Anatomy and Surgery 4

Question 1

Primary curvatures of the vertebral column

Answer 1

Thoracic and Sacral

Question 2

Atypical cervical vertebrae

Answer 2

C1, C2, C7

Question 3

Which cervical vertebrae has an odontoid process?

Answer 3

C2

Question 4

Divided into 3 parts by scalenous anterior muscle

Answer 4

Subclavian artery

Question 5

Vertebral level of hyoid bone

Answer 5

C3 - also bifurcation of common carotid artery

Question 6

Vertebral level: thyroid cartilage

Answer 6

C5

Question 7

Vertebral level: cricoid cartilage

Answer 7

C6 - also start of trachea and esophagus

Question 8

Vertebral level: sternal angle of louie

Answer 8

T4 - also bifurcation of trachea

Question 9

Vertebral level: hiatus of IVC

Answer 9

T8

Question 10

Vertebral level: iliac crest

Answer 10

L4

Question 11

Vertebral level: end of sigmoid colon

Answer 11

S3

Question 12

Action: nodding and sideways tilting

Answer 12

Atlanto-Occipital joint

Question 13

Action: turning head side to side, “no” gesture

Answer 13

Atlanto-Axial joint (C1 and C2)

Question 14

Spinal cord is held in position by:

Answer 14

Denticulate ligaments on each side, Filum terminale inferiorly

Question 15

Termination of spinal cord

Answer 15

Lower border of L1, upper border of L2

Question 16

Sensory tract in the white matter of the spinal cord

Answer 16

Posterior horn - bodies of neurons are in the dorsal root ganglion

Question 17

Motor tract in the white matter of the spinal cord

Answer 17

Anterior horn

Question 18

Disease due to degeneration of anterior horn cells

Answer 18

Poliomyelitis

Question 19

Anterior spinothalamic tract vs Lateral spinothalamic tract

Answer 19

Anterior - touch and pressure. Lateral - pain and temperature.

Question 20

Ascending tract for position sense, 2 pt discrimination, fine discriminative sense, vibratory sense, stereognosis

Answer 20

Dorsal/Posterior Column - if already in brainstem, call it the medial lemniscus

Question 21

Dermatome: tip of shoulder

Answer 21

C5

Question 22

Dermatome: thumb

Answer 22

C6

Question 23

Dermatome: middle finger

Answer 23

C7

Question 24

Dermatome: small finger

Answer 24

C8

Question 25

Dermatome: nipple

Answer 25

T4

Question 26

Dermatome: umbilicus

Answer 26

T10

Question 27

Dermatome: big toe

Answer 27

L4-L5

Question 28

(+) swaying with eyes open

Answer 28

Cerebellar ataxia, (-) Romberg's sign

Question 29

(+) swaying with eyes closed. Normal stance when eyes are open.

Answer 29

Sensory ataxia, (+) Romberg's sign

Question 30

Definition of UMN

Answer 30

Descending pathways in the spinal cord

Question 31

Definition of LMNs

Answer 31

Motor cells in the anterior gray horn of the SC and motor nuclei of cranial nerves - final common pathway for control of skeletal muscle activity

Question 32

Where does the corticospinal tract decussate?

Answer 32

Lower medulla

Question 33

Cavitation around the central canal of the spinal cord

Answer 33

Syringomyelia - loss of pain and temp sensations in hands and forearms, cape like distribution

Question 34

Disease of anterior horn cells leading to LMN lesions

Answer 34

Poliomyelitis

Question 35

Secondary degeneration of dorsal columns due to neurosyphilis

Answer 35

Tabes dorsalis - loss of vibration and position senses

Question 36

Degeneration of anterior horn cells (LMN) and corticospinal tract (UMN)

Answer 36

ALS - pure motor disease

Question 37

Degeneration of posterior and lateral columns due to Vit B12 deficiency

Answer 37

Subacute combined degeneration - loss of position sense and vibration in legs

Question 38

Spinal cord hemisection: Brown Sequard's Syndrome

Answer 38

Contralateral loss of pain and temp, ipsilateral loss of propioception

Question 39

Temporary loss of all cord functions below the level of the lesion in the SC

Answer 39

Spinal shock - <24 hours up to 1 to 4 weeks

Question 40

Most severe type of spina bifida

Answer 40

Spina bifida with myeloschisis - area is open

Question 41

Small dimple at the back with a tuft of hair. No clinical manifestations

Answer 41

Spina bifida occulta

Question 42

Site of lumbar hernia

Answer 42

Lumbar Triangle of Petit - ext oblique abdom, lat dorsi, iliac crest

Question 43

Forms a false capsule of the thyroid gland

Answer 43

Pretracheal layer of the cervical fascia

Question 44

Contents of the carotid sheath

Answer 44

Common and internal carotid arteries , internal jugular vein, vagus nerve

Question 45

This rib articulates with the sternum

Answer 45

2nd rib

Question 46

Verterbral level: angle of louie

Answer 46

Between T4 and T5

Question 47

Total number of ribs: 12 pairs

Answer 47

True ribs - 1 to 7. False ribs - 8 to 12. Floating ribs - 11 and 12.

Question 48

Weakest point of the rib where fractures are common

Answer 48

Anterior to angle of the rib - 7 to 10 most commonly fractured

Question 49

Compression of the lower trunk of the brachial plexus and subclavian artery/vein

Answer 49

Thoracic Outlet Syndrome

Question 50

Muscles that depress the ribs

Answer 50

Serratus posterior inferior, internal intercostal and transverse thoracis

Question 51

Level the descending thoracic aorta becomes the abdominal aorta

Answer 51

T12

Question 52

Distention of the veins of the neck on inspiration

Answer 52

Kussmaul's sign - cardiac tamponade

Question 53

Common site of an occlusion in MI

Answer 53

Anterior interventricular artery from L coronary artery - supplies RV, interventriular septum and apex

Question 54

Modified trabeculae carnae that crosses the interventricular septum

Answer 54

Moderator band - seen only at RV

Question 55

Most posterior of the heart chambers

Answer 55

L atrium

Question 56

Most common cause of cyanotic heart disease

Answer 56

Transposition of Great Arteries

Question 57

Most common congenital anomaly associated with maternal rubella infection

Answer 57

PDA - aortic blood is shunted into the pulmonary artery

Question 58

Tongue like extension beneath the cardiac notch

Answer 58

Lingula in the L lung - embryologic counterpart of R middle lobe