CHAPTER 13- The Spinal Cord and Spinal Nerves Choose the single best answer to each question. 1) Which of the following provide protection for the spinal cord? A) vertebra B) meninges C) cerebrospinal fluid D) A and B are correct. E) A, B and C are correct. 2) Place the meninges and associated spaces in order from most superficial to deepest: 1. subarachnoid space 2. pia mater 3. arachnoid mater 4. epidural space 5. dura mater 6. subdural space A) 4, 5, 6, 3, 1, 2 B) 4, 5, 6, 3, 2, 1 C) 4, 5, 6, 1, 3, 2 D) 4, 5, 6, 1, 2, 3 E) 4, 5, 6, 2, 3, 1 3) Which of the following is NOT true? A) The dura mater is composed of dense irregular connective tissue. B) The subdural space is filled with interstitial fluid. C) The arachnoid mater is the most vascular meninx. D) The subarachnoid space is filled with cerebrospinal fluid. E) The pia mater adheres directly to the spinal cord (and brain). 4) The spinal cord A) is flattened somewhat laterally. B) is characterized by thoracic and sacral enlargements. C) is longer than the vertebral column. D) is contiguous with the medulla oblongata. E) is tapered into a cone called the conus medullaris at its superior end. 5) CJ and Tye are studying a model of cross-section of the spinal cord in lab. CJ is confused about which side of the model is anterior vs. which is posterior. Tye says that it is easy to tell which side is which. What does the Tye use to distinguish between the sides of the model? A) The posterior (dorsal) side will have a ganglion on the nerve root. B) The anterior (ventral) median fissure is deeper and wider than the posterior median sulcus. C) The central canal is closer to the posterior side. D) A and B are correct. E) A, B and C are correct. 6) The gray matter of the spinal cord A) is primarily found at the periphery of the cord. B) contains the myelinated axons of motor neurons. C) contains the cell bodies and dendrites of neurons. D) excludes neuroglia. E) is shaped like the letter C or a caterpillar. 7) The gray matter of the spinal cord A) contains groups of cell bodies called tracts B) in the anterior horn contains somatic and autonomic sensory nuclei. C) in the posterior horn contains somatic and autonomic sensory nuclei. D) in the lateral horn contains somatic motor nuclei. E) All of these are correct. 8) The white matter of the spinal cord A) is divided into anterior, posterior and lateral columns. B) contains ascending myelinated axons in groups called sensory tracts. C) contains descending myelinated axons in groups called motor tracts. D) A and B are correct. E) A, B and C are correct. 9) A tumor is growing in the left lateral horns of several segments of a patient’s spinal cord. How might these tumors affect the patient? A) The patient may not be able to feel somatic sensations from the chest down. B) The patient may not be able to move the lower extremities. C) The patient may have simple difficulty regulating cardiac and smooth muscle contractions. D) A and B are correct. E) A, B and C are correct. 10) The spinal nerves A) allow communication between the spinal cord and the brain. B) have posterior sensory roots. C) have anterior root ganglia containing cell bodies of motor neurons. D) have posterior motor roots. E) exit the vertebral column anteriorly between the intervertebral discs and the vertebral bodies. 11) Spinal nerves are A) identified based on the region and level of the vertebral column from which they emerge. B) are mixed nerves containing both motor and sensory fibers. C) are all aligned with their corresponding vertebrae. D) A and B are correct. E) A, B and C are correct. 12) The connective tissue coverings of nerve fibers A) are organized in a similar manner to those of muscle fibers. B) are present only on unmyelinated nerves. C) are identical to the meninges. D) A and B are correct. E) A, B and C are correct. 13) Which of the following is NOT a branch of a spinal nerve? A) ventral ramus B) dorsal ramus C) dorsal root D) meningeal ramus E) ramus communicante 14) A patient is transported to the emergency room after being stabbed in the back several times with a broken ice pick. The attacker was apparently aiming for the spinal cord, but was not successful in penetrating the vertebrae. The physician is most worried about one wound; he mutters something about the rami communicantes. Why would the physician be concerned about damaged there? A) The rami communicantes are part of the control of the skin and the deep muscles of the back. B) The rami communicantes are part of the ANS, which controls vital functions. C) The rami communicantes are part of the control of the muscles of the limbs. D) A and B are correct. E) A, B and C are correct. 15) Which spinal nerves go directly to the tissues they supply rather than forming a plexus? A) C1 through C4 B) C4 through T1 C) T2 through T12 D) L1 through L5 E) S1 through S5 16) Which plexus supplies the skin and muscles of the head, neck, and superior part of the shoulders and chest? A) brachial B) cervical C) coccygeal D) lumbar E) sacral 17) Which nerve does NOT arise from the cervical plexus? A) greater auricular nerve B) ansa cervicalis C) transverse cervical D) phrenic E) axillary 18) Which plexus supplies the skin and muscles of the shoulders and upper extremities? A) brachial B) cervical C) coccygeal D) lumbar E) sacral 19) Which nerve arises from the brachial plexus? A) axillary B) suprascapular C) musculocutaneous D) A and B are correct. E) A, B and C are correct. 20) Which nerve does NOT arise from the brachial plexus? A) radial B) perforating cutaneous C) ulnar D) median E) medial pectoral 21) Which plexus supplies the anterolateral abdominal wall, external genitals, and part of the lower limbs? A) brachial B) cervical C) coccygeal D) lumbar E) sacral 22) Which nerve does NOT arise from the lumbar plexus? A) iliohypogastric B) ilioinguinal C) tibial D) femoral E) obturator 23) Which plexus supplies the buttocks, perineum, and lower limbs? A) brachial B) cervical C) coccygeal D) lumbar E) sacral 24) Which nerve arises from the sacral plexus? A) sciatic B) superior gluteal C) genitofemoral D) A and B are correct. E) A, B and C are correct. 25) Which plexus supplies a small area of skin in the coccygeal region? A) brachial B) cervical C) coccygeal D) lumbar E) sacral 26) Which of the following is true of a dermatome? A) It is a band of skin that provides sensory input to the CNS via one pair of spinal nerves. B) It may overlap with another dermatome. C) If it is stimulated but the sensation is not perceived, the nerves supplying it are damaged. D) A and B are correct. E) A, B and C are correct. 27) How does the spinal cord function in maintaining homeostasis? A) Nuclei in spinal cord gray matter receive and integrate incoming and outgoing information. B) Ascending tracts in white matter propagate sensory impulses toward the brain. C) Descending tracts in white matter propagate motor impulses toward effectors. D) A and B are correct. E) A, B and C are correct. 28) Which of the following spinal cord tracts is a sensory tract? A) posterior columns B) anterior spinothalamic tract C) rubrospinal tract D) A and B are correct. E) A, B and C are correct. 29) Which type of sensory information is NOT carried by spinothalamic tracts? A) proprioception B) itch C) pain D) deep pressure E) crude touch 30) Which type of sensory information is NOT carried by posterior column tracts? A) vibration B) warmth C) light pressure D) two point discrimination E) discriminative touch 31) The direct motor pathways of the spinal cord A) include the corticospinal tracts. B) include the corticobulbar tracts. C) control precise, voluntary movements. D) A and B are correct. E) A, B and C are correct. 32) Which of the following is NOT a function of indirect motor pathways in the spinal cord? A) coordinate automatic body movements B) maintain skeletal muscle tone C) coordinate body movements with olfactory stimuli D) maintain posture E) assist in maintenance of equilibrium 33) Mark goes to visit his friend, Frank, who is home on leave from the war. Frank doesn’t hear Mark call out to him because he is wearing headphones and listening to music. When Mark walks up behind Frank and taps him on the shoulder, he soon finds himself on the ground with one of Frank’s hands around his neck and the other in a fist rapidly approaching his nose. Frank’s reaction is an example of a(n) A) innate reflex. B) acquired reflex C) stretch reflex D) tendon reflex E) withdrawal reflex 34) Which of the following is NOT part of a spinal reflex arc? A) visual receptor B) sensory neuron C) integrating center D) motor neuron E) effector 35) Which of the following is NOT a somatic spinal reflex? A) stretch reflex B) tendon reflex C) pupillary reflex D) flexor reflex E) crossed extensor reflex 36) A stretch reflex A) is a monosynaptic reflex. B) occurs in response to the stretching of a muscle. C) can be observed at the elbow, wrist, knee and ankle. D) A and B are correct. E) A, B and C are correct. 37) Place the events that in a stretch reflex in the order in which they occur: 1. propagation of impulse along sensory neuron 2. generation of impulse by muscle spindle 3. integration of impulse at synapse in gray matter of spinal cord 4. activation of motor neuron in anterior gray horn 5. stimulation of muscle spindle 6. propagation of motor impulse 7. release of ACh from motor neuron 8. stimulation of muscle contraction A) 5, 2, 1, 3, 4, 6, 7, 8 B) 2, 5, 1, 3, 4, 6, 7, 8 C) 5, 2, 3, 1, 4, 6, 7, 8 D) 5, 2, 1, 3, 6, 4, 7, 8 E) 5, 2, 1, 3, 4, 7, 6, 8 38) Reciprocal innervation A) works in conjunction with the stretch reflex. B) allows the antagonist to the reflexively contracting muscle to relax. C) depends on stimulation from a collateral axon of the muscle spindle. D) A and B are correct. E) A, B and C are correct. 39) How does a tendon reflex differ from a stretch reflex? A) A tendon reflex adjusts length instead of tension. B) A tendon reflex uses Golgi tendon organs as sensory receptors instead of muscle spindles. C) A tendon reflex is more sensitive than a stretch reflex. D) A tendon reflex cannot override a stretch reflex. E) A tendon reflex is contralateral instead of ipsilateral. 40) Place the events of a tendon reflex in the order in which they occur: 1. decreased motor neuron impulse propagation 2. less ACh released 3. stimulation of tendon organ by increased tension on tendon 4. generation and propagation of impulse along sensory neuron 5. muscle relaxes reducing tension on tendon 6. activation of inhibitory interneuron 7. inhibitory interneuron hyperpolarizes motor neuron A) 3, 4, 6, 7, 1, 2, 5 B) 7, 4, 6, 3, 1, 2, 5 C) 1, 4, 6, 7, 3, 2, 5 D) 3, 6, 4, 7, 1, 2, 5 E) 7, 4, 6, 3, 1, 5, 2 41) Which of the following is NOT true of a flexor reflex? A) It is also called a withdrawal reflex. B) It moves a body part away from harm. C) It is monosynaptic. D) It is intersegmental E) It is ipsilateral. 42) Which of the following is NOT true of the crossed extensor reflex? A) It occurs with the flexor reflex. B) It allows an individual to maintain balance when withdrawing from harm’s way. C) It is contralateral. D) It involves only one spinal segment. E) It is polysynaptic. 43) Which of the following is NOT a reflex typically used for diagnosing neurological disorders? A) patellar reflex B) Babinski sign C) crossed-extensor reflex D) Achilles reflex E) abdominal reflex 44) The patellar reflex A) helps assess the function of spinal segments L2 through L4. B) may be absent in people with diabetes mellitus or neurosyphilis. C) may be stronger than normal if certain motor tracts have been injured. D) A and B are correct. E) A, B and C are correct. 45) A man gently strokes the lateral sole of his wife’s foot, and her toes curl toward the sole. He strokes his six month old baby’s foot, and the baby’s big toe flexes up toward his tibia. Should the man be concerned about the health of either his wife or his child? A) No, direction of toe curling has nothing to do with health. B) No, they are both exhibiting normal Babinski signs for their ages. C) Yes, they are both exhibiting abnormal Babinski signs for their ages. D) Yes, the baby has an abnormal Babinski sign. E) Yes, the wife has an abnormal Babinski sign. 46) A U.N. worker was part of a crew clearing land mines from a school yard. Unfortunately one of the mines went off, sending shrapnel into the worker’s neck. Now the worker’s right arm is paralyzed, but he has retained the functions of his other limbs. Which term describes his condition? A) diplegia B) hemiplegia C) monoplegia D) quadriplegia E) spinal shock 47) A 3 year old fell out of a second story window. The paramedics on the scene note that the child is areflexic below T1, with slow heart rate, flaccid skeletal muscle paralysis, and loss of somatic sensation. The child displays the signs of A) diplegia B) hemiplegia C) monoplegia D) quadriplegia E) spinal shock 48) Which of the following signs would be displayed by a patient suffering from a hemisection of the spinal cord that damaged her right posterior column and lateral corticospinal tract but not her spinothalamic tract at L2? A) loss of proprioception for the right leg B) loss of skeletal muscle contraction for the right leg C) loss of temperature and pain sensation on the left leg D) A and B are correct. E) A, B and C are correct. 49) Which patient has the best prognosis? A) transection of the spinal cord at C3 B) recently developed spinal cord compression due to a herniated disc at L4 C) transaction of the spinal cord at T8 D) hemisection of the spinal cord at C5 E) hemisection of the spinal cord at T12 50) Which of the following is NOT true of post-polio syndrome? A) It usually occurs within months of the initial infection. B) It involves a slow degeneration of motor neurons that control skeletal muscle fibers. C) It is associated with progressive muscle weakness and loss of muscle function. D) It is associated with fatigue and muscle pain. E) It is treated with exercise, drugs that enhance ACh activity and nerve growth factors.