Download Spinal Anatomy - Circle of Docs

Spinal Anatomy
1. Taste fibers lie within which nucleus:
a. Nucleus solitarius – sensory nucleus for CN VII, IX, X
b. Red nucleus – in midbrain; rubrospinal tract does the proximal muscles of
the upper extremity
c. Lentiform nucleus – part of globus pallidus that inhibits thalamus
d. Caudate nucleus -- part of globus pallidus that inhibits thalamus
2. What is the dermatome level of the xiphoid process:
a. T-4 – nipple
b. T-6
c. T-8
d. T-10 – umbilicus
3. Which part of a rib is most easily broken:
a. Neck
b. Head
c. Tubercle
d. Shaft – “angle” would be better answer
4. Through which opening does the vertebral artery enter the skull:
a. Foramen magnum
b. Jugular foramen – CN IX, X, XI, jugular vein
c. Foramen lucerum – nothing goes through it; it closes in adult life
d. Hypoglossal canal – CN XII
5. The neonatal spheno-occipital joint is classified as a ______________ joint.
a. Syndesmosis
b. Synchondrosis
c. Diarthrodial
d. Symphysis
6. Which of the following cranial nerves is responsible for taste sensation from the
palate:
a. V – general sensation, anterior 1/3
b. VII – taste from hard and soft palate and anterior 2/3 of tongue
c. IX – posterior 1/3 taste and sensation
d. X – epiglottis, and there is some taste there
7. Afferent fibers for taste from the posterior 1/3 of the tongue pass through which
of the following openings:
a. Jugular foramen
b. Foramen ovale
c.
Rotate to the max; oval man; spin the middle
Foramen rotundum – maxillary
Foramen ovale – mandibular
Foramen spinosum – middle meningeal
8. The optic canal passes through the __________ of the sphenoid bone
a. greater wing
b. lesser wing
c. petrous portion
d. sella turcica
ophthalmic artery and optic nerve pass through optic canal through greater wing of
sphenoid
9. In which part of the spine are the intervertebral foramen directed anterior and
inferior:
a. Cervical – 45 degrees anterior, 15 degrees inferior
b. Thoracic – lateral
c. Thoracolumbar – lateral
d. Lumbar – lateral
10. The inferior border of the intervertebral foramena is formed by the
a. Vertebral body
b. Intervertebral disc
c. Ligamentum flava
d. Superior vertebral notch
Superior and inferior – pedicles (vertebral notches are on pedicles)
Posterior – facet
Anterior – vertebral body
11. Which feature of a typical vertebra functions as a lever arm for the attached
musculature:
a. Pedicle
b. Lamina
c. Transverse process
d. Mammillary process
semi-spinalis, multifidus, rotators: subluxation muscles; considered contralateral
rotators; more recently, considered basically receptors
12. The groove for the vertebral artery is located on which of the following vertebrae:
a. C-1 – sulcus arterio vertebralis
b. C-2
c. C-6
d. C-7
C-1 nerve innervates the suboccipital muscles and the vertebral artery
Suboccipital muscle that attaches to the dura: rectus capitus posterior minor
C-2 – greater occipital
13. What is the orientation of the superior articular facets in the lumbar spine:
a. Posteromedial
b. Posterior
c. Posterolateral
d. Posterior to superior
Cervical spine, inferior facets: AIL (anterior, inferior, lateral);
Thoracics: AIM (anterior, inferior, medial)
Lumbars: AIL
Superior facets: BUM, BUL, BUM
14. Which of the following ribs articulates with a full costal facet on the vertebral
body:
a. T-3
b. T-6
c. T-9
d. T-12
Ribs 1, 10, 11, 12 articulate with a full costal facet
Rib always articulates with the same level vertebral body and the one above
15. Cranial nerve VII does not innervate which of the following muscles
a. Frontalis
b. Masseter
c. Buccinator
d. Mentalis
Muscles of mastication: TIME
16. Paralysis of the superior oblique muscle will result in inability to move the eye in
which of the following directions:
a. Inferior and lateral
b. Inferior and medial
c. Superior and lateral
d. Superior and medial
17. The muscles of mastication are derived from which of the following:
a. Mesoderm of the pharynx
b. Ectoderm of the mouth
c. Neural crest cells of pharyngeal arch 2
d. Mesoderm of pharyngeal arch 1
1st arch: CN V
2nd arch: CN VII
3rd arch: CN IX
4th arch: CN X
5th arch: CN X and recurrent laryngeal
18. Which of the following spinal levels innervates the detrusor muscle of the urinary
bladder and stimulates bladder emptying:
a. L-1, L-2
b. T-10, T-11
c. L-5, S-1
d. S-2 to S-4 – parasympathetic; pelvic splanchnics; all the other splanchnics
are sympathetic
19. Which branch of the pudendal nerve supplies the levator ani muscle:
a. Perineal
b. Inferior rectal
c. Middle rectal
d. Dorsal penial
S2-S4 keeps it off the floor (poo and penis/clitoris)
20. Which of the following innervates the dura mater, posterior longitudinal ligament,
the intervertebral disc at the level the nerve enters and the intervertebral disc
above:
a. Ventral root
b. White rami
c. Dorsal root
d. Recurrent meningeal nerve
Comes off the ventral root, re-enters the IVF and innervates the dura, PLL, and disc
21. Which of the following ligaments attaches to the spinous process:
a. Posterior longitudinal
b. Anterior longitudinal
c. Flaval
d. Nuchal
22. Which of the following ligaments attaches the sacrum to the ischium:
a. Anterior sacroiliac
b. Posterior sacroiliac
c. Interosseous sacroiliac
d. Sacrotuberous – makes up floor of lesser sciatic foramen; attaches sacrum
to ischial tuberosity
e. Sacrospinous – divides greater and lesser sciatic foramen; goes from
sacrum to ischial spine
lesser sciatic foramen PIANO – pudendal nerve, internal pudendal artery, nerve to
obturator internus
greater sciatic foramen – piriformis, sciatic nerve, gluteal nerves and arteries
(inferior to glut max; superior to glut min, med)
sciatic nerve passes through piriformis in 20% of people
23. Which of the following ligaments limits rotation in the upper cervical spine:
a. Tectorial – is the posterior longitudinal ligament above C2 (PLL turns into
tectorial above C2)
b. Alar – limits rotation; goes from occipital condyles to the lateral grooves
of dens/odontoid
c. Apical – from anterior foramen magnum to tip of dens
d. Transverse – from anterior arch of atlas around back of dens to the other
arch of atlas
24. Which ligament connects adjacent laminae:
a. Capsular – around joints
b. Posterior longitudinal – back of bodies
c. Flaval
d. Nuchal – supraspinous ligament above C7
25. Which of the following ligaments attaches the basilar portion of the occiput to the
posterior body of C-2:
a. Anterior atlanto-occipital
b. Apical
c. Posterior atlanto-occipital
d. Atlanto cruciform – transverse and cruciate ligaments
26. Which of the following ligaments is responsible for the prevention of
hyperflexion in the cervical spine:
a. Anterior longitudinal
b. Alar
c. Tectorial membrane (PLL in cervical spine)
d. Transverse ligament of atlas
PLL limits flexion
Alar limits rotation
ALL limits extension
Transverse prevents anterior translation of atlas
27. Which sinus drains into the internal jugular vein:
a. Greater petrosal
b. Lesser petrosal
c. Sigmoid
d. Cavernous
28. Which of the following arteries supplies the pre-motor cortex:
a. Anterior and middle cerebral – frontal lobe; everything in the frontal
lobe is supplied by anterior cerebral artery with 1 exception: Broca’s
speech area, which is in the inferior frontal lobe and supplied by middle
cerebral artery
b. Anterior and posterior cerebral
c. Middle and posterior cerebral
d. Middle and internal carotid
Middle cerebral artery goes to temporal and parietal lobes
Posterior cerebral artery goes to occipital lobe
Internal carotid becomes the anterior and middle cerebrals
29. Cerebrospinal fluid in the lateral ventricles flows next to the ______________.
a. Third ventricle
b. Fourth ventricle
c. Foramen Lushka
d. Cerebral aqueduct
30. Leptomeninges are composed of:
a. Pia and dura
b. Dura and arachnoid
c. Pia and arachnoid
d. Periosteum and dura
Pachymeninges = dura mater
31. Which of the following cells are phagocytes in the central nervous system:
a. Oligodendrocytes – myelinate
b. Microglia – phagocytes in CNS
c. Astrocytes – blood brain barrier
d. Monocytes – blood born phagocytes; turn into macrophages when they get
to tissues
e. Macrophages – tissue phagocytes
32. Which of the following muscles is innervated by the dorsal primary rami:
a. Teres minor
b. Trapezius
c. Rhomboid major
d. Longissimus
33. Entrapment of the superficial peronial nerve at the fibular head causes loss of
which function:
a. Eversion of the foot
b. Inversion of the foot
c. Dorsiflexion of the foot
d. Flexion of the great toe
34. Which of the following muscles is innervated by the glossopharyngeal nerve:
a. Stylopharyngeus – only swallowing muscle not innervated by vagus
b. Palatopharyngeus
c. Salpingopharyngeus
d. Genioglossus
35. Which of the following does not contribute to the pupillary reflex:
a. Pretectal area
b. Edinger Westphal nucleus
c. Ciliary body – parasympathetic
d. Lateral geniculate body – for vision, but it’s in the thalamus and not
involved in reflex
e. Medial geniculate body – hearing
36. (Which of the following nerves, if disrupted, would interrupt bladder function)
Disruption of the bladder epithelium is transmitted by which of the following
nerves:
a. Greater splanchnic
b. Lesser splanchnic
c. Least splanchnic
d. Pelvic splanchnics
General to bladder is L1-L2
37. Which of the following are found in the olfactory epithelium:
a. Unipolar neuron of the optic
b. Unipolar neuron of the trigeminal
c. Amiotic neurons of Moll glands
d. Bipolar neurons
38. Damage to the vestibulococchlear nerve may result in which of the following
symptoms:
a. Dysarthria – difficulty speaking
b. Dysphagia – difficulty swallowing
c. Vertigo
d. Hoarseness of speech – often recurrent laryngeal, innervated by CN X
39. Which nerve has been disrupted if sensation to the medial knee, ankle and foot
have been lost:
a. Sural – comes off of tibial nerve; sensory to lateral leg
b. Medial sural branch of the femoral
c. Femoral cutaneous
d. Saphenous nerve – sensory nerve that comes off of femoral nerve and
innervates medial side of leg, ankle, and foot
e. Deep fibular – sensory to dorsum of foot
40. Which of the following ligaments holds the dens against the anterior arch:
a. Transverse fibers of the cruciform ligament
b. Superior fibers of the cruciform ligament
c. Inferior fibers of the cruciform ligament
d. Alar ligament
41. Which of the following is the most common cause of alteration in dermatomes:
a. Cutaneous nerves
b. Spinal nerves
c. 3 consecutive spinal roots
d. cranial nerves
e. this is a stupid question
A dermatome is an area of skin innervated by a single spinal nerve
42. Which of the following is a primary ossification center:
a. Pedicle
b. Neural arch
c. Transverse process
d. Mammillary process
Primary ossification centers: body, and 2 neural arches
Secondary: 2 endplates, 2 TVP’s, spinous
43. Which of the following is not a synovial joint:
a. Sternoclavicular
b. Coracoclavicular
c. Temporomandibular
d. Costovertebral
44. Which motor nerve is part of the accommodation reflex:
a. Optic
b. Abducens
c. Ophthalmic
d. Oculomotor
Accommodation – far to near vision; pupil constricts
45. Where do the preganglionic sympathetic fibers originate?
a. Anterior horn
b. Posterior horn
c. Intermediolateral cell column – T1-L2
d. Substantia gelatinosa
Immune organs only have sympathetic innervation
46. Which of the following cells line the central canal:
a. Oligodendrocytes
b. Ependymal cells
c. Astrocytes
d. Microglia
47. Which of the following ligaments prevents hyperextension of the back?
a. Anterior longitudinal – hyperextension
b. Posterior longitudinal – flexion
c. Ligamentum flavum – flexion
d. Supraspinous ligament – flexion
48. Which of the following ligaments is a continuation of the posterior longitudinal
ligament:
a. Anterior atlanto-occipital
b. Tectorial
c. Ligamentum nuchae
d. Posterior atlanto-axial
49. The neurohypophysis is derived from which of the following:
a. Diencephalon
b. Telencephalon
c. Mesencephalon
d. Metencephalon
Neurohypophysis is posterior pituitary; derived from neural ectoderm; continuation of
hypothalamus; connected via infundibular stalk; does not make hormone, but stores ADH
(vasopressin) and oxytocin
Anterior pituitary, aka Rathke’s pouch, = oral ectoderm
50. The fovea dentalis is located on which of the following vertebrae:
a. C-1
b. C-2
c. C-3
d. C-4
Fovia dentalis is the back of anterior arch/tubercle of C1 and articulates with dens
51. Which of the following makes up the blood-brain barrier:
a. Astrocytes
b. Ependymal cells – produces CSF
c. Oligodendrocytes
d. Schwann cells – myelin in PNS
52. Which cranial nerve supplies taste to the anterior 2/3 of the tongue:
a. V
b. VII
c. IX
d. X
53. Which of the following muscles is involved in adduction?
a. Supraspinatus – abduction
b. Infraspinatus – external rotation
c. Subscapularis
d. Teres minor – external rotation
54. The dorsal scapular nerve does not innervate which of the following muscles:
a. Rhomboid minor
b. Rhomboid major
c. Serratus posterior superior – not a brachial plexus muscle, so it’s dorsal
rami
d. Levator scapulae
55. The dorsal root ganglion is derived from which part of the neural tube:
a. Ectoderm
b. Endoderm
c. Mesoderm
d. Neural crest cells – anything outside cord itself
56. ________________ is the action of the medial pterygoid muscle:
a. lifts the soft palate – palotopharyngeus (CN X)
b. retraction of the jaw – lateral pterygoid
c. closing of the mandible
d. protrusion of the mandible
Lateral pterygoid is the only muscle that opens the jaw; also protrudes and retracts it; all
others close jaw
Digastrics – raise hyoid bone in swallowing; assist in opening jaw
Anterior belly of digastric – CN V
Posterior belly – CN VII
57. Which of the following forms the anterior border of the intervertebral foramen:
a. Vertebral body
b. Pedicle
c. Laminae
d. Articular pillar
58. Which of the following muscles has its origin on the C-2 spinous process and
inserts into the occiput:
a. Rectus capitis posticus major
b. Rectus capitis posticus minor – attaches to dura; implicated in migraines
c. Inferior oblique
d. Superior oblique
59. Which structure is located at the junction of the metencephalon and
myelencephalon:
a. Pontine flexure
b. Colic flexure
c. Cervical flexure
d. Midbrain flexure
Pons is between metencephalon and myelencephalon; cervical flexure is between medulla
and cervical spine; midbrain flexure is b/w mesencephalon and diencephalons
60. In which direction do the superior articulating facets face in the thoracic spine:
a. Posterolateral
b. Posteromedial
c. Anterolateral
d. Anteromedial
61. A lesion of the dorsal scapular nerve prevents which of the following actions:
a. Arm abduction
b. Arm extension
c. Retraction of the scapula
d. Protraction of the scapula – serratus anterior
62. Which of the following is responsible for the absorption of cerebrospinal fluid:
a. Oligodendrocytes
b. Ependymal cells – cells in choroids plexus; produce CSF
c. Choroid plexus – produces CSF
d. Arachnoid villi
63. The optic bud is derived from which of the following:
a. Forebrain
b. Midbrain
c. Hindbrain – met and myelin
d. Metencephalon
64. The caudate nucleus, globus pallidus and putamen are all parts of the:
a. Basal ganglia
b. Pyramidal motor system
c. General sensory distribution
d. Special sensory distribution
Basal ganglia inhibit thalamus; thalamus fires cortex; lesion to basal ganglia leads to lack
of inhibition to cortex (tremors, Parkinson’s…)
65. An outgrowth from the anterior superior iliac spine will produce loss of sensation
over which of the following parts of the thigh:
a. Anterolateral
b. Superolateral
c. Anteromedial
d. Posterior
ASIS – sartorius (weaver’s muscle)
AIIS – rectus femoris
66. Which of the following will cause contralateral rotation of deep muscles when
contracted:
a. Semispinalis
b. Iliocostalis
c. Longissimus
d. Spinalis
67. In which part of the brain are the basal ganglia located:
a. Telencephalon
b. Diencephalons
c. Mesencephalon
d. Metencephalon
68. Which of the following muscles originates from the mammillary processes in the
lumbar spine:
a. Longissimus lumborum
b. Iliocostalis
c. Rotators
d. Multifidus – subluxation muscle
69. Certain types of fibers that are parallel in the cerebellum synapse with which of
the following cells:
a. Mossy – become parallel fibers; intertwine b/w Purkinje
b. Climbing – perpendicular to mossy and Purkinje; source: inferior olive
c. Golgi
d. Purkinje – in cerebellar cortex; synapse with deep cerebellar nuclei
70. Which of the following originates in the inferior olivary nucleus and projects to
the cerebellum:
a. Climbing fibers
b. Corticospinal fibers
c. Spinothalamic fibers
d. Rubrospinal fibers
71. Where do the climbing fibers originate?
a. Inferior olivary nucleus
b. Superior olivary nucleus
c. Vestibular nucleus
d. Purkinje cells
72. What is the location of the lesion that produces bilateral hemianopsia:
a. Optic radiation
b. Optic tract
c. Optic chiasm
d. Optic nerve
Temporal fields of vision are affected; pituitary tumor
73. With right lateral lumbar flexion, which way will the vertebral body rotate:
a. Left rotation
b. Right rotation
c. Left lateral
d. Right lateral
Lateral flexion, body goes into convexity and spinous goes into concavity
74. The sensation of vibration is carried by the spinal cord to which of the following
parts of the thalamus:
a. Ventral posterolateral – vibration from body and limbs
b. Ventral posteromedial – from face
c. Ventral lateral
d. Ventral medial
75. The alpha motor neurons originate from the
a. Anterior horn
b. Posterior horn – sensory; afferent pathway
c. Lateral horn – sympathetics; IML
d. Posterior fasciculus – dorsal columns; general sensory
Classic disease of anterior horn: Lou Gehrig’s disease
76. The greater splanchnic nerve contains fibers which are considered to be:
a. Preganglionic sympathetic
b. Postganglionic sympathetic
c. Preganglionic parasympathetic
d. Postganglionic parasympathetic
Greater splanchnics – T-5-T9
Lesser – T10-T11
Least – T11-T12
77. The deltoid ligament is located ______ relative to the ankle.
a. Medial
78. Taste fibers pass through which of the following foramina in the skull:
a. Hypoglossal canal
b. Foramen ovale
c. Internal auditory meatus
d. Foramen spinosum
79. The superior articulating facets in the cervical spine face in the
_______________.
a. Anterior and superior
b. Anterior and inferior
c. Posterior and superior
d. Posterior and inferior