Unit 3, Lecture 2

In what direction do intervertebral discs tend to herniate? A. Laterally B. Anteriorly C. Medially D. Posteriorly

*didn't put answer Slide 29

Which disc spaces do not contain an intervertebral disc? A) C1/C2 & the sacral discs B) C1/C2 C) L4/L5 and below D) the sacral discs

A) C1/C2 & the sacral discs

What is the function of the ligamenta flava? A) Stop abrupt flexion of the spine B) Resist Hyperflexion C) Prevent hyperextension D) Prevent posterior herniation of nucleus E) Act as a fulcrum with movement

A) Stop abrupt flexion of the spine

A mother brings her two year old girl into the ED. The mother reports that the child woke up that morning screaming and has been rigidly extending her head, neck and spine. The child has a fever and you suspect meningitis. What special positioning consideration must you make when performing the lumbar puncture to access the CSF? A) The conus medullaris finishes near L3 at birth, but at L1-2 by adulthood. B) The conus medullaris finishes near L1-2 at birth, and slowly grows toward L3 in adulthood. C) The iliac crest intersects the spine at approximately the L3-4 interspace. You should always puncture superior to this disc space regardless of the age of the patient. D) The cauda equina occupies 70% of the length of the spinal cord at birth as the conus medullaris is found only near the foramen magnum and takes doesn't fully descend until puberty.

A) The conus medullaris finishes near L3 at birth, but at L1-2 by adulthood.

Which ligament does NOT work to prevent hyperflexion of the vertebral column? A. Anterior Longitudinal Ligament B. Interspinous Ligament C. Supraspinous Ligament D. Intertransverse Ligament

A. Anterior Longitudinal Ligament (Slide 12)

Aaron, a 22-year-old male, presents to the emergency room after a car accident. Winter decided that it wasn't finished with poor Duluthians and hit the northland with a late snow storm. As Aaron was carefully making his way down the steep hill of 21st Ave East, he was rear-ended by the car behind him. Fortunately, the cars were not damaged severely, but Aarons head was flung backwards. Now, Aaron is experiencing neck pain, especially with movement. He complains of a headache and unusual fatigue. You are worried that when Aaron's head quickly jolted backwards, he suffered whiplash. Which ligament, which runs from the pelvic surface of the sacrum to the anterior tubercle of C1 and prevents hyperextension, are you worried may have been severely stretched and injured? A. Anterior Longitudinal Ligament B. Posterior Longitudinal Ligament C. Nuchal Ligament D. Ligamenta flava

A. Anterior Longitudinal Ligament 3/22/18 Lecture Slides 9-16. Moore 478

A 43 yo women presents to the clinic complaining of lower back pain. She states she was walking into work about 3 weeks ago and slipped and fell on her butt. After a few days of soreness she thought she was back to normal, but she has developed this lower back pain. You x-ray and see a decreased disc height and herniation at L5-S1. What ligament is being compressed on the spinal nerve root causing the pain? A. Posterior Longitudinal Ligament B. Interspinous Ligament C. Anterior Longitudinal Ligament D. Supraspinous Ligament

A. Posterior Longitudinal Ligament *Pg 474-475 Herniation of Nucleus Pulposus

The anterior vertebral canal branches supply blood to what important part of the vertebrae? A. The red marrow in the vertebral bodies B. The red marrow in the vertebral arches C. The yellow marrow in the vertebral arches D. The ligaments along the vertebral bodies E. The ligaments along the vertebral arches

A. The red marrow in the vertebral bodies **p11/slide 21 of lecture

A 19-year-old male was at a rock concert where he took part in the traditional head banging among the members of the crowd. For the first half an hour he was doing all right and was only getting slightly sore, but then he felt a much greater pain when he had brought his head forward and down in the middle of a head bang but also looked over to his friend that had been calling his name. This led his neck to be consequently flexed and rotated at the same time. Which of the following injuries is he likely to have sustained? A) Hyperflexion of the neck B) Rupture of the alar ligament C) Hyperextension of the neck D) Rupture of the transverse ligament of atlas

B) Rupture of the alar ligament

As your hometown's rural primary care PA you see many familiar faces. Your most recent experience was with your old high school history teacher, Mr. Roberts. Mr. Roberts presents to your clinic for complaints of ongoing lower back pain. The patient denies any aggravating activity or precipitating event. He has a BMI of 38 and has been told he needs to lose weight by other providers as they consider this the causation for his lower back pain. Upon your examination, you note abnormal curvature with anterior tilting of the pelvis and increased extension of the lumbar vertebrae. In addition, Mr. Roberts states that he has poor trunk musculature. You also agree with previous providers and discuss actions Mr. Roberts can take to decrease his weight. What is the abnormal curvature that Mr. Roberts presented with? A. Excessive kyphosis B. Excessive lordosis C. Scoliosis D. Rhizolysis E. Kyphoscoliosis

B. Excessive lordosis Moore p. 481

What is the function of the Anterior Longitudinal Ligament? A. Resist hyperflexion B. Prevent hyperextension C. Attachment for neck muscles D. Limit abrupt spine flexion E. Prevent lateral flexion

B. Prevent hyperextension

A 36-year old Caucasian male presents to the emergency department. He is having intense back pain, 103 degree fever, and chills. He has a history of diabetes and IV drug use. After ordering an MRI, you determine that the patient has vertebral osteomyelitis, an infection of the spine affecting the vertebrae and intervertebral discs. Why is an infection of the intervertebral discs especially difficult to treat? A. There are not antibiotics that cover infections of the intervertebral discs B. The intervertebral discs loose vascular supply as a person ages C. Antibiotics do not cross the blood-brain barrier and thus cannot enter the discs D. The dosage needed to treat intervertebral disc causes serious adverse effects E. Infections of the intervertebral discs do not occur

B. The intervertebral discs loose vascular supply as a person ages Slide 23

Sue presents to your clinic with lower back tenderness and right-sided leg pain and tingling upon standing. She denies recent injury to that leg, and also denies any symptoms in the left leg. X-Ray shows no evidence of vertebral fracture, so you obtain an MRI for more specific assessment of the vertebral column and it's soft tissues, which confirms a herniated l4 disc, causing impingement of its intervertebral foramen. Sue wonders why she is only having one-sided symptoms, and you tell her: A. The anterior ligament acts as a barrier, keeping the herniation contained to the right side. B. The posterior ligament acts as a barrier, keeping the herniation contained to the right side C. The herniation completely lacerated only her right nerve at the level of the L4 disc D. It is only a matter of time before the herniation spreads throughout the entire annulus, affecting both legs and eventually paralyzing her

B. The posterior ligament acts as a barrier, keeping the herniation contained to the right side (Slide 28 and lecture discussion as to "why herniated discs present w/ unilateral pain/paresthesia instead of bilateral)

Christopher Reeve, the actor famous for playing Superman, was paralyzed after breaking his neck in a cross-country equestrian event when his horse, Buck, abruptly stopped before a jump, throwing Reeve headfirst to the ground. His publicist later stated, "He sustained complex fractures to the first and second cervical vertebrae". What ligament in the upper cervical region of the spinal cord running between the first two vertebrae was most likely ruptured, thus causing paralysis of all four limbs due to compression of the spinal cord? A. Annulus Fibrosus B. Transverse Ligament of Atlas C. Anterior Longitudinal Ligament Posterior D. Longitudinal Ligament Ligamenta Flava

B. Transverse Ligament of Atlas (Pg. 477)

A 20 year old female patient presents to the clinic with complaints of mild back pain. She denies any recent trauma or injury. She says the discomfort has been happening intermittently throughout adolescence and young adulthood. Upon flexion at the hip, one shoulder appears higher than the other and a curve in the spine is visible. On closer examination, the left limb is slightly shorter than the right in length and there is a pelvic tilt evident when the patient is standing upright. What type of scoliosis is likely the cause of the patient's presentation? A. myopathic scoliosis B. functional scoliosis C. habit scoliosis D. lateral scoliosis E. idiopathic scoliosis

B. functional scoliosis

Which of the following regarding the Posterior Longitudinal Ligament is false? A: It runs in the vertebral column B: It resists hyperextension of the spine C: It is weaker and more narrow vs. the Anterior Longitudinal Ligament D: It attaches mainly to the discs of C2 to the sacrum

B: It resists hyperextension of the spine -Slide 10 in the "Vertebral Column" lecture slides

What is the function of the anterior longitudinal ligament of the vertebral column? A) Prevent hyperflexion B) Prevent lateral flexion C) Prevent hyperextension D) All of the above E) None of the above

C) Prevent hyperextension

A 7 month-old is brought into the ER by her parents who state she has had a high fever and seems less active than usual. On exam you notice the baby is indeed lethargic and there is nuchal rigidity. You suspect meningitis and order a lumbar puncture to confirm your diagnosis. At what level will the lumbar puncture be performed? A. Between L2-L3 B. Between L3-L4 C. Between L4-L5 D. You don't want to perform a lumbar puncture on an infant

C. Between L4-L5 pg 505

All the ligaments of the Vertebral Column prevent hyperflexion except for which one? a. Anterior Longitudinal ligament b. Interspinous Ligament c. Supraspinous Ligament d. Intertransverse Ligament

a. Anterior Longitudinal ligament

After Paige aced her last Anatomy exam of PA school, she decided to do a somersault to celebrate. After flexing and rotating the right side of her head much too far in the process, she presented to the ER in serious pain. As the attending PA in the ER, you notice during your physical exam of Paige that she has an unusual increase of about 30% in the range of motion of the contralateral side of her head (left side). What diagnosis is highest on your list after listening to the history and doing the physical exam? A: Rupture of the Transverse Ligament of the Atlas B: This is simply normal aging of Paige's intervertebral discs C: Rupture of an Alar Ligament D: Herniation of the Nucleus Pulposus

C: Rupture of an Alar Ligament -Blue Box on "Rupture of Alar Ligaments" on pg. 477 of Moore

A 63 yo male patient comes into your office with sudden right leg pain. He said he was taking out the trash when his symptoms started a few days ago. The pain is getting worse even with a "heavy dose of ibuprofen." He has no significant clinical medical history and his physical exam does not reveal any bulges, trauma, or injury. He says the pain is worst when you have him lift a straight right leg. He does not report any back pain. What kind of disc herniation do you suspect? A) Disc Degeneration/bulge B) Prolapse C)Extrusion D)Sequestration

D)Sequestration

What can cause the abnormal extension deformity of excessive lordosis, also called hollow back or swayback? A. Pregnancy B. Weakened trunk musculature C. Obesity D. All of the above

D. All of the above

What is the correct order of the layers of the meninges from external to internal on the spinal cord? A. Arachnoid mater, pia mater, dura mater B. Pia mater, arachnoid mater, dura mater C. Pia mater, dura mater, arachnoid mater D. Dura mater, arachnoid mater, pia mater

D. Dura mater, arachnoid mater, pia mater *Slide 38 from lecture

All of the following are true regarding intervertebral discs except: A. Intervertebral Discs account for 20-25% of the height of the vertebral column. B. They act as shock absorbers and allow movement of the spinal column. C. There is no intervertebral disc between C1 and C2 or below L5 and S1. D. Intervertebral discs are made up of layers of fibrocartilage and have a thicker posterior portion compared to anterior portion.

D. Intervertebral discs are made up of layers of fibrocartilage and have a thicker posterior portion compared to anterior portion. 3/22/18 Lecture Slides 5-6 The anterior portions of intervertebral discs are thicker than the posterior portions.

Which of the following are the two segmental branches that supply the spinal vertebrae? A. segmental medullary and radicular branches B. anterior vertebral and posterior vertebral branches C. anterior vertebral and radicular branches D. periosteal and equatorial branches E. radicular and equatorial branches

D. periosteal and equatorial branches slide 20

All of the following about the Anterior Longitudinal Ligament are true, EXCEPT a. It is a broad strong ligament from the pelvic surface of the sacrum to the anterior tubercle of C1 b. it prevents hyperflexion c. it reinforce the intervertebral disc d. it covers and connects the anterolateral aspects of the vertebral bodies and IV discs e. it helps maintain stability of the joints between the vertebral bodies

b. it prevents hyperflexion

A 35-year-old patient presents to urgent care after being involved in a car accident. The man states he was rear-ended while looking to his left and thus had "whiplash" which resulted in a flexion injury while his head was rotated. He now states he can look farther over his left shoulder than was previously possible. What is on the top of your differential? A. Atlas dislocation B. Atlas fracture C. Dens Axis fracture D. Axis herniation E. Rupture of Alar Ligament

E. Rupture of Alar Ligament (Pg.477 Injury to the right side due to hyper flexion and rotation results in increased ROM to contralateral side)

A 50 year old male patient comes into your office complaining of leg pain. He states it stared as lower back pain after a vigorous round of golf about three weeks ago, before progressing until he had pain in both his leg and back. A few days ago, the back pain got better but the leg pain is still bothering him. Even without an MRI, what do you suspect is going on? A. Herniation of cervical disk B. A healing lumbar vertebral fraction C. Laceration in a lumbar artery D. Rupture of the tectorial membrane E. Sequestration of a herniated disk

E. Sequestration of a herniated disk **p15/slide 29 of lecture, page 475 of Moore

Which of these is a feature of the posterior longitudinal ligament of the vertebral column? a) wide and strong b) runs from C1 to sacrum c) resists hyperflexion d) runs outside of the vertebral column

c) resists hyperflexion Case question: page 475 Blue box "Herniation of Nucleus Propulsus" young individuals tend to have strong, turgid IV discs that don't rupture in a vertebral fracture

A 60 year old man presents to the clinic with complaints of bothersome back pain. He is a farmer and has had to do lots of heavy lifting throughout his life. He admits to not always using the best form and tends to use his back more than he should when lifting heavy items. His pain is in his lower back and began about a week ago while he was lifting a heavy tractor part and it has not really gone away. He is having no pain in his legs. What is the most likely diagnosis? a. Herniated disc b. Prolapse c. Pulled Latissimus Dorsi d. Sequestration

a. Herniated disc (Slide 29)

The anterior longitudinal ligament prevents which of the following motions of the back? a. Hyperextension b. Hyperflexion c. All of the Above

a. Hyperextension

A 24-year-old male presents with an excruciating headache, fever, fatigue, and observed irregularities from his normal behavior. After examining the patient your findings include fever, photophobia, and neck stiffness. You are suspecting meningitis and want to treat him with vancomycin, but before starting treatment you first decide to perform a lumbar puncture to obtain a CSF sample. On this specific patient where would you insert a needle in order to perform a lumbar puncture? a. L1 b. L4 c. L5 d. L7

a. L1 *** Answer found during discussion of lecture slide 37, discussion about development of the spinal cord and where a LP would be performed on a child versus an adult***

89 year old woman presents to clinic complaining of generalized back pain for the past couple weeks. She denies recent falls or trauma and says she first noticed the pain after getting out of the Lazy-Boy to go to the bathroom. On physical exam you note a focal kyphosis and height reduction from her previous visit just two months ago during a routine wellness check. She denies any focal bony tenderness or pain in the thigh, buttock or leg. MRI and CT confirms no central canal stenosis. Plain Radiograph shows a T12 compression fracture in osteoporotic bone. Your preceptor asks for five differentials and a unique feature(s) about each that you could hang your hat on. Which choice below best applies to this patient? a. Osteoporotic spinal compression fracture: Postmenopausal women, low bone mineral density, mostly isolated fractures of the anterior spinal column b. Spinal stenosis - spinal claudication (pain in the buttock, thigh, or calf) c. Osteomalacia - hypophosphatemia, hypocalcemia, increased alkaline phosphatase levels, low levels of vitamin D metabolites, and secondary hyperparathyroidism. d. Thoracolumbar spine trauma - history of mechanical trauma e. Osteoporosis - typically presents with normal serum calcium, phosphorus, alkaline phosphatase, vitamin D, and PTH levels

a. Osteoporotic spinal compression fracture: Postmenopausal women, low bone mineral density, mostly isolated fractures of the anterior spinal column

What ligament of the vertebral column functions to resist hyperflexion and prevent posterior herniation of nucleus pulposus? a. Posterior longitudinal ligament b. Ligamenta flava c. Interspinous ligaments d. Nuchal ligament

a. Posterior longitudinal ligament Vertebral column - slide 13

A 28-year old male is brought in to the emergency department following a motorcycle accident. He is conscious and oriented to person place and time. He appears to be moving all 4 extremities as he is flailing them in his state of extreme pain. He asks you if you can take off the collar around his neck as it is making him more uncomfortable. You explain to him that you need to stabilize his cervical spine until you know the extent of his injury and that you are worried he may have a fracture of his dens. Which of the following is false regarding this type of fracture. a. The dens is at risk for injury due to its location on the atlas. b. The transverse ligament of the atlas may become interposed between fragments, making this an unstable fracture. c. Avascular necrosis may occur because the dens no longer has a blood supply. d. The most common location of fracture of the dens is at the base.

a. The dens is at risk for injury due to its location on the atlas. Blue box "Fracture of Dens of Axis" p.476

Until what age are the intervertebral discs vascularized via blood vessels in the cartilage endplates? a. 5 b. 7 c. 11 d. 19 e. 20

b. 7 *** Answer found on lecture slide 24 ***

A boxer comes into your office a day after a fight. During this fight he was knocked out by a strong right hook while his head was in the flexed position, causing his head to rotate forcefully. Today he today he has noticed one side of his neck seems to be more flexible and he can rotate in that direction farther than the other. Rupture of what ligament would allow this to happen? a. Transverse ligament of the Axis b. Alar ligaments c. Tectorial membrane d. Apical ligament

b. Alar ligaments Moore pg. 477

What ligament serves as an attachment for neck muscles? a. Ligamenta flava b. Nuchal ligament c. Posterior longitudinal ligament d. Anterior longitudinal ligament

b. Nuchal ligament

Which structure prevents hyperflexion of the vertebral column? a. Anterior longitudinal ligament b. Posterior longitudinal ligament c. Ligamenta flava d. Vertebral body

b. Posterior longitudinal ligament (slide 10)

A 75-year-old male presents to your clinic for his yearly Medicare wellness visit. While taking his vitals you confirm that he is 5 feet 9 inches tall. He has concerns about "shrinking" and mentions that he used to be closer to 5 feet 11 inches "back in the day." What is a correct and most likely explanation for your patient's height related change? a. He consumed too much caffeine as a child. b. b. As we age, the discs between our vertebrae tend to become more dry, granular, and decrease in size. c. As we get older, the thicker discs are replaced with a thin layer of bone causing an overall decrease in height. d. His decrease in height is most likely related to a lack of calcium in his diet.

b. b. As we age, the discs between our vertebrae tend to become more dry, granular, and decrease in size. Moore Blue Boxes p 474

Which is true regarding the annulus fibrosus of the intervertebral discs? a. The posterior portion is thicker than the anterior portion b. it is made up of collagen fibers, arranged obliquely at 30 degree angles c. It is the portion of the intervertebral disc that acts as a fulcrum for movement d. All of the above are true

b. it is made up of collagen fibers, arranged obliquely at 30 degree angles

Bria is a strong, healthy woman who exercises regularly, eats a healthy diet and drinks lots of water. On one of her adventurous climbing expeditions in Red Rock Canyon, she had a violent fall where Donna couldn't catch her in time and her thoracic spine hit the ground first. She heard a loud crack and had immediate pain in her back, and being smart she did not move and had Donna radio for a Life Flight; the flight medics got her C-spine immobilized on a backboard and out of the canyon to the nearest Level 1 Trauma Center (Don't worry, they took Donna too, as she is an excellent copilot). In the trauma bay, the burly ED PA determined that Bria was hemodynamically stable, had sensation and ability to move both feet, and her back pain, although severe, was localized and did not radiate. Step-off was noted at the level of T10. What is the nature of Bria's injury? a) vertebral fracture with intervertebral disc herniation b) vertebral dislocation with intervertebral disc rupture c) vertebral fracture without disc rupture d) Intervertebral disc rupture without vertebral fracture

c) vertebral fracture without disc rupture Other question: slides 10 and 11

A 24 year old male is brought to the ER after hitting his head on the bottom of the pool after diving in a "no diving" zone. Your immediate concern is assessment for Jefferson fracture with rupture of the transverse ligament of the atlas. CT scan shows fragmentation of the anterior arch and outward shifting of lateral masses of C1. What is the likely outcome of this trauma? a. Eventual complete recovery as this type of fracture is mild b. Partial paralysis of lower body and legs c. Complete paralysis including trunk and all four limbs d. Immediate death as this type of fracture is incompatible with life

c. Complete paralysis including trunk and all four limbs Blue boxes pg 458-459

Which of the following ligaments consists of the transverse ligament of the atlas and the superior and inferior longitudinal bands. a. Alar ligament b. Supraspinous ligament c. Cruciate ligament of the atlas d. Ligamenta flava e. Nuchal Ligament

c. Cruciate ligament of the atlas Slide 16 of Vertebral Column and p. 469 in Moore

A mature woman presents to your clinic complaining of a history of antalgia with frequent episodes of acute low back pain. She tells you that she does a lot of heavy lifting for her job, and denies any leg pain. Based on her physical signs, what do you think is most likely going on with your patient? a. Prolapse b. Sequestration c. Disc Degeneration/Bulge d. Extrusion e. Pregnant

c. Disc Degeneration/Bulge *** Answers found on lecture slide 29 ***

Which of the following is incorrect regarding the intervertebral discs of the spine? a. They are composed of fibrocartilage b. They are composed of an annulus fibrosis (ring) and nucleus pulposis (fleshy center) c. The posterior portion is thicker with the nucleus pulposis lying anteriorly d. The discs are flexible and become deformed with vertical force to the s

c. The posterior portion is thicker with the nucleus pulposis lying anteriorly (slides 5-7, lecture 2)

Patrick and Christina go into the clinic to visit a PA. Patrick has had some recent neck pain, especially when nodding "yes" because his wife is always right. Which of the following joints is experiencing some inflammation and causing Patrick's cervical pain? a. Alanto-Axial Joint b. Intervertebral Joint c. Sacro-iliac Joint d. Alanto-Occipital Joint

d. Alanto-Occipital Joint

Which ligament of the vertebral column prevents hyperextension? a. Supraspinous b. Ligamenta flava c. Posterior longitudinal d. Anterior longitudinal

d. Anterior longitudinal

A 25-year old hockey player presents to the clinic after suffering a herniated intervertebral disk in his neck. The herniated disk is compressing the spinal nerve that is exiting through the intervertebral foramen between the 5th and 6th cervical vertebrae. Which spinal nerve is being compressed? a. C 5 b. C 4 c. C 7 d. C 6

d. C 6

An 83 year old caucasian woman comes into your clinic complaining of back pain. While taking her history you find that this has been an issue for several years and she explains that it is starting to interfere with her ability to go to bingo every Thursday evening and she has had difficulties grocery shopping. During the physical, you note that the patient has a significant hunchback. Which of the following terms correctly correlates with her posture? a. Scoliosis b. Excessive lordosis c. Hemivertebra d. Excessive kyphosis

d. Excessive kyphosis

What is the spinal cord NOT protected by? a. Vertebra b. Muscles c. Spinal Meninges d. Sacrum e. Cerebral Spinal Fluid

d. Sacrum Slide 32

You are caring for a 22 year old male in the emergency department who presented with a fever of 102.6F, nausea, headache, and severe neck pain with rigidity. You recommend to this family that he undergo a lumbar puncture because you are very concerned for meningitis, an inflammation of the layers of tissue which surround the spinal cord and brain. Which of the following is false regarding the meninges? a. They are comprised of three layers: the pia mater, arachnoid mater, and dura mater b. The dura mater is innervated by the recurrent meningeal nerves, which become irritated with meningitis c. The arachnoid mater has spider-like extensions that anchor the meningeal layers together. d. The cerebrospinal fluid is primarily enclosed beneath the innermost pia mater, covering the surfaces of the brain and spinal cord

d. The cerebrospinal fluid is primarily enclosed beneath the innermost pia mater, covering the surfaces of the brain and spinal cord (slides 42-45. The CSF is primarily within the subarachnoid space between the arachnoid mater and pia mater, and the pia mater directly covers the spinal cord/ brain)

A 68-year old female presents to her primary care clinic expressing concern about bothersome pain in her low back and buttocks, as well as recent numbness and tingling in her thigh. She denies any recent bowel or bladder incontinence. After thorough evaluation and examination, the patient is diagnosed with lumbar disc protrusion. At what vertebral level do 95% of lumbar disc protrusions occur? a. L4-L5 b. L3-L4 c. L5-S1 d. A&B e. A&C f. All of the above

e. A&C

Considering the vertebral column, the intervertebral discs can be said to a. Account for 20-25% of the height of the vertebral column b. Allow movement of the column c. Act as a shock absorber d. Be made up of annulus fibrosus and nucleus pulposus e. All of the above

e. All of the above *** Answers found on lecture slide 5 ***

In which area(s) of the spine are intervertebral discs absent in an adult? Lecture Slide 5 a. Between C7 and T1 b. Between C1 and C2 c. Between L5 and S1 d. A and B e. B and C

e. B and C

What is NOT true about the intervertebral discs of the vertebral column? a. They act as shock absorbers b. They allow for movement of the spinal column c. They insert in articular surfaces of vertebral bodies inside epiphyseal rings d. They are made up of annulus fibrosus and a nucleus pulposus e. They account for 15-18% of the height of the vertebral column

e. They account for 15-18% of the height of the vertebral column Slide #5