Anatomy - MSK 2 MCQ (MD2)

Which of the following structures form the anterior wall of the vertebral canal?

Which structure is deficient in the lower half of the sacrum, specifically at the sacral hiatus?

The size of the vertebral canal is generally larger in which regions, corresponding to areas of increased movement and spinal cord size?

Which statement accurately describes the spinal dura mater?

The spinal dura mater is firmly attached to which of the following?

Which of the following is a potential risk associated with injections into the epidural space?

Which of the following accurately describes the subdural space in a healthy individual?

What causes the separation of the leptomeninges (arachnoid and pia mater) from a single membrane?

What is the principal function of the denticulate ligaments?

Where do the denticulate ligaments originate from?

At approximately what vertebral level does the spinal cord typically terminate in adults?

What is the anatomical composition of the cauda equina?

What is the lumbar cistern?

Why is the L3/4 intervertebral space typically preferred for lumbar punctures?

Which of the following structures would NOT be found within the sacral vertebral canal below the S1-S2 level?

What is the anatomical landmark used to guide the injection in a caudal block?

Why might a lower dose of anesthetic be required for a caudal block compared to other types of epidural anesthesia?

During epidural anaesthesia for a C-section, where is the incision typically made?

What is the typical injection site for epidural anaesthesia during a C-section?

What is the outermost layer of connective tissue that surrounds a peripheral nerve?

What structure lies in front of the denticulate ligaments?

Which of the following spaces continues as far as the dorsal root ganglion?

What replaces the meninges beyond the dorsal root ganglion?

Which is the correct order of connective tissue layers surrounding nerve fibers, from the innermost to the outermost?

What is the functional significance of the spinal cord being unsegmented?

In an early fetus, how does the length of the spinal cord compare to the length of the vertebral column?

In adults, the spinal cord typically terminates at the level of L1, while in newborns it terminates at S1. What accounts for this difference?

Which statement best describes the relationship between the spinal nerve and the intervertebral foramen in the thoracic region?

What occurs during flexion within the spinal cord?

What is a primary function of the white matter in the spinal cord?

What is the main function of the gray matter in the spinal cord?

The intermediolateral horn is associated with autonomic nerves. Which region houses sympathetic nerves?

Which of the following spinal cord segments is associated with CN XI spinal accessory nerve?

After injecting dye into the sacral hiatus for a caudal block, the dye might reach the base of the skull. What does this suggest about the continuity of the epidural space?

A patient undergoing an epidural for pain management experiences a rapid drop in blood pressure and loss of consciousness. What is the most likely explanation for this complication, considering the anatomy of the epidural space?

A researcher is investigating the expression patterns of specific genes in the spinal cord during embryonic development. They notice that a particular gene, crucial for motor neuron differentiation, is expressed in the ventral horn but not in the dorsal horn. Based on your understanding of spinal cord organization, where would you expect to find the cell bodies of the neurons most directly affected by this gene?

A surgeon is planning a procedure to place a catheter into the epidural space for continuous pain relief. They want to insert the catheter as far cranially as possible while avoiding any risk to the spinal cord itself. Considering the relationship between the vertebral levels and the termination of the spinal cord and dural sac, what is the most cranial vertebral level at which the surgeon could safely insert the catheter without risking spinal cord injury?

Which of the following best describes the extent of the vertebral canal?

Which of the following is a component of the posterior wall of the vertebral canal?

Which of the following structures is located within the epidural space?

What causes separation of the arachnoid and pia mater?

The spinal cord ends at approximately what vertebral level in adults?

What is the filum terminale internum?

Which of the following correctly describes the order of meningeal layers from superficial to deep?

What occupies the subarachnoid space?

Why is the L3/4 intervertebral space often preferred for lumbar punctures?

For a planned C-section, which space is targeted using a spinal block?

Which of the following best describes the function of the denticulate ligaments?

During a caudal block, what is the target site for anesthetic injection?

What type of tissue replaces the meninges beyond the dorsal root ganglion (DRG)?

What is the primary reason why a lower dose of anesthetic may be required for a caudal block, compared to other epidural approaches?

What is the functional significance of the spinal cord being described as 'unsegmented'?

How does the position of the spinal cord within the vertebral canal change during spinal flexion?

Which of the following is the MOST accurate description of the dura mater's attachment within the vertebral canal?

A patient is undergoing a procedure where an injection is made into the subarachnoid space of lumbar spine. What might be seen in a sample from the injection?

The epidural space extends a short distance into each intervertebral foramen. What is its relationship with the dura mater in that area?

How do the attachments of the dura mater contribute to its function of protecting the spinal cord?

Lumbar lordosis affects the spinal cord and vertebral column. How does?

Where does the spinal cord receive input and send axons?

The filum terminale is important to several procedures. Which statement about it is true??

A herniated disc impinging directly on the spinal cord at the T8 level would most likely affect which type of nerve fibers?

A neurosurgeon is performing a delicate surgery near the foramen magnum and is concerned about accidentally compromising the blood supply to the spinal cord. Which of the following arterial structures is MOST at risk during this procedure?

Compare the spinal cord in early fetus versus birth. What statement is true?

If a dye is injected into the epidural space at the sacral hiatus, where might the dye reach?

What would NOT be found in the sacral vertebral canal below the S1-S2 level?

What are the layers of connective tissue around the nerve fibers from innermost to outermost?

A surgeon is performing an incision during an epidural for a C-section delivery. Where is the incision made?

Where do the spinal rootlets of CN XI Spinal Accessory Nerve branch?

What information is needed to judge the abdominal wall dermatomes for an epidural?

What is in front of the denticulate ligaments?

How does lumbar spinal stenosis, characterized by a narrowing of the vertebral canal, typically affect the position of the spinal cord and nerve roots?

Imagine you're explaining referred pain patterns to a medical student. A patient experiencing severe angina (chest pain due to heart ischemia) also reports pain in the T2 dermatome along the inner aspect of their left arm. How would you explain the anatomical basis for this phenomenon, related to the organization of the spinal cord?

During a surgery to relieve a spinal cord compression, the surgeon notes that the patient's dura mater is abnormally adherent to the overlying bone. What is the MOST likely consequence of this abnormal adhesion in the context of spinal cord function?

A researcher is developing a novel drug delivery system targeting the spinal cord. They want to ensure the drug reaches the dorsal horn, specifically affecting neurons involved in pain processing. Considering the anatomical barriers and structures surrounding the spinal cord, which of the following delivery methods would likely be MOST effective in achieving this targeted delivery?

Following a traumatic injury, a patient is diagnosed with a complete spinal cord transection at the level of T10. Although the patient undergoes extensive rehabilitation, which of the following functions would MOST likely be permanently lost, given the anatomical characteristics of the spinal cord?

A patient reports loss of pain and temperature sensation only on the left side of their body, but with preservation of light touch and proprioception after a spinal cord injury. Based on your understanding of spinal cord tracts, which anatomical location is MOST likely affected by this injury based on the information in this presentation?

A researcher discovers a novel proteoglycan within the vertebral canal that appears to dynamically regulate the diffusion of molecules across the dura mater. If this proteoglycan were selectively degraded, which of the following consequences would MOST likely be observed?

A patient presents with progressive spasticity and hyperreflexia in the lower extremities following a spinal cord injury. Imaging reveals a localized area of dural adhesion to the posterior longitudinal ligament. Which mechanism would BEST describe the pathophysiology of the patient's symptoms?

A team of neuroanatomists is investigating the structural determinants of spinal cord flexibility and resilience to trauma. They hypothesize that the arrangement and material properties of the connective tissue layers surrounding nerve fibers (endoneurium, perineurium, epineurium) are critical. If they were to selectively disrupt the perineurium in a controlled experiment, which of the following outcomes would be MOST probable?

A researcher is developing a novel technique to selectively ablate specific nerve rootlets in the spinal cord to treat chronic pain. To optimize the precision and minimize off-target effects, which anatomical landmark would provide the MOST reliable guidance for targeting specific nerve rootlets during the procedure?

During a surgical procedure to relieve spinal cord compression, a surgeon inadvertently disrupts the venous drainage from the anterior internal vertebral plexus. Which of the following immediate physiological consequences is MOST likely?

A genetic study identifies a mutation that disrupts the normal development and function of the filum terminale. Which of the following clinical manifestations would MOST likely be associated with this mutation in an adult patient?

A researcher discovers that a novel virus selectively targets and destroys cells within the intermediolateral horn of the spinal cord. Considering the function of this region, which of the following symptoms would MOST likely be observed in an infected individual?

A patient with severe lumbar spinal stenosis experiences relief of radicular pain by assuming a flexed posture (e.g., sitting, bending forward). What is the MOST likely anatomical explanation for this phenomenon?

During an autopsy, it is observed that the spinal dura mater is abnormally thickened and calcified. This condition would MOST likely affect:

A researcher aims to visualize the real-time dynamics of cerebrospinal fluid (CSF) flow within the subarachnoid space during various spinal maneuvers. Which imaging modality would provide the MOST comprehensive and clinically relevant assessment of CSF flow patterns?

A researcher discovers a novel, rapidly progressive condition characterized by the obliteration of the epidural space. Considering the contents of this space, which of the following immediate physiological consequences would be MOST detrimental?

A previously asymptomatic patient presents with a constellation of neurological deficits, including progressive lower extremity weakness, bowel and bladder dysfunction, and sensory abnormalities in the saddle region. Imaging reveals a space-occupying lesion within the vertebral canal. Considering the anatomical organization of the vertebral canal, which of the following locations would be MOST consistent with these findings?

A researcher is investigating the biomechanical properties of the spinal meninges in the context of traumatic spinal cord injury. They hypothesize that the arrangement of collagen fibers within the dura mater contributes significantly to its ability to withstand tensile forces. Which configuration of collagen fibers within the dura mater would BEST support this hypothesis?

A researcher is developing a novel imaging technique to visualize the real-time dynamics of cerebrospinal fluid (CSF) flow within the subarachnoid space during spinal flexion and extension. Which of the following anatomical features would MOST significantly influence the observed CSF flow patterns?

A patient undergoing a lumbar puncture experiences a persistent cerebrospinal fluid (CSF) leak, resulting in chronic intracranial hypotension. This leads to compensatory mechanisms within the brain. Which of the following is the MOST likely long-term consequence of this chronic CSF leak?

A neuroanatomist discovers a rare genetic mutation that disrupts the normal development of the denticulate ligaments. Considering the function of these ligaments, which of the following structural abnormalities would MOST likely be observed within the vertebral canal?

A researcher is investigating the effects of aging on the vertebral canal. They observe a significant decrease in the elasticity of the ligamentum flavum and increased deposition of calcium within the intervertebral discs. Which of the following biomechanical changes would be the MOST likely consequence of these age-related changes?

A patient presents with symptoms suggestive of a tethered spinal cord. Which finding in the Filum Terminale would be MOST suggestive of this diagnosis?

A forensic pathologist discovers, during an autopsy, that a deceased individual had an undiagnosed condition characterized by the complete absence of arachnoid trabeculae within the subarachnoid space. Which of the following antemortem findings would MOST likely have been associated with this condition?

A researcher is investigating the relationship between spinal cord segmentation and the vertebral column. They hypothesize that the degree of mismatch between spinal cord segments and vertebral levels varies systematically along the rostrocaudal axis. Which of the following statements accurately describes the expected pattern of this mismatch?

Which structure(s) does the median nerve innervate?

Which muscles are innervated by the ulnar nerve in the anterior forearm?

What motor function is generally associated with muscles innervated by the posterior cord of the brachial plexus?

Which muscles, with one exception, perform extension and are innervated by the posterior cord?

Through what structure does the axillary artery pass to enter the 'arm pit'?

What bony landmark is located on the lateral aspect of the humerus and is associated with innervation by the axillary nerve?

Which of the following is contained within the quadrangular space?

Which structure forms the lateral border of the cubital fossa?

What structures are contained within the cubital fossa, listed from lateral to medial?

Which of the following correctly lists the borders of the femoral triangle?

What is the primary route by which superficial veins of the lower limb enter the venous system, proximal to the knee?

Which set of structures form the borders of the popliteal fossa?

Which nerve is found within the popliteal fossa?

Which of the following is a content of the popliteal fossa?

Which of the following structures passes through the sub-sartorial canal?

Given that the sciatic nerve typically divides into the tibial and common fibular nerves, what is the appropriate way to describe the innervation of specific muscles by the “sciatic nerve”?

What structure passes from the sub-sartorial canal to the popliteal fossa?

The long head of the triceps brachii muscle forms a border for which anatomical space?

What structures are typically found within the popliteal fossa?

Which of the following structures is typically found in the femoral triangle?

What nerve is most vulnerable in fractures of the surgical neck of the humerus?

Which of the following structures is NOT typically found within the posterior triangle of the neck?

Through which structure do vessels pass from the sub-sartorial canal to the popliteal fossa?

What structures are located within the posterior triangle of the neck?

Which landmark is important to identify within the femoral triangle?

Which of the following muscles does NOT border the popliteal fossa?

What is the primary superficial venous structure that enters the saphenous hiatus?

What best describes the relative positions of the femoral vein and femoral artery as they pass through the femoral triangle?

A patient presents with a stab wound to the posterior triangle of the neck. Which of the following would MOST likely be compromised?

A surgeon operating in the cubital fossa must be especially cautious to avoid damaging which of the following structures?

Damage to what nerve would affect the ability to abduct the arm between 15 and 90 degrees?

What landmark can best be used to identify the proximal border of the cubital fossa?

A patient presents with pain in the neck radiating down the arm, and an MRI reveals compression of the brachial plexus roots as they emerge from the intervertebral foramina. Which muscles are MOST likely contributing to this compression?

A clinician assesses a patient with suspected nerve damage after a motorcycle accident. The patient exhibits weakness in wrist extension and finger abduction. Based on this presentation, which structure is most likely involved?

After a knee replacement surgery, a patient experiences numbness and tingling along the medial aspect of the lower leg and foot. Which of the following is the MOST likely explanation, considering the anatomical structures in the region?

Which of the following BEST describes the path of the great saphenous vein prior to its termination?

What anatomical relationship explains the proximity of the sciatic nerve to the piriformis muscle in the gluteal region?

A patient experiencing chronic lower back pain is diagnosed with compression of the lateral femoral cutaneous nerve. Where would the patient most likely experience symptoms?

Following a traumatic injury, a patient exhibits weakness in knee extension and loss of sensation over the anterior thigh. What nerve is MOST likely affected?

A patient reports experiencing paresthesia (numbness and tingling) in the medial aspect of their thigh. This symptom would MOST likely indicate involvement of which nerve?

A marathon runner develops pain and numbness in the plantar aspect of their foot. What anatomical region is MOST likely the site of nerve entrapment?

A patient presents with foot drop (inability to dorsiflex the foot) following a sports injury. Which nerve is MOST likely compromised?

A surgeon is planning to harvest the saphenous vein for a coronary artery bypass graft. The surgeon needs to make an incision along a safe path that avoids potential nerve damage. What region would be the SAFEST approach to the saphenous vein?

After meticulously dissecting the posterior triangle of the neck, a surgical team identifies a previously undocumented anatomical variation. Instead of traversing the triangle as expected, the accessory nerve (CN XI) pierces the splenius capitis muscle before emerging near the trapezius. If, during a subsequent surgical procedure, the nerve is inadvertently damaged within the splenius capitis, which of the following specific functional deficits would MOST likely be observed, considering the nerve's pre- and post-splenius course?

During a complex reconstructive surgery involving the cubital fossa, a surgeon encounters significant anatomical distortion due to prior trauma. To accurately identify the median nerve amidst the altered tissue planes, which of the following strategies would provide the MOST reliable means of differentiating it from the radial and ulnar nerves at this specific location, considering their respective relationships to the surrounding structures?

A medical student is asked to describe the structural and functional consequences that would arise from the selective ablation of the arachnoid trabeculae within the subarachnoid space of the spinal cord. Which of the following responses would demonstrate the MOST comprehensive and accurate understanding of the trabeculae's role?

A researcher is investigating the microstructural adaptations of the filum terminale in individuals with congenital tethered cord syndrome. They hypothesize that altered collagen fibril orientation within the filum contributes to its reduced elasticity. Which of the following experimental findings would BEST support this hypothesis?

A novel neurotoxin selectively targets the chloride channels within the satellite glial cells surrounding dorsal root ganglion (DRG) neurons. How will this impact pain?

During a microsurgical procedure to decompress the brachial plexus in the posterior triangle of the neck, a surgeon encounters an anomalous anatomical variation: the roots of the brachial plexus emerge through the scalenus medius muscle, rather than between the anterior and middle scalene muscles. If gentle retraction of the scalenus medius is required to access and release the compressed nerve roots, which of the following potential complications poses the GREATEST immediate risk to the patient?

A pharmaceutical company is developing a novel drug targeting pain management by selectively enhancing the function of perineurial cells surrounding peripheral nerves. What is the MOST likely mechanism?

Consider a patient presenting with paresthesia (numbness and tingling) exclusively along the medial aspect of their thigh. What surgical intervention would MOST likely address this patient's symptoms, considering the anatomical trajectory and typical entrapment points of the relevant nerve?

Damage to which nerve would cause the inability to oppose the thumb and consequently difficulty with fine motor tasks such as buttoning a shirt or picking up small objects?

A patient presents with a distinct sensory deficit following a penetrating injury to the popliteal fossa. The patient reports loss of pain and temperature sensation on the dorsum of the foot, but preservation of light touch and proprioception. What specific nerve is MOST likely injured?

What is the general action associated with the ventral muscles of the pectoral girdle?

Which nerve innervates the serratus anterior muscle, a key protractor of the scapula?

Which of the following muscles is innervated by the medial pectoral nerve?

Which head of the pectoralis major is more involved in arm flexion at the glenohumeral joint?

Which nerve primarily innervates the clavicular head of the pectoralis major muscle?

Which of the following muscles is considered a ventral muscle of the pectoral girdle because it originates from costal elements supplied by ventral rami?

Clinically, what action do muscles 1-3 (Serratus Anterior, Pectoralis minor and Pectoralis Major) primarily prevent?

Which of the following describes the relationship between the tendons of the clavicular and sternocostal heads of the pectoralis major muscle?

What is the general action associated with the dorsal muscles of the pectoral girdle?

Which nerve innervates the levator scapulae and rhomboid muscles?

Which of the following best describes the innervation pattern of the trapezius muscle?

Which nerve innervates the latissimus dorsi muscle?

What is the functional role of the latissimus dorsi in relation to movements at the glenohumeral joint?

Which muscle spans from the nuchal lines of the skull to approximately T12 and is involved in every scapular movement except protraction?

Where does the latissimus dorsi insert?

Why is the nerve supply to the latissimus dorsi traced from the posterior cord?

The latissimus dorsi prevents trunk flexion while _____.

What is the functional outcome of upward rotation?

Which two muscles are primarily responsible for producing upward rotation of the scapula?

Which factor most significantly impacts a person's ability to rotate the arm upwards?

Which motion is facilitated by the serratus anterior and trapezius muscles?

Which set of muscles is BEST known to cause downward rotation?

What action can downward rotators prevent?

Why is it important to have coordinated forces at corners, when making the scapula rotate?

When considering a coordinated scapular movement like retraction, what does a low trapezius-to-Latissimus Dorsi ratio usually indicate?

Clinically, if a patient exhibits weakness in both scapular retraction AND downward rotation, which nerve is the MOST likely candidate for being compromised?

In most patients, upward rotation is poor as it is posture dependent. Which posture most impacts this?

The Dorsal Scapular nerve can branch from what two location(s)?

Regarding the pectoralis major, which direction will the tendons of the respective heads cross over each other?

In general, muscles that attach from the ventral vertebral column originate from ventral osseus elements and are innervated by what?

Pectoralis Major also possess 2-3 heads generally. Which of the following is not one of the 3 main heads?

Compared to the location of the medial cord, where is the location of the lateral cord?

Which of the following is most true of isolated muscle use?

Strongest retraction when pulling through a level transverse plane best describes what?

How many muscles and tendons MUST the medial pectoral nerve bisect to reach the sternocostal head of the pectoralis major?

Dorsal muscles attach from dorsal elements of the vertebrae. From where to where do they span?

Considering the coordinated action required for scapular rotation, if a patient exhibits significantly limited upward rotation but normal strength in individual shoulder abduction and flexion, which precise combination of muscle dysfunction is MOST likely contributing to this specific functional deficit?

During a high-speed collision, a driver sustains a complex injury resulting in avulsion of the ventral muscles of the pectoral girdle from their costal attachments, coupled with damage to the thoracodorsal nerve. Which functional compromise would be MOST pronounced, acutely, following this injury, given the interplay between trunk and upper limb movements?

A surgical resident, during a Level 1 Trauma response involving a subclavian artery injury, inadvertently severs the dorsal scapular nerve during proximal clamping. Which of the following compensatory movement strategies would the patient MOST likely develop to approximate normal shoulder function following extensive physical therapy?

An elite gymnast performing an iron cross maneuver experiences a sudden, sharp pain in their chest and axilla and presents with weakness in adduction, internal rotation, and extension of the arm. Imaging reveals a complete rupture of the sternocostal head of the pectoralis major, along with neuropraxia of the medial pectoral nerve. Which of the following biomechanical consequences would be MOST significant during subsequent attempts at similar maneuvers?

A martial artist injures their spinal accessory nerve (CN XI) during a sparring match. Post-injury, they exhibit significant weakness in shoulder elevation and rotation. If the long thoracic nerve remains intact and fully functional, what compensatory strategy could the martial artist employ to BEST approximate their pre-injury range of motion and functional capacity during an arm raise?

Consider a patient who has undergone a modified radical neck dissection for metastatic cancer, resulting in iatrogenic injury to the spinal accessory nerve (CN XI) and the dorsal scapular nerve. Despite aggressive rehabilitation, the patient demonstrates persistent drooping of the shoulder, limited abduction and flexion, and noticeable winging of the scapula. Which of the following surgical interventions would MOST effectively address the constellation of deficits?

A patient presents with a rare congenital absence of the serratus anterior muscle bilaterally. Given the critical role of the serratus anterior in scapulothoracic articulation and upper limb function, which adaptive biomechanical change is MOST likely to occur over time, and what secondary musculoskeletal pathology might this predispose the individual to?

Clinically, if a physical therapist observes a patient struggling to perform scapular protraction against even minimal resistance, and further examination reveals no palpable muscle activity in the axilla during attempted protraction, which of the following diagnostic findings would BEST confirm a long thoracic nerve injury?

A patient undergoes a surgical procedure involving the removal of a deep-seated tumor within the axilla. Postoperatively, the patient exhibits a constellation of deficits including an inability to elevate the arm above 90 degrees, weakened scapular upward rotation, and impaired shoulder abduction. Preoperative imaging revealed the rumor directly compressed the lateral cord. What specific branching nerve of the lateral cord was MOST likely compromised that resulted in the described constellation of deficits?

In a patient presenting with scapular winging attributed specifically to serratus anterior palsy, what precise biomechanical impairment explains the observed instability of the scapula against the rib cage during forward flexion of the arm?

A patient presents to a sports medicine clinic with gradually worsening shoulder pain and limited overhead reach following an intense rowing season. Clinical examination reveals marked weakness in scapular protraction, significant scapular winging upon resisted forward flexion, and noticeable atrophy along the lateral chest wall. Electrodiagnostic studies confirm significant denervation potentials within the serratus anterior muscle. Which of the following activities is MOST likely to exacerbate the patient's symptoms and further compromise their upper extremity function?

A researcher is investigating the effects of targeted gene therapy on muscle regeneration following severe trapezius muscle injury. They selectively enhance the follistatin gene, which inhibits myostatin (a negative regulator of muscle growth), specifically within the trapezius. How would you best describe the influence of the levator scapulae when using this therapy if both are injured?

Consider a patient who has undergone a mastectomy with axillary lymph node dissection, subsequently developing lymphedema and fibrosis in the axillary region. This has resulted in extrinsic compression neuropathy of the thoracodorsal nerve. To what degree would this impair the activity of the dorsal muscles? How would you expect the shoulder's ROM to change?

After a whiplash injury, a patient experiences persistent neck pain, limited cervical rotation, and an unusual sensation of scapular instability. Clinical examination reveals palpable tenderness and muscle spasm in the upper trapezius and levator scapulae, along with noticeable asymmetry in scapular positioning. Based solely on the anatomy of the dorsal muscles, how would the imbalance be BEST characterized?

During a surgical demonstration on axillary lymph node dissection, a medical student poses a hypothetical question. If the respective tendons of the Pectoralis Major heads crossed over each other, with the sternocostal tendon attaching more proximally underneath a more superficial and distal clavicular tendon insertion, what implication would this have on pectoral movement?