OMM Review - Savarese - COMLEX /
COMSAE UPDATED Questions and
CORRECT Answers
Which ligament runs vertically along the posterior aspect of the vertebral bodies? - CORRECT
ANSWER - Posterior Longitudinal Ligament (Begins to narrow at lumbar region)
Why is the lumbar spine more susceptible to disc herniations? - CORRECT ANSWER -
Narrowing of Posterior Longitudinal Ligament
In the thoracic and lumbar regions, the nerve root exits where in relation to the corresponding
vertebrae? - CORRECT ANSWER - Below
Where does the spinal cord usually terminate? - CORRECT ANSWER - L1-L2
Due to the termination of the spinal cord, where do the lumbar nerve roots exit in relation to the
intervertebral disc? - CORRECT ANSWER - Above
A pelvic side shift usually indicates what? - CORRECT ANSWER - Iliopsoas dysfunction
A positive Thomas test indicates what? - CORRECT ANSWER - Iliopsoas dysfunction
What landmark is used to locate the L4-L5 intervertebral disc? - CORRECT ANSWER -
Iliac Crest
What is the most common anomaly in the lumbar region? - CORRECT ANSWER -
Zygopophyseal Facet Trophism (predisposes to early degenerative changes)
,What is it called when one or both transverse processes of L5 articulate with the sacrum? -
CORRECT ANSWER - Sacralization
What is it called when there is a failure of S1 to fuse with the other sacral segments? -
CORRECT ANSWER - Lumbarization
A defect in the closure of the lamina of the vertebral segment is called: - CORRECT
ANSWER - Spina Bifida
No herniation through the defect, course patch of hair over site, rare neurologic deficits: -
CORRECT ANSWER - Spina Bifida Occulta
Herniation of meninges through defect: - CORRECT ANSWER - Spina Bifida
Meningocele
Herniation of meninges and nerve roots through defect, associated with neurological deficits: -
CORRECT ANSWER - Spina Bifida meningomyelocele
What is the major motion of the lumbar vertebrae? - CORRECT ANSWER - Flexion and
Extension
Sidebending of L5 will induce what in the sacrum? - CORRECT ANSWER - Oblique Axis
on the same side
Rotaion of L5 will induce what in the sacrum? - CORRECT ANSWER - Rotation to
opposite side
What is another name for the lumbosacral angle? - CORRECT ANSWER - Ferguson's
Angle
,What is the intersection of a horizontal line and the line of inclination of the sacrum called? -
CORRECT ANSWER - Lumbosacral Angle (Ferguson's Angle)
What is a normal angle for the Lumbosacral (Ferguson's angle)? - CORRECT ANSWER -
25-35 degrees
Where do 98% of herniations occur? - CORRECT ANSWER - L4-L5 or L5-S1
A herniated lumbar disc will exert pressure on the nerve root of the vertebrae (above or below)? -
CORRECT ANSWER - Below
Sharp, burning or shooting pain radiating down the leg which is worse with flexion is indicative
of what? - CORRECT ANSWER - Herniated disc
Increased pain when standing or wlking indicates what? - CORRECT ANSWER - Psoas
Syndrome
What is the gold standard for the diagnosis of herniated disc? - CORRECT ANSWER -
MRI
What is indicated if a patient has ipsilateral psoas syndrome and contralateral piriformis spasm? -
CORRECT ANSWER - Sciatica
A flexion contracture of the iliopsoas is often associated with what? - CORRECT
ANSWER - Non-neutral dysfunction of L1 or L2
Lower back pain that is worsened by extension (standing, walking or lying supine) is most likely
what? - CORRECT ANSWER - Spinal Stenosis
Anterior displacement of one vertebrae in relation to the one below is called: - CORRECT
ANSWER - Spondylolisthesis
, Fatigue fractures in the pars interarticularis is a common cause of what? - CORRECT
ANSWER - Spondylolisthesis
A defect of the pars interarticularis without anterior displacement of the vertebral body is called:
- CORRECT ANSWER - Spondylolysis
Oblique radiographs showing a Scotty Dog is indicative of what? - CORRECT
ANSWER - Spondylolysis
What should you look for on radiographs if suspicious of Spondylolysis? - CORRECT
ANSWER - Scotty Dog
Forward displacement of one vertebrae on another seen on lateral films is indicative of what? -
CORRECT ANSWER - Spondylolisthesis
Degenerative changes within the intervertebral disc and ankylosing of adjacent vertebral bodies
is called what? - CORRECT ANSWER - Spondylosis
Saddle Anesthesia, decreased deep tendon reflexes, decreased rectal sphincter tone, loss of bowel
and bladder control are indicative of what? - CORRECT ANSWER - Cauda Equina
Syndrome (Surgical Emergency)
What is the cause of Cauda Equina Syndrome? - CORRECT ANSWER - Massive Central
Disc Herniation
Grade 1 Spondylolisthesis is what percentage of displacement? - CORRECT ANSWER -
0-25%
Grade 2 Spondylolisthesis is what percentage of displacement? - CORRECT ANSWER -
25-50%
COMSAE UPDATED Questions and
CORRECT Answers
Which ligament runs vertically along the posterior aspect of the vertebral bodies? - CORRECT
ANSWER - Posterior Longitudinal Ligament (Begins to narrow at lumbar region)
Why is the lumbar spine more susceptible to disc herniations? - CORRECT ANSWER -
Narrowing of Posterior Longitudinal Ligament
In the thoracic and lumbar regions, the nerve root exits where in relation to the corresponding
vertebrae? - CORRECT ANSWER - Below
Where does the spinal cord usually terminate? - CORRECT ANSWER - L1-L2
Due to the termination of the spinal cord, where do the lumbar nerve roots exit in relation to the
intervertebral disc? - CORRECT ANSWER - Above
A pelvic side shift usually indicates what? - CORRECT ANSWER - Iliopsoas dysfunction
A positive Thomas test indicates what? - CORRECT ANSWER - Iliopsoas dysfunction
What landmark is used to locate the L4-L5 intervertebral disc? - CORRECT ANSWER -
Iliac Crest
What is the most common anomaly in the lumbar region? - CORRECT ANSWER -
Zygopophyseal Facet Trophism (predisposes to early degenerative changes)
,What is it called when one or both transverse processes of L5 articulate with the sacrum? -
CORRECT ANSWER - Sacralization
What is it called when there is a failure of S1 to fuse with the other sacral segments? -
CORRECT ANSWER - Lumbarization
A defect in the closure of the lamina of the vertebral segment is called: - CORRECT
ANSWER - Spina Bifida
No herniation through the defect, course patch of hair over site, rare neurologic deficits: -
CORRECT ANSWER - Spina Bifida Occulta
Herniation of meninges through defect: - CORRECT ANSWER - Spina Bifida
Meningocele
Herniation of meninges and nerve roots through defect, associated with neurological deficits: -
CORRECT ANSWER - Spina Bifida meningomyelocele
What is the major motion of the lumbar vertebrae? - CORRECT ANSWER - Flexion and
Extension
Sidebending of L5 will induce what in the sacrum? - CORRECT ANSWER - Oblique Axis
on the same side
Rotaion of L5 will induce what in the sacrum? - CORRECT ANSWER - Rotation to
opposite side
What is another name for the lumbosacral angle? - CORRECT ANSWER - Ferguson's
Angle
,What is the intersection of a horizontal line and the line of inclination of the sacrum called? -
CORRECT ANSWER - Lumbosacral Angle (Ferguson's Angle)
What is a normal angle for the Lumbosacral (Ferguson's angle)? - CORRECT ANSWER -
25-35 degrees
Where do 98% of herniations occur? - CORRECT ANSWER - L4-L5 or L5-S1
A herniated lumbar disc will exert pressure on the nerve root of the vertebrae (above or below)? -
CORRECT ANSWER - Below
Sharp, burning or shooting pain radiating down the leg which is worse with flexion is indicative
of what? - CORRECT ANSWER - Herniated disc
Increased pain when standing or wlking indicates what? - CORRECT ANSWER - Psoas
Syndrome
What is the gold standard for the diagnosis of herniated disc? - CORRECT ANSWER -
MRI
What is indicated if a patient has ipsilateral psoas syndrome and contralateral piriformis spasm? -
CORRECT ANSWER - Sciatica
A flexion contracture of the iliopsoas is often associated with what? - CORRECT
ANSWER - Non-neutral dysfunction of L1 or L2
Lower back pain that is worsened by extension (standing, walking or lying supine) is most likely
what? - CORRECT ANSWER - Spinal Stenosis
Anterior displacement of one vertebrae in relation to the one below is called: - CORRECT
ANSWER - Spondylolisthesis
, Fatigue fractures in the pars interarticularis is a common cause of what? - CORRECT
ANSWER - Spondylolisthesis
A defect of the pars interarticularis without anterior displacement of the vertebral body is called:
- CORRECT ANSWER - Spondylolysis
Oblique radiographs showing a Scotty Dog is indicative of what? - CORRECT
ANSWER - Spondylolysis
What should you look for on radiographs if suspicious of Spondylolysis? - CORRECT
ANSWER - Scotty Dog
Forward displacement of one vertebrae on another seen on lateral films is indicative of what? -
CORRECT ANSWER - Spondylolisthesis
Degenerative changes within the intervertebral disc and ankylosing of adjacent vertebral bodies
is called what? - CORRECT ANSWER - Spondylosis
Saddle Anesthesia, decreased deep tendon reflexes, decreased rectal sphincter tone, loss of bowel
and bladder control are indicative of what? - CORRECT ANSWER - Cauda Equina
Syndrome (Surgical Emergency)
What is the cause of Cauda Equina Syndrome? - CORRECT ANSWER - Massive Central
Disc Herniation
Grade 1 Spondylolisthesis is what percentage of displacement? - CORRECT ANSWER -
0-25%
Grade 2 Spondylolisthesis is what percentage of displacement? - CORRECT ANSWER -
25-50%
