Back Clinical Supplement

Question 1

Atlanto-Occiptal Articulation

Answer 1

Synovial condyloid

Question 2

Atlanto-Axial articulation

Answer 2

2 Synovial plane/gliding
1 Synovial pivot

Question 3

Zygapophyseal Joint Articulation

Answer 3

Facet joints

Plane/gliding

Question 4

Intervertebral disc articulation

Answer 4

Secondary cartilaginous

Question 5

Cervical Dislocation mechanism

Answer 5

Due to sloped facets, superior cervical segments can slide anteriorly and superiorly along inferior segments

Question 6

Jefferson fracture

Answer 6

Trauma (usually from above) travels through skull and bursts the the arch of the atlas. Usually no spinal cord damage.

Bonk go to horny jail

Question 7

Hangman Fracture

Answer 7

Hyperextension breaks pars articularis of axis bilaterally

Question 8

Osteoporosis cause

Answer 8

Ca++ metabolism deficiency

Question 9

Dowanger’s hump

Answer 9

Nana hump

Exaggerated kyphosis and decreased lordosis, makes you short

Question 10

Dens Fracture consequences

Answer 10

Avascular necrosis of dens

Dens fragments lacerate cord

Question 11

Transverse ligmanent of atlas rupture consequence

Answer 11

Compression of spinal cord by dens

Question 12

Populations with lax transverse ligament of atlas

Answer 12

Marfans
Down syndrome

Question 13

Spinal stenosis symptoms

Answer 13

Bilateral extremity pain or numbness
Incontinence

Question 14

Spinal stenosis fix

Answer 14

Surgical laminectomy

Question 15

Causes of spinal stenosis

Answer 15

Protruding intervertebral disc
Meningeoma
Bone changes
Ligament Hyperthropy (posterior longitudinal, ligamentum flavum)
Zygapophyseal joints

Question 16

Congenital Scoliosis cause

Answer 16

Improperly formed vertebra (fused/hemi)

Question 17

Myopathic Scoliosis

Answer 17

Muscle asymmetry (common in cerebral palsy)

Question 18

Functional Scoliosis

Answer 18

Different leg lengths

Question 19

Ankolysing Spondilitys

Answer 19

spondyLYTIS

Vertebral joint and ligament inflammation, causes calcification of annulus firbrosus

Question 20

Ankolysing Spondylitis symptoms

Answer 20

Fusion of vertebral segments, pain, stifness

Question 21

Epidural anesthesia site

Answer 21

Between lamina of L3-L4

Sacral hiatus

Question 22

Spinal Anesthesia

Answer 22

Injection into subarachnoid space

Done by lumbar puncture

Question 23

Uncovertebral Joints, Joints of Luschka

Answer 23

Plane synovial joints that develop in early adolescence

Develop between uncal/hook process of C3-C7

Question 24

Intervertebral disc innervation

Answer 24

Ventral rami ———> Recurrent branch———> Sinuverterbral nerves ———> intervertebral disc

Question 25

Zygapophyseal joint innervation

Answer 25

From dorsal rami. Overlaps and includes above joint as well

Question 26

Disc herniation common location

Answer 26

Posterior lateral Goes lateral to Posterior longitudinal ligament , annulus fibrosis is thinner here

Question 27

Nerves affected due to disc herniation

Answer 27

Nerve exiting at level in cervical spine Nerve level below in lumbar region

Question 28

Common disc herniation sites

Answer 28

95% L4-L5 5% C5-C6, C6-C7, C7-T1

Question 29

Central (midline) disc herniation consequences

Answer 29

Compress spinal cord (LL weakness, incontinence) or cauda equina

Question 30

Schorl nodes

Answer 30

Intervertebral disc herniation

Question 31

Nerve Root testing C5

Answer 31

Strength: Deltoid, Biceps brachii MSR: Brachioradialis Key Sensory Area: lateral shoulder and arm

Question 32

Nerve Root testing C6

Answer 32

Strength: biceps brachii, wrist extension MSR: brachioridialis Key Sensory Area: lateral forearm and palm, 1st digit

Question 33

Nerve Root Test C7

Answer 33

Strength: triceps brachii, wrist flex, finger extension MSR: triceps brachii Key Sensory Area: middle finger

Question 34

Nerve Root test C8

Answer 34

Strength: finger flex MSR: Triceps brachii Key Sensory Area: Fifth digit, medial forearm

Question 35

Nerve Root test T1

Answer 35

Strength: finger adduction/abduction MSR: no Key Sensory Area: medial arm

Question 36

Nerve Root test L4

Answer 36

Strength: tibiales anterior, quadriceps MSR: patellar tendon Key Sensory Area: medial leg, medial aspect of foot

Question 37

Nerve Root test L5

Answer 37

Strength: extensor hallucis longus, extensor digitorium longus, walk on heels MSR: tibiales posterior Key Sensory Area: dorsum of foot

Question 38

Nerve root test S1

Answer 38

Strength: fabularis longus, walk on toes MSR: calcaneal Key Sensory Area: lateral aspect of foot

Question 39

Provocative tests for disc herniations

Answer 39

UE: Spurling LE: straight leg test

Question 40

Radiculopathy

Answer 40

Injury or compression of spinal nerve root