A 53-Year-Old Man Comes to the Emergency Department Due to Severe

question 252

Multiple Choice

A 53-year-old man comes to the emergency department due to severe lower back pain.  The patient's back pain started 2 weeks ago without any preceding trauma and has been keeping him awake at night.  The pain has acutely worsened over the past 2 days and is not relieved with over-the-counter pain medications.  His vital signs are within normal limits.  Examination shows low back pain that is worse with back flexion and raising of the legs; it radiates into his left leg.  Pinprick in the perianal area does not cause rapid contraction of the anal sphincter.  The rest of the neurologic examination is normal.  Which of the following nerve roots is most likely to be involved in this patient's condition?

• A)T12
• B)L2
• C)L4
• D)L5
• E)S1
• F)S4

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Definitions:

Inspection

The process of examining something carefully with the goal of ensuring compliance with standards and preventing defect.

Leadership

The act of guiding or influencing a group towards achieving a common goal, often involving strategic thinking and motivational skills.

Management

The process of planning, organizing, directing, and controlling resources to achieve organizational goals effectively and efficiently.

Dialogue

A conversation between two or more people as a feature of a book, play, or movie, or a discussion aimed at reaching an understanding or resolution.