Spine

Question 0

Conus medullaris typically terminates at?

Answer 0

L1

Question 1

The artery of adamkiewicz arises from what levels?

Answer 1

left aorta between T1-T8

Question 2

Below the level of T1 the nerve roots come off above or below the level of the corresponding vertebral body?

Answer 2

Below (ex: the L5 nerve root comes out at the L5-S1 level)

Question 3

Which has a broad neck- protrusion or extrusion?

Answer 3

protrusion (neck of extrusion is narrow)

Question 4

What are the spaces for localization of a hernia?

Answer 4

central->para-median/lateral recess ->formainal -> extraforaminal

Question 5

What is scheuermann’s disease?

Answer 5

multiple schmorals nodes (at least 3) resulting in kyphosis

Question 6

Modic changes?

Answer 6

Type I - edema; T1 dark, T2 bright
Type II- fat; TI, T2 bright
Type III- fibrosis; T1, T2 dark

Question 7

What differentiates recurrent residual disc from scar tissue?

Answer 7

disc will not enhance, scar tissue enhances on delayed images

Question 8

How long can normal nerve roots enhance post-operatively?

Answer 8

Six weeks

Question 9

What are late stages of failed back surgery?

Answer 9

arachnoiditis

recurrent disc herniation

epidural fibrosis

Early stage- epidural abscess

Question 10

Jefferson fracture?

Answer 10

axial loading

burst fracture of C1

Neurologic injury is rare

Question 11

Hangman Fracture

Answer 11

Hyperextension injury

bilateral C2 pedical or pars fractures

Question 12

Anterior teardropfracture

Answer 12

Flexion injury

Associated with anterior cord syndrome

Unstable

Question 13

Clay-Shovelers

Answer 13

Avulsion of spinus process at C7-T1

Hyperflexion

Question 14

Which Odontoid fractures are unstable?

Answer 14

Type II (most common) and Type III (Best prognosis for healing)

Question 15

What is Os Odontoideum associated with?

Answer 15

Morquio Syndrome - mucopolysaccarhidoses

Os odontoideum is prone to subluxation and instability

Question 16

Bilateral pars dislocation results in likely disruption of?

Answer 16

Posterior longitudinal ligament

Question 17

Most important prognostic factor for outcome in spinal injury?

Answer 17

hemorrhage

Question 18

Myelomeningoceles are associated with?

Answer 18

Chiari II

Question 19

Lipomyelocele and lipomyelomeningoceles are associated with?

Answer 19

tethered cord (100%)

Question 20

Thickened filum terminale is greater than?

Answer 20

> 2mm

Question 21

What is caudal regression associated with?

Answer 21

VACTERL and curriano traid

Question 22

What is the curriano triad?

Answer 22

Anterior sacral meningocele

Anorectal malforamtion

Sacrococcygeal defect (simitar sacrum)

Question 23

What is foix Alajouanine syndrome?

Answer 23

myelopathy associated with a dural AVF- from venous hyeprtension

lower extremity weakness and sensory deficits

Question 24

Types of spinal AVF?

Answer 24

Type 1 : Dural AVF, single coiled vessel, most common Type 2: Intrameduallry nidus, SAH is most common presentation, associated with HHT and KTS Type 3: Juvenille Type 4: perimedullary, typically near the conus

Question 25

What causes "H" shaped vertebrae or widening of the disc space?

Answer 25

Sickel Cell Disease, Gauchers

Question 26

Brucellosis in the spine?

Answer 26

Favors the SI joints and lumbar spine

Question 27

Abnormal cranial nerve enhancement and demylinating lesions in the spine?

Answer 27

ADEM

Question 28

NMO antibody attacks?

Answer 28

Aquaporin 4 channels

Question 29

Guillian Barre Syndrome?

Answer 29

Caused by campylobacter Enhancement of the nerve roots of the cauda equina (anterior more than posterior) CNVII is most common CN affected

Question 30

Chronic Inflammatory Demylinating polyneuropathy (CIDP)

Answer 30

Thickened enhancing "onion bulb" nerve roots Counterpart to GBS

Question 31

Intramedullary spinal lesions?

Answer 31

astrocytoma, ependymoma, hemangioblastoma

Question 32

Extramedullary, Intradural Spinal Lesions

Answer 32

Schwannoma, Meningioma, Neurofibroma, Drop mets

Question 33

Extradural spinal Lesions?

Answer 33

Lymphoma, mets, herniated disc

Question 34

Myxopapillary ependymoma is typically located?

Answer 34

Conus/Filum

Question 35

Ependymoma appearence?

Answer 35

Central, span at least 4 segments, syrinx above and below with hemosidering, enhance

Question 36

Most common primary tumor to cause drop metastases?

Answer 36

Medulloblastoma Breast is most common metastasis