Unit 3 Quiz-GA

A 35-year-old man suffers a sudden hyperextension injury of the neck when his car is struck forcefully from behind by another automobile. Thorough subsequent evaluation in the emergency department reveals a traumatic spondylolysis of the C2 vertebra ("hangman's fracture"). The pedicles of C2 are fractured, the body and dens of the axis are displaced anteriorly but remain attached to the intact atlas, and the posterior portion of the C2 neural arch is attached to the C3 vertebra. Luckily for this patient, the spinal cord is not compressed or torn. Which of the following structures held the dens in place against the atlas, preventing it from dislocating and compressing the spinal cord?

Cruciate ligament

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?

Rectus capitis posterior minor

Attempting to do a backflip with his bicycle off a high ramp at the finish line of a race, a 24-year-old professional BMX rider fell from a height of 20 ft and attempted to land on his feet. A sagittal CT reveals a burst fracture of the L1 vertebral body with a posterior displaced fracture fragment compressing the medullary cone (conus medullaris). Which of the following spinal cord segments would most likely be impinged by the bone fragment in this injury?

S2

In a freak hunting accident, a 17-year-old boy was shot with an arrow that penetrated into his suboccipital triangle, injuring the 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?

Splenius capitis

You are examining the lateral spine radiograph of your 65-year-old female patient for an insufficiency fracture of her spine. You know that transitional stresses cause which of the following vertebra to be the most commonly fractured?

T12

A helmet-less 24-year-old man was riding an all-terrain vehicle (ATV or quad bike) when a thin, unseen, horizontal clothes line impacted the man's neck under his chin, knocking him backward off the ATV. Due to his forward momentum at the time of impact, his head was hyperextended on his neck. Emergency medical technicians (EMTS) established his airway, stabilized his neck, and brought him to the emergency room. A lateral cervical X-ray revealed pathology within the cervical vertebrae. Based upon the nature of the accident, which of the following diagnoses is most probable?

Traumatic spondylolysis of C2

Following abdominal aorta aneurysm surgery, the 60-year-old patient became paraplegic. What most likely caused the patient's paraplegia?

latrogenic (inadvertent) occlusion or transection of the great anterior segmental artery (of Adamkiewicz)

During the course of performing a lumbar puncture, the anesthesiologist observes slight muscle twitching in his patient's lower limbs. This evoked reaction suggests the spinal needle stimulated one or more of the components of the cauda equina. Which of the following is the correct composition of the cauda equina?

Anterior and posterior roots of lumbar, sacral, and coccygeal spinal nerves plus the filum terminale

A 12-year-old girl suffers from a type of neural tube defect called tethered cord syndrome, a congenital anomaly that results from defective closure of the neural tube. This syndrome is characterized by an abnormally low conus medullaris, which is tethered by a short, thickened filum terminale, leading to progressive neurologic defects in the legs and feet. Which of the following defects is commonly associated with the tethered cord syndrome?

Meningomyelocele

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?

Lateral horn

In the ED you are treating a patient with a severe upper neck wound. You want to temporarily stop the bleeding from the common carotid artery. To do so you would press strongly against the anterior tubercle of which of the following?

C6

A 73-year-old man comes to his physician complaining of a tingling numbness within the fourth and fifth digits of his right hand. These symptoms are exacerbated when he looks up at the ceiling. The given sagittal T2-weighted MRI reveals degenerative changes in his cervical vertebrae. Which of the following diagnoses is confirmed by the MRI and would result in the symptoms of this patient?

Cervical spinal stenosis

A 30-year-old man presents with symptoms suggestive of vascular insufficiency to the brain. Thorough medical evaluation reveals abnormal narrowing (stenosis) of the right side foramen transversarium in each of cervical vertebrae 2-5, resulting in periodic compression of the vertebral blood vessels. The stenotic condition may be the result of developmental hypertrophy of which of the following structures?

Costal process

An 81-year-old woman visits her family physician for an annual physical examination and complains of weakness and loss of sensation in her legs. Radiological studies show bony spurs (osteophytes) narrowing the intervertebral foramina at levels T12-L3. Which of the following structures is most likely to be impinged in this condition?

Dorsal Root Ganglia

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 fractured body of the T4 vertebra articulates with which of the following parts of the ribs?

Head of the fifth rib