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FearlessIrrational

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University of Western Australia

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vertebral development embryology anatomy biology

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This document contains multiple-choice questions (MCQs) on vertebral development. The questions cover different stages of development and related skeletal anomalies. The MCQs relate to the formation of vertebral structures, and the roles of signaling (such as notochordal signaling) and gene expression (such as Hox gene expression).

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Lecture 1 1. Which of the following statements regarding the notochord’s role in vertebral development is NOT correct? A. The notochord signals the development of the vertebral column before vertebral segmentation occurs. B. Remnants of the notochord become part of the nucleus pulposus within the...

Lecture 1 1. Which of the following statements regarding the notochord’s role in vertebral development is NOT correct? A. The notochord signals the development of the vertebral column before vertebral segmentation occurs. B. Remnants of the notochord become part of the nucleus pulposus within the intervertebral discs. C. The notochord directly ossifies to form the vertebral centrum. D. Excess notochordal cells during ossification can result in a butterfly vertebra. E. Insufficient notochordal cells during ossification can contribute to block vertebra formation. Answer: C. Explanation: The notochord does not ossify; it is replaced by vertebral elements formed from mesenchymal cells. Its remnants form the nucleus pulposus. 2. During which stage of vertebral development do the paired primary centres of chondrification first form, and what do they differentiate into? A. Mesenchymatous stage; perinotochordal sheath B. Cartilaginous stage; centrum and neural arches C. Osseous stage; neural arches and costal elements D. Cartilaginous stage; costal elements and zygapophyseal joints E. Mesenchymatous stage; intervertebral discs Answer: B. Explanation: In the cartilaginous stage (6-9 weeks), paired primary centres of chondrification form the centrum, neural arches, and costal elements. 3. A neonate presents with scoliosis. Imaging reveals hemivertebrae. Which developmental error most likely caused this condition? A. Failure of re-segmentation during the mesenchymatous stage B. Failure of one primary ossification centre to form in the osseous stage C. Failure of notochordal signalling during the cartilaginous stage D. Persistent neurocentral cartilage beyond 6 years of age E. Excessive Hox10 expression in thoracic vertebrae Answer: B. Explanation: Hemivertebrae occur when one primary cartilage centre fails to form during the cartilaginous stage, causing vertebral asymmetry. 4. A mutation in Hox10 expression results in which of the following skeletal abnormalities? A. Additional ribs in the thoracic region B. Rib formation in the lumbar region C. Vertebral fusion in the cervical region D. Increased vertebral height due to delayed epiphyseal fusion E. Formation of butterfly vertebrae due to excess notochordal cells Answer: B. Explanation: Loss of Hox10 expression leads to thoracic-isation of the lumbar vertebrae, resulting in rib formation in this region. 5. In the vertebral development process, failure of segmentation during which stage is most likely to result in block vertebrae? A. Mesenchymatous stage B. Cartilaginous stage C. Osseous stage D. Secondary ossification stage E. Growth plate closure stage Answer: A. Explanation: Block vertebrae result from segmentation failure beginning in the mesenchymatous stage, affecting subsequent cartilage and bone formation. 6. During the mesenchymatous stage, sclerotome cells migrate to form which of the following vertebral structures? A. Intervertebral discs, annulus fibrosus, and nucleus pulposus B. Centrum, neural arch, and costal element C. Zygapophyseal joints, transverse processes, and mammillary processes D. Cartilage growth plates, interlaminar cartilage, and neurocentral cartilage E. Spinous processes, transverse processes, and ring epiphyses Answer: B. Explanation: Sclerotome cells migrate to form the perinotochordal sheath (centrum), neural arch, and costal elements during this stage. 7. The presence of interlaminar and neurocentral cartilage growth plates is characteristic of which stage of vertebral column development? A. Mesenchymatous stage B. Cartilaginous stage C. Osseous stage D. Secondary ossification stage E. Growth plate fusion stage Answer: C. Explanation: Interlaminar and neurocentral cartilage are growth plates present in the osseous stage, separating ossification centres. 8. Which vertebral element contributes to the formation of the zygapophyseal joints and mammillary processes? A. Centrum B. Neural arch element C. Costal element D. Spinous process E. Ring epiphysis Answer: B. Explanation: The neural arch element forms the dorsal arch, zygapophyseal joints, and mammillary processes. 9. A 12-year-old patient has vertebral anomalies due to a lack of bone deposition at the site of the nucleus pulposus. What is the most likely congenital condition? A. Hemivertebra B. Block vertebra C. Butterfly vertebra D. Thoracic-isation of lumbar vertebrae E. Spina bifida Answer: C. Explanation: Butterfly vertebra results from the persistence of too many notochordal cells, inhibiting bone deposition at the site of the nucleus pulposus. 10. Which process drives the re-segmentation of somites during vertebral development? A. Notochordal signalling to mesenchymal cells B. Vascularisation and body wall vessel development C. Hox gene expression and intersegmental artery location D. Formation of the nucleus pulposus and annulus fibrosus E. Fusion of neurocentral and interlaminar cartilage Answer: C. Explanation: Re-segmentation is driven by Hox gene expression and the location of intersegmental arteries. 1. Which of the following accurately describes the mesenchymatous stage of vertebral development? A. Formation of primary ossification centres in the centrum and neural arches B. Migration of sclerotome cells to the perinotochordal sheath, neural arch, and costal elements C. Appearance of secondary ossification centres in the spinous processes and transverse processes D. Differentiation of the notochord into the nucleus pulposus and annulus fibrosus E. Fusion of cartilage growth plates into the vertebral body Answer: B. Explanation: The mesenchymatous stage involves sclerotome migration to form the perinotochordal sheath, neural arch, and costal elements. 2. Which vertebral anomaly arises due to a failure of one cartilage centre to develop during the cartilaginous stage? A. Butterfly vertebra B. Block vertebra C. Hemivertebra D. Thoracic-isation of lumbar vertebrae E. Lumbar-isation of thoracic vertebrae Answer: C. Explanation: Hemivertebra results from the failure of one cartilage centre during the cartilaginous stage, causing vertebral asymmetry. 3. The intervertebral discs align with which developmental structure during the cartilaginous stage? A. Neural arches B. Sclerotomes C. Notochordal remnants D. Segments and somites E. Costal elements Answer: D. Explanation: Intervertebral discs develop in line with somite-derived segments, ensuring alignment. 4. During vertebral segmentation, what defines the location of a vertebral segment? A. Site of intervertebral disc development and nerve root exit B. Position of the neural arch and transverse processes C. Presence of interlaminar cartilage between vertebrae D. Hox gene activation at the thoracic-lumbar boundary E. Position of primary ossification centres in the centrum Answer: A. Explanation: Vertebral segments are defined by intervertebral disc location and where nerve roots emerge. 5. A patient is diagnosed with butterfly vertebra. What developmental abnormality most likely caused this condition? A. Excess notochordal cells inhibiting bone deposition in the centrum B. Fusion failure of neurocentral cartilage plates C. Loss of Hox10 expression during thoracic-lumbar boundary formation D. Deficient ossification of spinous and transverse processes E. Failure of sclerotome migration during the mesenchymatous stage Answer: A. Explanation: Butterfly vertebra results from excess notochordal cells inhibiting bone deposition in the centrum. 6. Which vertebral structures form directly from the costal element during development? A. Entire vertebral body and nucleus pulposus B. Ribs in the thoracic region and transverse processes in other regions C. Neural arches and zygapophyseal joints D. Spinous processes and mammillary processes E. Intervertebral discs and annulus fibrosus Answer: B. Explanation: The costal element forms ribs in the thoracic region and contributes to transverse processes in other regions. 7. How does the notochord contribute to vertebral development during the cartilaginous stage? A. It signals segmentation of somites into vertebral bodies and discs. B. It forms the nucleus pulposus of the intervertebral discs. C. It creates Hox gene expression patterns for rib formation. D. It induces the appearance of secondary ossification centres. E. It becomes segmented into individual vertebral arches. Answer: B. Explanation: The notochord forms the nucleus pulposus, with fibrocartilage forming the surrounding annulus fibrosus. 8. Which of the following is a direct consequence of Hox10 gene deletion in vertebral development? A. Excessive rib formation in the lumbar and sacral regions B. Increased height of the vertebral bodies at puberty C. Fusion of the neural arches during the osseous stage D. Retention of mesenchymal cells in the perinotochordal sheath E. Reduction in thoracic vertebrae due to lumbarisation Answer: A. Explanation: Loss of Hox10 expression causes thoracic-isation, with rib formation in the lumbar and sacral regions. 9. What is the significance of neurocentral cartilage growth plates in vertebral development? A. They allow the ribs to attach to transverse processes. B. They separate primary ossification centres in the vertebral body and neural arches. C. They differentiate into secondary ossification centres in the spinous processes. D. They contribute to the formation of the intervertebral disc’s annulus fibrosus. E. They signal the re-segmentation of somites into intervertebral structures. Answer: B. Explanation: Neurocentral cartilage growth plates separate ossification centres in the vertebral body and neural arches during development. 10. In the osseous stage, which process contributes to the continuation of vertebral growth beyond birth? A. Formation of secondary ossification centres in the ring epiphysis B. Closure of interlaminar and neurocentral cartilage growth plates C. Proliferation of hyaline cartilage in the costal elements D. Persistence of intersegmental arteries between vertebrae E. Deposition of bone towards the vertebral body endplates Answer: A. Explanation: Secondary ossification centres in the ring epiphysis contribute to vertebral growth during the osseous stage. 11. What is the primary clinical manifestation of block vertebra? A. Loss of mobility between fused vertebral segments B. Presence of a hypoplastic vertebral arch C. Structural scoliosis due to vertebral asymmetry D. Rib anomalies in the thoracic region E. Compression of intersegmental arteries Answer: A. Explanation: Block vertebra causes reduced mobility due to the fusion of vertebral segments. 12. What distinguishes the neural arch element in vertebral development? A. It forms the entirety of the vertebral body. B. It contributes to the dorsal arch, zygapophyseal joints, and lateral vertebral body. C. It fuses with the costal element to create the nucleus pulposus. D. It signals the segmentation of sclerotome cells into somites. E. It differentiates into the spinous processes and transverse processes. Answer: B. Explanation: The neural arch element forms the dorsal arch, zygapophyseal joints, and contributes to the lateral vertebral body. 23. What distinguishes the mesenchymatous stage from the cartilaginous stage in vertebral development? A. Formation of sclerotome cells into primary ossification centres. B. Migration of sclerotome cells into perinotochordal and neural arch regions. C. Replacement of mesenchyme with hyaline cartilage. D. Development of intervertebral discs from Hox gene expression. E. Fusion of interlaminar cartilage plates. Answer: C. Explanation: The cartilaginous stage is marked by the replacement of mesenchyme with hyaline cartilage, forming vertebral structures. 24. During the osseous stage, which process is responsible for continuing vertebral growth after birth? A. Proliferation of primary ossification centres in costal elements. B. Closure of neurocentral cartilage growth plates. C. Growth of the ring epiphysis, contributing to vertebral body height. D. Segmentation of somites into vertebral bodies. E. Hyaline cartilage differentiation into neural arches. Answer: C. Explanation: Growth of the ring epiphysis allows vertebral bodies to continue growing in height during the osseous stage. 25. Which Hox gene expression error is associated with lumbar-isation of thoracic vertebrae? A. Loss of Hox10 expression in lumbar segments. B. Gain of Hox10 expression in thoracic segments. C. Loss of Hox6 expression in cervical regions. D. Gain of Hox11 expression in lumbar segments. E. Gain of Hox8 expression in sacral regions. Answer: B. Explanation: Gain of Hox10 expression causes lumbar-isation of thoracic vertebrae. 26. What developmental process ensures nerve roots exit between vertebrae? A. Migration of notochordal cells into nucleus pulposus. B. Alignment of segments with intervertebral discs during somite re-segmentation. C. Appearance of secondary ossification centres at puberty. D. Formation of interlaminar cartilage between spinous processes. E. Fusion of costal elements to vertebral bodies. Answer: B. Explanation: Somite re-segmentation aligns intervertebral discs with nerve root exit sites. 27. Failure of segmentation during which stage contributes to block vertebra? A. Cartilaginous stage B. Mesenchymatous stage C. Osseous stage D. Secondary ossification stage E. Ring apophysis stage Answer: B. Explanation: Block vertebrae result from segmentation failure during the mesenchymatous stage, affecting later cartilage and bone formation. 28. Which vertebral structure forms exclusively from the costal element? A. Zygapophyseal joints in the thoracic vertebrae. B. Ribs in the thoracic region and parts of the transverse process in other regions. C. Spinous processes in lumbar and thoracic vertebrae. D. Entire vertebral bodies in the cervical region. E. Ring epiphysis in lumbar vertebrae. Answer: B. Explanation: The costal element contributes ribs in the thoracic region and transverse processes elsewhere. 29. What clinical condition may result from the persistence of neurocentral cartilage after 8 years of age? A. Scoliosis due to asymmetry in vertebral height. B. Failure of vertebral body fusion, leading to hemivertebrae. C. Thoracic-isation of lumbar vertebrae. D. Butterfly vertebra due to notochordal persistence. E. Structural weakness in the vertebral arch. Answer: E. Explanation: Persistent neurocentral cartilage can affect the integrity of the vertebral arch. 30. A neonate presents with thoracic ribs extending into the lumbar region. Which developmental process is most likely disrupted? A. Notochord segmentation during the mesenchymatous stage. B. Hox gene expression during thoracic-lumbar differentiation. C. Failure of neural arch ossification in the cartilaginous stage. D. Excess neurocentral cartilage retention in thoracic segments. E. Migration of sclerotome cells into costal elements. Answer: B. Explanation: Disrupted Hox10 expression leads to thoracic-isation, with ribs extending into the lumbar region. 31. What is the role of the nucleus pulposus in intervertebral disc function? A. Prevents vertebral fusion during mesenchymatous development. B. Facilitates segmentation by separating vertebral elements. C. Acts as a remnant of the notochord, providing shock absorption. D. Directly ossifies to contribute to vertebral height. E. Promotes bone deposition in the annulus fibrosus. Answer: C. Explanation: The nucleus pulposus, a remnant of the notochord, provides shock absorption within intervertebral discs. 32. Which of the following secondary ossification centres is responsible for increasing vertebral height during puberty? A. Spinous processes B. Ring epiphysis C. Mammillary processes D. Neurocentral cartilage E. Costal elements Answer: B. Explanation: Ring epiphysis contributes to the vertical growth of vertebral bodies during puberty. 33. Which condition results from excess nucleus pulposus formation during development? A. Block vertebra B. Butterfly vertebra C. Hemivertebra D. Spina bifida E. Thoracic-isation Answer: B. Explanation: Excess nucleus pulposus due to notochordal cell persistence causes butterfly vertebra. 34. What distinguishes vertebral growth plates from epiphyseal plates in long bones? A. Vertebral growth plates ossify earlier than epiphyseal plates. B. Vertebral growth plates allow circumferential rather than linear growth. C. Vertebral growth plates persist until age 8, unlike epiphyseal plates. D. Vertebral growth plates do not ossify but transform into costal elements. E. Vertebral growth plates do not influence height growth in vertebrae. Answer: C. Explanation: Neurocentral and interlaminar growth plates close by age 8, distinguishing them from long bone epiphyseal plates. Lecture 2 1. Which of the following evolutionary adaptations distinguishes mammalian vertebral columns from those of reptiles? A. Presence of a sacrum for weight-bearing in reptiles B. Greater flexibility of the lumbar spine to facilitate lateral undulation C. Rotation of limbs under the body, limiting lateral undulation in mammals D. Cervical vertebrae specialising for propulsion in aquatic mammals E. Increased number of thoracic vertebrae in mammals compared to reptiles Answer: C. Explanation: Mammals evolved with limbs rotated under the body, reducing lateral undulation and transferring this function to the hips. 2. How do thoracic vertebrae in humans differ in their contribution to movement compared to cervical and lumbar vertebrae? A. They have the greatest range of flexion and extension. B. They primarily permit rotation, constrained by the ribcage. C. They facilitate coupled movements of lateral flexion and rotation. D. They lack any inter-facet angle, limiting movement. E. They allow hyperextension due to tangential facet orientation. Answer: B. Explanation: Thoracic vertebrae permit rotation but are constrained in lateral flexion and flexion-extension by the ribs. 3. Which binary characteristic is used to definitively identify cervical vertebrae? A. Presence of facets for ribs B. Fused vertebrae C. Transverse foramina D. Absence of transverse processes E. Presence of zygapophyseal joints Answer: C. Explanation: Transverse foramina are a binary feature unique to cervical vertebrae. 4. A patient presents with lateral flexion deficiency in the lumbar spine. Which structural feature of lumbar vertebrae contributes to this deficiency? A. Tangentially oriented facets B. Radially oriented inter-facet joints C. Lack of transverse foramina D. Ribs restricting motion E. Absence of a nucleus pulposus Answer: B. Explanation: Lumbar vertebrae have radially oriented inter-facet joints, which interlock laterally to allow flexion and extension but limit lateral flexion and rotation. 5. Which of the following features is NOT region-specific but instead varies continuously along the vertebral column? A. Shape of the vertebral body B. Orientation of articular facets C. Presence of transverse foramina D. Rib facets E. Fusion of sacral vertebrae Answer: A. Explanation: The shape of the vertebral body varies continuously and is not exclusive to any one region, while features like transverse foramina and rib facets are region-specific. 6. What functional adaptation explains the limited ability of lumbar vertebrae to rotate? A. Presence of intervertebral discs B. Radial orientation of the inter-facet joints C. Lack of a sacrum in the lumbar region D. High tensile strength of the annulus fibrosus E. Presence of transverse foramina Answer: B. Explanation: The radial orientation of lumbar inter-facet joints prevents rotation while allowing flexion and extension. 7. The anterior component of a vertebral motion segment primarily consists of: A. Zygapophyseal joints and their associated ligaments B. Vertebral bodies and intervertebral discs C. Pedicles and laminae D. Transverse processes and spinous processes E. Articular cartilage and capsular ligaments Answer: B. Explanation: The anterior component includes the vertebral bodies, intervertebral discs, and associated longitudinal ligaments, which bear the majority of the load. 8. Which component of the intervertebral disc is responsible for transmitting compressive loads? A. Annular apophysis B. Cartilage endplate C. Nucleus pulposus D. Outer annulus fibrosus E. Zygapophyseal joints Answer: C. Explanation: The nucleus pulposus transmits compressive loads by dispersing pressure within its hydrophilic, gel-like structure. 9. During flexion of the cervical spine, which coupled movement typically occurs? A. Rotation around the nucleus pulposus B. Posterior displacement of adjacent vertebrae C. Lateral flexion in the same direction as rotation D. Axial rotation combined with lateral flexion E. Pure anterior-posterior flexion without displacement Answer: D. Explanation: Coupled movements, such as axial rotation with lateral flexion, are common in the cervical spine due to its oblique disc-facet angle. 10. Which movement is primarily constrained by the zygapophyseal joints in the lumbar spine? A. Flexion-extension B. Axial rotation C. Lateral flexion D. Coupled movements E. Anterior translation Answer: B. Explanation: The orientation of lumbar zygapophyseal joints prevents significant axial rotation while allowing flexion, extension, and lateral flexion. 1. Which evolutionary adaptation in amphibians contributed to the development of the sacrum in the vertebral column? A. Weight-bearing hindlimbs requiring force transduction B. Increased reliance on cervical vertebrae for head rotation C. Development of lateral undulation for aquatic propulsion D. Flattening of cervical vertebrae for streamlined movement E. Evolution of fused caudal vertebrae for tail propulsion Answer: A. Explanation: The sacrum evolved in amphibians to transmit forces from weight-bearing hindlimbs to the vertebral column. 2. What is the primary function of the anterior component of the vertebral motion segment? A. Controlling direction of motion B. Transmitting compressive loads C. Facilitating axial rotation D. Allowing coupled movements E. Enhancing lateral flexion Answer: B. Explanation: The anterior component, consisting of vertebral bodies, longitudinal ligaments, and intervertebral discs, transmits approximately 80% of compressive loads. 3. What structural feature allows thoracic vertebrae to facilitate rotation but limits lateral flexion? A. Orientation of zygapophyseal joints on the arc of a circle B. Radial alignment of inter-facet joints C. Presence of transverse foramina D. Increased thickness of the annulus fibrosus E. Flattened spinous processes Answer: A. Explanation: Thoracic zygapophyseal joints are tangentially aligned, allowing rotation while ribs restrict lateral flexion. 4. Which binary feature is critical for identifying a vertebra as belonging to the thoracic region? A. Absence of transverse processes B. Presence of costal facets for rib articulation C. Fusion of vertebral bodies D. Flattened vertebral foramen E. Orientation of zygapophyseal joints Answer: B. Explanation: The presence of costal facets is unique to thoracic vertebrae and is used as a binary characteristic for identification. 5. Why does the lumbar spine have limited rotational capacity compared to other vertebral regions? A. Lack of intervertebral discs in the lumbar spine B. Radial orientation of inter-facet joints interlocks vertebrae laterally C. Absence of zygapophyseal joints in the lumbar region D. Hyaline cartilage endplates restrict axial motion E. Reduced size of the nucleus pulposus in lumbar intervertebral discs Answer: B. Explanation: The radial orientation of lumbar inter-facet joints restricts rotation while allowing flexion, extension, and lateral flexion. 6. How do intervertebral discs contribute to the overall height of the vertebral column? A. Annular fibres compress during axial rotation, increasing disc thickness. B. The hydrophilic nucleus pulposus retains water, contributing to height. C. Cartilage endplates ossify, adding height to vertebral bodies. D. Annular apophysis fuses to the vertebral body, elongating the spine. E. Zygapophyseal joints prevent height loss by stabilising motion. Answer: B. Explanation: The nucleus pulposus retains water, maintaining disc height and contributing to vertebral column height, especially in the morning. 7. Which structural feature differentiates cervical vertebrae from all other vertebral regions? A. Presence of spinous processes B. Zygapophyseal joint orientation C. Transverse foramina for vertebral artery passage D. Larger vertebral body size E. Lack of annular apophysis Answer: C. Explanation: Transverse foramina are a unique binary feature of cervical vertebrae. 8. What is the role of the annulus fibrosus in intervertebral discs? A. Facilitating lateral flexion by distributing loads B. Enclosing and containing the nucleus pulposus under pressure C. Allowing coupled movements of rotation and flexion D. Absorbing compressive forces directly E. Forming cartilage endplates to support vertebral bodies Answer: B. Explanation: The annulus fibrosus encloses the nucleus pulposus, maintaining disc integrity and containing pressure. 9. Which movement pattern in the cervical spine results from the oblique (~45°) disc-facet angle? A. Pure axial rotation B. Translation combined with lateral flexion C. Rotation pivoting around the nucleus pulposus D. Flexion without displacement E. Pure lateral flexion Answer: B. Explanation: The oblique angle in cervical vertebrae facilitates translation combined with lateral flexion during movement. 10. What characteristic of zygapophyseal joints limits thoracic extension? A. Flattened vertebral foramen B. Tangential alignment of facet joints C. Orientation of facets on the arc of a circle D. Presence of ribs restricting thoracic mobility E. Radial alignment of inter-facet joints Answer: D. Explanation: Ribs and the associated costal structure limit thoracic extension despite tangential facet alignment. 11. Which evolutionary factor is most responsible for the reduction in cervical vertebrae mobility in aquatic mammals like whales? A. Flattening of transverse processes B. Fusion of cervical vertebrae into a rigid structure C. Loss of zygapophyseal joint articulation D. Increased size of intervertebral discs E. Elongation of the nucleus pulposus Answer: B. Explanation: In aquatic mammals, cervical vertebrae are often fused, reducing mobility and aiding streamlined movement. 12. What is the primary consequence of degeneration of the nucleus pulposus with age? A. Increased axial rotation capacity B. Reduction in vertebral height and disc resilience C. Formation of additional transverse foramina D. Fusion of annulus fibrosus with the cartilage endplate E. Enhanced water retention by the intervertebral discs Answer: B. Explanation: Degeneration of the nucleus pulposus reduces water content, leading to reduced vertebral height and decreased disc resilience. 13. Which component of the motion segment is primarily responsible for controlling the direction of spinal motion? A. Intervertebral discs B. Anterior longitudinal ligament C. Zygapophyseal joints D. Cartilage endplate E. Spinous processes Answer: C. Explanation: Zygapophyseal joints constrain and control the direction of spinal motion. 14. How does rib structure influence thoracic vertebral movements? A. It enhances lateral flexion capacity by supporting the transverse processes. B. It restricts rotation by increasing stiffness at zygapophyseal joints. C. It limits flexion and extension by constraining rib cage mobility. D. It facilitates pure axial motion in the thoracic region. E. It reduces the tensile strength of the annulus fibrosus. Answer: C. Explanation: The rib cage restricts flexion and extension, limiting thoracic vertebral movement. 15. Which feature defines lumbar vertebrae when binary differences are considered? A. Absence of costal facets and transverse foramina B. Presence of rib attachments C. Fused vertebrae forming the sacrum D. Radial alignment of the zygapophyseal joints E. Presence of the annular apophysis Answer: A. Explanation: Lumbar vertebrae lack costal facets and transverse foramina, distinguishing them from other regions. Here is the properly formatted response, adhering strictly to your instructions: 1. Which evolutionary adaptation in amphibians contributed to the development of the sacrum in the vertebral column? A. Weight-bearing hindlimbs requiring force transduction B. Increased reliance on cervical vertebrae for head rotation C. Development of lateral undulation for aquatic propulsion D. Flattening of cervical vertebrae for streamlined movement E. Evolution of fused caudal vertebrae for tail propulsion Answer: A. Explanation: The sacrum evolved in amphibians to transmit forces from weight-bearing hindlimbs to the vertebral column. 2. Which of the following statements about cervical vertebrae is NOT correct? A. They possess transverse foramina for the passage of vertebral arteries. B. Their zygapophyseal joints are oriented obliquely at ~45 degrees. C. The nucleus pulposus of cervical intervertebral discs pivots movement. D. Coupled movements of lateral flexion and rotation occur in the cervical region. E. Cervical vertebrae allow a greater range of motion compared to lumbar vertebrae. Answer: C. Explanation: In the cervical region, the movement centre is not around the nucleus pulposus but the vertebra below, allowing complex coupled movements. 3. A 45-year-old office worker presents with back pain that worsens with prolonged sitting and bending forward. MRI reveals a bulging disc pressing on the posterior longitudinal ligament. Which vertebral region is most likely affected, and why? A. Cervical, due to high disc-facet obliquity B. Thoracic, because rib attachments weaken disc structure C. Lumbar, due to increased compressive loads and motion demands D. Sacral, because of fusion defects E. Cervical, due to translation during motion Answer: C. Explanation: Lumbar intervertebral discs bear significant compressive loads and motion, making them prone to bulging and herniation. 4. Which is MOST correct regarding lumbar spine movement? A. The lumbar spine allows pure rotation due to its zygapophyseal joint alignment. B. The lumbar spine is highly flexible in extension but limited in flexion. C. Radially oriented inter-facet joints restrict rotation but allow flexion and extension. D. Coupled movements in the lumbar spine result from its intervertebral disc structure. E. Lateral flexion is the primary movement allowed by lumbar vertebrae. Answer: C. Explanation: The radial orientation of lumbar zygapophyseal joints allows flexion and extension while restricting rotation. 5. What structural feature allows thoracic vertebrae to facilitate rotation but limits lateral flexion? A. Orientation of zygapophyseal joints on the arc of a circle B. Radial alignment of inter-facet joints C. Presence of transverse foramina D. Increased thickness of the annulus fibrosus E. Flattened spinous processes Answer: A. Explanation: Thoracic zygapophyseal joints are tangentially aligned, allowing rotation while ribs restrict lateral flexion. 6. Why does the lumbar spine have limited rotational capacity compared to other vertebral regions? A. Lack of intervertebral discs in the lumbar spine B. Radial orientation of inter-facet joints interlocks vertebrae laterally C. Absence of zygapophyseal joints in the lumbar region D. Hyaline cartilage endplates restrict axial motion E. Reduced size of the nucleus pulposus in lumbar intervertebral discs Answer: B. Explanation: The radial orientation of lumbar inter-facet joints restricts rotation while allowing flexion, extension, and lateral flexion. 7. A swimmer complains of reduced neck rotation and mild neck pain. Imaging reveals no cervical fusion or injury. Which cervical structure is most likely contributing to this limited range of motion? A. Annular apophysis ossification B. Flattened vertebral foramen C. Zygapophyseal joints with oblique disc-facet alignment D. Nucleus pulposus degeneration E. Transverse foramina compression Answer: C. Explanation: Oblique (~45°) cervical zygapophyseal joints facilitate coupled movements like rotation and lateral flexion, which can become restricted. 8. Which movement is primarily constrained by the zygapophyseal joints in the lumbar spine? A. Flexion-extension B. Axial rotation C. Lateral flexion D. Coupled movements E. Anterior translation Answer: B. Explanation: The orientation of lumbar zygapophyseal joints prevents significant axial rotation while allowing flexion, extension, and lateral flexion. 9. Which binary feature is critical for identifying a vertebra as belonging to the thoracic region? A. Absence of transverse processes B. Presence of costal facets for rib articulation C. Fusion of vertebral bodies D. Flattened vertebral foramen E. Orientation of zygapophyseal joints Answer: B. Explanation: The presence of costal facets is unique to thoracic vertebrae and is used as a binary characteristic for identification. 10. Which of the following features is NOT region-specific but instead varies continuously along the vertebral column? A. Shape of the vertebral body B. Orientation of articular facets C. Presence of transverse foramina D. Rib facets E. Fusion of sacral vertebrae Answer: A. Explanation: The shape of the vertebral body varies continuously and is not exclusive to any one region, while features like transverse foramina and rib facets are region-specific. 1. Which of the following statements about cervical vertebrae is NOT correct? A. They possess transverse foramina for the passage of vertebral arteries. B. Their zygapophyseal joints are oriented obliquely at ~45 degrees. C. The nucleus pulposus of cervical intervertebral discs pivots movement. D. Coupled movements of lateral flexion and rotation occur in the cervical region. E. Cervical vertebrae allow a greater range of motion compared to lumbar vertebrae. **Answer**: C. Explanation: In the cervical region, the movement centre is not around the nucleus pulposus but the vertebra below, allowing complex coupled movements. 2. Which of the following statements about the thoracic spine is NOT correct? A. Rib attachments limit thoracic flexion and extension. B. Tangential zygapophyseal facet alignment allows rotational movements. C. The presence of transverse foramina is a defining feature of thoracic vertebrae. D. Thoracic vertebrae have facets for rib articulation. E. Rotation is more prominent in the thoracic spine than in the lumbar spine. **Answer**: C. Explanation: Transverse foramina are a feature of cervical vertebrae, not thoracic vertebrae. 3. Which of the following statements about intervertebral discs is NOT correct? A. The annulus fibrosus provides tensile strength to contain nucleus pulposus pressure. B. Nucleus pulposus water content decreases with age. C. The annulus fibrosus directly fuses with vertebral bodies. D. The nucleus pulposus contributes to height differences throughout the day. E. Intervertebral discs are symphysis joints. **Answer**: C. Explanation: The annulus fibrosus attaches to the cartilage endplate and annular apophysis but does not fuse directly with vertebral bodies. 4. A 45-year-old office worker presents with back pain that worsens with prolonged sitting and bending forward. MRI reveals a bulging disc pressing on the posterior longitudinal ligament. Which vertebral region is most likely affected, and why? A. Cervical, due to high disc-facet obliquity B. Thoracic, because rib attachments weaken disc structure C. Lumbar, due to increased compressive loads and motion demands D. Sacral, because of fusion defects E. Cervical, due to translation during motion **Answer**: C. Explanation: Lumbar intervertebral discs bear significant compressive loads and motion, making them prone to bulging and herniation. 5. A swimmer complains of reduced neck rotation and mild neck pain. Imaging reveals no cervical fusion or injury. Which cervical structure is most likely contributing to this limited range of motion? A. Annular apophysis ossification B. Flattened vertebral foramen C. Zygapophyseal joints with oblique disc-facet alignment D. Nucleus pulposus degeneration E. Transverse foramina compression **Answer**: C. Explanation: Oblique (~45°) cervical zygapophyseal joints facilitate coupled movements like rotation and lateral flexion, which can become restricted. 6. A patient sustains a rib fracture from a fall. They report difficulty rotating their upper body. Which mechanism best explains this limitation? A. Rib fracture interfering with thoracic facet joint mobility B. Loss of zygapophyseal joint alignment in the lumbar region C. Inflammation of transverse processes in cervical vertebrae D. Disruption of the annular apophysis in lumbar discs E. Compression of sacral nerve roots **Answer**: A. Explanation: Rib fractures can interfere with the mobility of thoracic zygapophyseal joints, which are essential for rotation. 7. Which is MOST correct regarding the role of the annulus fibrosus? A. It directly absorbs compressive loads in the vertebral column. B. It fuses with vertebral endplates to transmit tensile forces. C. It encloses the nucleus pulposus, containing internal pressure under load. D. It promotes coupled movements of flexion and extension. E. It forms a rigid boundary to prevent disc herniation. **Answer**: C. Explanation: The annulus fibrosus encloses and contains the nucleus pulposus, allowing it to function as a pressure reservoir during load-bearing. 8. Which is MOST correct regarding lumbar spine movement? A. The lumbar spine allows pure rotation due to its zygapophyseal joint alignment. B. The lumbar spine is highly flexible in extension but limited in flexion. C. Radially oriented inter-facet joints restrict rotation but allow flexion and extension. D. Coupled movements in the lumbar spine result from its intervertebral disc structure. E. Lateral flexion is the primary movement allowed by lumbar vertebrae. **Answer**: C. Explanation: The radial orientation of lumbar zygapophyseal joints allows flexion and extension while restricting rotation. 9. Which is MOST correct regarding the nucleus pulposus? A. It primarily functions as a tensile force absorber during motion. B. Its water content is unaffected by aging but reduced by loading. C. It facilitates vertebral column height recovery during rest periods. D. It forms the outermost layer of the intervertebral disc. E. It ossifies during adulthood to support vertebral bodies. **Answer**: C. Explanation: The hydrophilic nucleus pulposus rehydrates during rest, recovering vertebral column height. Lecture 3 1. Which of the following statements regarding multi-segmental ligaments of the vertebral column is NOT correct? A. The anterior longitudinal ligament reinforces the intervertebral discs anteriorly. B. The posterior longitudinal ligament extends along the entire length of the vertebral column. C. The supraspinous ligament spans the entire vertebral column, including the cervical region. D. The supraspinous ligament is replaced by the ligamentum nuchae in the cervical region. E. Multi-segmental ligaments help control vertebral movement and stability. Answer: C. Explanation: The supraspinous ligament does not span the cervical region; it is replaced by the ligamentum nuchae in that area. 2. Which ligament of the vertebral column is most responsible for preventing hyperextension? A. Anterior longitudinal ligament B. Posterior longitudinal ligament C. Ligamentum flavum D. Interspinous ligament E. Zygapophyseal joint capsular ligament Answer: A. Explanation: The anterior longitudinal ligament prevents hyperextension by running along the anterior aspect of the vertebral bodies and discs. 3. A patient presents with stiffness and limited mobility in the thoracic region. Imaging shows thickened ligaments posterior to the spinal cord. Which ligament is most likely involved? A. Supraspinous ligament B. Ligamentum flavum C. Interspinous ligament D. Intertransverse ligament E. Posterior longitudinal ligament Answer: B. Explanation: The ligamentum flavum is located posterior to the spinal cord, and its elastic nature prevents buckling. Thickening can limit mobility. 4. Which muscle is part of the transversospinales group and crosses the greatest number of vertebral segments? A. Rotatores B. Multifidus C. Semispinalis D. Interspinalis E. Levator costarum Answer: C. Explanation: Semispinalis crosses 5–6 segments and is part of the transversospinales group, attaching from transverse processes to spinous processes. 5. Which is MOST correct regarding the function of the erector spinae muscles? A. They primarily facilitate rotation of the thoracic spine. B. They act as unisegmental muscles for precise movements. C. They are multi-segmental muscles providing both movement and proprioception. D. They resist flexion in the cervical spine but create flexion in the lumbar spine. E. They act as passive ligaments rather than active stabilisers. Answer: C. Explanation: Erector spinae muscles are multi-segmental and provide regional movement as well as proprioceptive feedback. 6. A patient reports chronic headaches and neck pain. Examination reveals tightness in the suboccipital triangle. Which nerve is most likely implicated in their symptoms? A. Dorsal ramus of C1 B. Dorsal ramus of C2 C. Greater auricular nerve D. Vertebral nerve E. Ventral ramus of C2 Answer: B. Explanation: The greater occipital nerve (C2 dorsal ramus) is commonly associated with neuralgia and pain in the suboccipital region. 7. Which of the following features is NOT a characteristic of the thoracolumbar fascia in the lumbar region? A. It has three distinct layers: anterior, middle, and posterior. B. It is reinforced by the latissimus dorsi and gluteus maximus muscles. C. It is thin and elastic to accommodate thoracic breathing. D. It provides attachment for abdominal wall muscles. E. Its posterior layer is particularly strong and durable. Answer: C. Explanation: The thoracolumbar fascia is thin and elastic in the thoracic region but thick and durable in the lumbar region. 8. Which is NOT correct regarding the innervation of intrinsic back muscles? A. They are all innervated by the dorsal rami of mixed spinal nerves. B. The splenius muscles are innervated by ventral rami. C. The erector spinae group receives innervation from dorsal rami. D. The transversospinales group is innervated segmentally by dorsal rami. E. Suboccipital muscles are innervated by the dorsal ramus of C1. Answer: B. Explanation: The splenius muscles, like all intrinsic back muscles, are innervated by the dorsal rami of mixed spinal nerves. 9. A weightlifter sustains a lumbar strain while deadlifting. Which component of the erector spinae group is most likely to be injured, given its attachment to costal elements? A. Spinalis B. Longissimus C. Iliocostalis D. Multifidus E. Semispinalis Answer: C. Explanation: Iliocostalis attaches to costal elements and angles of ribs, making it prone to strain during heavy lifting. 10. Which muscle of the suboccipital group contributes to ipsilateral rotation of the head? A. Rectus capitis posterior minor B. Rectus capitis posterior major C. Obliquus capitis superior D. Obliquus capitis inferior E. Semispinalis capitis Answer: D. Explanation: Obliquus capitis inferior contributes to ipsilateral rotation, attaching from the transverse process of C1 to the spinous process of C2. 11. Which unisegmental muscle is highly proprioceptive and functions as an "active ligament"? A. Interspinous B. Rotatores C. Multifidus D. Intertransverse E. Levator costarum Answer: D. Explanation: Intertransverse muscles function as active ligaments with a high density of muscle spindles for proprioception. 12. Which is NOT correct regarding the subgroups of the transversospinales muscles? A. Rotatores are most prominent in the thoracic region. B. Multifidus is well-developed in the lumbar region. C. Semispinalis has components extending to the occiput. D. All transversospinales muscles contribute to creating rotational movement. E. Rotatores primarily resist rotational movement rather than create it. Answer: D. Explanation: Transversospinales muscles are more involved in resisting rotational movements than creating them. 13. Which ligament is most likely to be injured in hyperflexion of the lumbar spine? A. Anterior longitudinal ligament B. Posterior longitudinal ligament C. Supraspinous ligament D. Ligamentum flavum E. Zygapophyseal joint capsular ligament Answer: C. Explanation: The supraspinous ligament is most prone to injury during hyperflexion, as it resists excessive separation of spinous processes. 1. Which ligament runs along the anterior surface of the vertebral bodies and helps to prevent hyperextension of the spine? A. Posterior longitudinal ligament B. Ligamentum flavum C. Supraspinous ligament D. Anterior longitudinal ligament E. Interspinous ligament Answer: D. Explanation: The anterior longitudinal ligament runs along the anterior surface of the vertebral bodies and helps prevent hyperextension. 2. Which of the following statements about the ligamentum flavum is NOT correct? A. It is a unisegmental ligament. B. It is elastic and prevents buckling under compression. C. It runs along the anterior surface of the spinal cord. D. It is positioned just posterior to the spinal cord. E. It is part of the unisegmental ligaments of the vertebral column. Answer: C. Explanation: The ligamentum flavum runs along the posterior surface of the spinal cord, not the anterior surface. 3. Which is MOST correct about the role of the posterior longitudinal ligament? A. It reinforces the vertebral body posteriorly but does not connect to the intervertebral disc. B. It prevents hyperextension by running along the posterior aspect of the spine. C. It strengthens the posterior intervertebral disc and resists hyperflexion. D. It is replaced by the ligamentum nuchae in the cervical region. E. It runs along the anterior margin of the spinal cord, reinforcing the annulus fibrosus. Answer: C. Explanation: The posterior longitudinal ligament reinforces the posterior intervertebral discs and resists hyperflexion. 4. Which of the following ligaments is replaced by the ligamentum nuchae in the cervical region? A. Supraspinous ligament B. Interspinous ligament C. Ligamentum flavum D. Posterior longitudinal ligament E. Annulus fibrosus Answer: A. Explanation: The supraspinous ligament is replaced by the ligamentum nuchae in the cervical region. 5. Which muscle group is responsible for providing proprioception and resisting rotational movement in the thoracic spine? A. Rotatores B. Erector spinae C. Intertransverse muscles D. Levator costarum E. Semispinalis Answer: A. Explanation: Rotatores are part of the transversospinales group and resist rotational movement while providing proprioception in the thoracic spine. 6. Which ligament directly connects adjacent spinous processes? A. Supraspinous ligament B. Interspinous ligament C. Anterior longitudinal ligament D. Posterior longitudinal ligament E. Ligamentum flavum Answer: B. Explanation: The interspinous ligament connects adjacent spinous processes. 7. A 34-year-old runner presents with lumbar pain after a hyperextension injury. Which ligament is most likely injured? A. Anterior longitudinal ligament B. Posterior longitudinal ligament C. Ligamentum flavum D. Interspinous ligament E. Zygapophyseal joint capsular ligament Answer: A. Explanation: The anterior longitudinal ligament prevents hyperextension, making it susceptible to injury in hyperextension incidents. 8. Which unisegmental muscle acts as an active ligament, with a high density of muscle spindles sensitive to length changes? A. Intertransverse B. Multifidus C. Rotatores D. Semispinalis E. Levator costarum Answer: A. Explanation: Intertransverse muscles act as active ligaments and contain a high density of muscle spindles for proprioception. 9. Which of the following muscles is NOT part of the transversospinales group? A. Rotatores B. Multifidus C. Semispinalis D. Spinalis E. None of the above Answer: D. Explanation: Spinalis is part of the erector spinae group, not the transversospinales group. 10. Which of the following statements regarding the suboccipital triangle is NOT correct? A. It is formed by the rectus capitis posterior major, obliquus capitis superior, and obliquus capitis inferior. B. It contains the vertebral artery and the dorsal ramus of C1. C. The greater occipital nerve passes within the triangle. D. The obliquus capitis inferior attaches to the spinous process of C2. E. Neuralgia in the greater occipital nerve can cause referred pain in this region. Answer: C. Explanation: The greater occipital nerve (C2 dorsal ramus) does not pass through the suboccipital triangle. 11. Which muscle subgroup of the erector spinae group attaches to costal elements and the angles of ribs? A. Spinalis B. Longissimus C. Iliocostalis D. Multifidus E. Rotatores Answer: C. Explanation: Iliocostalis attaches to costal elements and the angles of ribs. 12. A patient reports difficulty with lateral flexion and rotation of their head. Which suboccipital muscle is most likely affected? A. Rectus capitis posterior minor B. Rectus capitis posterior major C. Obliquus capitis superior D. Obliquus capitis inferior E. Splenius capitis Answer: C. Explanation: Obliquus capitis superior contributes to lateral flexion and extension of the head. 13. Which component of the thoracolumbar fascia is reinforced by the latissimus dorsi and gluteus maximus? A. Anterior layer B. Middle layer C. Posterior layer D. Sacral layer E. Lumbar layer Answer: C. Explanation: The posterior layer of the thoracolumbar fascia is reinforced by the latissimus dorsi and gluteus maximus. 14. Which muscle group has the primary function of resisting movement rather than creating it? A. Transversospinales B. Erector spinae C. Suboccipital muscles D. Extrinsic back muscles E. Intertransverse muscles Answer: A. Explanation: The transversospinales group primarily resists movement and provides stability. 15. Which intrinsic back muscle group originates from the sacrospinalis aponeurosis and spans multiple segments? A. Transversospinales B. Interspinous muscles C. Erector spinae D. Intertransverse muscles E. Suboccipital muscles Answer: C. Explanation: The erector spinae muscles originate from the sacrospinalis aponeurosis and span multiple vertebral segments. 16. Which is MOST correct about the role of the supraspinous ligament in the vertebral column? A. It connects adjacent spinous processes to resist extension. B. It reinforces the intervertebral discs from both anterior and posterior aspects. C. It runs along the tips of spinous processes, resisting flexion of the spine. D. It is elastic in nature, preventing compression of the spinal cord. E. It is located anterior to the posterior longitudinal ligament. Answer: C. Explanation: The supraspinous ligament runs along the tips of spinous processes and resists flexion. 17. A patient complains of low back pain after heavy lifting. MRI reveals strain in the intrinsic lumbar back muscles. Which muscle is most likely affected? A. Iliocostalis B. Quadratus lumborum C. Multifidus D. Rotatores E. Longissimus Answer: C. Explanation: Multifidus is prominent in the lumbar region and is often strained in cases of low back pain due to lifting. 18. Which unisegmental muscle of the intrinsic back has a high density of muscle spindles and functions to reinforce vertebral ligaments? A. Rotatores B. Multifidus C. Interspinous D. Intertransverse E. Levator costarum Answer: D. Explanation: Intertransverse muscles function as active ligament reinforcers with high proprioceptive sensitivity. 19. Which ligament attaches to the lamina of adjacent vertebrae and provides elastic recoil to assist spinal extension? A. Posterior longitudinal ligament B. Anterior longitudinal ligament C. Ligamentum flavum D. Supraspinous ligament E. Interspinous ligament Answer: C. Explanation: The ligamentum flavum connects adjacent laminae and provides elastic recoil, aiding spinal extension. 20. Which layer of the thoracolumbar fascia is absent over the psoas major muscle? A. Anterior layer B. Middle layer C. Posterior layer D. Sacral layer E. Aponeurotic layer Answer: A. Explanation: The anterior layer of the thoracolumbar fascia does not cover the psoas major. 21. Which muscle group provides the majority of cervical stability and coordination through the occipital-atlas-axis complex? A. Suboccipital muscles B. Erector spinae muscles C. Transversospinales muscles D. Splenius muscles E. Levator scapulae Answer: A. Explanation: The suboccipital muscles stabilise the occipital-atlas-axis complex and are essential for cervical coordination. 22. Which intrinsic back muscle is the most superficial and forms the lateral column of the erector spinae group? A. Spinalis B. Iliocostalis C. Longissimus D. Multifidus E. Rotatores Answer: B. Explanation: Iliocostalis forms the lateral column of the erector spinae group and is the most superficial. 23. Which of the following is a defining characteristic of the semispinalis muscle? A. It is found only in the lumbar region. B. It crosses 5-6 vertebral segments. C. It attaches to costal elements of ribs. D. It is innervated by the ventral rami of spinal nerves. E. It forms part of the suboccipital triangle. Answer: B. Explanation: Semispinalis crosses 5–6 segments and is part of the transversospinales group. 24. Which suboccipital muscle is responsible for ipsilateral rotation and attaches from the C1 transverse process to the C2 spinous process? A. Rectus capitis posterior minor B. Rectus capitis posterior major C. Obliquus capitis superior D. Obliquus capitis inferior E. Splenius capitis Answer: D. Explanation: Obliquus capitis inferior attaches from the C1 transverse process to the C2 spinous process and performs ipsilateral rotation. 25. A patient with neuralgia affecting the greater occipital nerve is most likely to experience pain in which region? A. Suboccipital triangle B. Anterior cervical spine C. Sacroiliac region D. Lumbar interspinous region E. Thoracic paraspinal muscles Answer: A. Explanation: The greater occipital nerve (C2 dorsal ramus) is closely associated with the suboccipital triangle and is a common site of neuralgia. 26. Which extrinsic back muscle is innervated by the ventral rami and inserts onto the superior borders of ribs? A. Serratus posterior superior B. Splenius capitis C. Levator scapulae D. Rhomboid minor E. Latissimus dorsi Answer: A. Explanation: Serratus posterior superior is an extrinsic back muscle that inserts onto the superior borders of ribs and is innervated by ventral rami. 27. Which component of the thoracolumbar fascia connects laterally to the abdominal wall muscles? A. Anterior layer B. Middle layer C. Posterior layer D. Deep fascia of the erector spinae E. Ligamentum flavum Answer: C. Explanation: The posterior layer of the thoracolumbar fascia connects laterally to the abdominal wall muscles. 28. Which intrinsic muscle group has fibers that run obliquely, resembling an "A" shape, and contributes to resisting movement rather than creating it? A. Erector spinae B. Suboccipital muscles C. Transversospinales D. Interspinous muscles E. Intertransverse muscles Answer: C. Explanation: The transversospinales group, including rotatores, multifidus, and semispinalis, has oblique fibers that primarily resist movement. 29. Which muscle is responsible for extension and ipsilateral rotation of the head and attaches to the C2 spinous process? A. Rectus capitis posterior minor B. Rectus capitis posterior major C. Obliquus capitis superior D. Obliquus capitis inferior E. Splenius cervicis Answer: B. Explanation: Rectus capitis posterior major extends and rotates the head ipsilaterally, attaching to the C2 spinous process. 30. Which intrinsic muscle is most prominent in the lumbar region and stabilises the spine during movement? A. Rotatores B. Semispinalis C. Multifidus D. Iliocostalis E. Spinalis Answer: C. Explanation: Multifidus is most prominent in the lumbar region and provides spinal stabilisation during movement. 16. Which of the following is NOT correct regarding the interspinous ligament? A. It connects adjacent spinous processes. B. It helps to limit flexion of the spine. C. It is a unisegmental ligament. D. It attaches to the vertebral endplates. E. It provides minimal proprioceptive feedback. Answer: D. Explanation: The interspinous ligament connects adjacent spinous processes and helps limit flexion, but it does not attach to vertebral endplates. 17. A 25-year-old gymnast presents with chronic thoracic back pain. Imaging shows hypertrophy of muscles responsible for resisting rotational movements in this region. Which muscle group is most likely involved? A. Erector spinae B. Transversospinales C. Intertransverse D. Splenius capitis E. Suboccipital muscles Answer: B. Explanation: The transversospinales group, particularly the rotatores in the thoracic region, resists rotational movements. 18. Which is MOST correct regarding the function of the posterior longitudinal ligament? A. It reinforces the annulus fibrosus from the anterior aspect. B. It limits hyperextension of the vertebral column. C. It runs along the posterior surface of vertebral bodies, limiting flexion. D. It connects the spinous processes of adjacent vertebrae. E. It replaces the supraspinous ligament in the cervical region. Answer: C. Explanation: The posterior longitudinal ligament runs along the posterior surface of the vertebral bodies and limits flexion. 19. Which ligament is directly responsible for resisting hyperflexion in the cervical spine? A. Supraspinous ligament B. Ligamentum flavum C. Anterior longitudinal ligament D. Posterior longitudinal ligament E. Zygapophyseal joint capsular ligament Answer: A. Explanation: The supraspinous ligament resists hyperflexion by connecting the tips of spinous processes. 20. A patient experiences difficulty with extension and lateral flexion of the head after trauma. Which suboccipital muscle is most likely affected? A. Rectus capitis posterior major B. Rectus capitis posterior minor C. Obliquus capitis superior D. Obliquus capitis inferior E. Splenius capitis Answer: C. Explanation: Obliquus capitis superior is responsible for head extension and lateral flexion. 21. Which of the following is NOT correct regarding the thoracolumbar fascia? A. It is thin and elastic in the thoracic region. B. It is thick and durable in the lumbar region. C. It reinforces the anterior longitudinal ligament. D. Its posterior layer is reinforced by the latissimus dorsi and gluteus maximus. E. It provides lateral attachments for the abdominal wall muscles. Answer: C. Explanation: The thoracolumbar fascia does not reinforce the anterior longitudinal ligament; it supports posterior structures. 22. A patient presents with pain radiating from the cervical spine to the suboccipital region. Which nerve is most likely implicated? A. Dorsal ramus of C1 B. Greater occipital nerve C. Vertebral nerve D. Anterior ramus of C3 E. Lesser occipital nerve Answer: B. Explanation: The greater occipital nerve is commonly associated with referred pain in the suboccipital region. 23. Which ligament is MOST responsible for stabilising the zygapophyseal joints? A. Posterior longitudinal ligament B. Anterior longitudinal ligament C. Ligamentum flavum D. Z-joint capsular ligament E. Interspinous ligament Answer: D. Explanation: The zygapophyseal joint capsular ligament stabilises the joints and limits excessive movement. 24. A 50-year-old patient with a history of poor posture reports upper thoracic back pain. Imaging reveals atrophy of a muscle that inserts on the angles of the ribs. Which muscle is most likely involved? A. Longissimus B. Iliocostalis C. Multifidus D. Splenius cervicis E. Serratus posterior superior Answer: B. Explanation: Iliocostalis, part of the erector spinae group, inserts onto the angles of the ribs and is involved in maintaining posture. 25. Which is MOST correct regarding the role of the multifidus muscle in lumbar stability? A. It spans 5-6 vertebral segments, providing dynamic stability. B. It is most prominent in the thoracic region, resisting flexion. C. It stabilises the lumbar spine during flexion and extension movements. D. It primarily contributes to lateral flexion of the thoracolumbar junction. E. It is innervated by the ventral rami of spinal nerves. Answer: C. Explanation: Multifidus is most prominent in the lumbar region and stabilises the spine during flexion and extension. 26. Which of the following is NOT an intrinsic back muscle? A. Iliocostalis B. Longissimus C. Serratus posterior superior D. Multifidus E. Rotatores Answer: C. Explanation: Serratus posterior superior is an extrinsic back muscle innervated by ventral rami. 27. Which unisegmental intrinsic muscle spans two vertebral segments and functions in proprioception? A. Levator costarum B. Interspinous C. Rotatores D. Intertransverse E. Multifidus Answer: A. Explanation: Levator costarum spans two segments and has a proprioceptive function. 28. Which muscle group originates from the sacrospinalis aponeurosis and provides independent regional function? A. Transversospinales B. Erector spinae C. Suboccipital muscles D. Splenius muscles E. Interspinalis Answer: B. Explanation: The erector spinae group originates from the sacrospinalis aponeurosis, allowing independent regional movement and proprioception. 29. Which is MOST correct regarding the rectus capitis posterior major? A. It is innervated by the ventral ramus of C1. B. It attaches from the atlas transverse process to the occiput. C. It provides extension and ipsilateral rotation of the head. D. It is part of the erector spinae group. E. It primarily stabilises the thoracic spine. Answer: C. Explanation: Rectus capitis posterior major extends and rotates the head ipsilaterally, attaching to the occiput. 30. Which extrinsic back muscle, outside the thoracolumbar fascia, contributes to rib movement during respiration? A. Serratus posterior inferior B. Splenius cervicis C. Levator scapulae D. Iliocostalis E. Longissimus thoracis Answer: A. Explanation: Serratus posterior inferior is an extrinsic back muscle that assists in rib movement during respiration. Lecture 4 1. Which is NOT correct about the vertebral canal? A. It extends from the base of the skull to the coccyx. B. Its anterior wall consists of the vertebral bodies, intervertebral discs, and posterior longitudinal ligament. C. The vertebral canal is largest in the thoracic region due to the presence of the ribs. D. The posterior wall is formed by the laminae, ligamentum flavum, and zygapophyseal joints. E. Its lateral boundaries are defined by the pedicles and intervertebral foramina. Answer: C. Explanation: The vertebral canal is smallest in the thoracic region due to reduced motion demands. 2. Which structure primarily prevents the spinal cord from collapsing anteriorly within the vertebral canal? A. Posterior longitudinal ligament B. Ligamentum flavum C. Dura mater D. Denticulate ligaments E. Intervertebral discs Answer: A. Explanation: The posterior longitudinal ligament provides posterior reinforcement to the vertebral bodies and intervertebral discs. 3. Which space contains fat and the internal vertebral venous plexus? A. Subdural space B. Epidural space C. Subarachnoid space D. Interspinous space E. Lumbar cistern Answer: B. Explanation: The epidural space, located outside the dura but inside the vertebral canal, contains fat and the venous plexus. 4. A patient is injected with anaesthetic into the epidural space for childbirth. What is the primary risk if the anaesthetic enters a vein? A. Loss of sensation in lower limbs B. General anaesthesia, coma, or death C. Blockage of the cauda equina nerves D. Paralysis of respiratory muscles E. Restricted diffusion into the subarachnoid space Answer: B. Explanation: Anaesthetic entering the veins in the epidural space can cause systemic effects, including general anaesthesia and potentially fatal outcomes. 5. Which of the following is MOST correct regarding the dura mater? A. It is firmly attached to the vertebral bodies at every segment. B. It is loosely attached to the posterior longitudinal ligament. C. It extends to the sacral hiatus without any firm attachment. D. It adheres tightly to the arachnoid layer at all levels. E. It does not form sleeves around spinal nerves. Answer: B. Explanation: The dura mater is loosely attached to the posterior longitudinal ligament and forms a sheath around spinal nerves. 6. Which meningeal layer adheres faithfully to the spinal cord and nerve roots? A. Dura mater B. Arachnoid mater C. Pia mater D. Epidural fat E. Ligamentum flavum Answer: C. Explanation: The pia mater follows the spinal cord and nerve roots closely, providing structural support. 7. A 40-year-old patient undergoes a lumbar puncture. Which space is accessed, and at what vertebral level is this procedure typically performed? A. Epidural space, L1/L2 B. Subdural space, T12/L1 C. Subarachnoid space, L3/L4 D. Lumbar cistern, T11/T12 E. Interspinous space, L5/S1 Answer: C. Explanation: A lumbar puncture accesses the subarachnoid space at L3/L4 to obtain cerebrospinal fluid. 8. Which of the following structures is located within the subarachnoid space? A. Denticulate ligaments B. Posterior longitudinal ligament C. Epidural fat D. Spinal roots and cerebrospinal fluid E. Zygapophyseal joint capsules Answer: D. Explanation: The subarachnoid space contains cerebrospinal fluid, spinal roots, and strands of connective tissue. 9. What is the primary function of the denticulate ligaments? A. Anchor the spinal cord laterally to the dura mater B. Prevent hyperextension of the vertebral column C. Reinforce the posterior longitudinal ligament D. Support the intervertebral foramina E. Facilitate cerebrospinal fluid circulation Answer: A. Explanation: Denticulate ligaments, lateral projections of the pia mater, anchor the spinal cord to the dura mater. 10. Which of the following is NOT a feature of the cauda equina? A. It originates from the conus medullaris. B. It is surrounded by the subarachnoid space. C. It is composed of spinal nerve roots. D. It terminates at the sacral hiatus. E. It is covered by all three meningeal layers. Answer: D. Explanation: The cauda equina does not terminate at the sacral hiatus; it continues to the lumbar cistern. 11. During spinal flexion, what positional change occurs to the spinal cord? A. Moves dorsally within the vertebral canal B. Moves ventrally within the vertebral canal C. Remains stationary within the vertebral canal D. Becomes compressed by the posterior longitudinal ligament E. Causes elongation of nerve roots Answer: B. Explanation: During spinal flexion, the cord moves ventrally, while extension causes dorsal movement. 12. What is the significance of the lumbar cistern? A. It is the site of conus medullaris termination. B. It contains cerebrospinal fluid and the cauda equina. C. It is located within the epidural space. D. It is the narrowest point of the vertebral canal. E. It contains the filum terminale externum only. Answer: B. Explanation: The lumbar cistern, extending from L1/L2 to S1/S2, contains CSF and the cauda equina. 13. Which region of the vertebral canal has the smallest diameter, limiting movement potential? A. Cervical B. Thoracic C. Lumbar D. Sacral E. Coccygeal Answer: B. Explanation: The thoracic region has the smallest vertebral canal due to reduced movement potential. 14. Which is MOST correct regarding the termination of the spinal cord? A. It terminates at the L5 vertebral level in adults. B. The conus medullaris is at the level of L1/L2 in adults. C. It is fully segmented, aligning with vertebral levels. D. Spinal cord termination occurs in the sacral canal during fetal development. E. The filum terminale internum begins at S1. Answer: B. Explanation: The spinal cord terminates at L1/L2 in adults, forming the conus medullaris. 15. Which of the following statements about the filum terminale is NOT correct? A. The filum terminale internum is a continuation of the pia mater. B. The filum terminale externum is covered by all three meningeal layers. C. The filum terminale attaches to the coccyx. D. The filum terminale begins at the level of the sacral hiatus. E. The filum terminale stabilises the spinal cord in the canal. Answer: D. Explanation: The filum terminale begins at the conus medullaris, not the sacral hiatus. 16. A 35-year-old patient is undergoing a caudal block. Which anatomical feature allows for the administration of anaesthetic in this procedure? A. Conus medullaris B. Epidural space around the sacral hiatus C. Subarachnoid space at the lumbar cistern D. Posterior longitudinal ligament E. Intervertebral foramina of L3/L4 Answer: B. Explanation: A caudal block involves injecting anaesthetic into the epidural space through the sacral hiatus. 17. Which is MOST correct regarding the epidural space in the sacral region? A. It is absent below the level of S2. B. It contains cerebrospinal fluid and the cauda equina. C. It is filled with fat and veins. D. It extends only as far as the dorsal root ganglia. E. It has no clinical relevance for anaesthetic administration. Answer: C. Explanation: The epidural space in the sacral region is filled with fat and veins and can be accessed for anaesthetic purposes. 18. Which meningeal layer continues along the spinal roots until the dorsal root ganglion? A. Dura mater B. Arachnoid mater C. Pia mater D. Ligamentum flavum E. Epineurium Answer: A. Explanation: The dura mater and arachnoid mater extend along the spinal roots to the dorsal root ganglion. 19. Which is NOT a function of the denticulate ligaments? A. Anchoring the spinal cord laterally to the dura mater B. Preventing excessive lateral displacement of the spinal cord C. Connecting the spinal cord to the intervertebral discs D. Piercing the arachnoid mater E. Providing stabilisation within the vertebral canal Answer: C. Explanation: The denticulate ligaments do not connect the spinal cord to intervertebral discs; they anchor it to the dura. 20. What structure forms a potential space only in the presence of pathology? A. Epidural space B. Subarachnoid space C. Subdural space D. Lumbar cistern E. Intervertebral foramen Answer: C. Explanation: The subdural space is a potential space that only exists in pathological conditions. 21. Which clinical procedure specifically targets the lumbar cistern to extract cerebrospinal fluid? A. Epidural injection B. Caudal block C. Lumbar puncture D. Subdural block E. Spinal fusion Answer: C. Explanation: A lumbar puncture targets the lumbar cistern to obtain CSF. 22. Which is NOT correct regarding the subarachnoid space? A. It contains cerebrospinal fluid. B. It extends as far as the dorsal root ganglia. C. It is continuous with the ventricular system of the brain. D. It provides a pathway for autonomic nerves. E. It contains the cauda equina in the lumbar cistern. Answer: D. Explanation: The subarachnoid space does not provide a pathway for autonomic nerves; it contains CSF and nerve roots. 23. Which spinal cord region contains the greatest amount of white matter relative to grey matter? A. Cervical B. Thoracic C. Lumbar D. Sacral E. Coccygeal Answer: A. Explanation: The cervical spinal cord contains the most white matter because it carries both ascending and descending tracts. 24. Which ligament is directly anterior to the spinal cord within the vertebral canal? A. Ligamentum flavum B. Anterior longitudinal ligament C. Posterior longitudinal ligament D. Supraspinous ligament E. Interspinous ligament Answer: C. Explanation: The posterior longitudinal ligament is directly anterior to the spinal cord within the vertebral canal. 25. Which is MOST correct regarding the cauda equina? A. It originates at L1 and terminates at S1. B. It contains nerve roots for both the lumbar and sacral plexuses. C. It is a continuation of the spinal cord into the sacral canal. D. It contains both autonomic and somatic nerve fibres. E. It is enclosed by the dura mater but not the arachnoid mater. Answer: B. Explanation: The cauda equina contains nerve roots for the lumbar and sacral plexuses, originating from the conus medullaris. 26. Which is MOST correct regarding lumbar enlargement of the spinal cord? A. It corresponds to T1-T12 vertebral levels. B. It provides innervation to the upper limb via the brachial plexus. C. It extends from L1-S3 spinal levels and supplies the lower limbs. D. It contains autonomic nerves for sympathetic innervation. E. It is located at the level of the conus medullaris. Answer: C. Explanation: The lumbar enlargement extends from L1-S3 spinal levels and innervates the lower limbs via the lumbosacral plexus. 27. Which structure anchors the spinal cord to the coccyx? A. Filum terminale internum B. Cauda equina C. Denticulate ligaments D. Filum terminale externum E. Posterior longitudinal ligament Answer: D. Explanation: The filum terminale externum anchors the spinal cord to the coccyx. 28. Which is NOT a boundary of the vertebral canal? A. Pedicles and intervertebral foramina laterally B. Posterior longitudinal ligament anteriorly C. Ligamentum flavum posteriorly D. Laminae anteriorly E. Zygapophyseal joints posteriorly Answer: D. Explanation: The laminae are part of the posterior boundary, not anterior. 29. During spinal extension, what happens to the spinal cord and roots? A. Spinal cord moves dorsally; roots are pulled caudally. B. Spinal cord moves ventrally; roots are pulled cranially. C. Spinal cord remains stationary; roots move caudally. D. Both spinal cord and roots move ventrally. E. Spinal cord moves dorsally; roots remain stationary. Answer: A. Explanation: In extension, the spinal cord moves dorsally, and the roots are pulled caudally. 30. Which is the main role of the subarachnoid space? A. Contains the epidural venous plexus B. Facilitates cerebrospinal fluid flow around the spinal cord C. Provides a pathway for dorsal and ventral rami D. Supports intervertebral disc nutrition E. Anchors the spinal cord to the vertebral canal Answer: B. Explanation: The subarachnoid space contains CSF and facilitates its flow around the spinal cord. 31. Which of the following statements about the spinal meninges is MOST correct? A. The dura mater is firmly attached to the vertebral bodies at every level. B. The arachnoid mater adheres to the pia mater to prevent CSF flow. C. The pia mater forms the denticulate ligaments. D. The epidural space lies between the arachnoid and dura mater. E. The dura mater terminates at the filum terminale externum. Answer: C. Explanation: The pia mater forms the denticulate ligaments, which anchor the spinal cord laterally. 32. What is the significance of the conus medullaris in spinal cord anatomy? A. It marks the beginning of the cauda equina. B. It is the terminal end of the spinal cord, located at L1/L2. C. It anchors the spinal cord to the coccyx via the filum terminale externum. D. It forms the lumbar enlargement responsible for lower limb innervation. E. It is the narrowest point of the vertebral canal. Answer: B. Explanation: The conus medullaris is the tapered end of the spinal cord located at L1/L2. 33. Which of the following is NOT a characteristic feature of the lumbar cistern? A. It contains the cauda equina. B. It is filled with cerebrospinal fluid. C. It extends to the S2 vertebral level. D. It contains the filum terminale externum. E. It is accessed during lumbar punctures. Answer: D. Explanation: The lumbar cistern contains the filum terminale internum, not the externum. 34. Which of the following structures is found within the epidural space? A. Cerebrospinal fluid B. Spinal arteries C. Fat and internal vertebral venous plexus D. Denticulate ligaments E. Arachnoid trabeculae Answer: C. Explanation: The epidural space contains fat and the internal vertebral venous plexus, providing cushioning and venous drainage. 35. A patient with a thoracic spine injury experiences compression of the spinal cord. Which vertebral canal feature contributes to this risk in this region? A. The thoracic vertebral canal is the narrowest. B. The thoracic region contains the largest epidural space. C. The conus medullaris is located in the thoracic canal. D. The zygapophyseal joints are more mobile in this region. E. The thoracic vertebral canal lacks ligamentous reinforcement. Answer: A. Explanation: The thoracic vertebral canal is the narrowest, increasing the risk of spinal cord compression. 36. Which is MOST correct regarding the arachnoid trabeculae? A. They connect the dura mater to the vertebral bodies. B. They span the subarachnoid space, suspending the spinal cord. C. They are found in the epidural space, supporting the venous plexus. D. They form the denticulate ligaments in the lumbar cistern. E. They anchor the spinal cord to the sacral canal. Answer: B. Explanation: Arachnoid trabeculae are delicate connective tissue strands that suspend the spinal cord in the subarachnoid space. 37. Which of the following is NOT found in the subarachnoid space? A. Cerebrospinal fluid B. Arachnoid trabeculae C. Denticulate ligaments D. Fat deposits E. Spinal nerve roots Answer: D. Explanation: Fat deposits are found in the epidural space, not the subarachnoid space. 38. During a lumbar puncture, which ligament is pierced before reaching the subarachnoid space? A. Anterior longitudinal ligament B. Ligamentum flavum C. Posterior longitudinal ligament D. Denticulate ligament E. Zygapophyseal joint capsule Answer: B. Explanation: The ligamentum flavum is pierced during a lumbar puncture before accessing the subarachnoid space. 39. Which of the following is NOT a role of cerebrospinal fluid within the subarachnoid space? A. Providing cushioning for the spinal cord and brain B. Facilitating nutrient and waste exchange for neural tissues C. Maintaining intracranial pressure D. Lubricating the intervertebral discs E. Suspending the spinal cord in the vertebral canal Answer: D. Explanation: CSF does not lubricate intervertebral discs; it cushions and suspends the spinal cord and brain. 40. Which ligament is responsible for connecting the laminae of adjacent vertebrae and contributes to the posterior wall of the vertebral canal? A. Posterior longitudinal ligament B. Anterior longitudinal ligament C. Ligamentum flavum D. Supraspinous ligament E. Interspinous ligament Answer: C. Explanation: The ligamentum flavum connects the laminae of adjacent vertebrae and contributes to the posterior boundary of the vertebral canal. Lecture 5. PreLab 1 1. Which of the following is NOT correct regarding the brachial plexus? A. It is derived from roots C5-T1. B. It divides into trunks, divisions, cords, and terminal branches. C. It provides motor and sensory innervation to the lower limb. D. The musculocutaneous nerve arises from the lateral cord. E. The radial nerve arises from the posterior cord. Answer: C. Explanation: The brachial plexus does not innervate the lower limb; it supplies the upper limb. 2. Which cord of the brachial plexus gives rise to the median nerve? A. Lateral cord only B. Medial cord only C. Posterior cord only D. Lateral and medial cords E. Posterior and medial cords Answer: D. Explanation: The median nerve is formed by contributions from both the lateral and medial cords. 3. A 28-year-old patient suffers an injury affecting the posterior cord of the brachial plexus. Which nerve is LEAST likely to be involved? A. Axillary nerve B. Radial nerve C. Thoracodorsal nerve D. Ulnar nerve E. Upper subscapular nerve Answer: D. Explanation: The ulnar nerve arises from the medial cord, not the posterior cord. 4. Which is NOT correct regarding the anatomical compartments of the arm? A. The anterior compartment contains the musculocutaneous nerve. B. The posterior compartment contains the radial nerve. C. The anterior compartment is responsible for flexion at the elbow. D. The posterior compartment is innervated by the median nerve. E. The humerus forms the lateral boundary of the compartments. Answer: D. Explanation: The posterior compartment is innervated by the radial nerve, not the median nerve. 5. Which is MOST correct about the axilla? A. It is bordered posteriorly by the subscapularis and serratus anterior. B. The axillary artery and vein run through its floor. C. It contains the cords and branches of the brachial plexus. D. It is bordered medially by the pectoralis major. E. It terminates at the superior border of the latissimus dorsi. Answer: C. Explanation: The axilla contains the cords and branches of the brachial plexus, along with the axillary artery and vein. 6. Which muscle forms the medial border of the cubital fossa? A. Brachioradialis B. Pronator teres C. Biceps brachii D. Supinator E. Palmaris longus Answer: B. Explanation: The pronator teres forms the medial border of the cubital fossa. 7. A case study: A 45-year-old presents with impaired shoulder abduction and loss of sensation over the lateral deltoid. Which anatomical space is most likely involved? A. Quadrangular space B. Cubital fossa C. Axilla D. Triangular interval E. Sub-sartorial canal Answer: A. Explanation: The quadrangular space contains the axillary nerve, which innervates the deltoid and teres minor. 8. Which nerve is found in the quadrangular space? A. Median nerve B. Axillary nerve C. Ulnar nerve D. Radial nerve E. Thoracodorsal nerve Answer: B. Explanation: The axillary nerve and posterior circumflex humeral artery pass through the quadrangular space. 9. Which structure is NOT a content of the cubital fossa? A. Biceps brachii tendon B. Median nerve C. Brachial artery D. Ulnar nerve E. Radial nerve Answer: D. Explanation: The ulnar nerve runs posterior to the medial epicondyle, not through the cubital fossa. 10. Which nerve is at risk of damage during a supracondylar fracture of the humerus? A. Ulnar nerve B. Axillary nerve C. Median nerve D. Radial nerve E. Musculocutaneous nerve Answer: C. Explanation: The median nerve lies anterior to the humerus and is vulnerable during supracondylar fractures. 11. What is the superior boundary of the quadrangular space? A. Teres major B. Teres minor C. Latissimus dorsi D. Subscapularis E. Long head of the triceps brachii Answer: B. Explanation: The superior boundary of the quadrangular space is the teres minor. 12. Which nerve innervates the posterior compartment of the forearm? A. Median nerve B. Radial nerve C. Ulnar nerve D. Axillary nerve E. Musculocutaneous nerve Answer: B. Explanation: The radial nerve innervates the posterior compartment of the forearm. 13. Which muscle forms part of the floor of the femoral triangle? A. Sartorius B. Pectineus C. Adductor magnus D. Gluteus medius E. Rectus femoris Answer: B. Explanation: The pectineus, iliopsoas, and adductor longus form the floor of the femoral triangle. 14. Which is NOT a boundary of the popliteal fossa? A. Semimembranosus B. Gastrocnemius heads C. Biceps femoris D. Sartorius E. Semitendinosus Answer: D. Explanation: The popliteal fossa is bounded by hamstrings and gastrocnemius but not the sartorius. 15. What is the primary content of the sub-sartorial canal? A. Tibial nerve B. Femoral nerve C. Femoral artery and vein D. Popliteal artery and vein E. Small saphenous vein Answer: C. Explanation: The femoral artery and vein pass through the sub-sartorial canal. 16. Which is MOST correct regarding the posterior triangle of the neck? A. It contains the thoracic duct. B. Its boundaries include the sternocleidomastoid, trapezius, and clavicle. C. It is bordered superiorly by the mandible. D. It houses the internal carotid artery. E. It contains the musculocutaneous nerve. Answer: B. Explanation: The posterior triangle is bordered by the sternocleidomastoid, trapezius, and clavicle. 17. A patient presents with winged scapula following trauma. Which structure is most likely injured? A. Accessory nerve (CN XI) B. Thoracodorsal nerve C. Long thoracic nerve D. Axillary nerve E. Median nerve Answer: C. Explanation: The long thoracic nerve innervates the serratus anterior, which stabilises the scapula. 18. What passes through the adductor hiatus? A. Femoral artery and vein B. Sciatic nerve C. Obturator nerve D. Popliteal artery and vein E. Great saphenous vein Answer: D. Explanation: The popliteal artery and vein pass through the adductor hiatus to reach the popliteal fossa. 19. Which vein enters the femoral triangle through the saphenous hiatus? A. Great saphenous vein B. Small saphenous vein C. Popliteal vein D. Femoral vein E. Basilic vein Answer: A. Explanation: The great saphenous vein enters the femoral triangle via the saphenous hiatus. 20. Which of the following is NOT a content of the axilla? A. Axillary artery B. Axillary vein C. Cords of the brachial plexus D. Long thoracic nerve E. Thoracic duct Answer: E. Explanation: The thoracic duct is not a content of the axilla; it drains into the venous angle. 21. Which nerve exits the popliteal fossa laterally? A. Tibial nerve B. Femoral nerve C. Common fibular nerve D. Obturator nerve E. Deep fibular nerve Answer: C. Explanation: The common fibular nerve exits laterally from the popliteal fossa. 22. Which is NOT a branch of the posterior cord of the brachial plexus? A. Axillary nerve B. Radial nerve C. Median nerve D. Thoracodorsal nerve E. Upper subscapular nerve Answer: C. Explanation: The median nerve arises from the lateral and medial cords, not the posterior cord. 23. What is the lateral border of the femoral triangle? A. Adductor longus B. Sartorius C. Inguinal ligament D. Iliopsoas E. Tensor fasciae latae Answer: B. Explanation: The sartorius forms the lateral border of the femoral triangle. 24. Which ligament forms the superior border of the femoral triangle? A. Sacrospinous ligament B. Pubofemoral ligament C. Inguinal ligament D. Iliofemoral ligament E. Ischiofemoral ligament Answer: C. Explanation: The inguinal ligament forms the superior boundary of the femoral triangle. 25. Which muscle forms the superior boundary of the popliteal fossa medially? A. Biceps femoris B. Semitendinosus C. Semimembranosus D. Sartorius E. Gracilis Answer: C. Explanation: The semimembranosus forms the superior medial boundary of the popliteal fossa. 26. Which is MOST correct regarding the lumbosacral plexus? A. It supplies the upper limb. B. It is derived from L4-S4 nerve roots. C. The femoral nerve arises from the posterior divisions of L2-L4. D. It does not provide motor innervation to the leg. E. The obturator nerve arises from L5-S1. Answer: C. Explanation: The femoral nerve arises from the posterior divisions of L2-L4 and supplies the anterior thigh. 27. Which nerve passes through the sub-sartorial canal to reach the leg? A. Obturator nerve B. Saphenous nerve C. Sciatic nerve D. Femoral nerve E. Tibial nerve Answer: B. Explanation: The saphenous nerve, a branch of the femoral nerve, passes through the sub- sartorial canal. 28. Which is NOT correct regarding the brachial artery? A. It lies medial to the biceps brachii tendon in the cubital fossa. B. It divides into the radial and ulnar arteries at the cubital fossa. C. It runs posterior to the humerus throughout its course. D. It supplies blood to the anterior compartment of the arm. E. It is a continuation of the axillary artery. Answer: C. Explanation: The brachial artery runs anterior to the humerus, not posterior. 29. Which artery accompanies the axillary nerve in the quadrangular space? A. Subscapular artery B. Posterior circumflex humeral artery C. Anterior circumflex humeral artery D. Deep brachial artery E. Thoracoacromial artery Answer: B. Explanation: The posterior circumflex humeral artery passes through the quadrangular space with the axillary nerve. 30. What is the most lateral structure in the cubital fossa? A. Brachial artery B. Median nerve C. Biceps tendon D. Radial nerve E. Pronator teres Answer: C. Explanation: The biceps tendon is the most lateral structure in the cubital fossa. 31. Which space contains the subclavian artery and brachial plexus trunks? A. Subclavian triangle B. Posterior triangle of the neck C. Axilla D. Interscalene triangle E. Cervical plexus Answer: D. Explanation: The interscalene triangle contains the subclavian artery and brachial plexus trunks. 32. Which vein drains into the popliteal vein in the popliteal fossa? A. Great saphenous vein B. Basilic vein C. Small saphenous vein D. Femoral vein E. Anterior tibial vein Answer: C. Explanation: The small saphenous vein drains into the popliteal vein in the popliteal fossa. 33. Which is NOT correct about the thoracodorsal nerve? A. It arises from the posterior cord of the brachial plexus. B. It innervates the latissimus dorsi muscle. C. It accompanies the thoracodorsal artery. D. It arises from C6-C7 only. E. It is a motor nerve. Answer: D. Explanation: The thoracodorsal nerve arises from C6-C8 nerve roots. 34. Which is NOT a content of the femoral triangle? A. Femoral artery B. Femoral vein C. Femoral nerve D. Great saphenous vein E. Deep fibular nerve Answer: E. Explanation: The deep fibular nerve is not located in the femoral triangle. 35. Which is MOST correct regarding the contents of the sub-sartorial canal? A. It contains the femoral nerve, femoral artery, and femoral vein. B. It contains only the femoral artery and vein. C. It contains the femoral artery, femoral vein, and saphenous nerve. D. It contains only the saphenous nerve. E. It contains the great saphenous vein. Answer: C. Explanation: The sub-sartorial canal contains the femoral artery, femoral vein, and saphenous nerve. 36. What is the most common site of injury to the ulnar nerve? A. Cubital tunnel B. Axilla C. Quadrangular space D. Sub-sartorial canal E. Popliteal fossa Answer: A. Explanation: The ulnar nerve is commonly injured in the cubital tunnel near the elbow. 37. Which is NOT a branch of the femoral nerve? A. Saphenous nerve B. Lateral femoral cutaneous nerve C. Intermediate femoral cutaneous nerve D. Medial femoral cutaneous nerve E. Branches to the quadriceps Answer: B. Explanation: The lateral femoral cutaneous nerve is not a branch of the femoral nerve; it arises directly from the lumbar plexus. 38. Which structure is medial to the femoral vein in the femoral triangle? A. Femoral artery B. Femoral nerve C. Great saphenous vein D. Femoral canal E. Sartorius Answer: D. Explanation: The femoral canal lies medial to the femoral vein within the femoral triangle. 39. Which is NOT a boundary of the sub-sartorial canal? A. Adductor longus B. Adductor magnus C. Sartorius D. Rectus femoris E. Vastus medialis Answer: D. Explanation: The sub-sartorial canal is not bordered by the rectus femoris. 40. Which muscle forms the superior border of the cubital fossa? A. Biceps brachii B. Brachialis C. Pronator teres D. Triceps brachii E. Line connecting the epicondyles Answer: E. Explanation: The superior border of the cubital fossa is a line connecting the medial and lateral epicondyles. Lecture 6. PreLab 2 1. Which of the following is NOT correct regarding the innervation of the anterior compartment of the arm? A. The musculocutaneous nerve arises from the lateral cord of the brachial plexus. B. The musculocutaneous nerve innervates the biceps brachii, brachialis, and coracobrachialis. C. The musculocutaneous nerve passes through the coracobrachialis. D. The musculocutaneous nerve provides sensory innervation to the skin of the forearm. E. The anterior compartment is innervated by the radial nerve. Answer: E. Explanation: The anterior compartment of the arm is innervated by the musculocutaneous nerve, not the radial nerve. 2. Which muscle is the primary flexor at the glenohumeral joint (GHJ) in the anterior compartment of the arm? A. Coracobrachialis B. Brachialis C. Short head of biceps brachii D. Long head of biceps brachii E. Deltoid (anterior fibres) Answer: A. Explanation: The coracobrachialis is the primary flexor at the GHJ in the anterior compartment. 3. Which of the following correctly describes the function of the brachialis muscle? A. Flexion and internal rotation at the glenohumeral joint B. Flexion of the elbow joint, with insertion into the radial tuberosity C. Flexion of the elbow joint, with insertion into the ulnar tuberosity D. Supination of the forearm E. Flexion and external rotation at the GHJ Answer: C. Explanation: The brachialis flexes the elbow and inserts into the ulnar tuberosity. 4. Which is NOT correct regarding the attachment points of the short head of biceps brachii? A. Originates from the coracoid process B. Inserts into the radial tuberosity C. Passes through the bicipital groove D. Functions as a flexor and supinator E. Is a ventral muscle crossing the GHJ Answer: C. Explanation: The short head of biceps does not pass through the bicipital groove; the long head does. 5. A patient has difficulty flexing the elbow and supinating the forearm. Which muscle is most likely affected? A. Coracobrachialis B. Long head of biceps brachii C. Brachialis D. Brachioradialis E. Pronator teres Answer: B. Explanation: The long head of biceps brachii is a major supinator and flexor of the elbow. 6. Which nerve passes through the triangular interval alongside the deep brachial artery? A. Axillary nerve B. Radial nerve C. Median nerve D. Musculocutaneous nerve E. Ulnar nerve Answer: B. Explanation: The radial nerve travels through the triangular interval with the deep brachial artery. 7. What is the function of the long head of the triceps brachii at the glenohumeral joint? A. Abduction B. Internal rotation C. Flexion D. Extension E. External rotation Answer: D. Explanation: The long head of the triceps extends the GHJ and the elbow. 8. Which is MOST correct regarding the radial nerve in the posterior compartment of the arm? A. It innervates only the triceps brachii. B. It travels in the spiral groove of the humerus with the profunda brachii artery. C. It supplies motor innervation exclusively to the upper limb. D. It enters the quadrangular space alongside the axillary nerve. E. It innervates both dorsal and ventral muscles. Answer: B. Explanation: The radial nerve travels in the spiral groove alongside the profunda brachii artery. 9. Which is NOT correct about the insertion of the triceps brachii? A. All three heads insert into the olecranon process of the ulna. B. The long head crosses the GHJ. C. It is innervated by the musculocutaneous nerve. D. It functions as an extensor of the elbow joint. E. The lateral head originates from the humerus. Answer: C. Explanation: The triceps brachii is innervated by the radial nerve, not the musculocutaneous nerve. 10. Which muscle originates from the infraglenoid tubercle? A. Long head of triceps brachii B. Long head of biceps brachii C. Coracobrachialis D. Deltoid E. Teres minor Answer: A. Explanation: The long head of the triceps brachii originates from the infraglenoid tubercle. 11. Which of the following is NOT a general characteristic of dorsal compartment muscles? A. They are innervated by the radial nerve. B. Their general action is extension. C. They cross the elbow joint. D. They originate from ventral components of the scapula. E. They insert distally on the olecranon process or bones of the forearm. Answer: D. Explanation: Dorsal compartment muscles originate from dorsal components, not ventral ones. 12. What is the common action of the biceps brachii and coracobrachialis? A. Flexion and external rotation of the GHJ B. Extension and internal rotation of the GHJ C. Flexion and internal rotation of the GHJ D. Supination and external rotation of the GHJ E. Abduction and internal rotation of the GHJ Answer: C. Explanation: Both muscles flex and internally rotate the glenohumeral joint. 13. Which is NOT a content of the triangular interval? A. Radial nerve B. Deep brachial artery C. Axillary nerve D. Profunda brachii vein E. None of the above Answer: C. Explanation: The axillary nerve passes through the quadrangular space, not the triangular interval. 14. Which nerve is MOST responsible for elbow extension? A. Musculocutaneous nerve B. Median nerve C. Ulnar nerve D. Radial nerve E. Axillary nerve Answer: D. Explanation: The radial nerve innervates the triceps brachii, the main extensor of the elbow. 15. Which muscle is deep to the biceps brachii and inserts into the ulnar tuberosity? A. Coracobrachialis B. Brachialis C. Triceps brachii D. Deltoid E. Brachioradialis Answer: B. Explanation: The brachialis lies deep to the biceps and inserts into the ulnar tuberosity. 16. Which muscle has dual innervation, receiving fibres from both the musculocutaneous and radial nerves? A. Biceps brachii B. Coracobrachialis C. Brachialis D. Triceps brachii E. Anconeus Answer: C. Explanation: The brachialis receives dual innervation from the musculocutaneous nerve (major) and the radial nerve (minor). 17. A patient with a fracture at the midshaft of the humerus is unable to extend their wrist. Which nerve is most likely affected? A. Axillary nerve B. Median nerve C. Radial nerve D. Ulnar nerve E. Musculocutaneous nerve Answer: C. Explanation: The radial nerve travels in the spiral groove at the midshaft of the humerus and innervates wrist extensors. 18. Which structure is NOT found in the quadrangular space? A. Axillary nerve B. Posterior circumflex humeral artery C. Long head of the triceps brachii D. Radial nerve E. Teres minor Answer: D. Explanation: The radial nerve passes through the triangular interval, not the quadrangular space. 19. Which muscle acts as both a flexor at the elbow and a supinator of the forearm? A. Coracobrachialis B. Long head of biceps brachii C. Brachialis D. Short head of biceps brachii E. Pronator teres Answer: D. Explanation: The biceps brachii (both heads) flex the elbow and supinate the forearm. 20. Which is NOT correct regarding the coracobrachialis muscle? A. It originates from the coracoid process of the scapula. B. It inserts on the medial shaft of the humerus. C. It is innervated by the radial nerve. D. It acts as a flexor of

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