Additional

Question 0

Patient presents with back pain – image if?

Answer 0

#Age of 50
#History of cancer
#pain duration over one month
#no relief even with bedrest
#glucocorticoid or IP drug use
#Systemic infection
#Percussion tenderness over spine

Question 1

Back pain made worse with Valsalva maneuver? Etiologies?

Answer 1

Radicular

#Herniated lumbar disc
#Epidural disease
#Degenerative joint disease

Question 2

L-2 – sensation to? Supplies what muscle?

Answer 2

Upper anterior thigh

Iliopsoas

Question 3

L3 – sensation to? Supplies what muscle?

Answer 3

Interior knee

Iliopsoas, quadriceps, hip adductors

Question 4

L4 – sensation to? Supplies what muscle?

Answer 4

Medial calf

quadriceps
tibialis anterior
Patellar reflex

Question 5

L5 – sensation to? Supplies what muscle?

Answer 5

Lateral calf, posterior thigh, dorsomedial foot

Extensor hallicus, Peronei, tibialis anterior

Question 6

S1 – sensation to? Supplies what muscle?

Answer 6

Plantar and lateral foot

Gastrocnemius, soleus, gluteus maximus

Question 7

C5 – sensation to? Supplies what muscle?

Answer 7

Shoulder, thumb

Deltoid, biceps

Question 8

C6 – sensation to? Supplies what muscle?

Answer 8

Thumb, index finger, radial hand, lateral forearm

Biceps, pronator teres

Question 9

C7 – sensation to? Supplies what muscle?

Answer 9

Middle digit, posterior forearm

Triceps, wrist extensors, finger extensors

Question 10

C8 – sensation to? Supplies what muscle?

Answer 10

Fifth digit, medial hand/forearm

Intrinsic hand muscles

Question 11

T1 – sensation to? Supplies what muscle?

Answer 11

Medial arm, axilla

Intrinsic hand muscles

Question 12

Patient presents with low back pain – no radiation or neurologic deficits. Intermittent muscle spasms. Suspected diagnosis? Work up? Treatment?

Answer 12

Lumbosacral sprain; no diagnostic test;

NSAIDs, encouraged normal activity

Question 13

Patient with recent back trauma presents with persistent local pain with overlying muscle spasm. Neurologic deficits may be present. Suspected diagnosis? Work up? Treatment?

Answer 13

Vertebral fracture; x-ray (or MRI if pathologic fracture suspected)

Pain control, orthopedic consult

Question 14

Patient presents with limitation of spine flexion and radicular features. Exacerbated by Valsalva.

Answer 14

Lumbar disc disease; MRI

conservative management for one month

Surgery if progressive weakness, bowel/bladder dysfunction, incapacitating pain

Question 15

Patient presents with bilateral leg pain provoked by standing or walking. Relieved by sitting. Suspected diagnosis? Work up? Treatment?

Answer 15

Spinal stenosis

MRI

NSAIDs, surgery if incapacitating pain or severe focal deficits

Question 16

Pain in center of spine increased by motion. Patient has limited motion. Suspected diagnosis? Work up? Treatment?

Answer 16

Spondylosis

X-ray

NSAIDs. Surgery if incapacitating pain or severe focal deficits

Question 17

Pt presents with constant dull back pain. Unrelieved by rest and worse at night. Suspected diagnosis? Work up? Treatment?

Answer 17

Neoplasm

MRI

Radiation or surgery if neurologic deficits

Question 18

Patient post trauma presents with bilateral leg weakness, incontinence, and mental status changes. Suspected diagnosis?

Answer 18

Bilateral ACA infarcts – subfalcine herniation

Question 19

Herniation that’s usually fatal?

Answer 19

Cerebellar tonsillar herniation