The general name for an alternate pathway of blood flow in or around an organ, around a joint, or past an obstruction is called:
an arteriovenous anastomosis a periarticular network a perivascular plexus a venous plexus collateral circulation
When standing in the Anatomical Position the palms of the hands face: anteriorly laterally medially posteriorly superiorly
While wandering around in the dark in an unfamiliar home, a visitor accidentally walks into a plate glass door. The door shatters and a shard of glass severs the posterolateral aspect of the woman's neck. Examination reveals that the she is unable to elevate the tip of her shoulder on the injured side. The nerve injured is: accessory dorsal scapular greater occiptal spinal nerve C4 thoracodorsal
The regionally named layer of tissue which encloses and binds muscle groups together is the: deep fascia intermuscular septum neurovascular bundle skin subcutaneous tissue
The portion of the skin that serves as a barrier to water loss is the: dermis subcutaneous tissue superficial fascia epidermis deep fascia
Hair, nails and teeth (enamel) originate in common with what layer? deep fascia epidermis panniculus adiposis subcutaneous tissue superficial fascia
A person receives a laceration along the anterior border of the trapezius muscle in the neck and subsequently the point of his shoulder (scapula) sags and he has some difficulty fully abducting his arm. What nerve appears to have been severed? accessory (Cr. N. XI) axillary dorsal scapular greater occipital suprascapular
When people are severely burned they have great difficulty with fluid loss because the portion of the skin which is the fluid barrier is destroyed. Which layer of the skin is responsible for preventing fluid loss? dermis epidermis investing fascia panniculus adiposus subcutaneous tissue
The cutaneous branch of the posterior primary ramus of C2 is called the: Accessory nerve Great auricular nerve Greater occipital nerve Lesser occipital nerve Superior ramus of the ansa cervicalis
Interruption of cranial nerve XI would paralyze which muscle? deltoid latissimus dorsi levator scapulae rhomboideus major trapezius
A motorcyclist lost control of his bike after hitting a wet spot on the pavement.
He hit a curb and was catapulted several feet, landing on the point of his right
shoulder and the right side of his head and neck, severely stretching his neck.
He was taken to the emergency room with abrasions, lacerations and multiple
injuries to both fleshy and bony tissues. Given this scenario, answer the following:
For the integument to bleed or for tissue fluid to ooze from the abrasions,
what layers must be damaged? epidermis and dermis epidermis and superficial fascia epidermis and deep fascia dermis and superficial fascia dermis and deep fascia
Sutures (stitches) would be placed in which tough layer of the skin in order to sew up the lacerations? epidermis deep fascia dermis subcutaneous tissue superficial fascia
After initial examination, the patient is sent to radiology. Radiographs reveal that the portion of the scapula forming the tip or point of the shoulder has been fractured. This bone is the: acromion angle coracoid glenoid spine
Elevation of the tip of the patient's right shoulder was still possible indicating that which of the following nerves was intact? accessory axillary dorsal scapular suprascapular thoracodorsal
Panniculus adiposus refers to an abundance of fat in the: deep fascia muscular fascia skin subcutaneous tissue neurovascular bundles
In order to make an intramuscular injection, the needle must pass through several layers of tissue to reach the muscle. Choose the correct order of tissues the needle would pass through from superficial to deep. Epidermis, dermis, investing fascia, subcutaneous tissue, muscle Epidermis, dermis, subcutaneous tissue, investing fascia, muscle Epidermis, investing fascia, dermis, subcutaneous tissue, muscle Epidermis, subcutaneous tissue, dermis, investing fascia, muscle Epidermis, subcutaneous tissue, investing fascia, dermis, muscle
From your observations while removing the skin from the cadaver, in which area did you find the skin to be the thickest? Anterior surface of the forearm Anterior surface of the chest Medial surface of the arm Posterior surface of the forearm Posterior surface of the neck and scalp
Loss of function, paralysis, of which muscle would result in drooping or sagging of the shoulder? Erector spinae Latissumus dorsi Levator scapulae Rhomboideus major Trapezius
During the first day of class a student lacerated his finger while putting a new blade on his scalpel. The cut penetrated the skin and it was necessary for him to go to the emergency room to have it stitched up. Which layers would the ER physician include in the stitches in order to close only the skin? Dermis, subcutaneous tissue, deep fascia Dermis, superficial fascia, deep fascia Epidermis, dermis Epidermis, dermis, investing fascia Epidermis, subcutaneous tissue
As you are sitting in a quiz, the skin immediately over the base of the spine of your scapula begins to itch. The sensation from this area is mediated through which nervous structure? Accessory nerve Dorsal primary ramus of C7 Dorsal root of T2 Ventral primary ramus C7 Ventral root of T2
A patient complains of pain on the lower left side of her back. A radiograph confirms a hernia passing posterolaterally immediately superior to the iliac crest. This hernia passes through the: Lumbar triangle Triangle of auscultation Inguinal triangle Triangle of Calot Greater sciatic foramen
If the right dorsal scapular nerve were cut near its origin, what would result: Skin of the upper back on the right side would be numb The point of the right shoulder would droop Scapular retraction on the right would be weakened Extension of the right arm would be weakened Inability to adduct the right arm
The transverse cervical artery is severed in an auto accident. What muscle would be affected the most? Levator scapulae Rhomboideus minor Rhomboideus major Trapezius Latissimus dorsi
During a triathalon biking accident, a rider fell and landed with the handle bar of her bike forced upward into her right axilla. Subsequently while swimming in another triathalon event she found that her right arm tired so badly during the swimming portion that she could barely finish the event. During examination it was found that movements involving adduction, medial rotation and extension of her arm were particularly weak and affected her swimming stroke. The nerve injured was the: Accessory Dorsal scapular Lateral pectoral Medial pectoral Thoracodorsal
In order for a skin abrasion to bleed, the lesion must penetrate at least into the: Dermis Deep fascia Epidermis Muscular fascia Subcutaneous tissue
After a penetrating wound in the area of the posterior axillary fold a patient had weakness in extension and adduction of the arm. Which muscle is likely involved? Latissimus dorsi Pectoralis major Levator scapulae Rhomboideus major Trapezius
The part of a spinal nerve that supplies the true back muscles and the skin overlying them is the:
dorsal primary ramus dorsal root ventral primary ramus ventral root
Which is a source of axons found in the dorsal primary ramus of the 4th thoracic spinal nerve? Afferent neurons arising from the skin overlying the trapezius muscle Somatic motor neurons supplying the levator scapulae muscle Somatic motor neurons supplying the rhomboid muscles Somatic motor neurons supplying the trapezius muscle
A football player suffers a herniated (ruptured) intervertebral disk in his neck. The disk compresses the spinal nerve exiting through the intevertebral foramen between the 5th and 6th cervical vertebrae. Which spinal nerve is affected? C 4 C 5 C 6 C 7 C 8
A man has a herniated intervertebral disk between the fourth and fifth lumbar vertebrae. If this disk herniates posterolaterally, which spinal nerve would most likely be affected? L 3 L 4 L 5 S 1 S 2
Kyphosis is an accentuated or abnormal curvature of which region of the spine? cervical thoracic lumbar sacral coccygeal
Both the dural sac and the subarachnoid space end at which vertebral level? L 4 L 5 S 2 S 1 S 4
It is decided to image the spinal cord and spinal nerve rootlets by doing a myelogram (injection of a radio-opaque dye into the subarachnoid space followed by a radiograph). In order to inject the dye without injury to the spinal cord, the injection is usually done below what vertebral level? L 1 L 2 L 3 L 4 L 5
The myelogram revealed that the dye had leaked out along the spinal nerves in the mid cervical region on the right side. For the dye to leak out, what layer must have been torn or ruptured? arachnoid denticulate ligament periosteum pia perineurium
The myelogram also revealed that the dorsal and ventral rootlets of the 5th and 6th cervical nerves had been avulsed (torn or pulled out) from the spinal cord on the right side. Which nerve fibers would not be damaged by the avulsion? general somatic afferent general somatic efferent preganglionic sympathetic postganglionic sympathetic
It was noted that after the injury the patient's face on the right side was flushed due to dilation of the blood vessels. The lack of vasoconstriction was due to interruption of what fibers somewhere along their course? somatic afferent somatic efferent parasympathetic sympathetic
The intervertebral disk is found between all adjacent vertebrae adds about 1/4th to entire length of vertebral column is a type of synovial joint within the vertebral column contains a compressible liquid center is perforated by the needle when performing a spinal tap
The conus medullaris: exhibits both a cervical and lumbar enlargement has a modification of neural tissue extending from its termination to the coccygeal ligament gives origin to most of the cauda equina is found at its lowest extent at S2 is normally anesthetized to perform a spinal tap
A neuron with a cell body in the dorsal root ganglia could convey what type of fibers? motor to the deep back muscles motor to the pectoralis major muscle sensory from the skin overlying the trapezius sympathetic preganglionics to the suprarenal medulla visceral efferents to the stomach
The denticulate ligament: is a modification of pia mater is found between all dorsal and ventral roots attaches to the dural sac continuously has its terminal attachment at S2 holds the radicular arteries in place
A patient is suspected of having bacterial meningitis. As part of the diagnostic procedure, a lumbar puncture is to be performed. The attending physician asks you where she should insert the spinal needle to withdraw CSF. You answer, "just below the spine of the 4th lumbar vertebra." What reference point would you use to identify the spine? Crest of the ilium Ischial tuberosity Pubic symphysis Umbilicus Xiphoid process
As the spinal needle in the above question is being inserted, which ligament would it pass through on its way to the subarachnoid space? Anterior longitudinal Denticulate Ligamentum nuchae Posterior longitudinal Supraspinous
Because of their structure and interconnections, which veins are especially important in the metastatic spread of cancer? Basilic Cephalic Dorsal scapular Internal vertebral venous plexus Transverse cervical
The number of vertebrae and number of spinal cord segments are the same in each region except: Cervical Thoracic Lumbar Sacral
The subtrapezial plexus of nerves includes: C3, C4 and the dorsal scapular nerve C3, C4 and the accessory nerve C3, C4 and nerve to levator scapulae Accessory and dorsal scapular nerves Accessory nerve and nerve to levator scapulae
If in the process of doing a lumbar puncture a spinal needle was inserted posteriorly in the midline until it had just penetrated the posterior longitudinal ligament, would the needle have entered the subarachnoid space? Yes No
While moving into a new apartment a student lifting a heavy box of books experiences a sharp pain in his back, radiating down the anterior thigh and medial side of his leg. After several days of misery, he finally goes for treatment and is told that he has a herniated intervertebral disk at the L 4 level which is compressing a spinal nerve where it exits the vertebral column. The point of compression is the: Central canal Foramen magnum Hiatus of the sacral canal Intervertebral foramen Vertebral foramen
Which muscle is innervated by posterior primary rami? Latissimus dorsi Levator scapulae Rhomboideus major Erector spinae Trapezius
The spinal cord is segmented like the vertebral column, but in contrast to the vertebrae, there are only _____ cord segments 28 29 30 31 32
A patient is suspected of having bacterial meningitis. A lumbar puncture is performed to remove cerebrospinal fluid (CSF) for analysis. If done properly, the needle used for the tap would penetrate all layers except: Arachnoid mater Epidural fat Dura mater Pia mater Supraspinous ligament
Quasimoto, the "Hunchback of Notre Dame," suffered from an abnormal thoracic curvature called kyphosis. In this condition the accentuated convexity of the curvature is: Anterior Caudal Lateral Medial Posterior
A patient is suspected of having bacterial meningitis. A lumbar puncture is performed to remove cerebrospinal fluid (CSF) for analysis. The fluid would be removed from the: Epidural space at the level of L3 Intervertebral foramen at the level of L2 Spinal canal at level of L 3 Subdural space at the level of L4 Subarachnoid space at the level of L4
A 60-year-old male presented with a number of unusual signs and symptoms in the facial region. Among others, it was found that the right side of his face was flushed (red). Further testing revealed a lack of ability to sweat in the same cutaneous region. Which nervous structures were most likely implicated in this set of clinical abnormalities? Cranial outflow of the ANS Dorsal roots of cervical nerves Gray rami communicantes of T 5 Sympathetic nerve fibers Vagus nerves
In the lumbar spine, the L4 nerve root sleeve exits: above the pedicle of L4 and at the top of the intervertebral foramen above the pedicle of L4 and at the bottom of the intervertebral foramen below the pedicle of L4 and at the top of the intervertebral foramen below the pedicle of L4 and at the bottom of the intervertebral foramen
Which structure does NOT contain efferent autonomic nerve fibers? Dorsal ramus of C4 Dorsal root of T6 Ventral root of T3 Ventral ramus of L2
In order to expose the spinal cord from the posterior side, it is necessary to remove the: Laminae, pedicles and ligamenta flavum Laminae, spinous processes and ligamenta flavum Pedicles, spinous processes and posterior longitudinal ligament Transverse processes, pedicles and ligamenta flavum
In an adult, the conus medullaris of the spinal cord is normally positioned at which
vertebral body levels: T10-T12 T12-L2 L2-L4 L5-S1
Inserting a spinal tap needle in the lumbar region, in the midline, you hear and feel a 'pop' at the needle tip. What structure was perforated to cause the 'pop?' intervertebral disk anterior longitudinal ligament ligamentum flavum dura mater arachnoid mater
Prostate cancer is diagnosed in an 82 year old male. Thereafter a malignant brain tumor of prostatic origin is found. He subsequently dies. An autopsy reveals
tumor sites in the prostate, vertebral column, and brain, but no other organs. By what vascular pathway did the cancerous cells get to the brain: anterior spinal artery vertebral venous plexus azygos venous system vertebral artery thoracic duct
Which of the following statements about the artery of Adamkiewicz is not correct? It is also known as the artery of the lumbar enlargement It is a radicular (or radiculomedullary) artery in the lower thoracic or upper lumbar region It is most frequently found on the left side It has extensive collateralization (anastomoses) on the surface of the thoracic spinal cord It passes along the surface of a ventral root of a spinal nerve to reach the cord
A 45-year-old man complained to his physician that the muscles of his upper limb were weak and he felt clumsy while walking. Tests revealed that he had amyotrophic lateral sclerosis (Lou Gehrig's disease), a disease which attacks the neurons of the voluntary motor system. Where would one expect to see atrophic or degenerated nerve cell bodies? Dorsal horn of the spinal cord Dorsal root ganglion Lateral horn of the spinal cord Sympathetic chain ganglia Ventral horn of the spinal cord
A patient is diagnosed as having a venous anomaly of the posterior spinal veins which have enlarged, putting pressure on the spinal cord. In order to expose the veins, the surgeon will have to pass through the skin, subcutaneous tissue, deep back muscles and then, in order, the: Laminae and ligamenta flava, posterior longitudinal ligament, epidural space, dura, subdural space, arachnoid, subarachnoid space, pia Pedicles and ligamenta flava, epidural space, dura, subdural space, arachnoid, subarachnoid space, pia. Laminae and ligamenta flava, epidural space, dura, subdural space, arachnoid, subarachnoid space, pia. Pedicles, posterior longitudinal ligament, epidural space, dura, subdural space, arachnoid, subarachnoid space, pia. Laminae and ligamenta flava, epidural space, pia.
A University student comes to the Emergency Room with a high fever, lethargy and a stiff neck. After further examination, meningitis is suspected and a lumbar puncture is ordered. What landmark could be used to insert the spinal needle between the 4th and 5th lumbar vertebral spines? Anterior superior iliac spine Costal margin Iliac crest Transpyloric plane Umbilicus
If one does a laminectomy (removing the laminae of two adjacent vertebrae) to expose the spinal cord, which ligament must be removed? anterior longitudinal denticulate ligamentum flavum ligamentum nuchae posterior longitudinal
In the final stages of labor a caudal anesthetic is sometimes given via a needle inserted into the sacral hiatus. The anesthetic is thus placed around the outside of the sacral spinal nerve roots and into the: Central canal Dural sinus Epidural space Subarachnoid space Subdural space