Gray's Anatomy Questions: Back (PART 1) Exam Questions With Verified Solutions
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Course
Anatomy
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Anatomy
Gray's Anatomy Questions: Back (PART 1)
Exam Questions With Verified Solutions
A 55-year-old man with severe coughing is admitted to the hospital. Radiographic examination
reveals tuberculosis of the right lung, with extension to the thoracic vertebral bodies of T6 and
T7, producing a "gibbus d...
EXAM STUDY MATERIALS July 23, 2024 4:26 PM Gray's Anatomy Questions: Back (PART 1) Exam Questions With Verified Solutions A 55 -year-old man with severe coughing is admitted to the hospital. Radiographic examination reveals tuberculosis of the right lung, with extension to the thoracic vertebral bodies of T6 and T7, producing a "gibbus deformity." Which of the following condit ions is most likely also to be confi rmed by radiographic examination? A. Lordosis B. Kyphosis C. Scoliosis D. Spina bifida E. Osteoarthritis - answer✔✔B. Kyphosis is characterized by a "hunchback" due to an abnormal increase in curvature of the thoracic reg ion of the vertebral column. Lordosis, or "swayback," is an increase in lumbar curvature of the spine. Lordosis can be physiologic, such as seen in a pregnant woman. Scoliosis is a lateral curvature of the spine with rotation of the vertebrae. Spina bifida is a neural tube defect characterized by failure of closure of the vertebral arch. Osteoarthritis is a degenerative disorder that affects the articular cartilage of joints and is not specifically related to the thoracic region of the spine. A 68 -year-old ma n is admitted to the hospital due to severe back pain. Radiographic examination reveals severe osteoporosis of the vertebral column, with crush fractures of vertebrae L4 and L5. Which of the following parts of the vertebrae are most likely to be fractured in this patient? A. Spinal process B. Vertebral bodies C. Transverse process D. Superior articular process E. Intervertebral disk - answer✔✔B. A crush fracture is characterized by compression of the entire vertebral body. The wedge fracture is simila r in that it affects the vertebral bodies, but it involves small fractures around the perimeter of the vertebral body. Both of these fractures cause reductions in overall height. Fracture of the spinal, transverse, or superior articular processes can be du e to an oblique, transverse, or comminuted fracture. Intervertebral disks are associated with disk herniation, not compression fractures. EXAM STUDY MATERIALS July 23, 2024 4:26 PM A 45 -year-old man is admitted to the hospital because of severe pain in the back and lower limb. Radiographic examinat ion reveals spinal stenosis syndrome. Which of the following conditions is most likely to be confirmed by MRI examination? A. Hypertrophy of supraspinous ligament B. Hypertrophy of interspinous ligament C. Hypertrophy of ligamentum flavum D. Hypertrop hy of anterior longitudinal ligament E. Hypertrophy of nuchal ligament - answer✔✔C. The ligamentum flavum connects the lamina of two adjacent vertebrae and forms the posterior wall of the vertebral canal. It is the only answer choice that is in direct con tact with the vertebral foramen. Therefore, hypertrophy of only the ligamentum flavum would present as spinal stenosis. The supraspinous and interspinous ligaments connect spinous processes. The anterior longitudinal ligament connects the anterior portion o f the vertebral bodies and intervertebral disks. Finally, the nuchal ligament is a thickened extension of the supraspinous ligament above the level of C7. A 35 -year-old man is admitted to the hospital after a severe car crash. Radiographic examination reveals an injury to the dorsal surface of the neck and a fracture in the medial border of the right scapula. During physical examination the patient presents with the scapula retracted laterally on the affected side. Which of the following nerves has most likely been injured on that side? A. Axillary B. Long thoracic C. Dorsal scapular D. Greater occipital E. Suprascapular - answer✔✔C. The dorsal scapular n erve (from the ventral ramus of C5) is responsible for innervating rhomboids major and minor. The rhomboids are responsible for medial retraction (adduction) of the scapula. Therefore, if this nerve is damaged, individuals present with a laterally displace d (abducted) scapula. In this case the levator scapular remains functional due to additional innervation provided by C3 -4 spinal nerves. The axillary nerve innervates the deltoid and teres minor muscles. The deltoid muscle abducts the humerus, and the teres minor laterally rotates the humerus. The long thoracic nerve innervates the serratus anterior, which functions to abduct and upwardly rotate the scapula. The greater occipital nerve is mainly sensory and is also contributing to the innervation of the sem ispinalis capitis. In addition, greater occipital nerve is implicated in occipital neuralgias. The suprascapular nerve innervates the supraspinatus and infraspinatus muscles. The supraspinatus abducts the humerus, and the infraspinatus muscles laterally ro tate the humerus. Injury to any of these other nerves would not present with a laterally retracted scapula.
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