Back, Vertebral Column, Spinal Cord

A 28-year-old pregnant woman is admitted to the obstetrics department for delivery. In the final stages of labor, a caudal anesthetic is administered via the sacral hiatus. Into which of the following spaces in the sacral canal is the anesthetic placed?

Epidural space

The gray and white rami that allow information exchange between the spinal nerves & the autonomic ganglia are collectively called the

`rami communicates

Activation of a sensory neuron results in the conduction of action potentials into the spinal cord along an ______ fiber

afferent

The outer fibrocartilage portion of an intervertebral disc is called the

annulus fibrosis (inner portion=nucleus pulposis)

Sever hyperextension of the neck (whiplash) ruptures which ligament?

anterior longitudinal ligament

The _________ arise at the junction of the vertebral pedicles and laminae, and are divided into a superior type, which projects cranially, and an inferior type, which projects caudally

articular processes

Where is/what is in the sacral triangle?

at the S2 spinous process; including the posterior superior iliac spine, median sacral crest, and sacral hiatus

________ is the condition of muscle wasting

atrophy

The ondontoid process (aka the dens) is found on the

axis (C2)

A race car driver is involved in a serious crash, and a large hematoma is evident. Radiographs reveal damage to the transverse processes of C3. What artery is most likely damaged? A) vertebral artery B)Posterior spinal arteries C)anterior medullary artery D) anterior spinal artery

vertebral artery

Every spinal segment is associated with a pair of _____________ that contain the cell bodies of sensory neurons

dorsal root ganglia

A 35-year-old man is admitted to the hospital after a severe car crash. Radiologic examination reveals an injury to the dorsal surface of the neck and a fracture of the medial border of the right scapula. During physical examination, the patient presents with the scapula retracted laterally on the affected side. Which of the following nerves has most likely been injured on that side?

dorsal scapular

A ________ is a regional anesthesia produced by the injection of an anesthetic into the epidural space near targeted spinal nerve roots

epidural block

A slender strand of fibrous tissue from the pia mater that blends into the coccygeal ligament and forms the most inferior extension from the spinal cord that anchors it to the sacral region is the

filum terminale

The ______ ribs attach only to the vertebrae, and not the sternum

floating/false

What is spondylolysis

fracture of bones connecting superior and inferior articular processes

A __________ is a common name for a condition caused by distortion of intervertebral disc

herniated disc or degenerative disc

The gray matter of the spinal cord is organized into anterior, posterior, and lateral _______

horns

A _________ is an extension movement that is carried past the anatomical position

hyperextension

enlargements of the spinal cord occur

in those spinal segments that control the limbs

The end of a muscle that is attached to the point that moves when the muscle contracts is called the

insertion

The __________ runs deep to the external oblique

internal oblique

Muscles located entirely within an organ are called

intrinsic

The surgical procedure performed to access a herniated disc is known as

laminectomy or dissectomy

The ventral root of a spinal nerve transmits ________ information ________ the spinal cord.

motor; away from

What is sciatica?

pain in lower back & hip, caused by herniated lumbar disc

A person who sustains damage to the spinal cord at the level of the lumbar plexus will suffer from

paraplegia

Loss of sensation and motor control of the lower limbs is called

paraplegia

All of the following originate on the scapula, except the: A) supraspinatus. B) pectoralis major. C) teres major. D) teres minor.

pectoralis major

Skeletal muscles in which the fascicles form a common angle with the tendon are ________ muscles.

pennate

The ________ innervates the diaphragm

phenic nerve

The iliac crest is the origin of the

quadratus lumborum

Flexion of the spinal column is accomplished by the ________ group of muscles in the abdominal wall

rectus abdominis

The muscle that adducts and rotates the scapula laterally is the

rhomboid

Damage to the atlantoaxial joint will lead to difficulties in

rotation

The muscle that originates on the sacrum and transverse process of each vertebrae and inserts on the spinous process of the third or fourth more superior vertebrae is the ______ muscle

rotatores

The group of five vertebrae that are normally fused and have a broad surface for muscle attachment are the ______ vertebrae

sacrum

Irritation of the muscles of the posterior aspect of the thigh can also cause irritation of the _________ nerve

sciatic

A specialized cell that monitors conditions either inside the body or in the external environment is a

sensory receptor

Ultrasound diagnosis on a patient reveals a large sac protruding from the back of the child. What is the most likely diagnosis of this congenital anomaly?

spina bifida cystica

The cell bodies of somatic motor neurons are found in the

spinal cord

Misalignment of adjacent vertebrae can result in many pain symptoms and functional impairment because of compression of the ______ that exist b/w vertebrae

spinal nerve

The ________ is the only joint between the axial and appendicular portions of the skeleton

sternoclavicular

A needle used in a spinal tap must be inserted until its tip is in the

subarachnoid space

The cerebrospinal fluid is located in the

subarachnoid space

A patient exhibits a lack of medial adduction and rotation, as well as extension of the humerus. Which nerve may be damaged?

suprascapular or subscapular ?

Muscles that are long and round in cross section are termed

teres

Administration of caudal epidural anesthesia uses what landmarks to locate the proper injection site?

the cornua of the sacral hiatus

Where is the supracristal line?

the high points of the iliac crest & crosses L4 spinous process, L4/L5 IVD

The most common lever systems in the body are those that have the applied force between the fulcrum and the load. These are called ________ levers.

third class

Which of the following regions of the spinal cord follows typical segmenting without mixing roots?

thoracic

A 27-year-old man is admitted to the emergency department after a car crash. Physical examination reveals weakness during medial rotation and adduction of the humerus. Which of the following nerves was most probably injured?

thoracodorsal

Which of the following nerves innervates the latissimus dorsi muscle?

thoracodorsal nerve

Compression of the spinal cord by the dens of the atlas may occur with a rupture of which ligament?

transverse ligament of the atlas

The muscle that inserts on the acromion and scapular spine is the

trapezius

The _________ of the spinal nerves are the portions that participate in the formation of nerve plexuses

ventral rami

Incomplete closure of the ________ during development results in a condition known as spina bifida.

vertebral arch

The spinal meninges function to

-assist in delivering nutrients and oxygen to the spinal cord. -stabilize the spinal cord. -protect the spinal cord. -absorb shocks to the spinal cord. (all of the above)

Three ligaments that attach the dens to the foramen magnum of skull:

1 apical ligament connecting them from the tip of the dens & 2 alar ligaments coming from the sides of the dens

How many joints are between adjacent vertebrae?

3 -1 symphysis bw bodies -2 zygapophyseal (facet) joints bw inferior & superior articular processes

How many spinal nerves?

31

How many vertebral discs are there?

33

The spinal cord continues to elongate until about age

4 years

The increased amount of gray matter in the lumbar region of the spinal cord is known as the

??

Which of the following muscles is most likely located immediately deep to the semispinalis muscles, pass from a lateral point of origin in a superomedial direction to attach to spinous processes, and cross between 2 and 4 vertebrae? A. Multifidus B. Rotatores C. Longissimus D. Iliocostalis E. Spinalis

A. multifidus

Which of the following is not a movement that can occur b/w vertebrae? A) lateral flexion B) flexion & extension C) supination D) rotation

C) supination

What is the only vertebral ligament that prevents extension

Anterior Longitudinal Ligament (ALL); it connects the anterior surface of vertebral bodies and IVD

Where are uncovertebral joints found?

C3-C7

Where does the supraspinous ligament start?

C7 spinous process; above that is the nuchal ligament

In a report of a radiograph of the cervical spine the radiologist wrote the following: "Severe narrowing of the C7-T1 intervertebral foramen (IVF) on the left." Which nerve was most likely compressed as a result of this finding?

C8

**Sensory input and motor innervation of deep back muscles is supplied by the

dorsal rami of spinal nerves

A 38-year-old man is admitted to the emergency department after a car collision. During physical examination several lacerations to the back are discovered. Pain from lacerations or irritations of the skin of the back is conveyed to the central nervous system by which of the following?

Dorsal primary rami

What is hemisacralization?

L5 fused into the sacrum

Reflection of the trapezius muscle exposes the

Infraspinatus and teres minor

A 44 year old comes into her doctor complaining of a headache and backache. On examination, she is found to have excess fluid in the spinal epidural space due to the damage to blood vessels or meninges. What structures are most probably ruptured?

Internal vertebral venous plexus

A 3-day-old girl develops a fever. She is irritable and not feeding. As part of the workup for fever of unknown origin, a lumbar puncture is performed. This puncture must be done below the spinal cord which usually ends at which vertebral level in a patient of this age?

L3

Where do most lumbar disc protrusion occur?

L4-L5 or L5-S1

A 45-year-old woman states that she has experienced moderate pain for 2 years over her left lower back; pain that radiates to her left lower limb. She states that after lifting a case of soft drinks, the pain suddenly became intense. She was admitted to the emergency department. Radiologic examination revealed intervertebral disc herniation between vertebral levels L4 and L5. Which of the following nerves was most likely affected by the disc herniation?

L5

A 6-year-old boy is admitted to the hospital with coughing and dyspnea. During taking of the history, he complains that it feels like there is glass in his lungs. Auscultation reveals abnormal lung sounds. The abnormal lung sounds are heard most clearly during inhalation with the scapulae protracted. Which of the following form the borders of a triangular space where one should place the stethoscope in order to best hear the lung sounds?

Latissimus dorsi, trapezius, rhomboid major

Most severe type of spina bifida?

Myelomeningocele

Carl is in a bad accident and his vertebral column is crushed at the level of L4. Will he suffer from a transection of the spinal cord?

No, spinal cord terminates b/w L1-L3

What is the PLL and what does it do?

Posterior Longitudinal Ligament; connects posterior surface of vertebral bodies & IVD

What is lumbarization?

S1 separated from sacrum

A 1-year-old girl is brought to the clinic for a routine checkup. The child appears normal except for a dimpling of the skin in the midline of the lumbar region with a tuft of hair growing over the dimple. What is this relatively common condition that results from incomplete embryologic development?

Spina bifida occulta

A 53 year old is admitted to the emergency room due to severe back pain. MRI examination reveals an anterior dislocation of the body of the L5 vertebra upon the sacrum. What is the most likely diagnosis?

Spondylolisthesis

Where is the last IVD

between L5 & S1

Two areas of the vertebral column that lack intervertebral discs are the coccyx and

between atlas & axis (C1 & C2)

The dorsal root ganglia mainly contain

cell bodies of sensory neurons

Transverse foramina are only found in the ___________ vertebrae

cervical

Injury to what region of the vertebral column is usually most threatening and why?

cervical; because the diaphragm

What does the ligamenta flava connect?

connect the lamina of adjacent vertebra

A fan-shaped muscle with a broad origin and fascicles that attach to a common site is a ________ muscle.

convergent

Another word for crossing over of axon is

decussation

The pia mater is connected to the dura mater to anchor the spinal cord in place at paired structures called

denticulate ligaments

Motor pathways go which way through the spinal cord?

descend

What is spondylolisthesis?

dislocation between adjacent vertebrae as forces push it out of alignment