Netter's spine

Question 1

what is a hip pointer

Answer 1

contusion of iliac crest

Question 2

common site for autologous bone graft harvest

Answer 2

iliac crest

Question 3

what part of the atlas (C1) is the attachment site for the ALL

Answer 3

anterior tubercle

Question 4

What part of the atlas (C1) is the attachment site of ligamentum nuchae?

Answer 4

posterior tubercle

Question 5

what is the primary horizontal stabilizer of the Axis (C2)

Answer 5

odontoid process (dens)

Question 6

What part of cervical vertebrae have foramen for vertebral artery except C7

Answer 6

transverse processes

Question 7

What part of cervical vertebrae can accept screws if angled laterally

Answer 7

lateral masses . . . artery at risk in foramen

Question 8

site of sponsylolysis fx

Answer 8

pars intercularis . .area between facets

Question 9

avulsion fracture can occur where on lumbar vertebrae

Answer 9

transverse process

Question 10

in the lumbar spine, failure of fusion of two neural arches (pedicle/lamina) ossification centers results in what?

Answer 10

spina bifida

Question 11

what is the first x ray in all trauma cases

Answer 11

lateral cross table of cervical spine

Question 12

In spinal cord trauma, what given within 8 hrs of injury may improved functional level?

Answer 12

IV methylprednisolone

Question 13

#1 type of spinal cord injury?
give mechanism and details

Answer 13

• central cord
• hyperextension
• seen in elderly with cervical spondylosis

Question 14

What is the primary stabilizer of the occipitoatlantal joint?

Answer 14

Tectorial membrane

Question 15

The tectorial membrane is a continuation of what?

it limits what movement?

Answer 15

• PLL

- extension

Question 16

strongest AA ligament that holds that odontoid to the atlas

Answer 16

Transverse atlantal

Question 17

This is part of the intervertebral disc that attaches to adjacent vertebral bodies and gives strong conncection b/t adjacent bodies

Answer 17

Annulus

Question 18

This is a strong, thick ligament that attaches to adjacent anterior vertebral bodies and resists hyperextension

Answer 18

ALL

Question 19

This ligament is weak, limits hyperflexion and the disc herniates around it

Answer 19

PLL

Question 20

This is a strong, NOT continuous ligament that may hypertrophy and contribute to nerve root impingement

Answer 20

Ligamentum flavum

Question 21

This ligament goes from L5 transverse process to the ilium and may avulse in pelvic fracture (eg, vertical shear fx)

Answer 21

iliolumbar

Question 22

2 parts of the intervertebral disc

Answer 22

• outside: annulus fibrosus

- inside: nucleus pulposus

Question 23

hypertrophic changes in the facet (zygapophyseal joint) in degenerative disease can cause/contribute to what?

Answer 23

nerve root impingement

Question 24

What type of cartilage is outer annulus made of

Answer 24

dense (type 1 collagen)

Question 25

what type of collagen is nucleus pulposus made of

Answer 25

type 2

Question 26

what happened to nucleus pulposus with advancing age

Answer 26

water and proteoglycan content decrease

Question 27

The nucleus pulposus can herniate out of the annulus and compress nerve root. . . what is #1 level

Answer 27

L4-5

Question 28

This is the articulation in cervical spine b/t the uncinate process on the concave superior end plates of the inferior vertebral body and the articulating portion of the convex inferior end plate of the superior adjacent vertebral body

Answer 28

Joints of Luschka

Question 29

Articular cartilage of the joints of Luschka can degenerate and contribute to what?

Answer 29

cervical spondylosis

Question 30

Bowel/bladder symptoms are concerning for what spinal cord pathology

Answer 30

Cauda equina syndrome

Question 31

C5 reflex?

Answer 31

biceps brachii

Question 32

C6 reflex?

Answer 32

brachioradialis

Question 33

C8 muscles

Answer 33

interossei

Question 34

C6 muscle

Answer 34

biceps brachii

Question 35

What reflexes in upper extremity are indicative of myelopathy (upper motor neuron lesion)?

Answer 35

- Inverted radial: tap BR tendon in distal forearm . . . hypoactive BR and hyperactive finger flexion - Hoffman's: flick MF DIPJ into flexion, pathologic if thumb IPJ flexes

Question 36

What reflexes in lower extremity are indicative of myelopathy (upper motor neuron lesion)?

Answer 36

- Babinski | - Ankle clonus

Question 37

Motor for L4

Answer 37

- Quads | - Tib ant

Question 38

Motor for L5

Answer 38

EHL

Question 39

what are the 3 erector spinae muscles from lateral to medial

Answer 39

- Iliocostalis - Longissimus - Spinalis

Question 40

The spinal cord fruns from the brain stem to conus medullaris which terminates where

Answer 40

L1

Question 41

Clavicle dermatome

Answer 41

C5

Question 42

nipple dermatome

Answer 42

T4

Question 43

umbilicus dermatome

Answer 43

T10

Question 44

inguinal dermatome

Answer 44

L1

Question 45

What is the most commonly compressed cervical nerve root

Answer 45

C6

Question 46

Most commonly compressed lumbar nerve root

Answer 46

L5

Question 47

What nerve roots are affected in cauda equina syndrome

Answer 47

S2-S4

Question 48

This is the primary blood supply to the thoracolumbar cord and injury can cause cord ischemia/paralysis

Answer 48

Artery of Adamkiewicz: single medullary artery (usually left T10-T12) to ant. spinal artery

Question 49

When assessing low back pain, what are Waddell signs?

Answer 49

- Presence indicates nonorganic pathology 1) Exaggerated response/overreaction 2) Pain to light touch 3) Nonanatomic pain localization 4) Negative flip sign with positive straight leg test

Question 50

Myelodysplasia is incomplete spinal cord development (neural tube closure defect) . . it is associated with elevated maternal levels of what

Answer 50

AFP .. prenatal folic acid decreases incidence

Question 51

Myelodysplasia is often associated with what allergy

Answer 51

latex

Question 52

In myelodysplasia, symptoms/exam are based on lowest functional level . . intact what levels allows ambulation

Answer 52

L4

Question 53

Types of scoliosis

Answer 53

- Congenital (abnormal vertebrae) - Idiopathic: most common, often + fam hx - Neuromuscular: associated with neuromuscular dz

Question 54

Most common type of idiopathic scoliosis? | Give certain traits

Answer 54

- Adolescent - F > M - R > L

Question 55

Curve progression in Scoliosis is evaluated by what?

Answer 55

- Curve magnitude: x-ray/Cobb angle | - Skeletal maturity: use Risser stage

Question 56

Neurologic findings in scoliosis are rare but are increased with what side

Answer 56

Left sided

Question 57

Anterior cervical spine approach accesses C3-T1. Most surgeons use which side and why

Answer 57

- Left | - Right recurrent laryngeal nerve is more susceptible to injury