Head and neck: hangman fracture: practice question

A Anatomy question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anatomy · Head and neck: hangman fracture

Sample item

A lateral cervical radiograph after a high-speed deceleration injury shows forward slip of C2 on C3 with fractures through both pars interarticularis of the axis. Which injury is this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Hangman fracture of C2

A hangman fracture is a bilateral fracture of the pars interarticularis of C2 with anterior slip of the C2 body on C3, caused by hyperextension with distraction. The ring of C1 fractures in a Jefferson injury, and clay-shoveler fracture affects a spinous process.

Option by option

  • A. Hangman fracture of C2 (correct)

    Correct. Bilateral pars fractures of C2 constitute the hangman fracture.

  • B. Type II dens fracture

    A dens fracture crosses the odontoid process, not the pars interarticularis.

  • C. Clay-shoveler fracture of C7

    The clay-shoveler fracture involves the spinous process of C6 or C7.

  • D. Jefferson fracture of C1

    A Jefferson fracture is a burst fracture of the ring of the atlas from axial loading.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anatomy question

What is the answer to this Anatomy question?

The best answer is A, Hangman fracture of C2. A hangman fracture is a bilateral fracture of the pars interarticularis of C2 with anterior slip of the C2 body on C3, caused by hyperextension with distraction.

Why is "Type II dens fracture" not the answer?

A dens fracture crosses the odontoid process, not the pars interarticularis.

Why is "Clay-shoveler fracture of C7" not the answer?

The clay-shoveler fracture involves the spinous process of C6 or C7.

Why is "Jefferson fracture of C1" not the answer?

A Jefferson fracture is a burst fracture of the ring of the atlas from axial loading.

What concept does this question test?

It tests Head and neck: hangman fracture in Anatomy. The ring of C1 fractures in a Jefferson injury, and clay-shoveler fracture affects a spinous process.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Head and neck: hangman fracture?

Learn every nerve by its route, its muscles and what a lesion looks like at the bedside. That one habit answers a large share of questions. Then use the flashcards and the other Anatomy questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.