Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gray's Review Questions > Back > Flashcards

Back Flashcards

1
Q

A 55-year-old man with severe coughing is admitted to the hospital. Radiologic examination is consistent with tuberculosis of the right lung, with extension to the thoracic vertebral bodies of T6 and T7, producing a “gibbus deformity.” Which of the following conditions is most likely also to be confirmed by radiologic examination?

A. Hyperlordosis 
B. Hyperkyphosis 
C. Scoliosis
D. Spina bifida 
E. Osteoarthritis
A

B. Hyperkyphosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

A 68-year-old man is admitted to the hospital due to severe back pain. Radiologic examination reveals severe osteoporosis of the vertebral column, with com- pression fractures to vertebrae L4 and L5. Which of the following parts of the vertebrae are most likely to be fractured in this patient?

A. Spinous process
B. Vertebral bodies 
C. Transverse process
D. Superior articular process 
E. Intervertebral disc
A

B. Vertebral bodies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

A 45-year-old man is admitted to the hospital because of severe pain in the back and lower limb. Radiologic examination reveals spinal canal stenosis syndrome. Which of the following conditions is most likely to be confirmed by a magnetic resonance imaging (MRI) examination?

A. Hypertrophy of supraspinous ligament 
B. Hypertrophy of interspinous ligament 
C. Hypertrophy of ligamentum flavum
D. Hypertrophy of anterior longitudinal ligament 
E. Hypertrophy of nuchal ligament
A

C. Hypertrophy of ligamentum flavum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

A 35-year-old man is admitted to the hospital after a severe car crash. Radiologic examination reveals an injury to the dorsal surface of the neck and a fracture of the medial border of the right scapula. During physi- cal examination, the patient presents with the scapula retracted laterally on the affected side. Which of the following nerves has most likely been injured on that side?

A. Axillary
B. Long thoracic 
C. Dorsal scapular
D. Greater occipital 
E. Suprascapular
A

C. Dorsal scapular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

A 64-year-old man arrived at the clinic with a painful rash and skin eruptions that are localized entirely on one side of his body, closely following the dermatome level of the spinal nerve C7. The patient was diagnosed with the a herpes zoster virus infection known as “shingles.” In what structure has the virus most likely proliferated to cause the patient’s current condition?

A. The sympathetic chain
B. The dorsal root ganglion of the C7 spinal nerve
C. The lateral horn of the C7 spinal cord segment
D. The posterior cutaneous branch of the dorsal primary ramus of C7
E. The ventral horn of the C7 spinal cord segment

A

B. The dorsal root ganglion of the C7 spinal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

A 45-year-old woman states that she has experi- enced moderate pain for 2 years over her left lower back; pain that radiates to her left lower limb. She states that after lifting a case of soft drinks, the pain suddenly became intense. She was admitted to the emergency department. Radiologic examination re- vealed intervertebral disc herniation between vertebral levels L4 and L5. Which of the following nerves was most likely affected by the disc herniation?

A. L1 
B. L2 
C. L3 
D. L4 
E. L5
A

E. L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A 3-year-old boy is brought by his mother to the emergency department with severe headache, high fever, malaise, and confusion. Radiologic and physical examinations reveal that the patient suffers from men- ingitis. A lumbar puncture is ordered to confirm the diagnosis. Which vertebral level is the most appropriate location for the lumbar puncture?

A. T12 to L1 
B. L1 to L2 
C. L2 to L3
D. L4 to L5 
E. L5 to S1
A

D. L4 to L5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When a lumbar puncture is performed to sample cerebrospinal fluid, which of the following external landmarks is the most reliable to determine the position of the L4 vertebral spine?

A. The inferior angles of the scapulae 
B. The highest points of the iliac crests 
C. The lowest pair of ribs bilaterally
D. The sacral hiatus
E. The posterior inferior iliac spines
A

B. The highest points of the iliac crests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A 39-year-old man presents with severe neck pain after a whiplash injury, sustained when his car was struck from behind. Radiologic studies reveal trauma to the ligament lying on the anterior surface of the cervical vertebral bodies. Which ligament is most likely disrupted?

A. Anterior longitudinal ligament 
B. Ligamentum flavum
C. Nuchal ligament
D. Posterior longitudinal ligament 
E. Transverse cervical ligament
A

A. Anterior longitudinal ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A 65-year-old man complains of severe back pain and the inability to move his left lower limb. Radiologic studies demonstrate compression of nerve elements at the intervertebral foramen between vertebrae L5 and S1. Which structure is most likely responsible for this space-occupying lesion?

A. Anulus fibrosus
B. Nucleus pulposus
C. Posterior longitudinal ligament
D. Anterior longitudinal ligament 
E. Ligamentum flavum
A

B. Nucleus pulposus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

A 27-year-old man is admitted to the emergency department after a car crash. Physical examination reveals weakness during medial rotation and adduction of the humerus. Which of the following nerves was most probably injured?

A. Thoracodorsal 
B. Axillary
C. Dorsal scapular
D. Spinal accessory 
E. Radial
A

A. Thoracodorsal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

A 39-year-old woman complains of an inability to reach the top of her head to brush her hair with her right hand. History reveals that she had undergone a mastectomy procedure of her right breast 2 months earlier. Physical examination demonstrates winging of her right scapula. Which nerves were most likely damaged during surgery?

A. Axillary
B. Spinal accessory
C. Long thoracic 
D. Dorsal scapular
E. Thoracodorsal
A

C. Long thoracic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

A 19-year-old man is brought to the emergency department after dislocating his shoulder while playing football. Following treatment of the dislocation, he cannot initiate abduction of his arm. An MRI of the affected shoulder shows a torn muscle. Which muscle was most likely damaged by the injury?

A. Coracobrachialis
B. Long head of the triceps brachii 
C. Pectoralis minor
D. Supraspinatus 
E. Teres major
A

D. Supraspinatus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

A 1-year-old girl is brought to the clinic for a routine checkup. The child appears normal except for a dimpling of the skin in the midline of the lumbar region with a tuft of hair growing over the dimple. What is this relatively common condition that results from incomplete embryologic development?

A. Meningomyelocele 
B. Meningocele
C. Spina bifida occulta
D. Spina bifida cystica 
E. Rachischisis
A

C. Spina bifida occulta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A young resident complains of an itch on his back that appears to be caused by an insect bite. Which nerve fibers carry the sensation of a mosquito bite on the back, just lateral to the spinous process of the T4 vertebra?

A. Somatic afferent
B. Somatic efferent
C. Visceral afferent
D. Visceral efferent
E. Somatic efferent and visceral afferent
A

A. Somatic afferent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

A 15-year-old woman was suspected of having meningitis. To obtain a sample of cerebrospinal fluid by spinal tap in the lumbar region (lumbar puncture), the tip of the needle must be placed in which of the following locations?

A. In the epidural space
B. Between anterior and posterior longitudinal ligaments
C. Superficial to the ligamentum flavum
D. Between arachnoid mater and dura mater
E. In the subarachnoid space

A

E. In the subarachnoid space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

A 19-year-old man is diagnosed with a herniated disc but he has no symptoms of spinal cord injury. In the event of intervertebral disc herniation in the cervi- cal region, which of the following ligaments is in an anatomic position to protect the spinal cord from direct compression?

A. Supraspinous
B. Posterior longitudinal 
C. Anterior longitudinal
D. Ligamentum flavum 
E. Nuchal ligament
A

B. Posterior longitudinal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In spinal anesthesia, the needle is often inserted between the spinous processes of the L4 and L5 verte- brae to ensure that the spinal cord is not injured. This level is safe because in the adult the spinal cord usually terminates at the disc between which of the following vertebral levels?

A. T11 and T12 
B. T12 and L1 
C. L1 and L2
D. L2 and L3 
E. L3 and L4
A

C. L1 and L2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

A 22-year-old woman is diagnosed with Ray- naud’s disease. In such a case, the patient suffers chronic vasospasm in response to cold. This can lead to arterial constriction and painful ischemia, especially in the fingers or toes. Relief from the symptoms in the hands would require surgical division of which of the following neural elements?

A. Lower cervical and upper thoracic sympathetic fibers
B. Lower cervical and upper thoracic ventral roots
C. Lower cervical and upper thoracic dorsal roots
D. Lower cervical and upper thoracic spinal nerves
E. Bilateral spinal accessory nerves

A

A. Lower cervical and upper thoracic sympathetic fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

A 69-year-old woman visits her physician due to severe neck pain. Radiologic studies reveal bony growths (osteophytes) in the intervertebral foramen between vertebrae C2 and C3. Which of the following muscles would be most likely affected by this condition?

A. Rhomboideus major 
B. Serratus anterior
C. Supraspinatus
D. Diaphragm
E. Latissimus dorsi
A

D. Diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

A 42-year-old woman is diagnosed with stenosis of the cervical vertebral canal. A laminectomy of two vertebrae is performed. Which of the following ligaments will most likely also be removed?

A. Anterior longitudinal 
B. Denticulate
C. Ligamentum flavum
D. Nuchal 
E. Cruciate
A

C. Ligamentum flavum

22
Q

A 28-year-old pregnant woman is admitted to the obstetrics department for delivery. In the final stages of labor, a caudal anesthetic is administered via the sacral hiatus. Into which of the following spaces in the sacral canal is the anesthetic placed?

A. Vertebral canal
B. Vertebral venous plexus 
C. Epidural space
D. Subarachnoid space 
E. Subdural space
A

C. Epidural space

23
Q

A 12-year-old child was brought to the emergency department by his parents because he has been suffer- ing from a very high fever and severe stiffness in his back. The initial diagnosis is meningitis. The attending physician orders a lumbar puncture to confirm the diagnosis. Upon microscopic examination of the cere- brospinal fluid, hematopoietic cells are seen. Which of the following ligaments was most likely penetrated by the needle?

A. Supraspinous
B. Denticulate
C. Anterior longitudinal
D. Posterior longitudinal 
E. Nuchal ligament
A

A. Supraspinous

24
Q

A 25-year-old male racing car driver is admitted to the emergency department after a severe car crash. Radiologic studies reveal damage to the tip of the trans- verse process of the third cervical vertebra, with a significantly large pulsating hematoma. What artery is the most likely to have been damaged?

A. Anterior spinal artery
B. Vertebral artery
C. Ascending cervical artery
D. Deep cervical artery
E. Posterior spinal arteries
A

B. Vertebral artery

25
Q

A 79-year-old man, a retired military veteran, presents to the outpatient clinic with an abnormal cur- vature of the vertebral column. He complains that it has become increasingly painful to walk around town. Upon physical examination, he has an abnormally increased convexity to his thoracic curvature resulting from osteoporosis. Which of the following is the most likely clinical condition of this patient’s spine?

A. Scoliosis
B. Hyperkyphosis 
C. Spinal stenosis
D. Lordosis
E. Herniated disc
A

B. Hyperkyphosis

26
Q

A 42-year-old woman complains of pain and stiff- ness in her neck. She was injured sliding into second base headfirst during her company’s softball game. Radiographs reveal no fractures of her spine. However, upon physical examination, her right shoulder is droop- ing and she has difficulty in elevating that shoulder. If you ordered an MRI, it would most likely reveal soft tissue damage involving which of the following nerves?

A. Thoracodorsal nerve 
B. Spinal accessory nerve 
C. Dorsal scapular nerve
D. Greater occipital nerve 
E. Axillary nerve
A

B. Spinal accessory nerve

27
Q

A 53-year-old man was in a head-on vehicle col- lision that resulted in compression of his spinal cord by the dens (odontoid process) of the axis, with result- ing quadriplegia. Which of the following ligaments was most probably torn?

A. Anterior longitudinal ligament 
B. Transverse ligament of the atlas 
C. Ligamentum flavum
D. Supraspinous ligament 
E. Nuchal ligament
A

B. Transverse ligament of the atlas

28
Q

An 18-year-old woman passenger injured in a rollover car crash was rushed to the emergency depart- ment. After the patient is stabilized, she undergoes physical examination. She demonstrates considerable weakness in her ability to flex her neck, associated with injury to CN XI. Which of the following muscles is most probably affected by nerve trauma?

A. Iliocostalis thoracis 
B. Sternocleidomastoid 
C. Rhomboid major
D. Rhomboid minor 
E. Teres major
A

B. Sternocleidomastoid

29
Q

A 23-year-old man was killed in a high-speed motor vehicle collision after racing his friend on a local highway. When the medical examiner arrives at the scene, it is determined that the most likely cause of death was a spinal cord injury. Upon confirmation by autopsy, the medical examiner officially reports that the patient’s cause of death was a fracture of the pedicles of the axis (C2). Breaking of which of the following ligaments would be most likely implicated in this fatal injury?

A. Ligamentum flavum
B. Nuchal ligament
C. Cruciform ligament
D. Posterior longitudinal ligament
E. Supraspinous ligament
A

C. Cruciform ligament

30
Q

A 65-year-old man is injured when a vehicle trav- eling at a high rate of speed hits his car from behind. Radiologic examination reveals that two of his articular processes are now locked together, a condition known as “jumped facets.” In which region of the spine is this injury most likely to occur?

A. Cervical 
B. Thoracic 
C. Lumbar
D. Lumbosacral 
E. Sacral
A

A. Cervical

31
Q

Following a car crash, a 47-year-old woman complains of severe headache and back pain. Radio- logic examination reveals bleeding of the internal ver- tebral venous plexus (of Batson), resulting in a large hematoma. In what space has the blood most likely accumulated?

A. Subarachnoid space 
B. Subdural space
C. Central canal
D. Epidural space 
E. Lumbar cistern
A

D. Epidural space

32
Q 
A 32-year-old man, an elite athlete, was lifting heavy weights during an intense training session. The athlete felt severe pain radiating to the posterior aspect of his right thigh and leg. The patient was taken to the hospital where MRI revealed a ruptured L4/L5 interver- tebral disc. Which nerve is most probably affected?
A. L3 
B. L4 
C. L2 
D. L5 
E. S1
A

D. L5

33
Q

A 24-year-old patient suffered a lower back strain after a severe fall while skiing. MRI studies reveal injury to the muscles responsible for extending and laterally bending the trunk. What arteries provide blood supply for these muscles?

A. Subscapular
B. Thoracodorsal
C. Anterior intercostal
D. Suprascapular
E. Posterior intercostal
A

E. Posterior intercostal

34
Q

A 22-year-old male soccer player is forced to leave the game following a head-to-head collision with another player. He is admitted to the hospital, and radiologic examination reveals slight dislocation of the atlantoaxial joint. As a result, he experiences decreased range of motion at that joint. What movement of the head would most likely be severely affected?

A. Rotation 
B. Flexion
C. Abduction
D. Extension 
E. Adduction
A

A. Rotation

35
Q

A 42-year-old man is struck in the back, rupturing the internal vertebral venous plexus (of Batson). Radio- logic studies reveal a hematoma causing compression of the spinal cord. When aspirating the excess blood, the physician performing the procedure should stop the needle just before puncturing which of the following structures?

A. Spinal cord
B. Pia mater
C. Arachnoid mater
D. Dura mater
E. Ligamentum flavum
A

D. Dura mater

36
Q

A 35-year-old man pedestrian is crossing a busy intersection and is hit by a truck. He is admitted to the emergency department, and a CT scan reveals a dislo- cation of the fourth thoracic vertebra. Which of the following costal structures is most likely also involved in the injury?

A. Head of the fourth rib 
B. Neck of the fourth rib 
C. Head of the third rib
D. Tubercle of the third rib 
E. Head of the fifth rib
A

E. Head of the fifth rib

37
Q

A 20-year-old male hiker suffers a deep puncture wound during a fall. Physical examination reveals a lesion between the trapezius and latissimus dorsi muscles on the right lateral side of his back. Upon admission to the hospital, physical examination reveals weak adduction and medial rotation of his arm. Which of the following muscles is most probably injured?

A. Teres minor
B. Triceps brachii 
C. Supraspinatus
D. Infraspinatus 
E. Teres major
A

E. Teres major

38
Q

A 22-year-old man is thrown through a plate glass wall in a fight. Radiologic examination reveals that the lateral border of his right scapula is shattered. He is admitted to the emergency department, and physical examination reveals difficulty laterally rotating his arm. Which of the following muscles is most probably injured?

A. Teres major
B. Infraspinatus
C. Latissimus dorsi
D. Trapezius
E. Supraspinatus
A

B. Infraspinatus

39
Q

A 24-year-old woman presents with severe head- ache, photophobia, and stiffness of her back. Physical examination reveals positive signs for meningitis. The attending physician decides to perform a lumbar punc- ture to determine if a pathogen is in the cerebrospinal fluid (CSF). What is the last structure the needle will penetrate before reaching the lumbar cistern?

A. Arachnoid mater 
B. Dura mater
C. Pia mater
D. Ligamentum flavum
E. Posterior longitudinal ligament
A

A. Arachnoid mater

40
Q

A 19-year-old presents at the emergency depart- ment with high fever, severe headache, nausea, and stiff neck that have persisted for 3 days. The attending physician suspects meningitis and obtains a sample of CSF using a lumbar puncture. From which of the fol- lowing spaces was the CSF collected?

A. Epidural space
B. Subdural space
C. Subarachnoid space
D. Pretracheal space
E. Central canal of the spinal cord
A

C. Subarachnoid space

41
Q

A 38-year-old man is admitted to the emergency department after a car collision. During physical examination several lacerations to the back are discov- ered. Pain from lacerations or irritations of the skin of the back is conveyed to the central nervous system by which of the following?

A. Dorsal primary rami 
B. Communicating rami 
C. Ventral primary rami
D. Ventral roots
E. Intercostal nerves
A

A. Dorsal primary rami

42
Q

A 66-year-old woman had been diagnosed with a tumor on her spine. She has started to retain urine and is experiencing rectal incontinence. Both of these symp- toms are signs of conus medullaris syndrome. At which of the following vertebral levels is the tumor probably located?

A. L3/L4 
B. L3
C. L4
D. T12 to L2 
E. T11
A

D. T12 to L2

43
Q

Examination of a 3-day-old male infant reveals protrusion of his spinal cord and meninges from a defect in the lower back. Which of the following describes this congenital anomaly?

A. Avulsion of meninges 
B. Meningitis
C. Spina bifida occulta
D. Spina bifida with myelomeningocele 
E. Spina bifida with meningocele
A

D. Spina bifida with myelomeningocele

44
Q

A 32-year-old mother complains of serious pain in the coccygeal area some days after giving birth. To determine whether the coccyx is involved, a local anes- thetic is first injected in the region of the coccyx and then dynamic MRI studies are performed. Physical examination reveals pain with palpation to the region of the coccyx. The local anesthetic is used to interrupt which of the following nerve pathways?

A. Visceral afferents 
B. Somatic efferent 
C. Somatic afferent
D. Sympathetic preganglionic
E. Parasympathetic preganglionic
A

C. Somatic afferent

45
Q

During a routine physical examination, a 65-year- old man is tested for ease and flexibility of the move- ments of his lumbar region. Which of the following movements is most characteristic of the intervertebral joints in the lumbar region?

A. Circumduction 
B. Lateral flexion 
C. Abduction
D. Adduction 
E. Inversion
A

B. Lateral flexion

46
Q

A 72-year-old man with cancer of the prostate gland presents with loss of consciousness and seizures. A CT scan is performed and a brain tumor is diagnosed. The tumor spread to the brain from the pelvis via the internal vertebral venous plexus (of Batson). What feature of the plexus allows this to happen?

A. The internal venous plexus contains the longest veins in the body.
B. The internal venous plexus has valves that ensure one-way movement of blood.
C. The internal venous plexus is located in the subarachnoid space.
D. The internal venous plexus is, in general, valveless.
E. The internal venous plexus is located in the subdural space.

A

D. The internal venous plexus is, in general, valveless.

47
Q

A 26-year-old man painting his house slipped and fell from the ladder, landing on the pavement below. After initial examination in the emergency department, the patient is sent to the radiology department. Radio- graphs reveal that the portion of his left scapula that forms the tip, or point, of the shoulder has been frac- tured. Which part of the bone was fractured?

A. Coracoid process
B. Superior angle of the scapula 
C. Glenoid
D. Spine of the scapula 
E. Acromion
A

E. Acromion

48
Q

A 43-year-old male construction worker survived a fall from a two-story building but lost all sensation in his lower limbs and was admitted to the hospital for examination and treatment. Radiologic studies revealed that he crushed his spinal cord at vertebral level C6. Which of the following muscles will most likely be paralyzed?

A. Sternocleidomastoid 
B. Trapezius
C. Diaphragm
D. Latissimus dorsi 
E. Deltoid
A

D. Latissimus dorsi

49
Q

A maternal serum sample with high alpha- fetoprotein alerted the obstetrician to a possible neural tube defect. Ultrasound diagnosis revealed a myelome- ningocele protruding from the back of the child. Which of the following is the most likely diagnosis of this congenital anomaly?

A. Cranium bifida
B. Spina bifida occulta 
C. Spina bifida cystica
D. Hemothorax
E. Caudal regression syndrome
A

C. Spina bifida cystica

50
Q

A 7-year-old girl who is somewhat obese is brought to the emergency department because of a soft lump above the buttocks. Upon physical examination you note the lump is located just superior to the iliac crest unilaterally on the left side. The protrusion is deep to the skin and pliable to the touch. Which of the following is the most probable diagnosis?

A. Tumor of the external abdominal oblique muscle
B. Herniation at the lumbar triangle (of Petit)
C. Indirect inguinal hernia
D. Direct inguinal hernia
E. Femoral hernia

A

B. Herniation at the lumbar triangle (of Petit)

Gray's Review Questions (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions