QUESTIONS WITH COMPLETE
SOLUTIONS LATEST UPDATE
at what vertebral level(s) should you perform a lumbar puncture ? -
CORRECT ANSWER ✔✔-L3/L4 or L4/L5; level of the iliac crests
what is scoliosis?
causes? - CORRECT ANSWER ✔✔--lateral deviation/torsion of the spine
-caused by poliomyelitis, leg length discrepancy, or hip disease
what is the pars interarticularis - CORRECT ANSWER ✔✔-connects the
superior facet and inferior facet
what is spondylolysis?
presentation? - CORRECT 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? - CORRECT 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
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,-rarely can cause cauda equina
-often results from spondylolysis
low back pain with extension or standing, relief with flexion - CORRECT
ANSWER ✔✔-spinal canal stenosis
positional pain, relieved with rest and analgesics, lumbar or cervical spine
- CORRECT ANSWER ✔✔-osteoarthritis/degenerative
low back pain with paravertebral spasm after history of lifting a heavy
object - CORRECT ANSWER ✔✔-lumbosacral strain
low back pain in elderly which is exacerbated on minor exertion or touch -
CORRECT ANSWER ✔✔-vertebral body fracture-- due to osteoporosis
low back pain with paravertebral spasm and fever - CORRECT 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 -
CORRECT 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 - CORRECT ANSWER ✔✔-cauda equina syndrome, surgical
emergency
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,low back pain in adolescent with slip off or step off in spine examination -
CORRECT ANSWER ✔✔-spondylolisthesis
back pain in pregnancy - CORRECT ANSWER ✔✔-lumbar lordosis
low back pain with loss of DTR's, loss of sensation in dermatome, +
straight leg - CORRECT ANSWER ✔✔-disc herniation
low back pain in IV drug user/immunocompromised, tenderness on
palpation of spinous process, fever - CORRECT ANSWER ✔✔-vertebral
osteomyelitis
low back pain, hip/butt/thigh claudication, impotence and atrophy of lower
extremities, weak femoral pulses, bruit heard over femoral area -
CORRECT ANSWER ✔✔-lehriche syndrome, aorticoiliac PAD
low back pain, male, 25-35 yo, morning stiffness and improves with
activity, may have diarrhea or uveitis - CORRECT ANSWER ✔✔-ankylosing
spondylitis, HLA B27
omohyoid innervation?
insertion/origin? - CORRECT ANSWER ✔✔--Scapula to the hyoid bone
-Innervated by ansa cervicalis C1-C3
what is injured at the surgical neck of the humerus? - CORRECT ANSWER
✔✔--axillary nerve and posterior humeral circumflex artery
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, what is injured in a midshaft humerus fracture? - CORRECT ANSWER ✔✔-
-radial nerve and profunda brachii artery (deep brachial)
-affect origin of brachialis muscle
what is affected in a supracondylar humeral fracture? - CORRECT
ANSWER ✔✔--brachial artery and median nerve
what is affected in a medial epicondyle fracture? - CORRECT ANSWER
✔✔-ulnar nerve
humerus, radius, ulna bony landmarks - CORRECT ANSWER ✔✔-
when doing a lumbar puncture, what does your needle pierce through -
CORRECT ANSWER ✔✔-skin --> fascia --> supraspinous ligament -->
interspinous ligament --> ligamentum flavum --> epidural space --> dura
mater --> subarachnoid space
What is a herniated disc? - CORRECT 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 - CORRECT ANSWER ✔✔-Lumbar
Levels= L4/L5 or L5/S1
cervical regions= C5/C6 or C6/C7
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