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121 Cards in this Set
- Front
- Back
Number of vertebra in the lumbar spine
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5
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The number of vertebra in the cervical spine
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7
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The number of vertebra in the thoracic spine
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12
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The lumbar spine curve is
a.) kyphotic b.) lordotic c.) neutral |
lordotic
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The cervical spine curve is:
a.) kyphotic b.) lordotic c.) neutral |
lordotic
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Bending forward at the waist to touch your toes is:
a.) flexion b.) extension c.) rotation |
flexion
Think of it like this...any time you are flexing, you're "closing the space" flexing your biceps...you're closing your arm...extension is opening the space |
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the motion segment includes
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disc
2 vertebra intervening ligaments all of the above |
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leaning backward and arching your back is known as:
rotation flexion extension side bending |
extension
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the inner softer hydrophilic gel of type II collagen in the disc space is the:
nucleus pulposus annulus fibrosis end plate none of the above |
nucleus pulposus
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a lag screw is smooth (without threads) at the distal tip
true or false |
false
also called smooth shank screw...never used in lumbar, only posterior cervical because of all the vascular structures and potential for the screw thread to wear on the arteries/veins/etc. |
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a 6.5 mm cannulated pedicle screw has a hole in the middle core of the shaft, so that it can be passed and advanced over the guide wire
true or false |
true
|
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the CSF is dark in t1 weighted MRI films
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true
T stands for Tesla...which is the unit MRI is measured in ...the "power" of the magnet |
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t2 weighted MRI will show water content of disc
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true
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a buttress plate will
a.) contain an anterior interbody cage or bone graft, so it will not expel b.) add reinforcement to stop gross motion while the space fuses c.) provides stability d. All of the above |
a.) contain an anterior interbody cage or bone graft, so it will not expel
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degenerative disc disease and disc space narrowing can be seen with a sagittal view T2 weighted MRI which shows the hydration water content of the disc
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true
|
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Semi constrained plates make up over 65% of the cervical ACDF market
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true
What other types of ACDF plates are there on the spectrum? rigid (fixed or constrained) dynamic (movable) |
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cephalad means
a.) towards the head b.) towards the feet c.) towards the right d.) towards the left |
towards the head
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distal means away from
true or false |
true
opposite of distal? proximal |
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caudal means
a.) towards the head b.) towards the feet c.) towards the right d.) towards the left |
towards the feet
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superior is above
true or false |
true
|
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inferior is below
true or false |
true
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sagittal means
side view a view of a body sliced from left to right a view of a body sliced from right to left all of the above |
all of the above
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an axial view is a cross-section
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true
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the largest peripheral nerve in the body is the
femoral nerve sciatic radial peroneal |
sciatic
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the dura mater is
grey outer most covering layer of spinal cord the arachnoid layer of the spinal cord the posterior longitudinal ligament none of the above |
grey outer most covering layer of the spinal cord
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pain radiating down the entire length of the nerve is:
a.) radiculitis b.) parathesia c.) myositis d.) none of the above |
radiculitis
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myelopathy is
a.) caused by spinal cord compression b.) produces upper motor neuron injury c.) is best seen on T2 weighted MRI images d.) all of the above |
all of the above
define the prefix myel? muscle define the suffix opathy? condition of disease |
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the flattened bone adjacent to the spinous process is the
a.) pedicle b.) lamina c.) transverse process d.) facet |
lamina
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the bone between the anterior elements and the lamina is the
a.) pedicle b.) spinous process c.) transverse process d.) facet |
pedicle
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the bone extending lateral from the arch is the
a.) pedicle b.) lamina c.) spinous process d.) transverse process |
transverse process
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the intervertbral foramen is bounded by
a.) Pedicle b.) disc c.) facet d.) all of the above |
all of the above
|
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the articulating bone on the arch is the
pedicle lamina transverse process facet |
facet
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the tough 8-20 ply outer layers of the disc is the
nucleus pulposus |
false
|
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the general principles of insertion of any interbody implant insertion are to
a.) decorticate the end plate b.) scrape to raw bleeding bone c.) compress the implant d.) all of the above |
all of the above
what is decorticate? cortical bone is the outer hard "shell" cancellous bone is the spongy, good **** where great **** happens what are the two types of bone? cancellous and cortical |
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the nerve root exits the spinal canal and traverses anteriorly and inferiorly from the spine
true or false |
true
|
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sterilization of allografts is by
a.) low dose gamma radiation b.) autoclave steam c.) ETO gas sterilization d.) all of the above |
not d, or c...don't know
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peek is an acronym for biocompatible plastic
A.) Poly Ether Ether Ketone B.) Poly Etylene Ester Ketone C.) Poly Ether Etylene Propylene D.) None of the above |
Poly ether ether ketone
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PEEK (without any tantulum markers) is radio opaque
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false
|
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the name of the strongest, thickest ligament that lies on the ventral side of the disc is
a.) anterior longitudinal ligament b.) posterior longitudinal ligament c.) ligamentum flavum d.) interspinous ligament |
anterior longitudinal ligament
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the name of the strongest, thickest ligament that lies on the dorsal side of the disc is
a.) anterior longitudinal ligament b.) posterior longitudinal ligament c.) ligamentum flavum d.) interspinous ligament |
posterior longitudinal ligament
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the name of the ligament that lies beneath and between the laminae is
a.) anterior longitudinal ligament b.) posterior longitudinal ligament c.) ligamentum flavum d.) interspinous ligament |
ligamentum flavum
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the name of the ligament between the spinous processes is
a.) anterior longitudinal ligament b.) posterior longitudinal ligament c.) ligamentum flavum d.) interspinous ligament |
d.) interspinous ligament
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the bone most prominent spinous process of the cervical spine is
a.) C3 b.) C4 c.) C5 d.) C7 |
c7
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in normal specimens the nerve hugs the side of the pedicle
a.) superiorly and medially b.) inferiorly and medially c.) laterally and inferiorly d.) laterally and superiorly |
inferiorly and medially
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spondyloptosis occurs with 2 vertebral bodies one of which is directly on top of the other
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false
“Spondylo” means spine and “listhesis” means slippage. |
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spondylolysis is the collar on the scotty dog representing a break on the pars
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true
the scotty dog appears on x-ray....the collar of the "dog" is a demonstration of the pars |
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spondylolithesis is a forward shift of one vertebral body on another, or in other words, the posterior vertebral body line is no longer in alignment
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true
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what does OPLL stand for
a.) osteo porotic longitudinal layer b.) osteo porotic longitudinal layer c.) ossification posterior longitudinal ligament d.) osseus partial lumbar laminotomy |
ossification posterior longitudinal ligament
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corpectomy is removal of the entire
a.) posterior spinal elements b.) cortex of the pedicle c.) vertebral body d.) core of the cancellous bone |
vertebral body
|
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making a window, or opening in the lamina is a
a.) laminectomy b.) laminotomy c.) laminoplasty d.) none of the above |
laminotomy
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Degenerative spondylolisthesis is seen most commonly at the _______ location.
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L4-L5
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A bone fracture called a pars defect can also lead to spondylolisthesis, often at the _____ location. This is typically seen in young adults and athletes.
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L5-S1
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ectomy
otomy oplasty |
removal
hole into repair of |
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ventral equals posterior?
true or false |
false
|
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the lowest 2 ribs are floating ribs
|
true
|
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stenosis of a foramen is defined as a
a.) closure b.) opening c.) narrowing d.) non of the above |
narrowing
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the load carried by the anterior elements of the spine
a.) 25% b.) 50% c.) 80% d.) 90% |
not 50%
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As the spine degenerates the load is transferred more to the anterior column. true or false
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false
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the 3 joint complex of the spine includes the
two facet joints and the discovertebral unit true or false |
true
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dorsal equals anterior
true or false |
false
|
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a disco-CT is designed to identify
a.) the volume of saline injected b.) the localization of the painful disc c.) the extent of contrast leakage d. all of the above |
all of the above
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the coronal view is
a.) anterioposterior projection b.) vertically divides the body into anterior and posterior sections c.) is reformatted from axial cuts of an MRI or CT scan d.) all of the above |
all of the above
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the pars interarticularis is the part of the vertebral arch which:
a.) is located within the pedicle b.) may be defective in spondylolisthesis c.) is not important in preventing forward slippage of one vertebra on another d.) is located between the laminae |
may be defective in spondylolisthesis
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fluoroscopy is frequently used:
a.) intraoperatively b.) with discography c.) for nerve root injections d.) all the above |
all of the above
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the cobb angle is used to measure
a.) scoliosis b.) lordosis c.) kyphosis d.) all the above |
all the above
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bone is bright white in a CT scan.
true or false |
true
|
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CSF is bright white on MRI T1 images
true or false |
false
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MRI is best for seeing soft tissue structures
true or false |
true
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CT is best for seeing soft tissue structures
true or false |
false
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Contrast CT is useful in detecting
a.) increased blood flow b.) decreased blood flow c.) fractures d.) none of the above |
a or b...not sure
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Myelography:
a.) was the gold standard to assess for neurological compression b.) dye is injected into the spinal fluid c.) largely replaced by MRI d.) all of the above |
all of the above
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a dynamic myelogram may demonstrate more neurological compression in:
a.) extension b.) compression c.) rotation d.) none of the above |
extension
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MRI
a.) an imaging technique using magnetic fields to obtain pictures of soft and bony anatomy b.) best for vascular, muscular and disc morphology c.) detects H2O concentration d.) all of the above |
all of the above
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T1 weighted MRI images are more useful than T2 MRI for visualizing tumors
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true
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the lumbar portion of the neural elements in the spinal canal is called:
a.) the spinal cord b.) the cauda equina c.) the lumbar rami d.) none of the above |
the cauda equina
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the intervertebral disc complex consists of:
a.) the nucleus pulposis b.) the annulus fibrosis c.) the end plate d.) all of the above |
all of the above
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spinal osteophytes are a result of degenerative disc disease
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true
|
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the facet joint is a synovial joint
true or false |
true
|
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the thickness of CT scan slices may be
a.) 1mm b.) 3mm c.) 5mm d.) all of the above |
all of the above
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the normal appearance of the nucleus pulposis on disco-CT is that of either a cotton ball or "hamburger"
true or false |
true
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the normal volume of saline accepted in the nucleus pulpois is 10cc true or false
|
false
|
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flexion/extension x-rays are useful in identifying instability as determined by:
a.) excess forward/backward slippage of 1 vertebra on another b.) decreased angulation of 1 vertebra on another c.) increased rotation of 1 vertebra on another d.) none of the above |
a.) excess forward/backward slippage of 1 vertebra on another
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one of the earliest MRI findings of degenerative disc disease is:
a.) a dark disc on T1 b.) a dark disc on T2 c.) a bright disc on T2 d.) a bright disc on T1 |
a dark disc on T2
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degenerative disc disease may lead to:
a.) spondylolisthesis b.) scoliosis c.) spinal steroids d.) all of the above |
all of the above
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disc collapse with posterior subluxation is an early x-ray sign of disc deterioration
true or false |
true
|
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cervical radiographs in rheumatoid arthritis may show
a.) disc narrowing b.) supra-axial subluxations c.) C1-C2 instability d.) all of the above |
not all of the above
|
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C1-C2 instability is diagnosed if there is:
a.) <3mm between the C1 arch and the odontoid b.) > 3mm between the C1 arch and the odontoid c.) > 3mm between the C1 spinous process and the C2 spinous process d.) <3mm between the C1 spinous process and the C2 spinous process |
> 3mm between the C1 arch and the odontoid
|
|
the grades of spondylolisthesis are numbered
a.) 0 to 6 b.) 1 to 5 c.) 0 to 4 d.) 0 to 5 |
not C
Grade I — 1 percent to 25 percent slip Grade II — 26 percent to 50 percent slip Grade III — 51 percent to 75 percent slip Grade IV — 76 percent to 100 percent slip |
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Spondylolisthesis is:
a.) the backward slip of 1 vertebra on the one below b.) the backward slip of 1 vertebra on the one above c.) the forward slip of 1 vertebra on the one below d.) the forward slip of 1 vertebra on the one above |
c.) the forward slip of 1 vertebra on the one below
|
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a grade 2 spondylolisthesis is a 50% slip
true or false |
true
|
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spondylolisthesis may be
a.) congenital b.) degenerative c.) traumatic d.) all of the above |
all of the above
|
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The commonest level for spondylolisthesis secondary to degenerative disc disease is
a.) L2-3 b.) L3-4 c.) L4-5 d.) L5-S1 |
L4-5
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The function of the disc is
a.) support b.) shock absorption c.) movement d.) all of the above |
all of the above
|
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a fractured transverse process is usually a sign of a rotational injury
true or false |
true
|
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one principle of spinal fracture treatment is to stabilize the spine
true or false |
true
|
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most compression spinal fractures require surgery
true or false |
false
|
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using the posterior approach in spinal fracture surgery it is possible to achieve the following:
a.) decompression b.) re-alignment c.) stabilization d.) all of the above |
all of the above
|
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the spinal canal can be cleared of spinal fracture fragments indirectly by pedicle screw distraction if done soon after the fracture has occured
true or false |
true
|
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in the surgical treatment of burst fractures the anterior approach:
a.) is the most consistent way to remove bony fragments in the spinal cord b.) does not usually require internal fixation after interbody grafting c.) must always be instrumented posteriorly d.) none of the above |
not d
|
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in spinal fractures:
a.) distraction injuries of the spine usually require surgery b.) rotational almost always require surgery c.) compression injuries of the spine can usually be treated non-operatively d.) all of the above |
i think d
|
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During the aging process the loss of water content in the disc predisposes the disc to develop degenerative disc disease.
true or false |
true
|
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herniated discs:
a.) usually require surgery b.) occur in 80% of the population c.) are not associated with radiculitis d.) none of the above |
d
|
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Radiculitis is caused by:
a.) disc herniation b.) bone spurs c.) lateral recess stenosis d.) all of the above |
all of the above
|
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degenerative disc disease
a.) may be asymptomatic b.) is treated non-operatively in over 80% of cases c.) is commonly seen on radiographs over the age of 60 d.) all of the above |
all of the above
|
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in degenerative disc disease
a.) decompression alone is not effective for patients with mainly radiculitis b.) fusion is always recommended when non-operative treatment fails c.) anterior surgery is the best approach d.) none of the above |
not b
|
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degenerative disc disease decompression usually includes removal of offending
a.) disc b.) bone c.) ligament d.) all of the above |
all of the above
|
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radiculitis is associated with
a.) pain in a nerve root distribution b.) weakness c.) parasthesiae d.) all of the above |
all of the above
|
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cauda equina syndrome may be associated with bladder incontinence
true or false |
true
|
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acute cauda equina syndrome is best treated
a.) after 48 hours of onset b.) with fusion c.) immediately (within 48 hours) with decompression d.) non surgically with epidural steroids |
c immediately within 48 hours with decompression
|
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treatment of spinal stenosis by epidural steroid injection is temporarily effective in about 50% of patients
true or false |
true
|
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interbody fusion is achieved with
a.) TLIF b.) PLIF c.) XLIF d.) All of the above |
all of the above
|
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anterior interbody fusion with instrumentation has a fusion rate of
a.) 50% b.) 60% c.) 70% d.) 90+% |
d. 90+%
|
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the best test for diagnosing a non-union is
a.) MRI b.) CT c.) Bone scan d.) X-rays |
CT
|
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treatment of non-union includes:
a.) autograft b.) bone growth stimulators c.) bone supplements d.) all of the above e.) none of the above |
all of the above
|
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Adjacent disc disease
a.) occurs secondary to a fused disc at the next level b.) does not result in degenerative disc disease c.) is never painful d.) always requires surgery |
a.) occurs secondary to a fused disc at the next level
|
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one goal of arthroplasty is to reduce mobility
true or false |
false
|
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arthroplasty is indicated if:
a.) there are 3 or more levels are involved b.) there if facet degeneration c.) there is no adjacent disc disease d.) the posterior elements are not intact |
not a
|
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an unconstrained total disc replacement has less than 6 degrees of freedom
|
false
|
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the alignment of a total disc replacement should be:
a.) on the front view, the midline of the artificial disc should be even with the midline of the vertebra b.) on the side view, the midline of the artificial disc should be slightly forward of the center of the disc c.) the front of the prosthesis should be recessed in from the anterior cortex of the vertebral body d.) all of the above |
d, all of the above
|
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one rationale for arthroplasty is to avoid adjacent level disc disease
true or false |
true
|
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Grades for Spondylolisthesis
|
Grade 1: 0–25% slip
Grade 2: 25–50% slip Grade 3: is 50–75% slip Grade 4: is 75–100% slip Over 100% (Spondyloptosis) slip |