Upper Limb and Back Clinical Correlate - Dr. Conforti

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Review Questions

True/False - September 22, 2011

1. The force of gravity exerts compression onto the vertebral column.
2. The unfused vertebrae interact at the facet joints and at the intervertebral disc.
3. The vertebral curvatures reduce stresses upon the vertebral column.
4. Overloading of the facet joints may result from an unfavorable posture.
5. The annulus fibrosus provides less support to the anulus fibrosus at the posterior margin of the vertebral body than at the anterior margin of the vertebral body.
6. The nucleus pulposus hydrates while asleep (horizontal orientation with respect to gravity) resulting in a morning height gain of more than two inches.
7. Flexion shifts the nucleus pulposus toward the posterior annulus fibrosus.
8. Scoliosis refers to lateral curvatures of the vertebral column.
9. Compression fractures of the vertebral bodies is bad.
10. Spinal stenosis may occur at either the vertebral foramen or the intervertebral foramen.
11. Spondylolisthesis refers to an anterior/posterior displacement of one vertebral body relative to the vertebral body it articulates with.
12. The L5 vertebra is particularly at risk for an anterior displacement of relative to S1.
13. Thoracic outlet syndrome results from compression of the brachial plexus.
14. Compression of the brachial plexus may occur at the scalene muscles, first rib, and pectoralis minor.
15. Dermatomal perturbations are expected in the case of root compression at the scalene muscles and peripheral nerve perturbations are expected in the case of cord/nerve compression at the pectoralis minor.
16. Suboccipital whiplash is expected to perturb the atlantooccipital and atlantoaxial joints.
17. Chronic impingement of the subacromial space may lead to erosion of the supraspinatus tendon.
18. Tearing of the supraspinatus tendon opens a communication between the subacromial bursa and the synovial cavity of the glenohumeral joint.
19. Occupational movements requiring frequent arm abduction (painting the Sistine Chapel) may lead to supraspinatus injury.
20. Compression of structures contained by the carpal tunnel may lead to paresthesia of the medial 1.5 fingers.
21. The lumbar facet joints are oriented to allow lateral deviation but not rotation.
22. Continuous flexion of the vertebral column may cause the annulus fibrosus to displace the posterior longitudinal ligament into the spinal canal.

True/False - 2010

1. Functional differences at different levels of vertebrae reflect facet orientation.
2. Active and passive support of the vertebral column is provided by ligaments and muscles respectively.
3. The facets of the cervical vertebrae are more vertically oriented than are the facets of the lumbar vertebrae.
4. Narrowing of the intervertebral foramina commonly causes compression of the spinal cord.
5. A disk herniation into the intervertebral foramen first compresses the motor fibers.
6. The nutrient supply to the intervertebral disc is provided by branches of the anterior and posterior arteries that penetrated the annulus fibrosus.
7. The symptoms of disk herniation begins with sensory disturbances and then progresses to muscle weakness.
8. Transverse fibers of the anterior longitudinal ligament provides support to the posterior aspect of the annulus fibrosus.
9. An anterior displacement of L5 on the S1 vertebra may perturb the L5 - S4 nerves.
10. Thoracic outlet syndrome refers, in part, to perturbations of the brachial plexus.
11. Disruption of the upper roots of the brachial plexus (lateral whiplash) is expected to weaken abduction at the shoulder joint.
12. Disruption of the C1 dorsal ramus is expected to interfere with rotation and flexion of the head.
13. Impingement of the supraspinatus muscle commonly occurs inferior to the acromion.
14. The subacromial bursa may become inflamed with repeated positioning of the upper extremity to locations above the head.
15. A lesion of the long thoracic nerve causes "winging" of the clavicle.
16. Compression of the median nerve at the carpal tunnel is expected to cause paraesthesia on the palmar side of the radial 3.5 fingers.

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