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Question 1

23619 – The vertebral canal
1: encloses the spinal cord, ending at L1, enclosed in a much longer dural sac
2: is small and circular in the thoracic region
3: contains the dorsal root ganglia of the thoracic spinal nerves
4: contains an extensive internal vertebral venous plexus in the epidural space

Answer 1

TTFT
Last 10th ed. PAGE: 425

Question 2

22199 – The sacral canal
1: contains the conus medullaris of the spinal cord
2: opens into four intervertebral foramina on each side
3: is circular in section
4: contains dura mater down to the the 2nd sacral segment

Answer 2

FTFT
Last 10th ed. PAGE: 429; 430

Question 3

15022 – The fourth lumbar vertebra
1: develops from sclerotomal mesoderm
2: is formed by fusion of caudal and cranial halves of adjacent somites
3: develops secondary centres of ossification at the tips of the spinous and transverse processes after puberty
4: ossifies from membrane

Answer 3

TTTF
Refer to Last, 10th Ed, page 415-416

Question 4

15278 – S: Rupture of the transverse band of the cruciform ligament of the atlas may be fatal because R: anterior dislocation of the dens causes pressure on the medulla oblongata

Answer 4

S is true and R is false
Refer to Last, 10th Ed, Ch 6, page 431

Question 5

23919 – The body of a lumbar vertebra
1: contains haemopoietic tissue only in childhood
2: has an arterial supply direct from the abdominal aorta
3: is wholly ossified from the ossification centre of the centrum
4: is separated from adjacent intervertebral discs by hyaline cartilage in the adult

Answer 5

FTFT
Last (10) PAGE: 431, 432.

Question 6

15365 – Lumbar vertebrae show
1: a large rounded vertebral foramen
2: a mammillary process projecting from the superior articular process
3: a body which is heart shaped
4: an accessory tubercle at the root of the transverse process

Answer 6

FTFT
Refer to Last, 10th Ed, Ch 6, page 426-427

Question 7

14987 – The lumbar triangle of Petit
1: is floored by the internal oblique muscle
2: is a common site of hernia formation
3: lies between external oblique and latissimus dorsi muscles
4: lies between external oblique and internal oblique muscles

Answer 7

TFTF
Refer to Last, 10th Ed, page 216

Question 8

15370 – The 4th lumbar nerve
1: contributes to the genito-femoral nerve
2: receives a white ramus communicans
3: gives a branch to the psoas major muscle
4: contributes fibres to the femoral and obturator nerves

Answer 8

FFFT
Refer to Last, 10th Ed, Ch 5, page 272
5.1 L4 does not contribute to the genitofemoral nerve.
5.2 L4 does not receive a white ramus. White ramus T1-L2
5.3 L4 can supply the psoas, but various sources disagree on the actually segmental supply of the psoas. Last says L1, 2, 3 means that 3: false.
5.4 L4 does contribute to the femoral and obturator nerves

Question 9

24294 – The 4th lumbar nerve
1: has no cutaneous fibres
2: receives a white ramus communicans
3: joins the 5th lumbar nerve in the psoas muscle
4: contributes fibres to the femoral and obturator nerves and common peroneal part of the sciatic nerve

Answer 9

FFFT
Last 10th Ed, Ch 5 PAGE: 317-318

Question 10

19342 – The dorsal (posterior) primary rami of spinal nerves
A. all have lateral branches innervating the skin
B. have no cutaneous branches from C1, C2
C. innervate the levator costae muscles
D. innervate the serratus posterior muscles
E. give off recurrent meningeal branches

Answer 10

C
Last 8th ed. PAGE: 18,246

Question 11

14168 – The lumbar fascia
1: is continuous with the thoracolumbar fascia and surrounds the quadratus lumborum muscle
2: forms a boundary of the lumbar triangle of Petit
3: gives origin to the external oblique muscle of the abdomen
4: is attached medially to the bodies of the lumbar vertebrae

Answer 11

TFFF
Refer to Last, 10th Ed, page 267-268

Lumbar fascia
- binds deep muscles of the back to the spine and to the transverse processes of the vertebrae.
- it is an attachment for the gluteus maximus and latissimus dorsi

4 - attach to spines and transverse processes, also attach to iliac crest, iliolumbar ligament, and ribs

Question 12

21513 – The lumbar fascia
1: consists of three lamellae
2: contains quadratus lumborum and erector spinae
3: is made up of tough fibrous tissue
4: has a posterior layer which is continuous with the thoraco-lumbar fascia

Answer 12

TTTT
Last (8) PAGE: 357

Question 13

22689 – The ligamentum denticulatum
1: is attached to the spinal cord by a continuous line
2: is attached laterally to the spinal dura
3: stabilizes the spinal cord within the spinal dura mater
4: has its lowest denticulation at the root of the first lumbar segment

Answer 13

TTTT
Last (8) PAGE: 625; 578
anchor the spinal chord to the dura mater
formed by pia mater

Question 14

22874 – The spinal pia mater
1: terminates at the level of the first lumbar vertebra
2: forms the denticulate ligaments
3: forms a posterior median septum in the subarachnoid space
4: blends with the epineurium of the spinal nerves

Answer 14

FTFT
Last (8) PAGE: 562

Question 15

12708 – The spinal dura mater
1: is firmly attached to the posterior longitudinal ligament on the body of the axis
2: is separated from the spinal canal by a layer of fat
3: is pierced segmentally by both anterior and posterior spinal nerves
4: forms a lateral projection entering each intervertebral foramen

Answer 15

TTTT
The spinal dura mater lies free of bony or ligamentous attachments except where it is attached to the membrana tectoria and the posterior longitudinal ligament on the body of the second cervical vertebra (A true). A layer of extra-dural fat contains the internal vertebral plexus (B true). The spinal nerve roots are covered by prolongations of the dura mater and pierce the dura mater within the intervertebral foramen (C and D true).

Question 16

23354 – The dura mater of the spinal cord
1: forms a covering for the spinal nerve roots as they form the spinal nerves
2: is separated from the walls of the vertebral canal by a space containing the internal vertebral venous plexus
3: extends downwards in the vertebral canal no further than the first sacral vertebra
4: is attached to the edge of the foramen magnum

Answer 16

TTFT
Last 8th ed. PAGE: 577.

Question 17

12566, 20121 – S. Injury to the anterior spinal artery in the cervical segment causes greatest ischaemia at C8 BECAUSE R. the nerve root arteries at T1 do not provide blood to the cervical part of the anterior spinal artery

Answer 17

S is true, R is true and a valid explanation of S
Last PAGE: 536.
The principal blood supply to the spinal cord is derived from anterior and posterior spinal arteries. The larger anterior spinal is formed by the union of a branch from each vertebral artery. Blood flow in the anterior spinal artery is supplemented by spinal branches of the first and eleventh intercostal arteries which anastomose with the anterior spinal artery (S true). Blood flow in the spinal branch of the first thoracic intercostal artery is directed distally rather than to the cervical part of the cord (R true and valid explanation of S).

Question 18

21045 – S. Damage to the arteria radicularis magna (Adamkiewicz) is unlikely to cause spinal cord infarction BECAUSE R. the anterior spinal artery provides an adequate blood supply to the spinal cord

Answer 18

both S and R and false
Last PAGE: 536

Question 19

15236 – Arterial blood is supplied to the spinal cord mostly from
A. the intercostal vessels
B. vessels entering the cervical intervertebral foramina
C. branches of the lumbar vessels
D. the vertebral arteries
E. the costo-cervical trunks

Answer 19

D
Refer to Last, 10th Ed, Ch 7, page 486

Question 20

23359 – The internal vertebral venous plexus
1: has numerous venous valves
2: drains into posterior intecostal veins
3: acts as a venous collateral in obstruction of the inferior vena cava
4: receives the basivertebral veins

Answer 20

FTTT
Last (8) PAGE: 577

Question 21

7090, 19336 – Which of the following pairs of spinal nerves supply adjacent
dermatomes on the trunk?
A. C3 and T1
B. C4 and T1
C. C4 and T2
D. C4 and T3
E. None of the above

Answer 21

C
ANATOMY Page 77 of 215. Last 8th ed. PAGE: 24.
C4 supplies neck skin around the clavicle and upper chest extending from the trunk as a cowl over the shoulder tip. T2 is the next dermatome below C4 on the trunk. The dermatomes of C5 to T1 have been drawn out onto the arm skin and do not extend to the trunk.

Question 22

20769 – S. In the Brown-Sequard syndrome (hemisection of the spinal cord) there is paralysis and loss of touch and kinaesthetic sense, below the level of the lesion BECAUSE R. the hemisection of the spinal cord lesion interrupts the lateral corticospinal tract and posterior column on the opposite side

Answer 22

S is true and R is false
Last 8th ed. Page: 632

Question 23

21518 – The approximate vertebral level of
1: the trans-tubercular plane is the 3rd lumbar vertebra
2: the sternal angle is the 4th thoracic vertebra
3: the transpyloric plane is the 1st lumbar vertebra
4: the suprasternal notch is the 3rd thoracic vertebra (upper border)

Answer 23

FTTT
Last (6) PAGE: 267, 250 & 191

Question 24

22194 – The lateral cortico-spinal tract
1: contains fibres derived mainly from cells of the frontal lobe
2: contains fibres which mainly terminate in synaptic contact with neurons of the posterior grey horn
3: contains mainly unmyelinated nerve fibres
4: is composed of crossed fibres

Answer 24

FFFT
Last PAGE: 537.

Question 25

22629 – The sacro-iliac joint
1: is a fibrous joint in young people
2: owes its stability to the neighbouring muscles
3: lies behind the bifurcation of the common iliac vessels and the ureter
4: allows only slight rotation and gliding movements

Answer 25

FFTT
Last 10th ed. PAGE: 315
1 - synovial plane joint

Question 26

22784 – The sacrum
1: articulates with the coccyx by a symphyseal joint
2: usually has four pairs of foramina on its pelvic surface
3: is completely covered by peritoneum, on its pelvic surface
4: contains the filum terminale which extends to the coccyx

Answer 26

TTFT
Last 10th ed. PAGE: 316; 428; 429

Question 27

15260 – S:The upper posterior chest wall, below the postaxial line, is supplied by medial branches of the posterior rami because R: all the posterior rami from C5-8 inclusive are drawn into the upper limb during
development

Answer 27

S is true and R is false
Refer to Last, 10th Ed, Ch 1, page 11-13