ANATOMY NBME CERTIFICATION EVALUATION
2026 QUESTIONS WITH PRACTICE SOLUTION
GRADED A+
◉ when doing a lumbar puncture, what does your needle pierce
through Answer: skin --> fascia --> supraspinous ligament -->
interspinous ligament --> ligamentum flavum --> epidural space -->
dura mater --> subarachnoid space
◉ What is a herniated disc? Answer: nucleus pulposus through
anulus fibrosus (nucleus pulposus is remnant of notochord)
-usually herniates postero-laterally
-compresses spinal nerve root
◉ most common levels of herniated disc Answer: Lumbar Levels=
L4/L5 or L5/S1
cervical regions= C5/C6 or C6/C7
◉ herniated disk presentation Answer: -individuals <50
-history of back pain that may radiate down to the lower limb
-pain begins soon after patient lifted something heavy
,-herniated lumbar disc compresses the nerve root one number
below (L4/L5 will compress the L5 root)
-lower limb reflexes are decreased on the affected side
-patellar --> L2/L3 or L3/L4 herniation
-achilles --> L5/S1 herniation
◉ what is kyphosis ?
who is it seen in? Answer: -exaggeration of the thoracic curvature
-may occur in the elderly as a result of osteoporosis or disk
degeneration
-osteoporosis= multiple compression fractures of the vertebral
bodies
◉ what is lordosis?
who is it seen in? Answer: -exaggeration of the lumbar curvature
that may be temporary
-occurs during pregnancy, spondylolisthesis, or potbelly
◉ what is scoliosis?
causes? Answer: -lateral deviation/torsion of the spine
-caused by poliomyelitis, leg length discrepancy, or hip disease
,◉ what is the pars interarticularis Answer: connects the superior
facet and inferior facet
◉ what is spondylolysis?
presentation? Answer: -defect/stress fracture in the pars
interarticularis
-most common reason for lower back pain in adolescent athletes
-usually at L5
◉ what is spondylolisthesis?
presentation? Answer: -forward slippage of one vertebral body with
respect to the one beneath it
-most commonly occurs at lumbosacral junction with L5 slipping
over S1
-low back pain aggravated by standing and walking
-rarely can cause cauda equina
-often results from spondylolysis
◉ low back pain with extension or standing, relief with flexion
Answer: spinal canal stenosis
, ◉ positional pain, relieved with rest and analgesics, lumbar or
cervical spine Answer: osteoarthritis/degenerative
◉ low back pain with paravertebral spasm after history of lifting a
heavy object Answer: lumbosacral strain
◉ low back pain in elderly which is exacerbated on minor exertion
or touch Answer: vertebral body fracture-- due to osteoporosis
◉ low back pain with paravertebral spasm and fever Answer:
epidural abscess
◉ lower back pain in elderly, continuous pain that is worse at night,
resistant to pain meds and positional changes. fever, weight loss,
night sweats Answer: cord compression due to metastatic tumor
Prostate Breast Kidney Thyroid Lung (PB KTL)
◉ radicular lower back pain, saddle anesthesia, loss of DTR's,
bowel/bladder issues Answer: cauda equina syndrome, surgical
emergency
◉ low back pain in adolescent with slip off or step off in spine
examination Answer: spondylolisthesis
2026 QUESTIONS WITH PRACTICE SOLUTION
GRADED A+
◉ when doing a lumbar puncture, what does your needle pierce
through Answer: skin --> fascia --> supraspinous ligament -->
interspinous ligament --> ligamentum flavum --> epidural space -->
dura mater --> subarachnoid space
◉ What is a herniated disc? Answer: nucleus pulposus through
anulus fibrosus (nucleus pulposus is remnant of notochord)
-usually herniates postero-laterally
-compresses spinal nerve root
◉ most common levels of herniated disc Answer: Lumbar Levels=
L4/L5 or L5/S1
cervical regions= C5/C6 or C6/C7
◉ herniated disk presentation Answer: -individuals <50
-history of back pain that may radiate down to the lower limb
-pain begins soon after patient lifted something heavy
,-herniated lumbar disc compresses the nerve root one number
below (L4/L5 will compress the L5 root)
-lower limb reflexes are decreased on the affected side
-patellar --> L2/L3 or L3/L4 herniation
-achilles --> L5/S1 herniation
◉ what is kyphosis ?
who is it seen in? Answer: -exaggeration of the thoracic curvature
-may occur in the elderly as a result of osteoporosis or disk
degeneration
-osteoporosis= multiple compression fractures of the vertebral
bodies
◉ what is lordosis?
who is it seen in? Answer: -exaggeration of the lumbar curvature
that may be temporary
-occurs during pregnancy, spondylolisthesis, or potbelly
◉ what is scoliosis?
causes? Answer: -lateral deviation/torsion of the spine
-caused by poliomyelitis, leg length discrepancy, or hip disease
,◉ what is the pars interarticularis Answer: connects the superior
facet and inferior facet
◉ what is spondylolysis?
presentation? Answer: -defect/stress fracture in the pars
interarticularis
-most common reason for lower back pain in adolescent athletes
-usually at L5
◉ what is spondylolisthesis?
presentation? Answer: -forward slippage of one vertebral body with
respect to the one beneath it
-most commonly occurs at lumbosacral junction with L5 slipping
over S1
-low back pain aggravated by standing and walking
-rarely can cause cauda equina
-often results from spondylolysis
◉ low back pain with extension or standing, relief with flexion
Answer: spinal canal stenosis
, ◉ positional pain, relieved with rest and analgesics, lumbar or
cervical spine Answer: osteoarthritis/degenerative
◉ low back pain with paravertebral spasm after history of lifting a
heavy object Answer: lumbosacral strain
◉ low back pain in elderly which is exacerbated on minor exertion
or touch Answer: vertebral body fracture-- due to osteoporosis
◉ low back pain with paravertebral spasm and fever Answer:
epidural abscess
◉ lower back pain in elderly, continuous pain that is worse at night,
resistant to pain meds and positional changes. fever, weight loss,
night sweats Answer: cord compression due to metastatic tumor
Prostate Breast Kidney Thyroid Lung (PB KTL)
◉ radicular lower back pain, saddle anesthesia, loss of DTR's,
bowel/bladder issues Answer: cauda equina syndrome, surgical
emergency
◉ low back pain in adolescent with slip off or step off in spine
examination Answer: spondylolisthesis
