Spine

Question 1

oppenheim reflex

Answer 1

UMN test

• rub tibial crest proximal to distal
• Normal: Toes PF
• Abnoraml: DF and splay

Question 2

Cremasteric reflex

Answer 2

T12-L1

• stroek medial thigh proximal to distal
  normal: upward scrotum
• abnormal: nothing

Question 3

anal wink refoex

Answer 3

S2-4
-stroke skin around anus

-sphincter contracts

Question 4

bulbocavernosus

Answer 4

S3-4

squeeze penis or clitoris or tug bladder catheter
normal: anal sphicnter contract

Question 5

PLC components

Answer 5

supraspinous ligament
interspinous ligament
ligamentum flavum
facet joint capsules

Question 6

sagital balance paramters

Answer 6

C Lordosis = 20-40
T kyphosis = 20-50
lumbar lordsosis = 20-80

Question 7

normal alignment

Answer 7

the vertical axis

• center of C2 to the anterior border of T7
• to middle of the T12/L1 disc
• to posterior to the L3 vertebral body
• posterosuperieor corner of the sacrum.

negative balance (axis post to sacrum = hyperlordosis)

Question 8

Cspine facet plane and function

Answer 8

plane: 0 coronal and 45 sagittal superiomedial
function: F/E, lateral flex, rotaiton

Question 9

T spine plane and function

Answer 9

plane: 20 coronoal and 55 sagittal (facet in coronal plane)

limited f/e

Question 10

l spine plane and function

Answer 10

50 coronal and 90 sagittal (facets sagittalplane)

f/x, minimal rotaiton

Question 11

C2 vialb eof rpedicle screw?

Answer 11

yes; same as c7

C3-6 use lateral mass

Question 12

Tspine pedicale diamter

Answer 12

2x as thick medially as distally

T4 narrowest & shortest pedicale diamter
T12 usually larger pedicle than L1

Question 13

pedicle length changes

Answer 13

lenght decrease T1-4, but increase further distal

Question 14

pedicle ange T spine

Answer 14

15 degree cephalad

neutral in Lspine

Question 15

pedicle angulation

Answer 15

angulate more medial moving distally
L1 = 10
L5 = 30

Question 16

On average, thoracic pedicle diameter is maximal at T1 and T12, and gradually “dips” to its smallest diameter at the T4 to T6 region.

Answer 16

T6 is smallest diamter

Question 17

coronal plane imablance adult deformity

Answer 17

> 10 degree from vertical

Question 18

sagittal plane imalance

Answer 18

XR imbalance >5 cm

Question 19

ALL attachemtns

Answer 19

axis: anterior body
atlas: anterior arch
foramen magnum: inferior edge

terminates as anterior atlanto-occipital membrane

Question 20

techtorial membrane is extension of what

Answer 20

PLL

primary stabilizer of occiput-C1 articulation and limits extension

Question 21

cruciate ligament xomplex

Answer 21

transverse atlantal ligament (TAL): runs between lateral masses of atlas posteiror to dens
-primary stbilzier of atlantoaxial motion, minimizing flexion, translation but allows rotation

Question 22

alar ligaments

Answer 22

dorsolateral dens to inferomedial occipital condyle

Question 23

vertebral artery course

Answer 23

92% patients- passess anteriorly to TP of C7

enter transverse forament at c6

course obliquely and medially on superior aspect of posterior arch C1 before entering forament magnum to format basilar artery