Deck 14: Cervical and Thoracic Spine and Thorax Pathologies

Question 1

Which of the following is false?

A) Lymph nodes are palpable beneath the mandible and within the scalenes.
B) The scalenes are located posterior to the sternocleidomastoid and at the C3-C6 vertebral level.
C) The larynx sits behind the thyroid cartilage and is found at the C4-C5 vertebral level.
D) The hyoid bone is located at the C3 vertebral level.

Answer 1

A

Question 2

The cervical plexus is comprised of the anterior rami of which nerve roots?

A) C1-C5
B) C5-C8
C) C5-T1
D) C1-C4

Answer 2

D

Question 3

Which special test is performed by running a blunt object or fingernail across the crest of the anteromedial tibia of a patient who has suffered an acute head or spinal injury?

A) Babinski test
B) Oppenheim test
C) Spurling test
D) Thomas test

Answer 3

B

Question 4

In what special test does a patient actively abduct an arm so that the hand rests on top of the head and must maintain this position for 30 seconds to determine whether a nerve root compression exists?

A) Brachial plexus traction
B) Shoulder abduction
C) Vertebral artery
D) Spurling

Question 5

What does the articulation between the anterior arch of the atlas and the dens form?

A) Facet joint
B) Atlanto-axial joint
C) Atlanto-occipital joint
D) Uncinate joint

Question 6

What test can confirm the narrowing of the intervertebral foramen secondary to exostosis,enlargement,or irritation of the nerve root's dural sheath and degeneration of the facet joints?

A) Cervical compression test
B) Babinski test
C) Oppenheim test
D) Cervical distraction test

Question 7

The cricoid cartilage is located anterior of what cervical vertebra level?

A) C4
B) C5
C) C6
D) C7

Question 8

In what position should a patient be placed when testing for cervical flexion and extension motion?

A) Supine
B) Side-lying
C) Standing
D) Seated

Question 9

Which muscle group sits deep and lateral to the semispinalis group?

A) Longus capitis and longus colli
B) Splenius capitis and splenius cervicis
C) Trapezius
D) Longissimus capitis and longissimus cervicis

Question 10

A congenital or acquired spasm of the sternocleidomastoid muscle that causes rotation of the chin opposite the side of the tilt is commonly referred to as what condition?

A) Stenosis
B) Scoliosis
C) Torticollis
D) Spondylolisthesis

Question 11

In what shape is the cervical spine of a patient considered healthy?

A) Kyphotic curve
B) Lordotic curve
C) Lateral curve
D) Sagittal curve

Question 12

Which statement is false concerning cervical intervertebral discs?

A) The disc structure is the same as in the lumbar region.
B) The annulus fibrosus thins as it travels posteriorly.
C) The annulus fibrosus does not completely enclose the nucleus pulposus.
D) The lateral aspect of the disc is not covered in the cervical region by the annulus fibrosus.

Question 13

What is the least common form of thoracic outlet syndrome?

A) Neurogenic
B) Vascular
C) Nonspecific
D) Cervical rib

Question 14

Which of the following nerve roots form(s)the upper trunk of the brachial plexus?

A) C5 and C6
B) C8 and T1
C) C7
D) C8

Question 15

What is the triangular septum structure in the cervical spine that serves as a broad area for muscular attachment?

A) Ligamentum flavum
B) Ligamentum teres
C) Ligamentum nuchae
D) Tectorial membrane

Question 16

What do the vertebral arteries and veins pass through?

A) Foramen magnum
B) Transverse foramen
C) Jugular foramen
D) Vertebral foramen

Question 17

Research has shown that the upper limb tension test (ULTT)only demonstrates adequate results for which nerve?

A) Median
B) Ulnar
C) Radial
D) Axillary

Question 18

The posterior cord of the brachial plexus splits into what two nerves?

A) Radial and median
B) Median and ulnar
C) Axillary and median
D) Axillary and radial

Question 19

Which method is more reliable in determining cervical range of motion (ROM)?

A) Goniometric measurement
B) Inclinometer measurement
C) Visual estimation
D) Laser measurement

Question 20

Which of the following nerve roots form(s)the lower trunk of the brachial plexus?

A) C5 and C6
B) C8 and T1
C) C7
D) C8

Question 21

Which of the lateral and anterior portions of ribs are the most commonly fractured?

A) 1 through 3
B) 2 through 4
C) 5 through 9
D) 10 through 12

Question 22

The spleen is located on the left side of the body,partially under which ribs?

A) 5 through 8
B) 6 through 9
C) 9 through 11
D) 11 through 12

Question 23

What are ribs 8 through 10,which articulate with the sternum through the conjoined costal cartilage,known as?

A) True ribs
B) False ribs
C) Floating ribs
D) Costal ribs

Question 24

Which is not a primary mover for cervical flexion?

A) Anterior scalene
B) Sternocleidomastoid
C) Longus colli
D) Rectus capitis anterior

Question 25

Which of the following is not a typical indication of a positive cervical compression test?

A) Narrowing of the intervertebral foramen
B) Degeneration of the facet joints
C) Irritation of the dural sheath surrounding the spinal cord in the cervical level
D) Thoracic outlet syndrome

Question 26

What is the typical cause of death that is associated with Marfan syndrome?

A) Aortic aneurysm
B) Abdominal aortic aneurysm
C) Cardiac arrest
D) Spontaneous pneumothorax

Question 27

Which of the following statements is true concerning the ribs?

A) The upper two ribs are protected by the clavicle and the pectoralis major.
B) The upper ribs 8 to 9 are protected posteriorly by the scapula.
C) Most rib fractures are the result of overuse injuries.
D) The floating ribs are the most commonly fractured ribs.

Question 28

Which of the following are false ribs?

A) 11 and 12
B) 8 and 9
C) 8, 9, and 10
D) 7, 8, and 9

Question 29

Which of the following statements is false?

A) A spontaneous pneumothorax can result secondary to a penetrating rib injury.
B) By using improper breathing patterns during weight lifting, one can cause a spontaneous pneumothorax.
C) A tension pneumothorax occurs when blood enters the pleural cavity and cannot exit.
D) A person may cough up bloody sputum with a hemothorax.

Question 30

Which of the following does not represent a musculoskeletal finding of someone with Marfan syndrome?

A) Elongated metacarpal and metatarsal bones
B) Systemic joint laxity
C) Pectus excavatum
D) Low arched palate

Question 31

Excruciating,deep thoracic pain that develops in the middle and upper back is the most distinctive early sign of which condition?

A) Cardiac arrest
B) Kidney stone
C) Gallstone
D) Aortic aneurysm

Question 32

What is inflamed in an athlete who has mononucleosis?

A) Liver
B) Gallbladder
C) Spleen
D) Pancreas

Question 33

Which is not correct when conducting the vertebral artery test?

A) The examiner passively flexes the cervical spine.
B) The head is rotated to one side.
C) The testing position is held for 30 seconds.
D) The patient should be supine during the test.

Question 34

What is the survival rate for commotio cordis if an external defibrillator and cardiopulmonary resuscitation (CPR)are used within 3 minutes?

A) 15%
B) 25%
C) 50%
D) 75%

Question 35

Which of the following occurs when blebs rupture and allow air to leak into the pleural cavity?

A) Spontaneous pneumothorax
B) Tension pneumothorax
C) Hemothorax
D) Cyanosis

Question 36

The onset of commotio cordis is influenced by all of the following factors.Which of these is most crucial?

A) Type of force
B) Timing of impact
C) Location of force
D) Amount of force

Question 37

What is the superior section of the sternum anatomically known as?

A) Xiphoid process
B) Manubrium
C) Body
D) Mediastinum

Question 38

Injury to what organ is indicated by pain referred to the left shoulder,also known as Kehr's sign?

A) Liver
B) Spleen
C) Gallbladder
D) Pancreas

Question 39

Which represents the correct beginning testing maneuver for the Spurling test?

A) Passive extension
B) Passive extension with lateral flexion
C) Passive extension with axial compression
D) Lateral flexion and axial compression

Question 40

Which nerve does the diaphragm innervate with?

A) Scapulothoracic
B) Phrenic
C) Axillary
D) Hypoglossal

Question 41

Kehr's sign is referred pain to the upper left abdomen and shoulder,indicating appendicitis.

Question 42

Symptoms of carpal tunnel syndrome can mimic those of a cervical nerve root impingement.

Question 43

MATCHING
Match each of the following terms with its definition.
a.Nystagmus
b.Patency
c.Torticollis
d.Myelopathy
Wry neck

Question 44

Name two tests that are used to check for an upper motor neuron lesion and state what a positive test is for each.

Question 45

MATCHING
Match each of the following terms with its definition.
a.Nystagmus
b.Patency
c.Torticollis
d.Myelopathy
Rapid,uncontrolled eye movement

Question 46

MATCHING
Match each of the following terms with its definition.
a.Nystagmus
b.Patency
c.Torticollis
d.Myelopathy
Freely open

Question 47

Which of the following muscles are responsible for expiration? Select all that apply.

A) Diaphragm
B) Transverse abdominis
C) External oblique
D) Rectus abdominis

Question 48

The supraspinous ligament is called the _______ ________ in the cervical region.

Question 49

The dens is a superior projection off of the atlas and allows for rotation.

Question 50

Which thoracic outlet tests would be positive if compression is by the pectoralis minor?

A) Roos test
B) Allen's test
C) Military brace test
D) Adson's test

Question 51

High blood pressure and a decreased heart rate are associated with splenic injury.

Question 52

The first position of the ULTT includes passive lateral flexion of the cervical spine toward the side not being tested and depression of the shoulder girdle on the side not being tested.

Question 53

When completing the brachial plexus tension test,a positive sign for tension pathology is radiating pain on the side toward the lateral bending.

Question 54

When performing a compression test for rib fracture,the pressure should be released slowly to avoid the potential for increased injury.

Question 55

A blow to the back may result in a kidney contusion,with the left kidney being more vulnerable due to its anatomical location.

Question 56

MATCHING
Match each of the following terms with its definition.
a.Nystagmus
b.Patency
c.Torticollis
d.Myelopathy
Diseases or conditions affecting the spinal cord

Question 57

Spurling's test is a modification of the cervical compression test.Explain the difference between the two tests.