chapter 14

What is the correct order for the parts of the spinal cord, from superior to inferior?

Cervical - thoracic - sacral - coccygeal - lumbar
→ Cervical - thoracic - lumbar - sacral - coccygeal
Thoracic - lumbar - sacral - cervical - coccygeal
Thoracic - cervical - lumbar - coccygeal - sacral
Thoracic - lumbar - sacral - coccygeal - cervical

A typical spinal cord in an adult is

24-26 inches long
12-14 inches long
8-10 inches long
→ 16-18 inches long
20-24 inches long

In adults, the spinal cord is a different length than the vertebral canal, and most of the lumbar part of the spinal cord is within:

the coccyx.
the sacrum.
the cervical vertebrae.
→ the thoracic vertebrae.
the cauda equina

The inferior tip of the spinal cord is the \___________ part.

thoracic
lumbar
→ coccygeal
cervical
sacral

What is the thin strand of pia mater that helps to anchor the spinal cord to the coccyx?

Conus medullaris
Cervical enlargement
Terminus coccyx
→ Filum terminale
Coccygeal tendon

The spinal cord part with the largest diameter is the \___________ part.

thoracic
→ cervical
lumbar
sacral
coccygeal

The tapered, conical inferior end of the spinal cord is called the conus \___________.

finalis
→ medullaris
equine
caudalis
sacralis

Each side of the spinal cord gives rise to \_____ cervical nerves.

two
six
seven
→ eight
twelve

The most inferior spinal nerve is:

C7
C8
→ Co1
Co7
CN XII

Which statement accurately describes spinal nerves?

Most spinal nerves are motor nerves.
→ Each spinal nerve is mixed in that it contains some sensory axons and some motor axons.
All spinal nerves are sensory nerves.
Odd numbered spinal nerves are sensory and even numbered spinal nerves are motor.
Spinal nerves are central axons contained within the vertebral canal.

Which space associated with the spinal cord meninges contains areolar connective tissue, blood vessels, and adipose connective tissue?

Subarachnoid space
→ Epidural space
Central canal
Subdural space
Epiarachnoid space

Which space associated with the spinal cord meninges contains cerebrospinal fluid?

Epidural space
Subdural space
→ Subarachnoid space
Epiarachnoid space
Subpial space

In a lumbar puncture (spinal tap), fluid is extracted from the:

central canal of the spinal cord.
epidural space.
subdural space.
epipial space.
→ subarachnoid space.

The most delicate of the meninges consists of elastic and collagen fibers and is known as the:

! pia mater.
dura mater.
falx cerebri.
arachnoid mater

The posterior horns of the spinal cord contain:

axons of motor neurons and cell bodies of interneurons.
axons of sensory and motor neurons.
axons of interneurons.
→ axons of sensory neurons and cell bodies of interneurons.
autonomic motor neurons.

The lateral horns of the spinal cord contain:

axons of motor neurons and interneuron cell bodies.
axons of sensory and motor neurons.
cell bodies of somatic sensory neurons.
axons of sensory neurons and interneuron cell bodies.
→ cell bodies of autonomic motor neurons.

This structure contains unmyelinated axons and serves as a communication route between the right and left sides of the gray matter in the spinal cord.

! Gray commissure
White commissure
Lateral commissure
Posterior commissure
Denticulate ligaments

Nuclei within the gray matter of the spinal cord that receive information from sensory receptors such as pain or pressure receptors in the skin are \_____ nuclei.

visceral sensory
→ somatic sensory
autonomic motor
somatic motor

The \_______ nuclei within the gray matter of the spinal cord send nerve impulses to skeletal muscles.

visceral sensory
somatic sensory
autonomic motor
→ somatic motor

These nuclei are located in the lateral horns and innervate smooth muscle, cardiac muscle, and glands.

Sensory nuclei
→ Autonomic motor nuclei
Visceral sensory nuclei
Somatic sensory nuclei
Somatic motor nuclei

In sum, there are \____ pairs of spinal nerves.

13
→ 31
40
51
12

The large section of spinal white matter that is found between the posterior gray horns is known as the posterior:

commissure.
→ funiculus.
decussation.
peduncle

Which of the following accurately compares sections of spinal white matter?

! A fasciculus is smaller than a funiculus.
A fasciculus is larger than a funiculus.
A fasciculus is smaller than a tract.
A fasciculus is larger than a tract

A conduction pathway consists of a:

nerve and effector.
nerve and a tract.
ganglion and a nucleus.
→ tract and a nucleus.
afferent, nerve, and effector.

Which accurately describes sensory and motor pathways?

! Sensory pathways terminate in the brain, and motor pathways terminate at effectors.
Both sensory and motor pathways terminate in the brain.
Both sensory and motor pathways terminate in the PNS.
Sensory pathways terminate at effectors and motor pathways terminate in the brain

Since most pathways decussate, each side of the brain processes information from the \_________ side of the body.

! contralateral
ipsilateral

\________ pathways have peripheral primary neurons and central secondary and tertiary neurons.

Motor
→ Sensory

Neurons of the thalamus that are part of sensory conduction pathways are considered:

primary neurons.
secondary neurons.
→ tertiary neurons.
quaternary neurons

Information about temperature, proprioception, and pressure from skin, joints, and muscles is conveyed by:

somatomotor pathways.
visceromotor pathways.
→ somatosensory pathways.
viscerosensory pathways.

The axons of primary sensory neurons make synaptic connections with:

posterior root ganglia of spinal nerves.
→ secondary neurons in the CNS.
secondary neurons in the PNS.
thalamic neurons.

The fasciculus cuneatus is part of the:

anterolateral pathway.
spinocerebellar pathway.
→ posterior funiculus--medial lemniscal pathway.
lateral spinothalamic tract.
fasciculus gracilis.

The medial lemniscus is:

gray matter in the spinal cord that processes information about proprioception and touch.
gray matter in the spinal cord that processes information about pain and temperature.
→ white matter in the brainstem that conducts information about proprioception and touch.
white matter in the brainstem that conducts information about pain and temperature

primary
→ secondary
tertiary
quaternary

Information about pain and temperature is conveyed to the brain by way of the:

posterior funiculus-medial lemniscal pathway.
spinocerebellar pathway.
→ anterolateral pathway.
fasciculus gracilis.
tectospinal tract.

The anterior spinocerebellar tract conducts signals about:

pain from the upper limbs.
pain from the lower limbs.
proprioception from the upper limbs.
→ proprioception from the lower limbs

The neurons that directly innervate skeletal muscles are called:

first order neurons.
second order neurons.
upper motor neurons.
→ lower motor neurons.

The function of upper motor neurons is to:

directly excite skeletal muscle cells.
excite or inhibit skeletal muscle cells.
→ excite or inhibit lower motor neurons.
excite motor portions of the thalamus.
excite or inhibit motor portions of the cerebral cortex.

The direct motor pathway originates in the:

! motor cortex of the cerebral cortex.
superior colliculus of the midbrain.
vestibular nuclei of the brainstem.
reticular formation of the brainstem

The lateral corticospinal tracts include a \________ of the upper motor neuron axons that pass through the medulla, and they govern control of \___________.

majority, axial muscles
→ majority, muscles used for finely controlled movements
minority, axial muscles
minority, muscles used for finely controlled movements

Axons of the corticobulbar tracts:

descend in the lateral funiculus of the spinal cord and synapse with anterior horn motor neurons.
descend in the anterior funiculus of the spinal cord and synapse with lateral horn motor neurons.
→ do not pass through the spinal cord, as they synapse with lower motor neurons in brainstem cranial nuclei.
do not pass through the spinal cord, as they synapse with cerebellar Purkinje cells.
connect the supplementary motor cortex with the primary motor cortex.

Motor pathways are \_________ tracts that control \_________.

ascending, affectors
ascending, effectors
descending, affectors
→ descending, effectors

Which of the rami is much smaller?

The anterior ramus
→ The posterior ramus

Which are not spinal nerve branches?

Rami communicantes
Posterior rami
Anterior rami
→ Lateral rami
No exceptions; all of the choices are spinal nerve branches

A posterior root contains:

! sensory axons only.
motor axons only.
a mix of sensory and motor axons.
autonomic nervous system axons

Which of the following structures is closest to the spinal cord?

Posterior ramus
Posterior root ganglion
→ Posterior rootlets
Posterior root

The third cervical spinal nerve exits the vertebral column through the:

! intervertebral foramen between C2 and C3 vertebrae.
intervertebral foramen between C3 and C4 vertebrae.
transverse foramen of C3 vertebra.
vertebral canal of vertebrae C2, C3 and C4

The second thoracic spinal nerve exits the spinal column through the:

vertebral canal of vertebrae T1, T2 and T3.
sacral hiatus.
→ intervertebral foramen between vertebrae T2 and T3.
intervertebral foramen between vertebrae T1 and T2

If a patient experiences numbness in the boundaries of a dermatome, it is suggestive of damage to:

the somatosensory cortex.
the thalamus.
one of the spinal funiculi.
the anterior horn of grey matter in the spinal cord.
→ a spinal nerve

The posterior ramus of a typical spinal nerve innervates the:

! deep muscles of the back and the skin of the back.
major thoracic and abdominal organs.
abdominal wall.
anterior and lateral trunk and the limbs.
special senses.

The anterior ramus of a typical spinal nerve innervates the:

deep muscles of the back and the skin of the back.
major thoracic and abdominal organs.
abdominal wall.
→ anterior and lateral trunk and the limbs.
special senses

A network of interwoven anterior rami of spinal nerves is a:

ramus.
communicans.
ganglion.
dermatome.
→ plexus.

The anterior rami of T1-T11 are called:

dorsal plexuses.
anterior plexuses.
→ intercostal nerves.
branchial nerves.
cervical nerves.

The plexuses that lie on either side of the neck are the \_____ plexuses.

! cervical
branchial
lumbar
radial
mandibular

If a person suffers a thorax-crushing injury and is unable to breathe properly, you would suspect that this nerve was damaged.

Transverse cervical nerve
Accessory nerve
→ Phrenic nerve
Sciatic nerve
Greater auricular nerve

posterior rami of spinal nerves C2-C6.
posterior rami of spinal nerves C4-C8.
→ anterior rami of spinal nerves C1-C4.
anterior rami of spinal nerves C3-C7.
rami communicantes of spinal nerves C1-C7.

The plexus that supplies the upper limbs is the \_________ plexus.

cervical
→ brachial
bronchiole
lumbar
sciatic

S1-Co1
L1-L5
→ C5-T1
L4-S4
C1-C5

Which of the following lists the components of the brachial plexus in correct order starting with the most medial?

Cords, divisions, nerves, rami
Rami, divisions, cords, trunks
Trunks, divisions, rami, cords
Ganglia, rami, nerves, terminals
→ Rami, trunks, divisions, cords

Within the axilla, axons of neurons are organized within:

! three cords--the posterior, medial, and lateral cords.
three divisions--the superior, middle, and inferior divisions.
five cords--the superior, inferior, medial, lateral, and middle divisions.
five divisions--proximal, distal, ulnar, median, and radial divisions

The nerve that innervates the deltoid muscle and receives sensory input from the superolateral lateral arm is the:

! axillary nerve.
musculocutaneous nerve.
median nerve.
radial nerve.
ulnar nerve.

Following an injury to his arm, a patient complains that he has no sensations from the thumb, index finger, middle finger, and part of the ring finger. What nerve do you suspect to be damaged?

! Median nerve
Radial nerve
Musculocutaneous nerve
Ulnar nerve
Axillary nerve

Following an injury to his arm, a patient complains that he has lost the ability to flex his elbow and supinate his forearm. Which nerve do you suspect he has damaged?

Median nerve
Radial nerve
→ Musculocutaneous nerve
Ulnar nerve
Axillary nerve

Following an injury to his arm, a patient complains that he cannot extend the forearm, wrist, and digits. You suspect that he has damaged the:

median nerve.
→ radial nerve.
musculocutaneous nerve.
ulnar nerve.
axillary nerve

Following an injury to his arm, a patient complains that he has no sensations from his "pinky". You suspect that he has damaged the:

A person suffering from carpal tunnel syndrome has lost function of the:

! median nerve.
radial nerve.
musculocutaneous nerve.
ulnar nerve.
axillary nerve.

Two of the nerves of the lumbar plexus are the:

femoral and sciatic nerves.
→ femoral and obturator nerves.
obturator and pudendal nerves.
pudendal and sciatic nerves.

The nerve responsible for innervation (movement) of the quadriceps femoris muscle is the \_____ nerve.

! femoral
sciatic
obturator
genitofemoral
tibial

The largest and longest nerve in the body is the \_________ nerve.

femoral
radial
→ sciatic
obturator
saphenous

This nerve helps to plant the foot and receives sensory signals from the skin of the sole.

Femoral nerve
Deep fibular nerve
Obturator nerve
Genitofemoral nerve
→ Tibial nerve

The spinal nerves that give rise to the sacral plexus are:

! L4-S4
T11-Co1
L2-S1
S4-C2

Where the sciatic nerve splits, it branches directly to the:

deep and superficial fibular nerves.
→ tibial and common fibular nerves.
femoral and obturator nerves.
deep femoral and tibial nerves.
popliteal and sural nerves

Reflexes are described as:

slow and spontaneous.
spontaneous and self-initiating.
pre-programmed and voluntary.
→ rapid and involuntary

What is the correct order for the events that occur during a reflex?
a: Impulse travels through sensory neuron to the CNS
b: A stimulus activates a receptor
c: Information is processed by interneurons
d: Motor neuron transmits impulse to effector
e: Effector responds

a, b, c, d, e
→ b, a, c, d, e
c, b, a, e, d
c, a, b, d, e
b, d, c, a, e

A reflex arc in which both the receptor and effector organs of the reflex are on the same side of the spinal cord is:

monosynaptic.
polysynaptic.
→ ipsilateral.
contralateral.
None of the choices is correct.

Late one night you are leaving the science building during a snowstorm. As you approach your car your right foot suddenly slips on a patch of ice. Your left leg immediately stiffens as you try to regain your balance. The reflex action you relied upon is a(n):

unilateral reflex.
ipsilateral reflex.
→ contralateral reflex.
voluntary reflex.
None of the choices is correct

Which type of reflex occurs with the smallest delay?

Polysynaptic
→ Monosynaptic

The simple knee-jerk reflex is an example of a(n) \_____ reflex.

ipsilateral
contralateral
→ monosynaptic
crossed-extensor
multisynaptic

Stepping on a piece of glass would most likely invoke a \_____ reflex.

Golgi tendon
→ withdrawal
stretch
pain
motor

If someone steps on a sharp object with their right foot it will lead to:

! polysynaptic reflexes involving contraction of the right hamstring and left quadriceps.
polysynaptic reflexes involving contraction of the right quadriceps and left hamstrings.
a monosynaptic reflex causing contraction of the right hamstring and a polysynaptic reflex causing contraction of the left hamstring.
a monosynaptic reflex causing contraction of the right quadriceps and a polysynaptic reflex causing contraction of the the left hamstring.

For many reflexes, including the stretch reflex, the excitation of a muscle leads to:

excitation of all motorneurons that are contralateral.
→ inhibition of motor neurons of its antagonist.
inhibition of motor neurons of its synergist.
excitation of motor neurons of the antagonist.
inhibition of sensory neurons that initiate the reflex.

The Golgi tendon reflex:

helps to overcome pain.
aids in sending sensory information to the muscles.
→ prevents skeletal muscles from tensing excessively.
prevents muscles from contracting.
helps to gain balance through a complex series of muscular contractions

A monosynaptic reflex that monitors and regulates skeletal muscle length is a \_____ reflex.

withdrawal
flexor
Golgi tendon
→ stretch
hypoactive

A diminished reflex response that may indicate damage to a segment of the spinal cord is a(n) \_____ reflex.

! hypoactive
hyperactive
diminutive
ponderous
excessive

Clonus often accompanies a \______ reflex after damage has occurred to the brain.

cremaster
pupillary
hypoactive
→ hyperactive

When the Achilles tendon is tapped or the bottom of the foot is stroked, the reflexive response is that the foot:

! plantar flexes.
dorsiflexes.
inverts.
everts.

The embryonic feature that gives rise to the anterior and lateral horns of gray matter is the \_____ plate.

! basal
alar
ulnar
anterior
posterior

The adult spinal cord extends inferiorly from the brain through the vertebral canal and ends at the level of the \_____ vertebra.

S4
→ L1
L6
S1
T8

The nerves projecting inferiorly from the spinal cord are collectively called the:

terminal finale.
→ cauda equina.
terminus filus.
caudal terminale.
caudus finalis.

The cell bodies of sensory neurons are located in the:

! posterior root ganglion.
anterior funiculus.
gray commissure.
anterior horn.
posterior funiculus

Which of these spinal nerve counts is incorrect?

! Thoracic nerves \= 8 pairs
Cervical nerves \= 8 pairs
Lumbar nerves \= 5 pairs
Sacral nerves \= 5 pairs
Coccygeal nerves \= 1 pair

This figure shows a cross section of a vertebra and the spinal cord. What structure does number 1 indicate

! Epidural space
Pia mater
Subarachnoid space
Central canal
Dura mater

This figure shows the spinal cord and spinal nerves. What structure does number 1 indicate?

Dura mater
Filum terminale
→ Cauda equina
Conus medullaris
Posterior rootlets

This figure shows the spinal cord and spinal nerves. What structure does number 2 indicate?

Dura mater
Filum terminale
Cauda equina
→ Conus medullaris
Posterior rootlets

This figure shows the spinal cord and spinal nerves. What structure does number 3 indicate?

Cervical plexus
→ Brachial plexus
Cervical enlargement
Lumbosacral enlargement
Sacral plexus

This figure shows an anterior view of the spinal cord and meninges. What structure does number 1 indicate?

Anterior root
Posterior root
Anterior root ganglion
→ Posterior root ganglion
Gray commissure

This figure shows an anterior view of the spinal cord and meninges. What structure does number 7 indicate?

! Arachnoid
Pia mater
Dura mater
Gray matter
White matter

This figure shows a cross section of the spinal cord. What structure does number 1 indicate?

Lateral horn
Anterior horn
Gray commissure
→ Posterior horn
Posterior funiculus

This figure shows a cross section of the spinal cord. What structure does number 2 indicate?

Lateral horn
Anterior horn
→ Gray commissure
Posterior horn
Posterior funiculus

This figure shows a cross section of the spinal cord. What structure does number 3 indicate?

Posterior funiculus
White commissure
Anterior funiculus
→ Lateral funiculus
Anterior median fissure

This figure shows a cross section of the spinal cord. What structure does number 4 indicate?

Posterior median sulcus
White commissure
Anterior funiculus
Lateral funiculus
→ Anterior median fissure