Cervical and Thoracic Spine

Question 1

What peripheral nerves arise from the roots of the brachial plexus?

Answer 1

Long thoracic nerve

Dorsal scapular nerve

Question 2

A lesion to the posterior cord can lead to:

Answer 2

Atrophy and motor function of:

Arm Extensors, Wrist Extensors, Deltoid, Teres Minor

Question 3

Where does the brain stem exit to become the spinal cord?

Answer 3

The foramen magnum

Question 4

True or False? The C8 spinal nerve exits above the C7 vertebrae

Answer 4

False; the C8 spinal nerve below the C7 vertebrae

Question 5

How many roots, trunks, divisions, cords and branches are there in the brachial plexus?

Answer 5

Roots: 5, Trunks: 3, Divisions: 6, Cords: 3, Branches: 5 (7 with suprascapular and lateral pectoral)

Question 6

Name the parts of the atlas vertebra.

Answer 6

Transverse foramina
Superior facets
Anterior tubercle and posterior tubercle
Groove for vertebral artery and first cervical nerve
Anterior arch
Posterior arch

Question 7

What is the ligamentum flavum?

Answer 7

A pair of elastic ligaments connecting the lamina of one vertebra to the lamina of the vertebra above it; limits flexion and rotation of the spine

Question 8

What are the muscles that make up the superficial layer of the extensor cervical musculature?

Answer 8

Splenius capitis and splenius cervicis

Question 9

What are deep to the splenius capitis and the splenius cervicis?

Answer 9

Semispinalis capitis, semispinalis cervicis

Question 10

What functions are the sternocleidomastoid responsible for?

Answer 10

Contralateral rotation and Ipsilateral flexion

Question 11

What structure passes through the scalene group?

Answer 11

Brachial plexus through the anterior and middle scalenes

Question 12

What is a positive sign for the Babinski Test?

Answer 12

Great toe extension and splaying of the other toes

Question 13

Where is Erb’s point located and why is it important in our clinical evaluation?

Answer 13

Erb’s point is located above the clavicle in front of the transverse process of the sixth cervical vertebra. It represents the most superficial passage of the brachial plexus.

Question 14

What does the Spurling test test for?

Answer 14

Nerve root impingement by narrowing of the neural foramina

Question 15

What does the shoulder abduction test test for? What is a positive sign for this test?

Answer 15

Herniated disk of nerve root compression; decrease in the patient’s symptoms secondary to decreased tension on the involved nerve root

Question 16

How is thoracic outlet syndrome caused?

Answer 16

Pressure on the trunks and medial cord of the brachial plexus, the subclavian artery and the subclavian vein

Question 17

What is the correct way to diagnose a thoracic outlet syndrome pathology?

Answer 17

Rule out cervical disk herniation, carpal tunnel syndrome, cubital tunnel syndrome, vascular occlusive disease, malignant tumors, multiple sclerosis, fibromyalgia, Raynaud’s disease, complex regional pain syndrome and angina!

Question 18

What is the percentage of individuals who display the clinical signs and symptoms of thoracic outlet syndrome?

Answer 18

10%

Question 19

What could predispose the onset of thoracic outlet syndrome?

Answer 19

Poor posture, drooping shoulders that depress the clavicles, forward shoulder posture, prolonged pressure on the upper surfaces of the first rib

Question 20

How many ribs exist in the human body?

Answer 20

12 pairs of ribs: (1-7 true ribs, 8-10 false ribs, 11-12 floating ribs)

Question 21

What innervates the diaphragm?

Answer 21

The phrenic nerve (C3, C4, C5)

Question 22

Name the parts of the respiratory tract.

Answer 22

Trachea –> principal bronchi
Left splits into two segmental bronchi
Right splits into three segmental bronchi

Bronchi then splits into bronchioles

Question 23

What forms the pleural cavity?

Answer 23

Parietal pleura (lining the thoracic wall)
Visceral pleura (surrounds the lungs)

Question 24

Name the cardiovascular pathway:

Answer 24

Right atrium to right ventricle to the lungs to the left atrium to the left ventricle to the ascending aorta and then to the aortic arch up the ascending aorta, carotid and subclavian arteries and then to the descending aorta and the abdominal aorta

Question 25

Where is McBurney’s Point?

Answer 25

Between the right ASIS and the navel

Question 26

What does rapid shallow breathing indicate when considering thoracic injuries?

Answer 26

Internal injury or shock

Question 27

What do deep quick breaths indicate when concerning thoracic injuries?

Answer 27

Pulmonary obstruction; asthma

Question 28

How many vertebrae and spinal nerves are in the cervical spine?

Answer 28

7 vertebrae and 8 spinal nerves

Question 29

What is an implication of apneustic breathing pattenrs?

Answer 29

Trauma to the pons of the brain

Question 30

What are some of the characteristics of the Biot’s abnormal breathing pattern?

Answer 30

Periods of apnea followed by hyperapnea

Question 31

What does would indicate hypertension if you were given blood pressure readings?

Answer 31

Systolic BP greater than 140 mmHg

Diastolic pressure greater than 90 mmHg

Question 32

What is Kehr’s sign?

Answer 32

Kehr’s sign refers to the pain in the upper left quadrant and the left shoulder. It indicates acute spleen trauma.

Question 33

What are signs of a kidney trauma?

Answer 33

Signs include bruising or bleeding over the area of contact. The patient may complain of rib pain that increases in intensity during deep respiration. Hematuria is also present.