Spine AP Questions PDF

**Anatomy of the Spinal Cord** 1. Where does the spinal cord begin? - a\) Occipital bone - b\) Foramen magnum - c\) C1 vertebra - d\) Conus medullaris\ **Answer: b** 2. At which vertebral level does the spinal cord typically end in adults? - a\) L2...

**Anatomy of the Spinal Cord** 1. Where does the spinal cord begin? - a\) Occipital bone - b\) Foramen magnum - c\) C1 vertebra - d\) Conus medullaris\ **Answer: b** 2. At which vertebral level does the spinal cord typically end in adults? - a\) L2 - b\) L3 - c\) S1 - d\) L4\ **Answer: a** 3. What structure forms below the conus medullaris from lumbar and sacral roots? - a\) Filum terminale - b\) Cauda equina - c\) Dorsal horn - d\) Pia mater\ **Answer: b** **Spinal Cord Blood Supply** 6. What artery supplies the anterior two-thirds of the spinal cord? - a\) Posterior spinal artery - b\) Vertebral artery - c\) Radicular artery - d\) Anterior spinal artery\ **Answer: d** 7. Where does the artery of Adamkiewicz most commonly originate? - a\) L1-2 - b\) T1-2 - c\) T8-12 - d\) C5-6\ **Answer: c** 8. What can happen if there is occlusion of the artery of Adamkiewicz? - a\) Paralysis - b\) Pain - c\) Muscle twitching - d\) Decreased proprioception\ **Answer: a** 9. Which regions of the spinal cord are most vulnerable to ischemia due to single blood supply? - a\) Cervical - b\) Lumbar - c\) Thoracolumbar - d\) Sacral\ **Answer: c** 10. What is the normal autoregulatory range for mean arterial pressure in the spinal cord? - a\) 30-100 mm Hg - b\) 50-150 mm Hg - c\) 70-180 mm Hg - d\) 40-120 mm Hg\ **Answer: b** **Spinal Cord Coverings** 11. Which layer of meninges closely adheres to the spinal cord surface? - a\) Dura mater - b\) Arachnoid mater - c\) Pia mater - d\) Subdural mater\ **Answer: c** 12. What connects the spinal cord to the dura mater? - a\) Denticulate ligaments - b\) Pia folds - c\) Arachnoid villi - d\) Conus medullaris\ **Answer: a** 13. The dura mater is: - a\) A thin, delicate layer - b\) The tough outer sheath - c\) Adherent to the spinal cord surface - d\) Only present around the brain\ **Answer: b** **Reflexes and Reflex Arcs** 14. The knee-jerk reflex is an example of: - a\) Polysynaptic reflex - b\) Autonomic reflex - c\) Monosynaptic reflex - d\) Reciprocal reflex\ **Answer: c** 15. Which of these is a function of the myotatic reflex? - a\) Increase blood pressure - b\) Resist gravity - c\) Aid in digestion - d\) Control pupil size\ **Answer: b** 16. Reciprocal inhibition involves: - a\) Agonist and antagonist muscle pairs - b\) Only agonist muscles - c\) Reflex arcs without interneurons - d\) A one-synapse pathway\ **Answer: a** 17. What is another name for the inverse myotatic reflex? - a\) Golgi tendon reflex - b\) Deep tendon reflex - c\) Polysynaptic reflex - d\) Reciprocal reflex\ **Answer: a** 18. The inverse myotatic reflex protects muscles from: - a\) Injury during extreme contraction - b\) Cold exposure - c\) Infection - d\) Excessive heat\ **Answer: a** **Clinical Conditions Related to the Spinal Cord** 19. Cauda Equina Syndrome is considered: - a\) A chronic illness - b\) A mild condition - c\) A medical emergency - d\) Self-limiting\ **Answer: c** 20. Which symptom is common in Cauda Equina Syndrome? - a\) Headache - b\) Urinary retention - c\) Coughing - d\) Shortness of breath\ **Answer: b** 21. Transient Neurologic Syndrome is characterized by: - a\) Severe motor deficits - b\) Mild to severe pain in legs and buttocks - c\) Permanent damage to the spinal cord - d\) Complete sensory loss\ **Answer: b** 22. Which of the following best describes the treatment for Transient Neurologic Syndrome? - a\) Surgical intervention - b\) High-dose corticosteroids - c\) NSAIDs and trigger point injections - d\) Antibiotics\ **Answer: c** 23. Which local anesthetic is associated with both Cauda Equina Syndrome and Transient Neurologic Syndrome? - a\) Bupivacaine - b\) Lidocaine - c\) Procaine - d\) Ropivacaine\ **Answer: b** 24. Anterior Spinal Artery Syndrome is also known as: - a\) Beck\'s syndrome - b\) Cauda Equina Syndrome - c\) Radicular Syndrome - d\) Posterior Spinal Syndrome\ **Answer: a** 25. In Beck\'s syndrome, which sensation is preserved? - a\) Pain - b\) Temperature - c\) Vibration - d\) Motor function\ **Answer: c** 26. Damage to the Artery of Adamkiewicz can cause: - a\) Flaccid paralysis - b\) Increased heart rate - c\) Memory loss - d\) Loss of proprioception\ **Answer: a** **Functions of the Spinal Cord** 27. Which part of the spinal cord is primarily responsible for sensory information? - a\) Anterior - b\) Posterior - c\) Lateral - d\) Inferior\ **Answer: b** 28. The spinal cord serves as a center for: - a\) Only motor function - b\) Only sensory function - c\) Reflex coordination - d\) Hormone production\ **Answer: c** 29. The anterior portion of the spinal cord is associated with: - a\) Sensory information - b\) Autonomic regulation - c\) Motor information - d\) Only reflexes\ **Answer: c** 31. The primary curves in the vertebral column include: - a\) Lumbar and cervical - b\) Sacral and thoracic - c\) Thoracic and cervical - d\) Lumbar and sacral\ **Answer: b** **Intervertebral Discs and Ligaments** 36. Which part of an intervertebral disc acts as a shock absorber? - a\) Anulus fibrosus - b\) Nucleus pulposus - c\) Vertebral end plate - d\) Ligamentum flavum\ **Answer: b** 37. What is the main structural difference between tendons and ligaments? - a\) Tendons connect bone to bone, ligaments connect muscle to bone - b\) Tendons connect muscle to bone, ligaments connect bone to bone - c\) Ligaments have a greater blood supply than tendons - d\) Tendons are more flexible than ligaments\ **Answer: b** 38. The ligamentum flavum is considered: - a\) The weakest ligament in the vertebral column - b\) The strongest ligament in the vertebral column - c\) Primarily responsible for shock absorption - d\) Exclusively located in the cervical region\ **Answer: b** 39. Herniation of the nucleus pulposus typically occurs: - a\) Through the anterior anulus fibrosus - b\) Through the posterior anulus fibrosus - c\) Into the spinal cord - d\) Only in the cervical region\ **Answer: b** 40. Intervertebral discs contribute to which of the following? - a\) Curvature of the spine - b\) Length of the spinal column - c\) Rotation of the vertebrae - d\) Only the cervical spine\ **Answer: b** **Somatic Motor Systems** 41. The somatic motor system primarily controls: - a\) Cardiac muscle - b\) Glandular secretions - c\) Voluntary muscle movements - d\) Reflex arcs only\ **Answer: c** 42. Upper motor neurons are located in the: - a\) Spinal cord - b\) Peripheral nervous system - c\) Cerebral cortex and brainstem - d\) Autonomic nervous system\ **Answer: c** 43. Alpha motor neurons are also known as: - a\) Lower motor neurons - b\) Interneurons - c\) Upper motor neurons - d\) Sensory neurons\ **Answer: a** 44. What neurotransmitter is released at the neuromuscular junction by motor neurons? - a\) Dopamine - b\) Serotonin - c\) Acetylcholine (ACh) - d\) Glutamate\ **Answer: c** 45. Which structure in the spinal cord relays feedback about muscle length? - a\) Golgi tendon organs - b\) Muscle spindles - c\) Pacinian corpuscles - d\) Free nerve endings\ **Answer: b** **Motor Pathways and Tracts** 46. The corticospinal tract is part of the: - a\) Pyramidal system - b\) Extrapyramidal system - c\) Autonomic nervous system - d\) Sensory system\ **Answer: a** 47. Which tract is responsible for fine motor control and originates in the red nucleus? - a\) Vestibulospinal tract - b\) Tectospinal tract - c\) Rubrospinal tract - d\) Reticulospinal tract\ **Answer: c** 48. Decussation of most corticospinal tract fibers occurs at the: - a\) Cerebral cortex - b\) Medulla - c\) Thalamus - d\) Spinal cord\ **Answer: b** 49. Damage to the upper motor neurons can lead to: - a\) Flaccid paralysis - b\) Hyperreflexia - c\) Hypotonia - d\) Fasciculations\ **Answer: b** 50. Lesions below the level of the medullary pyramids will produce: - a\) Contralateral weakness - b\) Ipsilateral weakness - c\) Complete loss of sensation - d\) Decreased blood flow\ **Answer: b** **Spinal Cord Disorders and Syndromes** 51. A lower motor neuron lesion typically results in: - a\) Hypertonia - b\) Flaccid paralysis - c\) Increased reflexes - d\) Spasticity\ **Answer: b** 52. Which of the following is a pure lower motor neuron disease? - a\) Multiple sclerosis - b\) Amyotrophic lateral sclerosis (ALS) - c\) Poliomyelitis - d\) Myasthenia gravis\ **Answer: c** 53. Amyotrophic lateral sclerosis (ALS) involves: - a\) Only lower motor neurons - b\) Only sensory neurons - c\) Both upper and lower motor neurons - d\) Only upper motor neurons\ **Answer: c** 54. Which spinal syndrome causes a loss of pain and temperature sensation while preserving proprioception and vibration? - a\) Brown-Séquard syndrome - b\) Anterior spinal artery syndrome - c\) Central cord syndrome - d\) Posterior cord syndrome\ **Answer: b** 55. What symptom is commonly preserved in anterior spinal artery syndrome? - a\) Temperature sensation - b\) Pain sensation - c\) Vibration sense - d\) Motor function\ **Answer: c** **Somatosensory System and Dermatomes** 56. Which type of sensation is NOT transmitted by the dorsal column-medial lemniscus pathway? - a\) Discriminative touch - b\) Vibration - c\) Pain - d\) Proprioception\ **Answer: c** 57. Which spinal nerve root keeps the diaphragm functioning? - a\) C3-4-5 - b\) C6-7-8 - c\) L1-2 - d\) S2-3-4\ **Answer: a** 58. Which condition can cause painful eruptions in a specific dermatomic area due to nerve infection? - a\) Scoliosis - b\) Herpes zoster - c\) Cauda equina syndrome - d\) Phantom limb pain\ **Answer: b** **Pain and Temperature Sensation** 61. Pain receptors in the body are also known as: - a\) Thermoreceptors - b\) Nociceptors - c\) Mechanoreceptors - d\) Photoreceptors\ **Answer: b** 62. Which type of fibers carry fast, sharp pain signals? - a\) Type C fibers - b\) Type A delta fibers - c\) Type B fibers - d\) Type C beta fibers\ **Answer: b** 63. What type of sensation is poorly localized and often described as burning or aching? - a\) Deep pain - b\) Sharp pain - c\) Referred pain - d\) Fast pain\ **Answer: c** 64. Phantom limb pain can occur: - a\) Only in amputees - b\) After spinal cord injuries - c\) After amputation or congenital limb deficiency - d\) Only with lower limb injuries\ **Answer: c** 65. Which of the following types of pain is associated with internal organ discomfort? - a\) Superficial pain - b\) Visceral pain - c\) Referred pain - d\) Phantom pain\ **Answer: b** **Temperature Sensation** 66. Which thermoreceptor responds to a broad range of temperatures? - a\) Hot fibers - b\) Cold fibers - c\) Ruffini endings - d\) Pacinian corpuscles\ **Answer: b** 67. Warm fibers respond to: - a\) Narrower temperature ranges - b\) Broad temperature ranges - c\) Only high temperatures - d\) Very cold temperatures\ **Answer: a** 68. Which sensory receptors are rapidly adapting and detect vibration? - a\) Merkel's disks - b\) Pacinian corpuscles - c\) Meissner's corpuscles - d\) Ruffini endings\ **Answer: b** 69. What is the primary function of cold fibers in the body? - a\) Control sweating - b\) Recognize skin contact changes - c\) Detect heat - d\) Constrict blood vessels\ **Answer: b** **Reflex Arcs and Muscle Function** 71. The brachioradialis reflex is primarily associated with which spinal nerve roots? - a\) C1-C2 - b\) C5-C6 - c\) C7-C8 - d\) T1-T2\ **Answer: b** 72. Reciprocal inhibition involves: - a\) Contraction of both agonist and antagonist muscles - b\) Relaxation of the antagonist muscle - c\) Only sensory neuron activation - d\) Inhibition of the agonist muscle\ **Answer: b** 73. Which reflex is also known as the knee-jerk reflex? - a\) Golgi tendon reflex - b\) Myotatic reflex - c\) Inverse myotatic reflex - d\) Reciprocal reflex\ **Answer: b** 74. The function of Golgi tendon organs is to: - a\) Detect muscle length - b\) Inhibit excessive muscle contraction - c\) Stimulate pain receptors - d\) Control joint movement\ **Answer: b** 75. Which spinal nerve roots are associated with the ankle reflex? - a\) S1 - b\) L2-L4 - c\) C5-C6 - d\) T2-T3\ **Answer: a** **Neural Pathways for Sensory Processing** 76. The dorsal column-medial lemniscus pathway decussates at the: - a\) Spinal cord - b\) Medulla - c\) Pons - d\) Cerebellum\ **Answer: b** 77. Loss of proprioception due to damage below the medulla results in: - a\) Ipsilateral loss of sensation - b\) Contralateral loss of sensation - c\) Loss of pain and temperature sensation - d\) Motor weakness\ **Answer: a** 78. Which receptor is involved in detecting steady pressure? - a\) Pacinian corpuscles - b\) Ruffini endings - c\) Merkel's disks - d\) Meissner's corpuscles\ **Answer: c** 79. The dorsal column-medial lemniscus pathway is primarily involved in: - a\) Pain and temperature sensation - b\) Light touch, vibration, and proprioception - c\) Reflex coordination - d\) Thermoregulation\ **Answer: b** 80. An injury to the spinothalamic tract would affect: - a\) Proprioception - b\) Pain and temperature sensation - c\) Vibration sense - d\) Reflex arcs\ **Answer: b** **Disorders Affecting the Dorsal Column-Medial Lemniscus Pathway** 81. A positive Romberg sign may indicate a problem with: - a\) Vestibular function - b\) Dorsal column-medial lemniscus pathway - c\) Spinothalamic tract - d\) Corticospinal tract\ **Answer: b** 82. Tabes dorsalis, a condition affecting the dorsal columns, is often associated with: - a\) Syphilis - b\) Tuberculosis - c\) Multiple sclerosis - d\) Herpes zoster\ **Answer: a** 83. Which vitamin deficiency can lead to neuropathy affecting the dorsal columns? - a\) Vitamin A - b\) Vitamin B12 - c\) Vitamin C - d\) Vitamin D\ **Answer: b** 84. Tabes dorsalis typically results in: - a\) Increased muscle tone - b\) Loss of touch and proprioception - c\) Pain and temperature sensation loss - d\) Unaffected reflexes\ **Answer: b** 85. Loss of proprioception can cause a: - a\) Spastic gait - b\) Ataxic, wide-based gait - c\) High-stepping gait - d\) Limping gait\ **Answer: b** **Additional Clinical Considerations** 86. Which nerve roots are associated with shoulder abduction and external rotation? - a\) C3-C4 - b\) C5 - c\) C6 - d\) T1\ **Answer: b** 87. Spinal cord injuries in the thoracolumbar region are most likely to affect: - a\) Upper limb sensation - b\) Lower limb movement - c\) Fine motor control of hands - d\) Cranial nerve function\ **Answer: b** 88. Injury to the posterior spinal artery would affect: - a\) Pain and temperature sensation - b\) Vibration and proprioception - c\) Motor control of lower limbs - d\) Only autonomic function\ **Answer: b** 89. Which spinal condition results in lateral curvature of the spine? - a\) Lordosis - b\) Kyphosis - c\) Scoliosis - d\) Ankylosing spondylitis\ **Answer: c** 90. Which muscle is primarily responsible for thigh flexion? - a\) Quadratus lumborum - b\) Psoas major - c\) Longissimus thoracis - d\) Iliocostalis thoracis\ **Answer: b**