BPK 241 LASTEST 2026 CORE EXAMS MANUAL QUESTIONS
AND SOLUTIONS GUARANTEE A+
✔✔Lumbar disc herniation - ✔✔- Nucleus pulposus breaks through annulus fibrosis
- Most often occurs at the L4L5 and L5S1 levels
- Vulnerable between ages 30 to 50 as elasticity and water content of the nucleus
pulposus decreases with age
- 4 stages (Protrusion, Prolapsed, Extrusion, Sequestered)
✔✔Intervertebral disc disease - ✔✔- associated with disc protrusion or herniation
- decrease in disc high therefor the ligaments don't tighten up and the vertebrae can
move around more which causes the muscles to have to stabalize the spine
SSx
- degenerative changes
- extra bony growth
- Instability
Tx
- Conservative if possible
- Surgical (discectomy, laminectomy, fusion)
✔✔boundaries of thorax - ✔✔- neck
- diaphragm
- thoracic vertebrae
- ribs, sternum, muscles
✔✔Primary muscles of respiration - ✔✔- diaphragm
- intercostal muscles
- sternocleidomastoid
- accessory muscles of respiration
✔✔Thorax muscle strains - ✔✔- Common in running
- Intercostals, diaphragm, others
Ssx
- Pain on deep inspiration; dyspnea
- Tenderness
Tx
- Rest, analgesics
✔✔Pneumothorax - ✔✔open = when air is entering the pleural cavity via a hole in the
pleura
closed = when air enters the pleural cavity via a hole in the lungs
SSx
,- severe dyspnea,
- shock,
- cyanosis,
- rapid RR,
- Hx of puncture if open
Tx
- cover opening,
- NPO,
- Hospital ASAP
✔✔Inguinal ligament and canal - ✔✔- Inguinal ligament goes from ASIS to pubic
tubercle
- inguinal canal is the site of inguinal herniations
✔✔femoral triangle - ✔✔- below inguinal canal
- common site of femoral herniation
- not as common compared to inguinal hernias but they are more likely to occur in
women is it does occur
✔✔abdominal contents - ✔✔Solid organs (highly vascularized and if injured will bleed
- Liver
- Spleen
- Kidneys
Intestines & glands
- Stomach,
- duodenum,
- ileum,
- jejunum,
- colon
- Pancreas,
- gall bladder
✔✔Coeliac plexus - ✔✔Blow to it can influence the phrenic nerve, phrenic nerve
innervates the diaphragm which causes the diaphragm to go into spams (getting the
wind knocked out of us)
✔✔Herniae (mechanism, degree, types, ssx, tx) - ✔✔- is a Protrusion of abdominal
contents through defect in muscle Mechanism
- Predisposition (weakness)
- Valsalva or direct blow Degrees
- Reducible
- Incarcerated
- Strangulated (emergency)
Types
- Inguinal (majority, male or female)
- Femoral (uncommon; more common in females)
, SSx
- "pull" or weakness
- Aching pain
- Swelling & tenderness above (inguinal) or below (femoral) inguinal ligament
- Pain & swelling worsen with cough
Tx
- Surgery
✔✔Sports Hernia - ✔✔Athletic pubalgia
SSx;
- chronic pelvic or groin pain
- pain with twisting, hip extension
- possible pain into testicles
Cause:
- Tear of abdominal muscles or tendon at attachment to pubic tubercle
- Often labral tear or adductor strain with it¤ Tx: Rest, surgery
✔✔Cervical spine anatomy - ✔✔- C1 = atlas (skull flexion/extension)
- C2 = axis (C1 pivots on C2 odontoid (Dens))
- C7 = vertebra prominens
✔✔Cervical Spinal nerves - ✔✔- C1 - C7 exit above same vertebrae
- C8 exits between C7 & T1
- C5 - T2 form brachial plexus
- C3 - C5 innervate diaphragm
✔✔whiplash - ✔✔Mechanisms
- Flexion & extension ("whiplash")
- Torsion¤ Compression
SSx
- Pain, tenderness
- Spasm (delayed?)
- Restricted R.O.M.
- Headaches
- N.B., check for evidence of bony and/or neurologic injury (ABCD's)
- Numbness? Weakness or paralysis?
- Point tenderness over spinous process?
- Stabilize; to hospital ASAP
Management
- Stabilize; physician to assess
- If Hx severe trauma, or neurologic SSx exist, assume fracture/ nerve damage
- May not be apparent at first
- May lead to permanent brachial plexus or spinal cord injury
Follow up for strain or sprain
- Rest (collar?)
- NSAID
AND SOLUTIONS GUARANTEE A+
✔✔Lumbar disc herniation - ✔✔- Nucleus pulposus breaks through annulus fibrosis
- Most often occurs at the L4L5 and L5S1 levels
- Vulnerable between ages 30 to 50 as elasticity and water content of the nucleus
pulposus decreases with age
- 4 stages (Protrusion, Prolapsed, Extrusion, Sequestered)
✔✔Intervertebral disc disease - ✔✔- associated with disc protrusion or herniation
- decrease in disc high therefor the ligaments don't tighten up and the vertebrae can
move around more which causes the muscles to have to stabalize the spine
SSx
- degenerative changes
- extra bony growth
- Instability
Tx
- Conservative if possible
- Surgical (discectomy, laminectomy, fusion)
✔✔boundaries of thorax - ✔✔- neck
- diaphragm
- thoracic vertebrae
- ribs, sternum, muscles
✔✔Primary muscles of respiration - ✔✔- diaphragm
- intercostal muscles
- sternocleidomastoid
- accessory muscles of respiration
✔✔Thorax muscle strains - ✔✔- Common in running
- Intercostals, diaphragm, others
Ssx
- Pain on deep inspiration; dyspnea
- Tenderness
Tx
- Rest, analgesics
✔✔Pneumothorax - ✔✔open = when air is entering the pleural cavity via a hole in the
pleura
closed = when air enters the pleural cavity via a hole in the lungs
SSx
,- severe dyspnea,
- shock,
- cyanosis,
- rapid RR,
- Hx of puncture if open
Tx
- cover opening,
- NPO,
- Hospital ASAP
✔✔Inguinal ligament and canal - ✔✔- Inguinal ligament goes from ASIS to pubic
tubercle
- inguinal canal is the site of inguinal herniations
✔✔femoral triangle - ✔✔- below inguinal canal
- common site of femoral herniation
- not as common compared to inguinal hernias but they are more likely to occur in
women is it does occur
✔✔abdominal contents - ✔✔Solid organs (highly vascularized and if injured will bleed
- Liver
- Spleen
- Kidneys
Intestines & glands
- Stomach,
- duodenum,
- ileum,
- jejunum,
- colon
- Pancreas,
- gall bladder
✔✔Coeliac plexus - ✔✔Blow to it can influence the phrenic nerve, phrenic nerve
innervates the diaphragm which causes the diaphragm to go into spams (getting the
wind knocked out of us)
✔✔Herniae (mechanism, degree, types, ssx, tx) - ✔✔- is a Protrusion of abdominal
contents through defect in muscle Mechanism
- Predisposition (weakness)
- Valsalva or direct blow Degrees
- Reducible
- Incarcerated
- Strangulated (emergency)
Types
- Inguinal (majority, male or female)
- Femoral (uncommon; more common in females)
, SSx
- "pull" or weakness
- Aching pain
- Swelling & tenderness above (inguinal) or below (femoral) inguinal ligament
- Pain & swelling worsen with cough
Tx
- Surgery
✔✔Sports Hernia - ✔✔Athletic pubalgia
SSx;
- chronic pelvic or groin pain
- pain with twisting, hip extension
- possible pain into testicles
Cause:
- Tear of abdominal muscles or tendon at attachment to pubic tubercle
- Often labral tear or adductor strain with it¤ Tx: Rest, surgery
✔✔Cervical spine anatomy - ✔✔- C1 = atlas (skull flexion/extension)
- C2 = axis (C1 pivots on C2 odontoid (Dens))
- C7 = vertebra prominens
✔✔Cervical Spinal nerves - ✔✔- C1 - C7 exit above same vertebrae
- C8 exits between C7 & T1
- C5 - T2 form brachial plexus
- C3 - C5 innervate diaphragm
✔✔whiplash - ✔✔Mechanisms
- Flexion & extension ("whiplash")
- Torsion¤ Compression
SSx
- Pain, tenderness
- Spasm (delayed?)
- Restricted R.O.M.
- Headaches
- N.B., check for evidence of bony and/or neurologic injury (ABCD's)
- Numbness? Weakness or paralysis?
- Point tenderness over spinous process?
- Stabilize; to hospital ASAP
Management
- Stabilize; physician to assess
- If Hx severe trauma, or neurologic SSx exist, assume fracture/ nerve damage
- May not be apparent at first
- May lead to permanent brachial plexus or spinal cord injury
Follow up for strain or sprain
- Rest (collar?)
- NSAID
