NBME ANATOMY 100 COMPREHENSIVE QUESTIONS AND
CORRECT ANSWERS EXAM PRACTICE VERIFIED GRADE
A+ 2024 UPDATE
what type of fracture are boxer's/fist fighters prone to?
-fractured necks of the metacarpal bones
-typically, fractures of the 2nd and 3rd metacarpals are seen in professional boxers
-fractures of the 5th and sometimes 4th metacarpals are seen in unskilled fighters
what is a mallet or baseball finger?
how does it occur?
-sudden extreme forced flexion of the DIP joint
-results in avulsion of the extensor digitorum tendon from the base of the distal phalanx
-the patient can no longer extend the DIP joint
-ex= when a baseball is mis-caught or a finger is jammed into a base pad
rotator cuff muscles?
what are the different shoulder abductor muscles?
0-15= supraspinatus (initiates abduction)
15-110= deltoid (abduction to the horizontal position)
110-180= trapezius and serratus anterior (raising the arm above the horizontal position
requires scapular rotation)
what are common causes of painful arm abduction?
-subacromial bursitis (inflammation of the subacromial bursa) --> often due to calcific
supraspinatus tendinitis
-inflammation or torn supraspinatus tendon
triceps insertion?
olecranon
what separates the olecranon from the skin?
-olecranon bursa
torn supraspinatus
what is "student's elbow"
-subcutaneous olecranon bursitis
-caused by repeated excessive pressure/friction causing the bursa to become inflamed
cause of lateral epicondylitis?
presentation?
-repeated forceful extension causes strain at the common extensor tendon and
inflammation of the lateral epicondyle's periosteum
-pain felt over the lateral epicondyle and radiates down the posterior aspect of the
forearm
-pain often felt when opening a door or lifting a glass
,NBME ANATOMY 100
origins of which muscles may be affected in lateral epicondylitis?
-extensor carpis radialis longus + brevis
-extensor digitorum
-extensor digit minimi
-extensor carpi ulnaris
at what vertebral level(s) should you perform a lumbar puncture ?
L3/L4 or L4/L5; level of the iliac crests
when doing a lumbar puncture, what does your needle pierce through
skin --> fascia --> supraspinous ligament --> interspinous ligament --> ligamentum
flavum --> epidural space --> dura mater --> subarachnoid space
What is a herniated disc?
nucleus pulposus through anulus fibrosus (nucleus pulposus is remnant of notochord)
-usually herniates postero-laterally
-compresses spinal nerve root
most common levels of herniated disc
Lumbar Levels= L4/L5 or L5/S1
cervical regions= C5/C6 or C6/C7
herniated disk presentation
-individuals <50
-history of back pain that may radiate down to the lower limb
-pain begins soon after patient lifted something heavy
-herniated lumbar disc compresses the nerve root one number below (L4/L5 will
compress the L5 root)
-lower limb reflexes are decreased on the affected side
-patellar --> L2/L3 or L3/L4 herniation
-achilles --> L5/S1 herniation
what is kyphosis ?
who is it seen in?
-exaggeration of the thoracic curvature
-may occur in the elderly as a result of osteoporosis or disk degeneration
-osteoporosis= multiple compression fractures of the vertebral bodies
what is lordosis?
who is it seen in?
-exaggeration of the lumbar curvature that may be temporary
-occurs during pregnancy, spondylolisthesis, or potbelly
what is scoliosis?
causes?
-lateral deviation/torsion of the spine
-caused by poliomyelitis, leg length discrepancy, or hip disease
what is the pars interarticularis
connects the superior facet and inferior facet
what is spondylolysis?
presentation?
, NBME ANATOMY 100
-defect/stress fracture in the pars interarticularis
-most common reason for lower back pain in adolescent athletes
-usually at L5
what is spondylolisthesis?
presentation?
-forward slippage of one vertebral body with respect to the one beneath it
-most commonly occurs at lumbosacral junction with L5 slipping over S1
-low back pain aggravated by standing and walking
-rarely can cause cauda equina
-often results from spondylolysis
low back pain with extension or standing, relief with flexion
spinal canal stenosis
positional pain, relieved with rest and analgesics, lumbar or cervical spine
osteoarthritis/degenerative
low back pain with paravertebral spasm after history of lifting a heavy object
lumbosacral strain
low back pain in elderly which is exacerbated on minor exertion or touch
vertebral body fracture-- due to osteoporosis
low back pain with paravertebral spasm and fever
epidural abscess
lower back pain in elderly, continuous pain that is worse at night, resistant to
pain meds and positional changes. fever, weight loss, night sweats
cord compression due to metastatic tumor
Prostate Breast Kidney Thyroid Lung (PB KTL)
radicular lower back pain, saddle anesthesia, loss of DTR's, bowel/bladder issues
cauda equina syndrome, surgical emergency
low back pain in adolescent with slip off or step off in spine examination
spondylolisthesis
back pain in pregnancy
lumbar lordosis
low back pain with loss of DTR's, loss of sensation in dermatome, + straight leg
disc herniation
low back pain in IV drug user/immunocompromised, tenderness on palpation of
spinous process, fever
vertebral osteomyelitis
low back pain, hip/butt/thigh claudication, impotence and atrophy of lower
extremities, weak femoral pulses, bruit heard over femoral area
lehriche syndrome, aorticoiliac PAD
low back pain, male, 25-35 yo, morning stiffness and improves with activity, may
have diarrhea or uveitis
ankylosing spondylitis, HLA B27
omohyoid innervation?
insertion/origin?
-Scapula to the hyoid bone
-Innervated by ansa cervicalis C1-C3
what is injured at the surgical neck of the humerus?
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