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Exam (elaborations)

nbme anatomy shelf Exam 2023

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Where and why are lumbar punctures performed? - Answer- Spinal Block -> Anesthetic (into epidural space) Spinal Tap -> CSF extraction (into subarachnoid space)W B/W L3/L4 or L4/L5 NB: Posterior to this is *cauda equina* Where does a *herniated intervertebral* disk occur? What causes i...

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  • April 2, 2023
  • 17
  • 2022/2023
  • Exam (elaborations)
  • Questions & answers

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  • nbme
  • nbme anatomy shelf exam 2023
  • where and why are lumbar punctures performed
  • where does a herniated intervertebral disk occur what causes it
  • what is the difference bw retrolisthesis and spondylo

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  • Nbme

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nbme anatomy shelf Exam 2023
Where and why are lumbar punctures performed? - Answer- Spinal Block -> Anesthetic (into epidural space)
Spinal Tap -> CSF extraction (into subarachnoid space)W
B/W L3/L4 or L4/L5
NB: Posterior to this is *cauda equina*
Where does a *herniated intervertebral* disk occur? What causes it? - Answer- Occurs b/w L4/L5 or *L5/S1* and C5/C6 or C6/C7
NB: affects lower spinal nerve #
Degeneration of annulus fibrosis followed by *sudden compression* of nucleus pulposus
What is the difference b/w *retrolisthesis* and *spondylolisthesis*? - Answer- Retro - backwards movement of vertebral bone
Spondylo - forward movement of bone
What is *lordosis*? - Answer- exaggerated *L*umbar curvature
What is *kyphosis*? - Answer- exaggerated thoracic curvature (can be seen w/osteoporosis)
What structures will be affected by a fracture of the *surgical neck*? - Answer- axillary nerve and posterior humeral circumflex artery
What structures will be affected by a fracture at *midshaft of humerus*? - Answer- radial
nerve and profunda brachii artery
What structures will be affected by a fracture at *supracondylar region of humerus*? - Answer- median nerve and brachial artery
What are differences b/w *Colles'* and *Smith's* Fractures? - Answer- Both are distal radial fractures
Smith's - flexion fracture (distal segment anterior)
Colles' - extension fracture (distal segment posterior/dorsal) - incl. avulced ulnar styloid process What are the carpal bones? - Answer- Some Lovers Try Positions That They Can't Handle
Scaphoid Lunate Triquetrum Pisiform Trapezium Trapezoid Capitate Hamate
Which carpal bone is most often fractured during a fall (symptoms)? - Answer- Scaphoid
"deep tenderness in anatomical snuff box"
What is a boxer's fracture? - Answer- Fracture of necks of metacarpals
What are the 4 muscles of the *rotator cuff*? - Answer- Supraspinatus
Infraspinatus
Teres Minor
Subscapularis
What *innervate* the four muscles of the rotator cuff? - Answer- Suprascapular N.
Suprascapular N.
Axillary N.
Upper/Lower Subscapular N.
What muscle (+ nerve) initiates abduction of upper limb? - Answer- 0°-15° by *supraspinatus* (suprascapular nerve)
What muscle (+ nerve) allow for abduction b/w 15° - 110°? - Answer- *deltoid* (axillary nerve)
What muscle (+ nerve) allow for abduction above horizontal position? - Answer- *trapezius* (CN XI) and *serratus anterior* (Long Thoracic N.)
What is tennis elbow? - Answer- AKA lateral epicondylitis; painful inflammation of common extensor tendon -> lateral epicondyle
What is golfer's elbow - Answer- AKA medial epicondylitis; inflammation of common *flexor* tendon
What are the arterial anastomoses around the scapula? - Answer- Problem: blockage of
subclavian or axillary a.
Sol'n: anastomoses b/w branches of *subscapular a.* and *thyrocervical trunk*
What are contents of *cubital fossa*? - Answer- From lateral to medial:
biceps brachii tendon
brachial a.
median n. What two muscles form borders of *cubital fossa*? - Answer- Pronator Teres (medial) and Brachioradialis (lateral)
What are *subcutaneous* structures of cubital fossa? - Answer- From lateral to medial:
cephalic v.
median cubital v. (connects the two; over bicipital aponeurosis)
basilic v.
What are causes/symptoms of *carpal tunnel syndrome*? - Answer- Causes: lesion that
↓ size of carpal tunnel (*dislocation of lunate bone*, fluid retention, infection), repetitive movement
Effect: median n. affected
-"pins and needles lateral 3.5 digits"
-palm sensation not affected
What causes *Upper Brachial Palsy*? - Answer- AKA Erb-Duchenne Palsy
Trauma during fall (head away from shoulder)
Pulling arm of child
*Lesion of C5/C6 or Upper Trunk*
What results from upper brachial palsy? - Answer- Waiter's tip hand
Medially rotated arm
Adducted shoulder
Extended elbow
Loss of sensation in lateral upper limb
What are the cause/result of *klumpke's paralysis*? - Answer- a. injury of lower root (C8/T1); "grabbing a tree limb"; *thoracic outlet syndrome*
b. combination lesions of *ulnar* (claw hand) and *median nerve* (ape hand)
What results from lesion to *musculocutaneous nerve*? - Answer- Cause: lesion of *lateral cord*
Effect: weak elbow flexion (biceps/brachialis) and forearm supination (biceps)
What are main innervations of arm? - Answer- 1. biceps brachii, brachialis, coracobrachialis *musculocutaneous n.*
2. back of arm - *radial n.*
3. forearm muscles (8) - *median n.*
Exception: f. digitorum profundus/f. carpi ulnaris *ulnar n.*

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