Question 1

Which of the following is false?

Accepted Answer

Lymph nodes are not typically palpable within the scalenes; they are more commonly found in areas like the neck, axilla, and groin.

Question 2

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

Accepted Answer

The cervical plexus is formed by the anterior rami of the C1-C4 nerve roots.

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?

Accepted Answer

The Oppenheim test involves running a blunt object or fingernail along the crest of the anteromedial tibia to elicit a response, often used in the context of neurological examination to assess for upper motor neuron lesions, which can be relevant in cases of acute head or spinal injury.

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?

Accepted Answer

The test described is called shoulder abduction or the shoulder abduction relief test. It is used to determine whether a nerve root compression exists in the cervical spine. The patient abducts their arm and places their hand on top of their head, which puts the cervical spine in a position where nerve root compression is more likely to occur. If the patient experiences relief of their symptoms (such as pain or numbness) when holding the position for 30 seconds, it suggests that nerve root compression may be present.

Question 5

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

Accepted Answer

The articulation between the anterior arch of the atlas and the dens of axis forms the atlanto-axial joint, which allows for rotation of the head.

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?

Accepted Answer

The cervical compression test is used to evaluate for nerve root compression, which can be caused by narrowing of the intervertebral foramen due to exostosis, enlargement, or irritation of the nerve root's dural sheath, and degeneration of the facet joints. The test involves applying a downward pressure on the top of the patient's head while the neck is in extension, which puts pressure on the cervical spine. If the patient experiences pain or neurological symptoms during the test, this can suggest nerve root compression. The Babinski and Oppenheim tests evaluate for upper and lower motor neuron lesions, respectively, and the cervical distraction test is used to evaluate for cervical spine instability.

Question 7

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

Accepted Answer

The cricoid cartilage is located anteriorly to the cervical vertebra level of C6.

Question 8

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

Accepted Answer

For testing cervical flexion and extension, the patient is typically placed in a seated position. This allows for a stable base and minimizes the involvement of the thoracic spine, providing a more accurate assessment of cervical range of motion.

Question 9

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

Accepted Answer

The longissimus capitis and longissimus cervicis are part of the erector spinae muscle group, which lies deep and lateral to the semispinalis group in the back.

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?

Accepted Answer

Congenital or acquired spasm of the sternocleidomastoid muscle is commonly referred to as torticollis. It causes rotation of the chin opposite the side of the tilt. Stenosis is a condition wherein the openings in the spine become narrow, causing compression of the spinal cord and nerve roots. Scoliosis is characterized by an abnormal lateral curvature of the spine. Spondylolisthesis is a condition where one vertebra in the spinal column slips forward or backward over the vertebra below it.

Question 11

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

Accepted Answer

The cervical spine of a patient who is considered healthy has a lordotic curve, which means that it curves inward at the neck. This is a natural and healthy curve that helps to support the weight of the head and allows for ease of movement. A kyphotic curve (A) is a curve that bends outward, which can lead to a hunched posture or other issues. A lateral curve (C) is a curve that is sideways, which could be a sign of scoliosis. A sagittal curve (D) is a curvature that occurs in the plane that divides the body into left and right portions, and could refer to either a lordotic or kyphotic curve depending on the location of the curvature.

Question 12

Which statement is false concerning cervical intervertebral discs?

Accepted Answer

The disc structure is not the same in the cervical and lumbar regions. Cervical discs are smaller, thinner, and have a relatively larger nucleus pulposus compared to the annulus fibrosus.

Question 13

What is the least common form of thoracic outlet syndrome?

Accepted Answer

Vascular thoracic outlet syndrome is the least common form, comprising a small percentage of cases compared to neurogenic thoracic outlet syndrome, which is the most common.

Question 14

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

Accepted Answer

The upper trunk of the brachial plexus is formed by the nerve roots of C5 and C6.

Question 15

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

Accepted Answer

The triangular septum is a structure in the cervical spine that serves as a broad area for muscular attachment, and it is formed by the ligamentum nuchae. The ligamentum flavum is a yellow ligament located in the posterior aspect of the spinal canal, the ligamentum teres is a ligament that connects the femoral head to the acetabulum, and the tectorial membrane is a continuation of the posterior longitudinal ligament that runs from the occipital bone to the axis.

Question 16

What do the vertebral arteries and veins pass through?

Accepted Answer

The vertebral arteries and veins pass through the transverse foramen of the cervical vertebrae.

Question 17

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

Accepted Answer

Research has shown that the ULTT is most effective in demonstrating adequate results for the median nerve. It may also be used to assess the involvement of other nerves, but its sensitivity for those nerves is not as high as it is for the median nerve.

Question 18

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

Accepted Answer

The posterior cord of the brachial plexus splits into two nerves, the axillary nerve and the radial nerve. The axillary nerve innervates the deltoid and teres minor muscles, while the radial nerve innervates the muscles of the posterior upper limb. The other options are incorrect because they do not include the nerve(s) that originate from the posterior cord.

Question 19

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

Accepted Answer

Inclinometer measurement is considered the most reliable method for determining cervical range of motion. Goniometric measurement can be affected by errors in alignment and measurement technique, visual estimation has a high degree of subjectivity and is prone to error, and laser measurement is not commonly used in clinical settings.

Question 20

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

Accepted Answer

The lower trunk of the brachial plexus is formed by the nerve roots of C8 and T1.

Quiz 14: Cervical and Thoracic Spine and Thorax Pathologies