Monday, February 8, 2010

98 - Spinal Injuries Mcqs

1q: Which is the commonest site of spinal injuries ?
a. Thoraco-lumbar segment
b. Lower cervical spine
c. Upper cervical spine
d. Sacral spine


2q: All of the following are true about spinal injuries except ?
a. About 80% of spinal injuries result in neurological deficit
b. Thoracolumbar spine injury may result in paraplegia
c. Cervical spine injury may result in Quadriplegia
d. Any lesion to the spinal cord above T5 causes hypotension


3q: Number of vertebrae in human body ?
a. 33
b. 34
c. 35
d. 36


4q: What are the number of Cervical,thoracic,lumbar,sacral and coccygeal vertebrae in the human body respectively?
a. 7,12,5,5,4
b. 8,12,5,5,4
c, 7,12,5,5,5
d. 8,12,5,5,5


5q: The nucleus pulposus is a remnant of ?
a. Sclerotomes
b. occipital myotomes
c. Notochord
d. Mesenchyme


6q: The entire vertebral column has similar articulation except
a. C1-C2
b. C7-T1
c. T12-L1
d. L5-S1


7q: The neural arches of adjacent vertebrae articulate through which joints
a. Facet joints
b. Ball in socket joints
c. Both
d. None


8q: The adjacent laminae of the vertebrae are joined together by ?
a. Ligamentum teres
b. Ligamentum flavum
c. Ligament of treitz
d. Anterior longitudinal ligaments


9q: Posterior ligament complex includes all of the following except
a. Ligamentum flavum which joins the adjacent laminae
b. Interspinous ligaments which connect the adjacent spinous processes
c. Supraspinous ligament which connects the tips of spinous processes
d. Inter-transverse ligaments which connect the adjacent transverse processes
e. Posterior longitudinal ligament which connects the vertebral bodies posteriorly


10q: Assertion: Pure dislocation (without associated fracture) does not occur in the lumbar spine.
        Reason: The facets of the lumbar spine are stout and vertically placed where as cervical spine facets are short and more horizontally placed.
a. Assertion is True but Reasoning is false
b. Assertion is false but Reasoning is true
c. Both are true
d. Both are false


11q: The 'Three-Column concept' divides the vertebra into which of these columns
a. Medial,middle and lateral columns
b. Anterior,middle and Posterior columns
c. Both
d. None


12q: Which of the following is True about the 'Three column concept' of the spine ?
a. The anterior column consists of the anterior longitudinal ligament and the anterior part of annulus fibrosis along with the anterior half of the vertebral body
b. The middle column consists of the posterior longitudinal ligament and the posterior part of the annulus fibrosis along with the posterior half of the vertebral body
c. The posterior column consists of the posterior bony arches along with the posterior ligament complex
d. All the above


13q: Which of the following is falsely matched (multiple answers)
a. Wedge compression fracture of the vertebra-One column disrupted-Stable spine
b. Wedge compression fracture of the vertebra-One column disrupted-Unstable spine
c. Burst fracture of the body of vertebra-Two columns disrupted-Unstable spine
d. Burst fracture of the body of vertebra-Three columns disrupted-Unstable spine
e. Dislocation of one vertebra over the other-Three columns disrupted-Unstable spine


14q: Spinal injuries are best classified on the basis of mechanism of injury into the following types :
1.Flexion injury
2. Flexion-rotation injury
3. Flexion distraction injury
4. Extension injury
5. Direct injury
6. Indirect injury due to violent muscle contraction
7. Vertical compression injury
- Of the above which is the most common type of spinal injury ?


15q:Spinal injuries are best classified on the basis of mechanism of injury into the following types :
1.Flexion injury
2. Flexion-rotation injury
3. Flexion distraction injury
4. Extension injury
5. Direct injury
6. Indirect injury due to violent muscle contraction
7. Vertical compression injury
- Of the above which is the worst type of spinal injury which leaves a highly unstable spine and has a high incidence of neurological damage ?


16q: In a Flexion injury of the spine, Compression fracture of which of the following cervical vertebrae is common ?
a. C1-C2
b. C3-C4
c. C5-C7
d. None 



17q: In a Flexion injury of the spine, Dislocation of one vertebrae over another is common in which part of the cervical spine?
a. C1 over C2
b. C3 over C4
c. C5 over C6
d. C6 over C7


18q: Which of the following is false about the Dorso-lumbar spine involvement in the flexion injury of the spine 
a. Wedge compression of the L1 is most common type of injury
b. Wedge compression of L2 is the second most common type of injury
c. Wedge compression of the T12 is the third most common type of injury
d. It is a stable injury if compression of the vertebra is more than 50 percent of its posterior height


19q: Which of the following is most commonly associated with burst fracture of spine ?
a. Flexion injury
b. Flexion-rotation injury
c. Vertical compression injury
d. Extension injury


20q: Extension injury is most commonly seen in :
a. Cervical spine
b. Thoracic spine
c. Lumbar spine
d. Any of the above


This injury results in chip fracture of the anterior rim of a vertebra. Forehead striking against the windscreen forcing the neck into hyperextension and shallow water diving .

21q: Which of the following type of spinal injury occurs most commonly due to seat belt while driving a car?
a. Flexion injury
b. Flexion-rotation injury
c. Extension injury
d. Flexion-distraction injury


22q: 'Chance fracture' is associated with which of the following type of spine injury ?
a. Flexion injury
b. Flexion-rotation injury
c. Extension injury
d. Flexion-distraction injury


*With the sudden stopping of a car, the upper part of the body is forced forward by inertia while the lower part is tied to the seat by the seat belt. The flexion force thus generated has a component of 'distraction' with it.It commonly results in a horizontal fracture extended into the posterior elements and involving a part of the body. It is termed a 'Chance fracture'. It is an unstable injury. 

23q: Which of the following type of spinal injury is associated with huge retroperitoneal hematoma ?
a. Direct injury
b. Flexion injury
c. Flexion-distraction injury
d. Violent muscle contraction


*Violent muscle contraction is a rare spinal injury, where sudden violent contraction of the psoas results in fractures of the transverse processes of multiple lumbar vertebrae. It may be assocaited with a huge retroperitoneal hematoma.

24q: Antero-posterior bending and sideways bending of the spine is called ________ and ________ respectively
a. Kyphosis and scoliosis
b. Scoliosis and kyphosis
c. kyphosis and lordosis
d. Lordosis and kyphosis


25q: In which of the following types of spinal injury, the plain X-ray appears normal in the presence of highly unstable spinal injury?
a. Fall from height on the buttocks
b. Strong hit on the shoulder
c. Whiplash injury to the cervical spine
d. Bullet injury to the spine


*In the whiplash injury to the cervical spine, all the three columns of the spine are disrupted in a sudden hyperflexion followed by sudden hyperextension of the neck. eg: after the sudden stopping of car.

26q: All of the following regarding the diagnosis of spinal injuries are true except
a. A tomogram helps in better delineation of a doubtful area
b. Myelogram has proved to be a very helpful investigation in acute spinal injuries
c. One can see damaged structures more clearly with CT scan
d. MRI is the best modality of imaging in an injured spine


27q: CT is of no help in which of the following type of injury ?
a. Vertical compression injury
b. Extension injury
c. Direct injury
d. Flexion rotation injury


*Caused by motor vehicle accident and shallow water diving leading to avulsion fracture of anterior lip of vertebra. C5-C6 and lumbar spine most commonly involved. There is only anterior column failure and it is a stable fracture.


28q: What is the name of the skull calipers used for skull traction for the reduction of Cervical spine fractures?
a. Crutchfield tongs traction
b. Hutchinson's tongs traction
c. Trendelenburg tongs traction
d. Gopalan's tongs traction



29q: All of the following are true about Wedge compression fracture of the vertebra except ?
a. Results from extension force
b. Posterior elements are usually intact
c. Stable injury
d. Reduction is not required in management
e. Neck is kept immobilized with the help of skull traction
f. Neck is supported by cervical collar, plaster of paris cast or brace once the pain and muscle spasm subsides
g. Exercises of the neck are started after 8-12 weeks


30q: All of the following are true about Jefferson's fracture except :
a. It is a burst fracture of atlas where both anterior and posterior arches of the atlas are fractured by a vertical force acting through the skull
b. Displacement is very severe
c. More often than not the spinal cord escapes injury
d. Treatment consists of traction, followed by immobilisation in Minerva jacket or halo-pelvic support


31q: Which of the following statement is true regarding atlanto-axial fracture dislocation?
a. A fracture-dislocation of the atlanto-axial joint is more common than pure dislocation
b. A pure dislocation is more often associated with a neurological deficit
c. The displacement is commonly posterior
d. Treatment consists of skull, traction followed by immobilisation in Minerva jacket


32q: Clay shoveller's fracture is a fracture of the spinous process of which vertebra?
a. C1
b. T1
c. L1
d. C2


33q: All of the following operative methods are performed whenever necessary in Thoracic and lumbar spine injuries except
a. Harrington instrumentation - bilateral
b. Luque instrumentation
c. Hartshill rectangle fixation
d. Pedicle screw fixation
e. Hongkong operation


34q: SOMI brace is used for
a. Cervical spine injuries
b. Thoracic spine injuries
c. Lumbar spine injuries
d. all

*SOMI stands for Sternal Occipital Mandibular Immobilizer, shown below.


35q: ASH brace is used for
a. Dorsolumbar spine injury
b. Cervical spine injury
c. Both
d. None

*ASH stands for Anterior-superior hyperextension brace, shown below.

2 comments:

pankaj bone smith said...

regard q no 31 q should be what is not true and 4th option is not the treatment now a days it is occipito cervical fixation

Anonymous said...

Your brace is on upside down for the 'ASH' device.

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