Gross Anatomy Test 1
12.Which of the following ligaments is primarily associated with the joints between vertebral bodies? A. Ligamentum flavum B. Interspinous C. Anterior longitudinal D. Supraspinous
? C. because it covers all of the intervertebral discs, and helps prevent hyperextension of the spine They all support the joints of the vertebral bodies
A 40-year-old woman survived a car crash in which her neck was hyperextended when her vehicle was struck from behind. At the emergency department a plain radiograph of her cervical spine revealed a fracture of the odontoid process (dens). Which of the following was most likely injured? ⃣ A. Anterior arch of the atlas ⃣ B. Posterior tubercle of the atlas ⃣ C. Atlanto-occipital joint ⃣ D. Inferior articular process of the axis ⃣ E. Anterior tubercle of the atlas
A
Which of the following paired muscles of the back is primarily responsible for extension of the vertebral column? A. Iliocostalis B. Latissimus dorsi C. Levator costarum D. Rhomboid major and minor E. Trapezius
A
9. Which of the following paired muscles of the back is primarily responsible for extension of the vertebral column? A. Iliocostalis B. Latissimus dorsi C. Levator costarum D. Rhomboid major and minor E. Trapezius
A B. works on the shoulder joint/arm, extrinsic muscle C. Had to google this, located posterior thorax and elevates rib cage D. Extrinsic back muscle that works on scapula E. Extrinsic back muscle that works on scapula
A 24-year-old female presents with severe headache, photophobia, and stiffness of her back. Physical examination reveals positive signs for meningitis. The attending physician decides to perform a lumbar puncture to determine if a pathogen is in the CSF. What is the last structure the needle will penetrate before reaching the lumbar cistern? ⃣ A. Arachnoid mater ⃣ B. Dura mater ⃣ C. Pia mater ⃣ D. Ligamentum fl avum ⃣ E. Posterior longitudinal ligament
A CSF is in the subarachnoid space, so A would be the last layer pierced
A 38-year-old male is admitted to the emergency department after a car collision. During physical examination several lacerations in 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? ⃣ A. Dorsal primary rami ⃣ B. Communicating rami ⃣ C. Ventral primary rami ⃣ D. Ventral roots ⃣ E. Intercostal nerves
A General somatic afferent fibers are conveyed from the skin of the back via the dorsal primary rami.
A 39-year-old male presents with severe neck pain after a whiplash injury, sustained when his car was struck from behind. Radiographic studies reveal trauma to the ligament lying on the anterior surface of the cervical vertebral bodies. Which ligament is this? ⃣ A. Anterior longitudinal ligament ⃣ B. Ligamentum fl avum ⃣ C. Nuchal ligament ⃣ D. Posterior longitudinal ligament ⃣ E. Transverse cervical ligament
A Key word is anterior surface of the bodies
A 27-year-old man is admitted to the emergency department after a car crash. Physical examination reveals weakness in medial rotation and adduction of the humerus. Which of the following nerves was most probably injured? ⃣ A. Thoracodorsal ⃣ B. Axillary ⃣ C. Dorsal scapular ⃣ D. Spinal accessory ⃣ E. Radial
A Medial rotation of humerus is the latissimus dorsi which is innervated by thoracodorsal nerve
A 50-year-old man is diagnosed with flaccid paralysis limited to the right arm, without pain or paresthesia. No sensory deficits are noted. Laboratory studies reveal that the patient is infected with West Nile virus. The target that the virus has infected resulting in this patient's symptoms is most likely the A. Ventral horn of spinal cord gray matter B. Ventral rami of spinal nerves C. Dorsal horn of spinal cord gray matter D. Dorsal rami of spinal nerves
A The patient has no sensory deficits and presents with only motor deficits. Therefore, the virus affects the ventral horn of the gray matter because that is the location of the motor neuron cell bodies.
A 22-year-old male soccer player is forced to leave the game following a head-to-head collision with another player. He is admitted to the hospital, and radiographic examination reveals slight dislocation of the atlantoaxial joint. As a result, he experiences decreased range of motion at that joint. What movement of the head would most likely be severely affected? ⃣ A. Rotation ⃣ B. Flexion ⃣ C. Abduction ⃣ D. Extension ⃣ E. Adduction
A remember the axis has the dens, when the atlas is placed on top it can rotate around it making the "no" gesture
A 65-year-old male is injured when a vehicle traveling at a high rate of speed hits his car from behind. Radiographic examination reveals that two of his articular processes are now locked together, a condition known as "facet jumping." In which region of the spine is this injury most likely to occur? ⃣ A. Cervical ⃣ B. Thoracic ⃣ C. Lumbar ⃣ D. Lumbosacral ⃣ E. Sacral
A this is tricky because we know this as spondylolysis, most common in cervical. Happens in lumbar too. low chance in thoracic due to ribs. impossible in sacral because of fusion.
13.Which extrinsic back muscle of the back contracts to produce a shrugging motion? A. Trapezius B. Rhomboid major C. Rhomboid minor D. Latissimus dorsi
A. if you workout just remember the trapezius is nicknamed the traps, when you do a trap workout you generally shrug a lot B. Retracts scapula C. retracts scapula D. adducts the shoulder
19.Dorsal (posterior) rami of spinal nerves innervate which of the following? A. Splenius capitis B. Serratus posterior superior C. Levator scapulae D. Latissimus dorsi
A. the dorsal rami innervates the intrinsic back muscles, not the extrinsic ones below B. is for the ribs so is intercostal nerves C. is for scapula so it is the dorsal scapular nerve D. Is the thoracodorsal nerve
Which nerve fi bers carry the sensation of a mosquito bite on the back, just lateral to the spinous process of the T4 vertebra? ⃣ A. Somatic afferent ⃣ B. Somatic efferent ⃣ C. Visceral afferent ⃣ D. Visceral efferent ⃣ E. Somatic efferent and visceral afferent
A. Afferent is sensory information to CNS, somatic is things we consciously perceive Efferent is motor information visceral is part of the autonomic NS more for internal conditions
The muscles of the posterior aspect of the thigh, or hamstring musculature, are responsible for flexing the knee joint. Beginning with the motor neuron cell bodies in the gray matter of the spinal cord, identify the most likely pathway that axons would travel from the spinal cord to the hamstring muscles? A. Ventral horn, ventral root, ventral ramus B. Ventral horn, ventral root, dorsal ramus C. Lateral horn, ventral root, ventral ramus D. Lateral horn, dorsal root, dorsal ramus E. Dorsal horn, dorsal root, ventral ramus F. Dorsal horn, dorsal root, dorsal ramus
A. All muscles of the limbs and body wall are innervated by ventral rami. Although the muscles are present along the posterior aspect of the thigh, muscles are still innervated by the ventral rami
During a routine physical examination a 65-yearold male patient is tested for ease and flexibility of the movements of his lumbar region. Which of the following movements is most characteristic of the intervertebral joints in the lumbar region? ⃣ A. Circumduction ⃣ B. Lateral flexion ⃣ C. Abduction ⃣ D. Adduction ⃣ E. Inversion
B
20.Which one of the following portions of the spinal cord is composed purely of pia mater? A. Conus medullaris B. Filum terminale C. Lumbar enlargement D. Cauda equina E. Cervical enlargement
B
6. An 18-year-old female passenger injured in a roll- over car crash was rushed to the emergency department. After the patient is stabilized, she undergoes physical examination. She demonstrates considerable weakness in her ability to flex her neck, associated with injury to CN XI. Which of the following muscles is most probably affected by nerve trauma? A. Iliocostalis thoracis B. Sternocleidomastoid C. Rhomboid major D. Rhomboid minor E. Teres major
B A. is innervated by posterior rami of thoracic vertabrae C. Innervated by the Dorsal scapularis nerve D. Same E. Teres major is innervated by the subscalpular nerve
5. A 53-year-old male was in a head-on vehicle collision that resulted in compression of the spinal cord by the dens of the axis, with resulting quadriplegia. Which of the following ligaments was most probably torn? A. Anterior longitudinal ligament B. Transverse ligament of the atlas C. Ligamentum flavum D. Supraspinous ligament E. Nuchal ligament
B A. is the Large ligament that runs anterior to the spinal cord, injured in hyperextension C. is the ligament that attaches the laminae of vertebrae together D. is the ligament that connect the spinous process of vertebrae E. is the ligament that connects C7 to occipital bone, extension of supraspinous ligament
14.Which of the following innervates the latissimus dorsi muscle? A. Accessory nerve B. Thoracodorsal nerve C. Dorsal scapular nerve D. Long thoracic nerve
B Starts in thoracic and has dorsi in the name
7. A 58-year-old male in the intensive care ward exhibited little voluntary control of urinary or fecal activity following a transplant procedure of his left kidney. In addition, physical examination revealed widespread paralysis of his lower limbs. These functions were essentially normal prior to admission to the hospital. The most likely cause of this patient's problems is which of the following? A. Injury to the left vertebral artery B. Injury of the great radicular artery (of Adamkiewicz) C. Ligation of the posterior spinal artery D. Transection of the conal segment of the spinal cord E. Division of the thoracic sympathetic chain
B E. isnt correct because he's having loss of motor functions D. isnt correct because it is safe inside the spinal cord C. apparently this is also protected by the spine A. this is in the cervical region
16.Which of the following is the function of the splenius capitis when contracting? A. Flex neck B. Rotate head ipsilaterally C. Shrug shoulders D. Rotate head contralaterally
B Bilaterally extends head, unilaterally rotates to same side
A 68-year-old man is admitted to the hospital due to severe back pain. Radiographic examination reveals severe osteoporosis of the vertebral column, with crush fractures of vertebrae L4 and L5. Which of the following parts of the vertebrae are most likely to be fractured in this patient? ⃣ A. Spinal process ⃣ B. Vertebral bodies ⃣ C. Transverse process ⃣ D. Superior articular process ⃣ E. Intervertebral disk
B Crush fracture is of the vertebral body
17.At which vertebral level does the spinal cord become the conus medullaris? A. T10 B. L2 C. L5 D. S4
B I just think that when the lumbar start the spinal cord ends
A 25-year-old male race car driver is admitted to the emergency department after a severe car crash. Radiographic studies reveal damage to the tip of the transverse process of the third cervical vertebra, with a significantly large pulsating hematoma. What artery is the most likely to have been damaged? ⃣ A. Anterior spinal artery ⃣ B. Vertebral artery ⃣ C. Ascending cervical artery ⃣ D. Deep cervical artery ⃣ E. Posterior spinal arteries
B Is the only artery that passes through the cervical transverse foramen A and E are inside the vertebral canal
A 42-year-old woman complains of pain and stiffness in her neck. She was injured sliding into second base headfirst during her company softball game. Radiographs reveal no fractures of her spine. However, upon physical examination her right shoulder is drooping and she has difficulty in elevating that shoulder. If you ordered an MRI, it would most likely reveal soft tissue damage to which of the following nerves? ⃣ A. Thoracodorsal nerve ⃣ B. Spinal accessory nerve ⃣ C. Dorsal scapular nerve ⃣ D. Greater occipital nerve ⃣ E. Axillary nerve
B Remember this innervates the trapezius which gives us that shrugging motion
3. A 64-year-old man arrived at the clinic with a severely painful rash and skin eruptions that are localized entirely on one side of his body, closely following the dermatome level of spinal nerve C7. The patient was diagnosed with herpes zoster virus. In what structure has the virus most likely proliferated to cause the patient's current condition? A. The sympathetic chain B. The dorsal root ganglion of the C7 spinal nerve C. The lateral horn of the C7 spinal cord segment D. The posterior cutaneous branch of the dorsal primary ramus of C7 E. The ventral horn of the C7 spinal cord segment
B Since it mentions Dermatomes it must be in the sensory pathway, This choice only effects sensory A. Is related to autonomic systems C. is found in T1 to L2 and are the cell bodies of sympathetic neurons D. this has both sensory and motor properties E. Ventral relates to motor function
A 79-year-old male retired military veteran presents to the outpatient clinic with an abnormal curvature of the vertebral column. He complains that it has become increasingly painful to walk around town. Upon physical examination he has an abnormally increased thoracic curvature resulting from osteoporosis. Which of the following is the most likely clinical condition of this patient's spine? ⃣ A. Scoliosis ⃣ B. Kyphosis ⃣ C. Spinal stenosis ⃣ D. Lordosis ⃣ E. Herniated disk
B cervical is lordosis thoracic is kyphosis lumbar is lordosis sacral is kyphosis
2. A 55-year-old man with severe coughing is ad- mitted to the hospital. Radiographic examination reveals tuberculosis of the right lung, with extension to the thoracic vertebral bodies of T6 and T7, producing a "gibbus deformity." Which of the following conditions is most likely also to be confirmed by radio- graphic examination? A. Lordosis B. Kyphosis C. Scoliosis D. Spina bifida E. Osteoarthritis
B gibbus deformity is kyphosis, Since thoracic vertebrae are effected there normal kyphosis becomes exaggerated
In the event of intervertebral disk herniation in the cervical region, which of the following ligaments is in an anatomic position to protect the spinal cord from direct compression? ⃣ A. Supraspinous ⃣ B. Posterior longitudinal ⃣ C. Anterior longitudinal ⃣ D. Ligamentum fl avum ⃣ E. Nuchal ligament
B helps direct the herniation posterolateral so you don't become paralyzed below that level, just effects the nerve root leaving at that level
A 65-year-old male complains of severe back pain and inability to move his left lower limb. Radiographic studies demonstrate the compression of nerve elements at the intervertebral foramen between vertebrae L5 and S1. Which structure is most likely responsible for this space-occupying lesion? ⃣ A. Anulus fi brosus ⃣ B. Nucleus pulposus ⃣ C. Posterior longitudinal ligament ⃣ D. Anterior longitudinal ligament ⃣ E. Ligamentum fl avum
B herniations are most common for intervertebral foramen compressions. Fibrosus tears and pulposus pokes through
A 34-year-old woman is admitted to the emergency department after a car crash. Radiographic examination reveals a whiplash injury in addition to hyperextension of her cervical spine. Which of the following ligaments will most likely be injured? ⃣ A. Ligamentum flavum ⃣ B. Anterior longitudinal ligament ⃣ C. Posterior longitudinal ligament ⃣ D. Anulus fibrosus ⃣ E. Interspinous ligament
B hyperextension damages the ALL, hyperflexion damages the PLL
An 18-year-old female passenger injured in a rollover car crash was rushed to the emergency department. After the patient is stabilized she undergoes physical examination. She demonstrates considerable weakness in her ability to fl ex her neck, associated with injury to CN XI. Which of the following muscles is most probably affected by nerve trauma? ⃣ A. Iliocostalis thoracis ⃣ B. Sternocleidomastoid ⃣ C. Rhomboid major ⃣ D. Rhomboid minor ⃣ E. Teres major
B not sure if this one is relevant to the back but just know XI is accessory nerve that also innervated trapezius
53-year-old male was in a head-on vehicle collision that resulted in compression of the spinal cord by the dens of the axis, with resulting quadriplegia. Which of the following ligaments was most probably torn? ⃣ A. Anterior longitudinal ligament ⃣ B. Transverse ligament of the atlas ⃣ C. Ligamentum fl avum ⃣ D. Supraspinous ligament ⃣ E. Nuchal ligament
B since the injury is next to the dens it needs to be a ligament in that area next closest ligament is C but it is in the posterior portion
15.Which muscle of the back elevates ribs 2-5? A. Serratus anterior B. Serratus posterior superior C. Serratus posterior inferior
B superior is in the name so it is the upper ribs
4. When a lumbar puncture is performed to sample cerebrospinal fluid, which of the following external landmarks is the most reliable to determine the position of the L4 vertebral spine? A. The inferior angles of the scapulae B. The iliac crests C. The lowest pair of ribs bilaterally D. The posterior superior iliac spines E. The posterior inferior iliac spines
B. A. lies at T7 C. lies at T12 D. Lies at S2 E. Lies below S2
A 19-year-old presents at the emergency department with high fever, severe headache, nausea, and stiff neck for 3 days. The attending physician suspects meningitis and obtains a sample of CSF using a lumbar puncture. From which of the following spaces was the CSF collected? ⃣ A. Epidural space ⃣ B. Subdural space ⃣ C. Subarachnoid space ⃣ D. Pretracheal space ⃣ E. Central canal of the spinal cord
C
A 53-year-old male is admitted to the emergency department due to severe back pain. MRI examination reveals anterior dislocation of the body of the L5 vertebra upon the sacrum. Which of the following is the most likely diagnosis? ⃣ A. Spondylolysis ⃣ B. Spondylolisthesis ⃣ C. Herniation of intervertebral disk ⃣ D. Lordosis ⃣ E. Scoliosis
B. since it is dislocated A. is when it is fractured
10. A 27-year-old man is brought to the emergency department after being involved in an automobile accident. Radiographic imaging studies indicate that he has sustained a fracture of the L1 vertebral arch and has a partially dislocated bone fragment impinging upon the underlying spinal cord. Which spinal cord level is most likely compressed by this bone fragment? A. C1 B. L2 C. S3 D. T4
C In an adult, the caudal end of the spinal cord is at the L1-L2 vertebral level. Therefore, a bone fragment from the L1 vertebra would have the potential of touching the caudal end of the spinal cord (In the vertebral canal not the root nerves exiting the intervertebral foramen), not the L1 spinal cord level. See picture, L1 could injure yellow portions which are S2-4
A 35-year-old man is admitted to the hospital after a severe car crash. Radiographic examination reveals an injury to the dorsal surface of the neck and a fracture in 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? ⃣ A. Axillary ⃣ B. Long thoracic ⃣ C. Dorsal scapular ⃣ D. Greater occipital ⃣ E. Suprascapula
C Rhomboids are innervated by this and cause medial retraction. When they relax this causes lateral retraction
A 23-year-old male was killed in a high-speed motor vehicle collision after racing his friend on a local highway. When the medical examiner arrives upon the scene, it is determined that the most likely cause of death was a spinal cord injury. Upon confi rmation by the autopsy, the medical examiner offi cially reports that the patient's cause of death was a fracture of the pedicles of the axis (C2). Breaking of which of the following ligaments would be most likely implicated in this fatal injury? ⃣ A. Ligamentum fl avum ⃣ B. Nuchal ligament ⃣ C. Cruciform ligament ⃣ D. Posterior longitudinal ligament ⃣ E. Supraspinous ligament
C Since this break is at C2 the closest ligament would be the cruciform ligament in the anterior portion
A 32-year-old mother complains of serious pain in the coccygeal area some days after giving birth. To determine whether the coccyx is involved, a local anesthetic is first injected in the region of the coccyx and then dynamic MRI studies are performed. The MRI reveals coccydynia, which confirms that her coccyx dislocates upon sitting. The local anesthetic is used to interrupt which of the following nerve pathways? ⃣ A. Visceral afferents ⃣ B. Somatic efferent ⃣ C. Somatic afferent ⃣ D. Sympathetic preganglionic ⃣ E. Parasympathetic preganglionic
C Somatic afferent fibers convey localized pain, typically from the body wall and limbs. Visceral afferents convey autonomic nervous system sensory information
18.What is the name given to the thickenings of the pia mater? A. Articulate ligaments B. Intermeningeal ligaments C. Denticulate ligaments D. Articular ligaments
C These are what attaches the pia to the dura sac A. I dont think this exists B. im not sure if this does either D. This is any ligament that attaches bone to bone
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? ⃣ A. Vertebral canal ⃣ B. Vertebral venous plexus ⃣ C. Epidural space ⃣ D. Subarachnoid space ⃣ E. Subdural space
C anesthetics are placed in the epidural
A 37-year-old pregnant woman is administered a caudal epidural block to alleviate pain during delivery. Caudal epidural block involves injection of local anesthetic into the sacral canal. Which of the following landmarks is most commonly used for the caudal epidural block? ⃣ A. Anterior sacral foramina ⃣ B. Posterior sacral foramina ⃣ C. Cornua of the sacral hiatus ⃣ D. Intervertebral foramina ⃣ E. Medial sacral crest
C dont think this would be asked
A 42-year-old female is diagnosed with constriction of the cervical vertebral canal. A laminectomy of two vertebrae is performed. Which of the following ligaments will most likely also be removed? ⃣ A. Anterior longitudinal ⃣ B. Denticulate ⃣ C. Ligamentum fl avum ⃣ D. Nuchal ⃣ E. Cruciate
C laminae are connected by flavum ligaments, all other ligaments aren't in the area of the vertebral canal
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 lumbar region with a tuft of hair growing over the dimple. You reassure the mother that this condition is seen in 10% to 25% of births and normally has no ill effects. What is this relatively common condition that results from incomplete embryologic development? ⃣ A. Meningomyelocele ⃣ B. Meningocele ⃣ C. Spina bifi da occulta ⃣ D. Spina bifi da cystica ⃣ E. Rachischisis
C occulta is the one with no negative effects cystica is the same as meningocele
11.A 45-year-old man is admitted to the emergency department after experiencing a sharp pain while lifting a box of books. He told the physician that he "felt the pain in my backside, the back of my thigh, my leg, and the side of my foot." During physical examination it is observed that his Achilles tendon jerk is weakened on the affected side. Which is the most likely cause of injury? A. Disk lesion at L3-4 B. Disk lesion at L4-5 C. Disk lesion at L5-S1 D. Disk lesion at S1-2
C pushes on dorsal root S1 plantar flexion A. pushes on L4, lifts toes from floor B. Pushes on L5, lifts greatest toe D. pushes on S2, (knee flexion)
A 23-year-old college student is admitted to the emergency department after jumping from a 50-foot waterfall. The MRI of his back reveals a lateral shift of the spinal cord to the left. Which of the following structures has most likely been torn to cause the deviation? ⃣ A. Posterior longitudinal ligament ⃣ B. Tentorium cerebelli ⃣ C. Denticulate ligaments ⃣ D. Ligamentum fl avum ⃣ E. Nuchal ligament
C since the cord itself is shifted
A 45-year-old man is admitted to the hospital because of severe pain in the back and lower limb. Radiographic examination reveals spinal stenosis syndrome. Which of the following conditions is most likely to be confi rmed by MRI examination? ⃣ A. Hypertrophy of supraspinous ligament ⃣ B. Hypertrophy of interspinous ligament ⃣ C. Hypertrophy of ligamentum fl avum ⃣ D. Hypertrophy of anterior longitudinal ligament ⃣ E. Hypertrophy of nuchal ligament
C spinal stenosis is pressure on the spinal cord, only flavum is near the cord
A maternal serum sample with high alpha-fetoprotein alerted the obstetrician to a possible neural tube defect. Ultrasound diagnosis revealed a meningocele protruding from the back of the child. Which of the following is the most likely diagnosis of this congenital anomaly? ⃣ A. Cranium bifida ⃣ B. Spina bifida occulta ⃣ C. Spina bifida cystica ⃣ D. Hemothorax ⃣ E. Arnold-Chiari malformation
C this is another term for meningocele.
A 34-year-old pregnant woman in the maternity ward was experiencing considerable pain during labor. Her obstetrician decided to perform a caudal epidural block within the sacral canal. What are the most important bony landmarks used for the administration of such anesthesia? ⃣ A. Ischial tuberosities ⃣ B. Ischial spines ⃣ C. Posterior superior iliac spines ⃣ D. Sacral cornua ⃣ E. Coccyx
D
A 66-year-old female had been diagnosed with a tumor on her spine. She has started to retain urine and is experiencing decreased anal and rectal tone. Both of these symptoms are signs of conus medullaris syndrome. At which of the following vertebral levels is the tumor probably located? ⃣ A. L3/L4 ⃣ B. L3 ⃣ C. L4 ⃣ D. T12 to L2 ⃣ E. T11
D Anything where the conus medullaris is, located around L1-L2
A 12-year-old child was brought to the emergency department by his parents because he has been suffering from a very high fever and severe stiffness in his back. The initial diagnosis is meningitis. The attending physician orders a lumbar puncture to confirm the diagnosis. Upon microscopic examination of the cerebrospinal fluid, hematopoietic cells are seen. Which of the following ligaments is most likely to be penetrated by the needle? ⃣ A. Supraspinous ⃣ B. Denticulate ⃣ C. Anterior longitudinal ⃣ D. Posterior longitudinal ⃣ E. Nuchal ligament
D Not sure how this one works, but I guess if they go to deep with the needle it pierces this ligament and introduces hematopoietic cells from the vertebral bone marrow under it.
A 3-year-old child is admitted to the emergency department with severe headache, high fever, malaise, and confusion. Radiographic and physical examinations reveal that the patient suffers from meningitis. A lumbar puncture is ordered. Which vertebral level is the most appropriate location for the lumbar puncture? ⃣ A. T12-L1 ⃣ B. L1-2 ⃣ C. L2-3 ⃣ D. L4-5 ⃣ E. L5-S1
D Spinal cord ends at L1 and L2, can do 3-4 but safer at 4-5
A 43-year-old male construction worker survived a fall from a two-story building but lost all sensation from his lower limbs and was admitted to the hospital for examination and treatment. Radiographic studies revealed that he crushed his spinal cord at vertebral level C6. Which of the following muscles will most likely be paralyzed? ⃣ A. Supraspinatus ⃣ B. Trapezius ⃣ C. Rhomboid muscles ⃣ D. Latissimus dorsi ⃣ E. Deltoid
D receives some innervation from C7 which would be affected
A 32-year-old male elite athlete was lifting heavy weights during an intense training session. The athlete felt severe pain radiating to the posterior aspect of his right thigh and leg. The patient was taken to the hospital where MRI revealed a ruptured L4/L5 intervertebral disk. Which nerve is most probably affected? ⃣ A. L3 ⃣ B. L4 ⃣ C. L2 ⃣ D. L5 ⃣ E. S1
D similar to other question
A 54-year-old woman is admitted to the emergency department due to increasing back pain over the preceding year. MRI reveals that her intervertebral disks have been compressed. It is common for the disks to shrink in people older than 40, and it can result in spinal stenosis and disk herniation. At which locations are the spinal nerves most likely to be compressed? ⃣ A. Between the denticulate ligaments ⃣ B. As they pass through the vertebral foramen ⃣ C. Between the superior and inferior articular facets ⃣ D. Between inferior and superior vertebral notches ⃣ E. Between the superior and inferior intercostovertebral joints
D these notches form the intervertebral foramen
1. A 69-year-old female visits her physician due to severe neck pain. Radiographic studies reveal bony growths (osteophytes) in the intervertebral foramen between vertebrae C2 and C3. Which of the following muscles would be most likely affected by this condition? A. Rhomboid B. Serratus anterior C. Supraspinatus D. Diaphragm E. Latissimus dorsi
D the phrenic nerve starts between these two vertebrae. Remember C3,4,5 keeps you alive, this refers to nerve roots not vertebrae (I.E. C3 exits between vertebrae C2 and C3)
8. Examination of a 3-day-old male infant reveals protrusion of his spinal cord and meninges from a defect in the lower back. Which of the following describes this congenital anomaly? A. Avulsion of meninges B. Meningitis C. Spina bifida occulta D. Spina bifida with meningomyelocele E. Spina bifida with meningocele
D. Myelo= spinal cord Mening= relating to the meninges both spinal cord and meninges are protruding A. Im not sure what this is? avulsions are tearing away B. Meningitis does not cause spinal defects C. This is a mild form of spina bifida, usually no visible signs except tuft of hair E. This has a space form from the meninges but no CNS protrudes into it
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 became intense. She was admitted to the emergency department. Radiographic examination revealed disk herniation between vertebral levels L4 and L5. Which of the following nerves was most likely affected by the disk herniation? ⃣ A. L1 ⃣ B. L2 ⃣ C. L3 ⃣ D. L4 ⃣ E. L5
E see picture attached
A 6-year-old boy is stung by a wasp between his shoulder blades. Identify the pain sensation pathway the axons would travel to course from the skin of his back to the spinal cord. A. Ventral horn, dorsal root, dorsal ramus B. Ventral horn, dorsal root, ventral ramus C. Ventral horn, ventral root, dorsal ramus D. Ventral horn, ventral root, ventral ramus E. Dorsal ramus, dorsal root, dorsal horn F. Dorsal ramus, dorsal root, ventral horn G. Dorsal ramus, ventral root, ventral horn H. Dorsal ramus, ventral root, dorsal horn
E
A 24-year-old patient suffered a lower back strain after a severe fall while snow skiing. MRI studies reveal injury to the muscles responsible for extending and laterally bending the trunk. What arteries provide blood supply for these muscles? ⃣ A. Subscapular ⃣ B. Thoracodorsal ⃣ C. Anterior intercostal ⃣ D. Suprascapular ⃣ E. Posterior intercostal
E Extending and laterally bending the trunk is the job of intrinsic back muscles A. subscapularis muscle B. latissimus dorsi C. the anterior portion of ribs D. supraspinatus and infraspinatus
A 15-year-old female was suspected to have meningitis. To obtain a sample of cerebrospinal fl uid by spinal tap in the lumbar region (lumbar puncture), the tip of the needle must be placed in which of the following locations? ⃣ A. In the epidural space ⃣ B. Between anterior and posterior longitudinal ligaments ⃣ C. Superfi cial to the ligamentum fl avum ⃣ D. Between arachnoid mater and dura mater ⃣ E. In the subarachnoid space
E This is where CSF is D. is the subdural space that only exists in the dead
