Practice Questions for the Back (Scroll down for Answer Key)

1. A dermatome is:
a) All of the muscles innervated by a peripheral nerve
b) All of the skin innervated by a peripheral nerve
c) All of the muscle innervated by a single spinal nerve
d) All of the skin innervated by a single spinal nerve
e) All of the skin overlying a group of synergistic muscles

2. Transecting an anterior (ventral) root of a spinal nerve (rhizotomy) might be recommened to:
a) Relieve muscle weakness.
b) Reduce severe limb pain
c) Increase heart rate
d) Reduce lymph flow
e) Reduce excessive muscle tone (spasticity)

3. Lumbar spinal stenosis refers to :

a) a narrowing of the lumbar intervertebral foramina
b) a narrowing of the vertebral (spinal) canal in one or more of the lumbar vertebrae
c) a congenitally restricted dural sheath in the lumbar region
d) osteoporotic changes in the lumbar bodies that reduce lumbar movements
e) progressive abnormal shortening of the lumbar spinous processes resulting in extreme
lordosis

4. Which of the following is incorrect pertaining to the sacrum?

a) It articulates with the L5 vertebra and the lumbosacral angle
b) It articulates with the coccyx at its apex.
c) Its sacral hiatus leads to the sacral canal.
d) Its cornua articulate with the inferior articular facts of the L5 vertebra.
e) It articulates with the ilium at the auricular surface.

5. Spina bifida cystica refers to a congenital anomaly characterized by:

a) An asymptomatic bifurcation of the cauda equina
b) A division of the L5 vertebral body that is often associated with sciatica
c) A developmental defect of one or more lumbar vertebral arches that may be associated
with limb paralysis and deficiencies in bowel/bladder control
d) An abnormal division of spinal nerves so that lower limb movement control is disturbed
e) The spinous processes of all of the presacral vertebral column being bifid.

6. Which of the following is incorrect pertaining to IV discs?

a) They are traversed by blood vessels that are branches of the anterior and posterior spinal
arteries
b) They differ in thickness in different parts of the vertebral column
c) Cervical and lumbar discs are thicker anteriorly than posteriorly
d) The nucleus pulposus is primarily composed of water
e) The annulus fibrosus is composed of concentric lamellae of fibrocartilage

7. Which of the following is correct pertaining to the longitudinal ligaments of the vertebral
column?
a) Both tend to limit hyperflexion
b) Both tend to limit hyperflexion
c) The anterior limits hyperextension whereas the posterior limits hyperflexion.
d) The anterior limits hyperflexion whereas the posterior limits hyperextension.
e) Both limit lateral flexion

8. Which of the following is incorrect pertaining to the neurovascular supply of the vertebral
column?
a) The vertebral bodies are supplied exclusively by the anterior and posterior spinal arteries
b) Venous drainage is to both internal (within vertebral canal) and external venous plexuses.
c) Zygapophyseal joints are supplied by medial branches of posterior rami of spinal nerves.
d) Pain fibers from the ligamentum flavum are conveyed by (recurrent) meningeal branches of
spinal nerves
e) Proprioceptive fibers from the anterior longitudinal ligament are conveyed by (recurrent)
meningeal branches of spinal nerves.

9. Which of the following is incorrect pertaining to the lumbar cistern?

a) It contains CSF.
b) It contains the cauda equina.
c) It contains the filum terminale.
d) It typically begins in adults at L1/L2.
e) It contains epidural fat.

10. The denticulate ligaments:

a) Anchor the dural sac to the walls of the vertebral canal
b) Anchor the spinal cord to the dural sac
c) Are composed of arachnoid mater
d) Are composed of dura mater
e) Attach to the filum terminale

11. One of your patients is about to undergo emergency surgery to repair an upper abdominal
aortic aneurysm. You explain to your patient that there is a distinct risk that when he awakes
from surgery, the lower half of his body will be paralyzed. The most likely reason is that:
a) The anesthesiologist will incorrectly inject the anesthetic fluid into the spinal cord instead of
into the lumbar cistern
b) The surgeon will accidently cut into the spinal cord
c) Ligation of the aorta will interrupt blood flow to the great anterior medullary artery (of
Adamkiewicz)
d) Access to the aorta requires partial transection of the lumbosacral trunk
e) During surgery, venous thrombosis may result in a stroke.

12. The semispinalis capitis:

a) Is part of the erector spinae group of muscles
b) When acting unilaterally, rotates the head so that the face points to the ipsilateral side.
c) When acting bilaterally, flexes the neck
d) Is innervated by cervical and upper thoracic posterior rami
e) Is superficial to the splenius capitis

13. A patient complains to you of pain in a limited strip on one side of his chest and back. Upon
examination you notice that the skin associated with the T3 dermatome of that side is read with
vesicular eruptions. Which of the following is your most reasonable conclusion about your
patients illness?
a) He has symphilis
b) He has shingles (herpes zoster).
c) He has localized dermatitis
d) An underlying thoracic disease has spread through the thoracic wall to the skin.
e) It is likely that the condition will spread to surrounding dermatomes before it improves.

14. Which of the following is incorrect pertaining to typical cervical vertebrae?

a) Nearly horizontal articular facets
b) Most mobile region of the vertebral column
c) Presence of transverse foramina (foramina transversaria)
d) Presence of bifid spinous processes
e) Dislocations that are always associated with spinal cord damage

15. Which of the following back muscles is innervated by dorsal rami?

a) Latissimus dorsi
b) Levator scapulae
c) Rhomboid Major
d) Serratus posterior inferior
e) Longissimus

16. Which of the following is not a deep (or intrinsic) muscle of the back?
a) Iliocostalis
b) Longissimus
c) Semispinalis capitis
d) Serratus posterior superior
e) Spinalis

17. The splenius capitis and cervicis muscles

a) extend the head and neck
b) flex the head and neck
c) elevate the ribs, assisting in inspiration.
d) stabilize the atlas and axis
e) move the upper limb

18. Which of the following muscles have insertions on the transverse processes of vertebrae?
a) Semispinalis capitis
b) Spinalis
c) Longissimus
d) Latissimus dorsi
e) iliocostalis

Answer Key
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3)
4)
5)
6)
7)
8)
9)
10)
11)
12)
13)
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d
e
b
d
c
a
c
a
e
b
c
d
b
e
e
d
a
c