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24 Cards in this Set
- Front
- Back
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During an outbreak of meningitis at a local college, a 20-year-old presents to a hospital emergency department complaining of headache, fever, chills and stiff neck. On examination, it appears that he may have meningitis and needs a lumbar puncture or a spinal tap. Cerebrospinal fluid (CSF) is normally withdrawn from which of the following spaces?
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Subarachnoid space
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A 23-year-old jockey falls from her horse and complains of headache, backache and weakness. Radiologic examination would reveal the blood in which of the following spaces if the internal vertebral venous plexus was ruptured?
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Epidural spaces
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A 42-year-old woman with metastatic breast cancer is known to have tumors in the intervertebral foramina between the fourth and fifth cervical vertebrae and between the fourth and fifth thoracic vertebrae. Which of the following spinal nerves may be damaged?
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Fifth cervical and fourth thoracic nerves
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A 39-year-old woman with headaches presents to her primary care physician with a possible herniated disk. Her magnetic resonance imaging (MRI) scan reveals that the posterolateral protrusion of the intervertebral disk between L4 and L5 vertebrase would most likely affect nerve roots of which of the following spinal nerves?
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Fifth lumbar nerve
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A 57-year-old woman comes into her physician's office complaining of fever, nausea, vomiting, and the worst headache of her life. Tests and physical examination suggest hydrocephalus (widening ventricles) resulting from a decrease in the absorption of cerebrospinal fluid (CSF). A decrease of flow in the CSF through which of the following structures would be responsible for these findings?
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Arachnoid villi
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After a 26-year-old man's car was broadsided by a large truck, he is brought to the emergency department with multiple fractures of the transverse processes of the cervical and upper thoracic vertebrae. Which of the following muscles might be affected?
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Levator scapulae
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A 27-year-old mountain climber falls from a steep rock wall and is brought to the emergency department. His physical examination and computed tomography (CT) scan reveal dislocation fracture of the upper thoracic vertebrae. The fracture body of the T4 vertebra articulates with which of the following parts of the ribs?
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Head of the fifth rib
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A young toddler presents to her pediatrician with rather new onset of bowel and bladder dysfunction and loss of the lower limb function. Her mother had not taken enough folic acid (to the point of a deficiency) during her pregnancy. On examination, the child has protusion of the spinal cord and meninges and is diagnosed with which of the following conditions?
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Meningomyelocele
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A 34-year-old woman crashes into a tree during a skiing lesson and is brought to a hospital with multiple injuries that impinge the dorsal primary rami of several spinal nerves. Such lesions could affect which of the following muscles?
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Illiocostalis
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During a domestic dispute, a 16-year-old boy receives a deep stab wound around the superior angle of the scapula near the medial border, which injures both the dorsal scapular and spinal accessory nerves. Such an injury could result in paralysis of weakness of which of the following muscles?
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Rhomboid major and trapezius
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An elderly man at nursing home is known to have degenerative brain disease. When cerebrospinal fluid (CSF) is withdrawn by lumbar puncture for further examination, which of the following structures is most likely penetrated by the needle?
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Ligamentum flavum
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A 27-year-old stuntman is thrown out of his vehicle prematurely when the car used for a particular scene speeds out of control. His spinal cord is crushed at the level of the fourth lumbar spinal segment. Which of the following structures would most likely be spared from destruction?
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Lateral horn
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A 24-year-old woman comes to a hospital to deliver her baby. Her obstetrician uses a caudal anesthesia during labor and childbirth to block the spinal nerves in the epidural space. Local anesthetic agents are most likely injected via which of the following openings?
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Sacral hiatus
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In a freak hunting accident, a 17-year-old boy was shot with an arrow that penetrated into his suboccipital nerve between the vertebral artery and the posterior arch of the atlas. Which of the following muscles would be unaffected by such a lesion?
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splenius capitis
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A 26-year-old heavyweight boxer was punched on his mandible, resulting in a slight subluxation (dislocation) of the atlantoaxial joint. The consequence of the injury was decreased range of motion at that joint. What movement would be most affected?
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Rotation
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A crushed injury of the vertebral column can cause the spinal cord to swell. Which structure would be trapped between the dura and the vertebral body by the swelling spinal cord?
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Posterior longitudinal ligament
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A 44-year-old woman comes to her physician and complains of headache and backache. On examination she is found to have fluid accumulated in the spinal epidural space because of damage to blood vessels or meninges. Which of the following structures is most likely ruptured?
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Internal vertebral venous plexus
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A 69-year-old man has an abnormally increased curvature of the thoracic vertebral column. Which of the following conditions is the most likely diagnosis?
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Kyphosis
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During a snowstorm, a 52-year-old man is brought to the emergency department after a multiple car accident. Which of the following conditions is produced by a force that drives the trunk forward while the head lags behind in a rear-end automobile collision?
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Whiplash injury
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A 37-year-old man is brought to the emergency department with a crushed second cervical vertebra (axis) that he suffered after a stack of pallets fell on him at work. Which of the following structures would be intact after the accident?
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Rectus capitis posterior minor
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A middle-aged coal miner injures his back after an accidental explosion. His magnetic resonance imaging (MRI) scan reveals that his spinal cord has shifted to the right because the lateral extensions of the pia mater were torn. Function of which of the following structures is most likely impaired?
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Denticulate ligament
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After an automobile accident, a back muscle that forms the boundaries of the triangle of ascultation and the lumbar triangle receives no blood. Which of the following muscles might be ischemic?
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Latissimus dorsi
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A 38-year-old woman with a long history of shoulder pain is admitted to a hospital for surgery. Which of the following muscles becomes ischemic soon after ligation of the superficial or ascending branch of the transverse cervical artery?
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Trapezius
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A 25-year-old soldier suffers a gunshot wound on the lower part of his back and is unable to move his legs. A neurologic examination and magnetic resonance imaging (MRI) scan reveal injury of the cauda equina. Which of the following is most likely damaged?
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Ventral roots of the sacral spinal nerves
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