greenstick fracture is an incomplete fracture in which one cortex breaks and the other bends, occurring in flexible pediatric bone. Spiral, comminuted, and crush patterns describe other fracture mechanisms.

Question 13Orthopaedic anatomy, terminology, and operative report fundamentals

What does open reduction of a fracture involve?

  1. Removal of a small bone fragment through a puncture
  2. Application of a cast after manual traction
  3. Manipulation of the fracture without an incision
  4. Surgical exposure of the fracture to realign it Correct answer.

Explanation

Open reduction means the fracture is exposed surgically and the bone ends are realigned under direct visualization. Closed reduction realigns the fracture by manipulation without an incision.

Question 14Orthopaedic anatomy, terminology, and operative report fundamentals

Arthrodesis refers to which surgical procedure?

  1. Surgical replacement of a joint
  2. Surgical inspection of a joint
  3. Surgical removal of joint lining
  4. Surgical fusion of a joint Correct answer.

Explanation

Arthrodesis is the surgical fusion of a joint, usually to relieve pain or provide stability. Arthroplasty replaces a joint, and arthroscopy is inspection through a scope.

Question 15Orthopaedic anatomy, terminology, and operative report fundamentals

Which statement accurately describes cortical bone?

  1. A porous trabecular network
  2. Composed mainly of cartilage in adults
  3. Found only in the vertebral bodies
  4. Dense outer layer with low porosity Correct answer.

Explanation

Cortical bone is the dense, low-porosity outer layer that provides most of a bone's mechanical strength. Cancellous bone is the porous, trabecular inner network.

Question 16Orthopaedic anatomy, terminology, and operative report fundamentals

The term proximal describes a structure that is which of the following?

  1. Closer to the midline of the body
  2. Closer to the trunk or point of origin Correct answer.
  3. Toward the posterior surface of the body
  4. Farther from the trunk or point of origin

Explanation

Proximal means closer to the trunk or to the point of origin of a structure. Distal means farther away; medial and lateral refer to closeness to the midline.

Question 17Orthopaedic anatomy, terminology, and operative report fundamentals

How many thoracic vertebrae are normally present in the human vertebral column?

  1. 12 Correct answer.
  2. 7
  3. 8
  4. 5

Explanation

The vertebral column normally has 7 cervical, 12 thoracic, and 5 lumbar vertebrae. The thoracic vertebrae articulate with the ribs.

Question 18Orthopaedic anatomy, terminology, and operative report fundamentals

What is a primary biomechanical function of the knee menisci?

  1. To distribute load and absorb shock in the knee Correct answer.
  2. To limit abduction at the hip joint
  3. To produce synovial fluid within the knee joint
  4. To attach the patella to the tibial tubercle

Explanation

The menisci are fibrocartilaginous wedges that distribute load and absorb shock in the knee. They also improve joint congruity and contribute to stability.

Question 19Orthopaedic anatomy, terminology, and operative report fundamentals

Subluxation of a joint is best defined as which of the following?

  1. A fracture that crosses the joint surface
  2. Inflammation of the synovial joint lining
  3. Partial displacement of the joint surfaces Correct answer.
  4. Complete loss of contact between joint surfaces

Explanation

Subluxation is partial or incomplete displacement of the articular surfaces, whereas dislocation is complete loss of contact. Both can injure ligaments and cartilage.

Question 20Orthopaedic anatomy, terminology, and operative report fundamentals

An allograft is best described as which of the following?

  1. Tissue taken from the patient
  2. Tissue from a donor of the same species Correct answer.
  3. A manufactured synthetic material
  4. Tissue harvested from a different animal species

Explanation

An allograft is tissue harvested from a donor of the same species, whereas an autograft comes from the patient. Allografts avoid donor-site morbidity but carry different biologic and infection considerations.

Question 21Orthopaedic anatomy, terminology, and operative report fundamentals

An operative report for a knee arthroscopy does not state which knee was operated on. Why is this a documentation deficiency?

  1. It is required only when a prosthesis is implanted
  2. It matters only for pediatric patients
  3. It is optional for arthroscopic procedures
  4. It prevents unambiguous identification of the side Correct answer.

Explanation

Laterality is a required identifier because paired structures can be operated on either side, and an unspecified side creates ambiguity for coding, billing, and patient safety. The operative report should state the side consistently in the diagnosis, procedure, and findings.

Question 22Orthopaedic anatomy, terminology, and operative report fundamentals

Which nerve is most at risk during a posterior approach to the hip?

  1. Saphenous nerve
  2. Sciatic nerve Correct answer.
  3. Femoral nerve
  4. Obturator nerve

Explanation

The posterior approach to the hip places the sciatic nerve at risk as it passes posterior to the acetabulum and proximal femur. The femoral nerve is more anterior, and the obturator nerve is medial.

Question 23Orthopaedic anatomy, terminology, and operative report fundamentals

A Salter-Harris type II physeal fracture involves which structures?

  1. Crush injury of the physis
  2. Fracture through physis and metaphysis Correct answer.
  3. Fracture confined to the physis alone
  4. Fracture through epiphysis and metaphysis

Explanation

Salter-Harris type II fractures pass through the physis and exit through the metaphysis, often producing a Thurston-Holland fragment. Type I involves only the physis, type III involves the epiphysis, and type IV crosses both metaphysis and epiphysis.

Question 24Orthopaedic anatomy, terminology, and operative report fundamentals

What is the biomechanical principle of tension band wiring?

  1. It provides rigid compression across a comminuted shaft fracture
  2. It is used only in the lower extremity
  3. It replaces the need for a cast in all fractures
  4. It converts tensile forces into compression at the fracture Correct answer.

Explanation

Tension band wiring converts tensile forces on the convex side of a bone into compression at the fracture site. It is commonly applied to transverse fractures of the patella or olecranon when stable reduction can be achieved.

Question 25Orthopaedic anatomy, terminology, and operative report fundamentals

In the Gustilo-Anderson classification, a clean open fracture wound measuring less than 1 cm is classified as which type?

  1. Type II
  2. Type IIIB
  3. Type I Correct answer.
  4. Type IIIA

Explanation

Gustilo-Anderson type I is a clean open fracture with a wound less than 1 cm. Type II wounds are 1 to 10 cm without extensive soft-tissue damage, and type III injuries have high-energy or extensive soft-tissue damage.

Question 26Orthopaedic anatomy, terminology, and operative report fundamentals

Which anatomical plane divides the body into equal right and left halves?

  1. Transverse plane
  2. Coronal plane
  3. Midsagittal plane Correct answer.
  4. Oblique plane

Explanation

The midsagittal plane runs vertically through the body's midline and separates it into equal right and left halves. The coronal and transverse planes divide the body along different axes, while an oblique plane is any slanted plane that is not one of the standard anatomical planes.

Question 27Orthopaedic anatomy, terminology, and operative report fundamentals

Which section of an operative report describes the technical steps and sequence of the operation?

  1. Findings
  2. Disposition
  3. Indications
  4. Procedure Correct answer.

Explanation

The procedure section is the narrative of the operative steps, including approach, technique, and closure. Indications explain why surgery was undertaken, findings record intraoperative observations, and disposition documents the patient's destination after recovery.

Question 28Orthopaedic anatomy, terminology, and operative report fundamentals

A fracture line that wraps around the shaft of a long bone after a twisting injury is best described as which pattern?

  1. Segmental
  2. Transverse
  3. Spiral Correct answer.
  4. Oblique

Explanation

A spiral fracture results from torsional force and produces a helical fracture line around the shaft. Transverse fractures run roughly perpendicular to the long axis, oblique fractures run at an angle, and segmental fractures involve two distinct fracture lines separating a segment of bone.

Question 29Orthopaedic anatomy, terminology, and operative report fundamentals

A patient has weakness in initiating shoulder abduction. Which rotator cuff tendon is most likely involved?

  1. Teres minor
  2. Supraspinatus Correct answer.
  3. Infraspinatus
  4. Subscapularis

Explanation

The supraspinatus initiates the first portion of shoulder abduction and is the tendon most associated with this specific weakness. Subscapularis medially rotates the arm, while infraspinatus and teres minor externally rotate it.

Question 30Orthopaedic anatomy, terminology, and operative report fundamentals

An operative report states that a fracture was "reduced and internally fixed" but does not name the implant or describe its configuration. Which missing element most directly limits reconstruction of the procedure?

  1. Preoperative medical clearance
  2. Estimated intraoperative blood loss
  3. Implant details Correct answer.
  4. Names of surgical assistants

Explanation

The report must identify the implant and its configuration so that the procedure can be understood and reproduced. Preoperative clearance, blood loss, and assistant names are relevant to the record but do not describe how the fracture was fixed.

Question 31Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

A physician treats a distal radius fracture closed without manipulation and applies the first cast. Which service is included in the fracture care code?

  1. Physical therapy for finger stiffness
  2. Application of the initial cast Correct answer.
  3. Radiographs taken after the global period
  4. Removal of the cast after the global period

Explanation

Fracture care codes include the initial cast or splint application and routine follow-up during the global period. Services outside the global period or unrelated to the fracture are reported separately.

Question 32Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

During closed treatment, the physician manually realigns fracture fragments without making an incision. Which treatment category applies?

  1. Closed treatment without manipulation
  2. Percutaneous skeletal fixation
  3. Closed treatment with manipulation Correct answer.
  4. Open treatment with internal fixation

Explanation

Closed treatment with manipulation is used when the fracture is reduced by external force without opening the fracture site. Closed treatment without manipulation is used when no reduction is performed, and open treatment requires an incision.

Question 33Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

A laceration is closed in layers involving subcutaneous tissue and fascia. How is this repair classified?

  1. Delayed primary closure
  2. Intermediate repair Correct answer.
  3. Complex repair
  4. Simple repair

Explanation

Intermediate repair includes layered closure of one or more deeper layers, such as subcutaneous tissue and fascia, in addition to skin closure. Simple repair is limited to superficial closure, and complex repair involves reconstructive techniques.

Question 34Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

For simple repair of a scalp, neck, axillary, trunk, arm, or leg wound, which length is reported with code 12001?

  1. 7.6 to 12.5 cm
  2. 2.6 to 7.5 cm
  3. 2.5 cm or less Correct answer.
  4. 12.6 to 20.0 cm

Explanation

Code 12001 is the first code in the simple repair series for these body areas and covers wounds 2.5 cm or smaller. Longer lengths move to higher codes in the same series.

Question 35Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

A shoulder dislocation is reduced closed under general anesthesia. Which code reflects the anesthesia requirement?

  1. 23655 rather than 23650 Correct answer.
  2. 23655 rather than 23660
  3. 23650 rather than 23655
  4. 23660 rather than 23655

Explanation

In the shoulder dislocation code pair, 23650 describes closed treatment without anesthesia and 23655 describes closed treatment with anesthesia. Open treatment is reported with 23660.

Question 36Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

What is required to report open treatment of a fracture?

  1. Reduction by traction without an incision
  2. Fixation placed through the skin without an incision
  3. Application of a cast without reduction
  4. A surgical incision at the fracture site Correct answer.

Explanation

Open treatment means the fracture site is exposed through a surgical incision, with or without internal fixation. Closed and percutaneous methods do not open the fracture site.

Question 37Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

A physician repairs a 4-cm simple forearm laceration and injects local anesthetic before closure. How is the anesthetic reported?

  1. As a separate E/M service
  2. As included in the repair code Correct answer.
  3. As a separate anesthesia code
  4. As a separate nerve block code

Explanation

Wound repair codes include the use of local anesthetic and normal wound cleaning. Separate anesthesia or E/M codes are not reported for the anesthetic alone.

Question 38Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

A physician evaluates a nondisplaced toe fracture and applies a splint but does not provide definitive fracture care. How should coding be performed?

  1. Fracture care code only
  2. Splint application plus E/M code Correct answer.
  3. Fracture care code plus splint code
  4. E/M code only

Explanation

When the physician does not provide definitive fracture treatment, the service is reported with the splint application code and the appropriate E/M code. A fracture care code is reserved for definitive treatment.

Question 39Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

Two simple lacerations on the same forearm measure 3 cm and 4 cm and are repaired in one session. Which length is used to select the simple repair code?

  1. Each wound is coded separately at its own length
  2. 3 cm
  3. 7 cm Correct answer.
  4. 4 cm

Explanation

For multiple wounds of the same complexity in the same anatomic grouping, CPT directs adding the lengths before selecting the code. Separate codes are not used for each wound in that situation.

Question 40Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

A patient has a 2-cm simple laceration and a 3-cm intermediate laceration on the same leg. How are the repairs reported?

  1. Add the lengths and report one intermediate code for 5 cm
  2. Report only the intermediate code for 3 cm
  3. Report one simple code for 5 cm
  4. Report simple and intermediate codes separately by length Correct answer.

Explanation

Wound lengths are added only within the same complexity classification and anatomic grouping. Simple and intermediate repairs are reported separately, each using its own length.

Question 41Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

Open treatment of an extra-articular distal radius fracture with internal fixation is reported with which code?

  1. 25600
  2. 25607 Correct answer.
  3. 25605
  4. 25608

Explanation

25607 describes open treatment of an extra-articular distal radius fracture, while 25608 is used for intra-articular involvement. The 25600 and 25605 codes describe closed treatment.

Question 42Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

Closed treatment of a tibial shaft fracture with manipulation is reported with which code?

  1. 27752 Correct answer.
  2. 27758
  3. 27759
  4. 27750

Explanation

27750 is closed treatment without manipulation, and 27752 is closed treatment with manipulation. Open treatment is reported with 27758 or 27759 depending on fixation.

Question 43Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

Closed treatment of a shoulder dislocation without anesthesia is reported with which code?

  1. 23655
  2. 23660
  3. 23650 Correct answer.
  4. 23665

Explanation

23650 is the closed shoulder dislocation code without anesthesia; 23655 is the same treatment with anesthesia. 23660 describes open treatment.

Question 44Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

A 3-cm simple laceration of the cheek is repaired. Which code is appropriate?

  1. 12013 Correct answer.
  2. 12014
  3. 12011
  4. 12001

Explanation

Face simple repairs use the 12011-12018 series; 12013 covers 2.6 to 5.0 cm. 12011 covers 2.5 cm or less, and 12014 begins at 5.1 cm.

Question 45Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

Which service is included in the global fracture care package during the 90-day period?

  1. Physical therapy prescribed for the fracture
  2. Treatment of a new unrelated fracture
  3. Routine follow-up visits related to the fracture Correct answer.
  4. Cast change by a different practice

Explanation

The fracture care global package includes routine follow-up visits related to the fracture and the initial cast or splint. Unrelated fractures and services by other practices are not part of that package.

Question 46Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

Open treatment of a metacarpal fracture with internal fixation is reported with which code?

  1. 26615 Correct answer.
  2. 26607
  3. 26605
  4. 26600

Explanation

26615 is the open treatment code for a metacarpal fracture. 26600 and 26605 are closed treatment codes, and 26607 is percutaneous fixation.

Question 47Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

Closed treatment of a bimalleolar ankle fracture with manipulation is reported with which code?

  1. 27810 Correct answer.
  2. 27814
  3. 27816
  4. 27808

Explanation

27808 is closed bimalleolar treatment without manipulation, and 27810 is the same with manipulation. 27814 is open treatment, and 27816 is closed trimalleolar without manipulation.

Question 48Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

Closed treatment of a traumatic hip dislocation requiring anesthesia is reported with which code?

  1. 27250
  2. 27254
  3. 27252 Correct answer.
  4. 27253

Explanation

27250 is closed hip dislocation treatment without anesthesia, and 27252 is the same with anesthesia. 27253 describes open treatment.

Question 49Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

An E/M service is performed and the decision to treat a fracture surgically is made on the same day. Which modifier supports separate payment for the E/M service?

  1. 25
  2. 57 Correct answer.
  3. 59
  4. 79

Explanation

Modifier 57 is used when an E/M service results in the decision to perform surgery. Modifier 25 is for a significant, separately identifiable E/M service on the same day as another procedure, not specifically the decision for surgery.

Question 50Musculoskeletal CPT coding: fractures, dislocations, and trauma repair

Simple lacerations of the right arm (3 cm) and the face (2 cm) are repaired. How are repair codes selected?

  1. Report the arm wound only because it is longer
  2. Report separate codes for the arm and face groupings Correct answer.
  3. Report the face wound only because it is more complex
  4. Add the lengths to 5 cm and report one code

Explanation

Lengths are added only for wounds in the same anatomic grouping and complexity. Arm and face simple repairs fall into different code series, so each is reported separately.