Cervical Spine Orthopedics II Practice Exam

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• Typical purpose of cervical epidural steroid injections?
• Where is the scalene triangle located?
• What imaging feature characterizes cervical spondylotic myelopathy on imaging even if the patient has no symptoms?
• What is the secondary complaint with thoracic outlet syndrome?
• TOS is more common in which gender?
• Which description best reflects the typical pattern of muscle imbalance in upper cross syndrome?
• Posterior cervical decompression with fusion is typically indicated in which scenario?
• Which option lists multiple risk factors for venous TOS?
• Which statement about onset of SJD is true?
• Age related OA of the spine with degenerative disc disease is termed?
• The scalenus anterior (scalenus anticus) syndrome is also known as which term?
• TOS is rare and least frequently encountered in which type?
• Which complication is commonly associated with the anterior approach for cervical spine surgery?
• By roughly 6-12 months after ACDF, what is expected if fusion is progressing normally?
• What is the primary complaint with thoracic outlet syndrome?
• A unique form of arterial TOS where the axillary artery is compressed is common in
• Which statement best describes chemical radiculitis related to the nucleus pulposus?
• OPLL is more common in which population group?
• Which nerve root corresponds to intrinsic hand muscles (interossei)?
• Which muscle is typically a phasic (weak) muscle in upper cross syndrome?
• Which is more common, soft disc injuries or hard disc injuries?
• Costoclavicular syndrome pain is exacerbated by which motion?
• Adjacent segment disease after cervical fusion results in degenerative changes at which levels?
• Which sign describes an electric shock sensation down the spine with neck flexion and is associated with cervical myelopathy?
• Which statement about reflexive SJD is true?
• Which statement about local neck pain in SJD is most accurate?
• Segmental joint dysfunction most commonly results in local radicular discomfort.
• Which form of thoracic outlet syndrome is associated with hyperabduction of the arm causing pressure on stretched subclavian vessels and divisions/cords?
• Which muscles are typically phasic (weak) in upper cross syndrome?
• What is the long-term risk in patients undergoing fusion at one level of the cervical spine?
• Which structure forms part of the neurovascular bundle in thoracic outlet syndrome?
• Which of the following are common complications associated with ACDF?
• The nerve root associated with intrinsic hand muscles (interossei) is which level?
• What is the distinct clinical finding indicating true neurogenic thoracic outlet syndrome?
• Which disc pathology is defined by a defect in the annulus that allows displacement of the nucleus beyond the disc boundaries?
• What intraoperative neuromonitoring modalities are commonly used in cervical spine surgery?
• A previous history of __ is often present in venous TOS patients.
• Which statement describes reflexive SJD?
• Local neck pain in SJD may exacerbate with which motion?
• After neurogenic TOS, the next most common is ______.
• Which scoring system is widely used to quantify functional impairment in cervical myelopathy?
• Which structures commonly contribute to canal compromise in multilevel degenerative cervical spondylotic changes?
• What is the most common area for TOS entrapment?
• Which nerve root corresponds to finger flexors?
• What term is used to describe degenerative changes of the intervertebral discs and adjacent structures?
• Ventral compressive pathology in multilevel cervical disease is best treated with which approach?
• Arterial TOS compression mechanism involving which rib anomaly?
• Degenerative changes in the spine associated with age-related osteoarthritis are called what?
• In scalenus anticus syndrome, turning the head to which side tends to provoke pain?
• Which patients are described as having soft disc injuries and are associated with chemical radiculitis?
• Thoracic Outlet Syndrome is best described as a condition caused by compression of which structure?
• Neurogenic thoracic outlet syndrome compression occurs at which part of the brachial plexus?
• In odontoid fracture classification, which type corresponds to apex fracture?
• What term is used to describe degenerative changes of the spine?
• Which diagnostic study is considered questionable value in TOS evaluation?
• Aka 'cervical crossed syndrome'; what is the term?
• During postural evaluation of upper cross syndrome, the scapula is typically described as which of the following?
• Which form is defined by compression of the neurovascular bundle between the clavicle and first rib?
• What might you visually observe on inspection of a patient's hand with TOS?
• Hangman’s fracture is best described as what pattern, and what is the typical treatment?
• Which nerve root corresponds to wrist extension?
• Which maneuver may relieve scalenus anticus pain?
• Which sign is commonly associated with SJD?
• In odontoid fractures, which type has the highest nonunion risk?
• What describes the onset of cervical segmental joint dysfunction?
• Which form is relieved by shoulder abduction?
• Which term refers to extruded disc material that has separated from the rest of the disc?
• What radiographic feature suggests pseudoarthrosis after cervical fusion?
• Which condition is described as a form of thoracic outlet syndrome involving a cervical rib?
• When are flexion-extension radiographs most useful in the cervical spine evaluation?
• Which form is associated with a positive Edens test?
• Which of the following is a sign commonly associated with SJD?
• What is the formal name for the thoracic outlet syndrome caused by spasm or hypertrophy of the anterior scalene muscle?
• Arterial TOS is typically caused by compression of the subclavian artery by
• Jefferson (C1 burst) fracture is described as what, and how is it typically managed?
• Which type is least common?
• Soft disc injuries occur more in which gender?
• Mechanical neck pain is best described as which of the following?
• Which statement best describes diffusion tensor imaging in the context of cervical myelopathy?
• What is the typical initial management for mild cervical radiculopathy without red flags?
• In ventral pathology without significant posterior compression, which surgical approach decompresses most effectively?
• Which nerve root corresponds to elbow extension/triceps?
• Which form of TOS is primarily associated with neurological symptoms?
• Lumbar disc herniations can regress spontaneously without surgery — true or false?
• Which area is most effectively decompressed by an anterior approach in ventral cervical pathology without posterior compression?
• What is the primary purpose of performing a fusion after decompression in multilevel disease?
• Which statement about TOS types is true?
• What is the onset of a hard disc injury?
• What is the role of diffusion tensor imaging in the evaluation of cervical myelopathy?
• What term describes nerve root inflammation caused by inflammatory chemicals leaking from a damaged spinal disc onto nearby nerves?
• Adjacent segment disease after cervical fusion is due to which of the following mechanisms?
• Does chemical radiculitis occur with hard disc injuries?
• Which action is part of Bakody's sign?
• TOS often occurs in people engaged in _________ activities.
• Lumbar disc herniations can regress or disappear spontaneously without surgical intervention.
• Which posterior decompression technique expands the spinal canal for multilevel stenosis while preserving or minimizing fusion?
• Which function is primarily monitored by motor-evoked potentials during cervical spine surgery?
• What is the correct order of rehabilitation steps for upper cross syndrome?
• The main indication for an anterior discectomy and fusion (ACDF) is what?
• A soft disc injury refers to which of the following phenomena?
• Which muscles are typically hypertonic in upper cross syndrome?
• A hard disc injury is best described as a disc injury caused by a bony structure such as an osteophyte. Which term matches this description?
• Which levels are most commonly affected by degenerative disc disease in the cervical spine?
• Among disc herniation categories, which is most likely to heal itself the fastest?
• Which scale grades the severity of cervical myelopathy based on gait and disability?
• Which statement best describes reflexive SJD?
• What is a common early clinical symptom of cervical spondylotic myelopathy?
• Which surgical option is preferred for rigid multilevel stenosis with preserved lordosis?
• Which statement best captures a recognized late complication of ACDF?
• Which statement about TOS evaluation is true?
• Specific rehab exercises for UCS include which of the following?
• Which statement about mechanical SJD is true?
• Which radiographic ratio assesses cervical canal size on plain X-ray, and what ratio indicates stenosis?
• Which term describes a soft disc injury?
• What comprises the neurovascular bundle?
• Which posterior decompression option is designed to expand the spinal canal for multilevel stenosis while aiming to preserve stability or minimize fusion?
• Which radiographic finding suggests instability after cervical fusion on postoperative flexion-extension films?
• What is the most common cervical level for radiculopathy due to disc herniation?
• What is a key factor in deciding between anterior vs posterior approach for multilevel cervical pathology?
• Which imaging modality is most informative for evaluating soft tissue and ligamentous injuries of the cervical spine?
• Pseudarthrosis at a fusion site is suggested on imaging by which finding?
• In acute cervical trauma, which imaging modality provides detailed anatomic bone information?
• Which best describes the pathophysiology leading to degenerative cervical spondylotic myelopathy?
• An increased atlas-dens interval (ADI) indicates what?
• Which of the following is part of the cervical radiculopathy clinical prediction rule?
• Laminoplasty is a posterior decompression technique commonly used for which condition?
• TOS can develop after trauma such as motor vehicle accidents or collisions to head, neck, and arm.
• If CT is negative but ligamentous injury is suspected, which imaging study is most informative?
• Rehabilitation for TOS targets which muscle groups?
• Which term denotes an extruded disc fragment that has completely separated from the rest of the disc?
• What is done second in upper cross syndrome treatment?
• Which description best characterizes mechanical SJD?
• And the least common is _______.
• Neurogenic TOS accounts for approximately what percentage of cases?
• Which statement about NTOS hand findings is accurate?
• The Jackson compression test is used to assess which condition?
• For Jefferson fracture, instability is most likely due to disruption of which ligament?
• What term describes antagonist muscles that are longer and weaker due to prolonged stretch of tonic muscles?
• Which term describes a painful condition where the neck muscles contract involuntarily, causing the head to twist or tilt to one side?
• What is the first step in assessing upper cross syndrome?
• What are the two basic origins of segmental joint dysfunction (SJD) in the cervical spine?
• Soft disc injuries occur mostly around what age?
• What type of motions especially lead to acute disc herniations?
• Which test is positive for pectoralis minor syndrome?
• Which is a hallmark sign associated with SJD?
• Which structure is NOT part of the neurovascular bundle in thoracic outlet syndrome?
• What is Bakody's sign and what does it indicate?
• Which type is most prevalent overall?
• Which range of motion in the cervical spine is especially painful with radicular symptoms?
• Which of the following is a component of TOS diagnostic studies?
• Which term describes a disc herniation in which the extruded material is still continuous with the parent disc?
• An anterior cervical corpectomy is indicated for which scenario?
• Which test is reported as positive in costoclavicular syndrome?
• Which nerve root corresponds to shoulder abduction (deltoid)?
• In disc pathology, involvement of more than 25 percent of the disc circumference is called which finding?
• In cases of posterior approach cervical stenosis, which surgical option is commonly employed?
• Which test differentiates neck-origin pain from facetogenic axial neck pain?
• What term describes focal or localized abnormalities of a disc margin that involve less than 25 percent of the disc circumference?
• What term describes overused muscle groups that are shorter and tighter?
• Radiculopathy occurs with hard disc injuries.
• How does ossification of the posterior longitudinal ligament (OPLL) typically present on imaging?
• SMT is more effective in patients with radicular symptoms than those without.
• What is the primary purpose of the JOA, Nurick, and related scales in cervical spine practice?
• Name two provocative tests used to reproduce radicular symptoms in suspected cervical radiculopathy.
• Degenerative disc injuries/hard disc/spondylosis occur more in which demographic?
• Posterior decompression is favored in multilevel cervical pathology when which spinal alignment is preserved?
• Scalenus anticus syndrome is typically worse at which time?
• Dysphagia after anterior cervical surgery is most directly caused by retraction of which structure?
• Which is more common: soft disc injuries or hard disc injuries?
• Which additional modality is sometimes used intraoperatively along with SSEPs and MEPs?
• A collection of signs and symptoms that result from compression of the neurovascular bundle describes which condition?
• How do you stretch tonic muscles in upper cross syndrome?
• Bruegger's position is used in UCS rehab for which purpose?
• Which form is associated with shoulder depression or retraction exacerbating pain?
• Which upper motor neuron sign is highly specific for cervical myelopathy and involves brisk finger flexion with a flick of the middle finger?
• What term describes nerve root inflammation due to chemical leakage from a damaged disc?
• Which form of thoracic outlet syndrome is defined by a narrow space between the clavicle and the first rib, compressing the neurovascular bundle?
• Hard disc injuries occur mostly at what age?
• Central canal stenosis typically presents with which type of clinical presentation compared to foraminal stenosis?
• What MRI finding most strongly supports cervical myelopathy?
• In cervical myelopathy due to OPLL with preserved lordosis, the typical management is?
• Most common form of TOS; approximately 85-95% of cases.
• Which two chemicals are released from the nucleus pulposus that cause chemical irritation/compression of the nerve root?
• What is the role of cervical traction in management of radicular symptoms?
• What is the role of facet joint injections in cervical spine pain?
• Postural evaluation in upper cross syndrome typically reveals which of the following?
• Soft disc injuries are most commonly observed in which of the following age ranges?
• Which form is described by hyperabduction of the arm causing pressure on the subclavian vessels and divisions/cords?
• What is done first in upper cross treatment?
• What is the most common level for disc injuries in the cervical spine?
• What is the typical gait described in cervical myelopathy?
• TOS diagnostic studies include which test focused on bony abnormality?
• Which dermatome corresponds to sensation over the lateral aspect of the forearm and thumb?