Practice Quiz - Back & Spinal Cord
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  1. 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
  2. When standing in the Anatomical Position the palms of the hands face:
    anteriorly
    laterally
    medially
    posteriorly
    superiorly
  3. 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
  4. The regionally named layer of tissue which encloses and binds muscle groups together is the:
    deep fascia
    intermuscular septum
    neurovascular bundle
    skin
    subcutaneous tissue
  5. The portion of the skin that serves as a barrier to water loss is the:
    dermis
    subcutaneous tissue
    superficial fascia
    epidermis
    deep fascia
  6. Hair, nails and teeth (enamel) originate in common with what layer?
    deep fascia
    epidermis
    panniculus adiposis
    subcutaneous tissue
    superficial fascia
  7. 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
  8. 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
  9. 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
  10. Interruption of cranial nerve XI would paralyze which muscle?
    deltoid
    latissimus dorsi
    levator scapulae
    rhomboideus major
    trapezius
  11. 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
  12. 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
  13. 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
  14. 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
  15. Panniculus adiposus refers to an abundance of fat in the:
    deep fascia
    muscular fascia
    skin
    subcutaneous tissue
    neurovascular bundles
  16. 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
  17. 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
  18. 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
  19. 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
  20. 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
  21. 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
  22. 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
  23. 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
  24. 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
  25. In order for a skin abrasion to bleed, the lesion must penetrate at least into the:
    Dermis
    Deep fascia
    Epidermis
    Muscular fascia
    Subcutaneous tissue
  26. 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
  27. 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
  28. 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
  29. 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
  30. 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
  31. Kyphosis is an accentuated or abnormal curvature of which region of the spine?
    cervical
    thoracic
    lumbar
    sacral
    coccygeal
  32. Both the dural sac and the subarachnoid space end at which vertebral level?
    L 4
    L 5
    S 2
    S 1
    S 4
  33. 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
  34. 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
  35. 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
  36. 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
  37. 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
  38. 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
  39. 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
  40. 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
  41. 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
  42. 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
  43. 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
  44. The number of vertebrae and number of spinal cord segments are the same in each region except:
    Cervical
    Thoracic
    Lumbar
    Sacral
  45. 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
  46. 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
  47. 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
  48. Which muscle is innervated by posterior primary rami?
    Latissimus dorsi
    Levator scapulae
    Rhomboideus major
    Erector spinae
    Trapezius
  49. 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
  50. 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
  51. 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
  52. 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
  53. 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
  54. 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
  55. 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
  56. 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
  57. 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
  58. 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
  59. 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
  60. 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
  61. 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
  62. 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.
  63. 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
  64. 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
  65. 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