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 compresses the spinal nerve in the intervertebral foramen immediately posterior to this disk, which spinal nerve would 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