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Exam (elaborations)

Anatomy NBME questions and answers 2026 Answers RATED A

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Anatomy Exam Answers and Key NBME 2026 | Updated for Current Exam at what vertebral level(s) should you perform a lumbar puncture ? - answer - L3/L4 or L4/L5; level of the iliac crests when doing a lumbar puncture, what does your needle pierce through - answer - skin -- fascia -- supraspinous ligament -- interspinous ligament -- ligamentum flavum -- epidural space -- dura mater -- subarachnoid space What is a herniated disc? - answer - nucleus pulposus through anulus fibrosus (nucleus pulposus is remnant of notochord) -usually herniates postero-laterally -compresses spinal nerve root most common levels of herniated disc - answer - Lumbar Levels= L4/L5 or L5/S1 cervical regions= C5/C6 or C6/C7 herniated disk presentation - answer - -individuals 50 -history of back pain that may radiate down to the lower limb -pain begins soon after patient lifted something heavy -herniated lumbar disc compresses the nerve root one number below (L4/L5 will compress the L5 root) -lower limb reflexes are decreased on the affected side -patellar -- L2/L3 or L3/L4 herniation -achilles -- L5/S1 herniation what is kyphosis ? who is it seen in? - answer - -exaggeration of the thoracic curvature -may occur in the elderly as a result of osteoporosis or disk degeneration -osteoporosis= multiple compression fractures of the vertebral bodies what is lordosis? who is it seen in? - answer - -exaggeration of the lumbar curvature that may be temporary -occurs during pregnancy, spondylolisthesis, or potbelly what is scoliosis? causes? - answer - -lateral deviation/torsion of the spine -caused by poliomyelitis, leg length discrepancy, or hip disease what is the pars interarticularis - answer - connects the superior facet and inferior facet what is spondylolysis? presentation? - answer - -defect/stress fracture in the pars interarticularis -most common reason for lower back pain in adolescent athletes -usually at L5 what is spondylolisthesis? presentation? - answer - -forward slippage of one vertebral body with respect to the one beneath it -most commonly occurs at lumbosacral junction with L5 slipping over S1 -low back pain aggravated by standing and walking -rarely can cause cauda equina -often results from spondylolysis low back pain with extension or standing, relief with flexion - answer - spinal canal stenosis positional pain, relieved with rest and analgesics, lumbar or cervical spine - answer - osteoarthritis/degenerative low back pain with paravertebral spasm after history of lifting a heavy object - answer - lumbosacral strain low back pain in elderly which is exacerbated on minor exertion or touch - answer - vertebral body fracture-- due to osteoporosis low back pain with paravertebral spasm and fever - answer - epidural abscess lower back pain in elderly, continuous pain that is worse at night, resistant to pain meds and positional changes. fever, weight loss, night sweats - answer - cord compression due to metastatic tumor Prostate Breast Kidney Thyroid Lung (PB KTL) radicular lower back pain, saddle anesthesia, loss of DTR's, bowel/bladder issues - answer - cauda equina syndrome, surgical emergency low back pain in adolescent with slip off or step off in spine examination - answer - spondylolisthesis back pain in pregnancy - answer - lumbar lordosis low back pain with loss of DTR's, loss of sensation in dermatome, + straight leg - answer - disc herniation low back pain in IV drug user/immunocompromised, tenderness on palpation of spinous process, fever - answer - vertebral osteomyelitis low back pain, hip/butt/thigh claudication, impotence and atrophy of lower extremities, weak femoral pulses, bruit heard over femoral area - answer - lehriche syndrome, aorticoiliac PAD low back pain, male, 25-35 yo, morning stiffness and improves with activity, may have diarrhea or uveitis - answer - ankylosing spondylitis, HLA B27 omohyoid


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