11. The subarachnoid space ends inferiorly at the level of the A. L5 vertebra. B. L3vertebra. C. S2–3vertebrae. D. T12 vertebra. E. L1vertebra.
C
12. In adults, the spinal cord usually ends inferiorly at the A. lowerborderofS2. B. upperborderofS1. C. lowerborderofS4. D. upper border of the coccyx. E. lowerborderofL1.
E
- The least serious congenital abnormality involving the
neural arch and the neural tube is
A. rachischisis.
B. meningohydroencephalocele. C. meningomyelocele.
D. spina bifida occulta.
E. meningoencephalocele.
D
14. To perform a lumbar puncture (spinal tap) in an adult, the needle is introduced between the spinous processes of A. L4and5. B. L2and3. C. S1andL2. D. T12andL1. E. S3andL4.
A
15. Lymph from the skin of the back in the region of the spinous process of the tenth thoracic vertebra drains into the A. posterior mediastinal lymph nodes. B. superficial inguinal lymph nodes. C. axillary lymph nodes. D. sacral lymph nodes.
C. The subscapular group of axillary nodes
16. The \_\_\_\_\_\_\_\_ passes between the sixth and seventh cervical vertebrae. A. vertebral artery B. seventh cervical spinal nerve C. sixth cervical spinal nerve D. vertebral vein E. eighth cervical spinal nerve
B
- The cauda equina is made up of the
A. spinal nerves of S1–3.
B. anterior rami of spinal nerves L2 and 3.
C. posterior rami of spinal nerves L1 to cocc 1.
D. anterior and the posterior nerve roots of the spinal nerves below the first lumbar segment of the spinal
cord.
E. spinal nerves of L1–5.
B. The cauda equina is not made up of the spinal nerves or the rami of the spinal nerves.
- The strength of the flexor muscles of the vertebral column can be assessed by asking the patient to
A. sit up from the supine position while keeping the hips and the knees extended.
B. lift the shoulders from the examining table while in the prone position.
C. extend the head while lying in the prone position.
D. sit up from the supine position while keeping the hips and the knees flexed.
E. perform the movement of forced expiration.
D. Sitting up from the supine position while keeping the hip and the knee joints extended results in use of the iliacus and psoas muscles in addition to the main flexor muscles the vertebral column.
- A herniated disc that causes sensory changes in a specific dermatome is pressing on
A. an anterior primary ramus.
B. an anterior gray horn of the spinal cord.
C. an anterior root.
D. a posterior primary ramus.
E. a spinal nerve or a posterior root.
E. Anterior and posterior primary rami arise from a spinal nerve outside the vertebral canal. An anterior root does not contain sensory nerve fibers. The anterior gray horn of the spinal cord contains motor neurons.
20.
Which of the following statements regarding the blood supply to the spinal cord is true?
A. The anterior spinal arteries are two in number and run down the anterior surface of the spinal cord close to the anterior nerve roots.
B. The posterior spinal arteries supply the posterior third of the spinal cord.
C. The veins of the spinal cord drain into the external
vertebral venous plexus.
D. The anterior and the posterior spinal arteries do not anastomose with the radicular arteries.
E. The spinal cord has a profuse blood supply.
B. There is only one anterior spinal artery formed by the union of branches from each vertebral artery The anterior spinal artery is small, and it runs downward in the anterior median sulcus of the spinal cord. The veins of the spinal cord drain into the internal vertebral venous plexus. The spinal cord has a relatively poor blood supply.
- The following statements concerning the vertebral column are correct except which?
A. The intervertebral discs make up approximately one
fourth the length of the vertebral column.
B. In old age, atrophy of the intervertebral discs tends to produce a continuous posterior convexity of the
vertebral column.
C. During pregnancy, the weight of the developing fetus increases the posterior lumbar concavity of the vertebral column.
D. The odontoid process of the axis represents developmentally the body of the atlas.
E. There are seven cervical spinal nerves and eight cervical vertebrae.
E. It is important to remember that there are eight cervical spinal nerves but only seven cervical vertEbrae
- The following statements concerning the vertebral column are correct except which?
A. The posterior ramus of the first cervical spinal nerve and its continuation, the great occipital nerve, supplies the skin over the back of the scalp.
B. When an individual is in the standing position, the line of gravity passes anterior to the cervical part of the vertebral column and posterior to the thoracic and lumbar regions of the column.
C. The tip of the spine of a thoracic vertebra lies directly behind the vertebral body of the vertebra below.
D. The intervertebral disc is innervated by a recurrent branch of spinal nerve that enters the vertebral canal
through the intervertebral foramen.
E. The atlantoaxial joints permit rotation of the atlas with the head on the axis.
B. In the standing position, the line of gravity passes through the odontoid process of the axis, in front of the thoracic vertebrae, and through the lumbar vertebrae but anterior to the sacrum (Fig.7-5).
- When performing a lumbar puncture (spinal tap), the following structures are pierced by the needle except which?
A. The posterior longitudinal ligament
B. The supraspinous ligament
C. The arachnoid mater D. The ligamentum flavum
E. The dura mater
A
- All the following characteristics are present in a lumbar vertebra except which?
A. There is a massive kidney-shaped body.
B. The transverse processes are short and thick.
C. The spinous processes are short, flat, and quadrangular in shape.
D. The transverse processes have no foramen.
E. The articular surfaces of the superior articular processes face medially.
B. The transverse processes are long and slender.
- The following statements regarding the internal vertebral venous plexus are correct except which?
A. It drains blood from the vertebral bodies.
B. It permits malignant cells from the prostate to metastasize to the skull.
C. It does not possess competent valves.
D. The venous flow is indirectly influenced by changes
in the intra-abdominal pressure.
E. It does not communicate with veins within the thorax.
E. The internal vertebral venous plexus communicates with the veins of the neck, the thorax, the abdomen, and the pelvis via the radicular veins.
- The following statements regarding herniation of an intervertebral disc are correct except which?
A. It generally herniates posteriorly.
B. In the lumbar region, it usually affects the spinal
nerve whose number corresponds to the vertebra below.
C. It is a portion of the nucleus pulposus that actually herniates.
D. A contributing factor to the herniation may be excessive compression of the posterior region of the disc.
E. It may press on the spinal cord.
D. Excessive compression of the anterior part of the disc, as in excessive forced flexion, may contribute to herniation.
- The following statements regarding an intervertebral disc are correct except which?
A. During aging, the fluid within the nucleus pulposus
is diminished and the amount of fibrocartilage is increased.
B. The atlantoaxial joint possesses a small disc.
C. The discs play a major role in development of the curvatures of the vertebral column.
D. The discs are thickest in the lumbar region.
E. The discs are innervated by adjacent spinal nerves.
B. The atlantoaxial joint has no intervertebral disc.
A 69-year-old woman complaining of a burning pain over the left shoulder and upper part of the left arm was seen by her physician. The pain had started approximately 2 weeks previously and had progressively worsened. The pain was made worse by moving the neck. At physical ex- amination, the patient showed hyperesthesia of the skin over the lower part of the left deltoid muscle and down the lateral side of the arm. In addition, her left deltoid and biceps brachii muscles were weaker than those on the right side. At radiologic examination, extensive osteoarthritic changes of the vertebrae with spur formation on the bodies of the fourth, fifth, and sixth cervical vertebrae were seen.
28. Assuming that the osteoarthritic changes caused nar- rowing of the cervical intervertebral foramina, which spinal nerve roots were most likely to have been pressed on to cause the burning pain and the hyperesthesia? A. C3 and 4 B. C6 C. C5 and 6 D. C7 E. C8 and T1
C. The burning pain and hyperesthesia occurred in the fifth and sixth cervical dermatomes on the left side.
- The weakness of the left deltoid and biceps brachii muscles could have resulted from pressure on which nerve roots?
A. the posterior nerve roots of C5 and 6
B. the anterior nerve roots of C5 and 6
C. the anterior nerve roots of C7 and 8
D. the anterior nerve roots of C8 and T1
E. None of the above.
B. The deltoid muscle is innervated by the axillary nerve (C5 and 6), and the biceps brachii muscle is innervated by the musculocutaneous nerve (C5, 6, and 7). Most of the motor fibers emerge from the spinal cord in the anterior nerve roots of the C5 and 6 spinal nerves.
30. The sensory and motor changes in this patient resulted from pressure on the cervical spinal nerves or their roots as they passed through the intervertebral foramina. The following structures form the boundaries of each foramen except which? A. intervertebral discs B. bodies of the cervical vertebrae C. the posterior longitudinal ligament D. articular processes of the vertebrae E. pedicles of the vertebrae
C
