STUDY GUIDE - Questions on BACK AND VERTEBRAL COLUMN

By O.W. Henson, Jr., Ph.D.

University of North Carolina at Chapel Hill

 

 

1.  With regard to the vertebral column as a whole:

 

a)    How many vertebrae are there?

b)    What are the names given to their regional subdivisions?

c)    What are the distinguishing features of the different regional vertebrae that allow you to quickly identify them?

d)    What are the names given to pathologic and/or vertebral curvatures?

e)    Which regions normally have specific curvatures? Which kind?

f)     What are the names given to the different movements of the vertebral column?

 

2. What are the two basic parts of a vertebra?

 

3. What are the functions of the different parts of a vertebra?

 

a)    Vertebral body

b)    Neural arch

c)    Spinous process

d)    Lamina

e)    Transverse process

e)    Pedicle

f)     Articular processes

 

4.    Define the following and indicate their significance relative to the vertebral column as a whole.

 

a)    Vertebral canal

b)    Sacral canal

c)    Foramen magnum

d)    Intervertebral foramina

e)    Interlaminar spaces

f)     Sacral hiatus

 

5)    Which parts of the vertebra and surrounding spaces can be seen in PA radiographs?  Lateral Radiographs?

 

6)   How are the individual vertebrae interconnected, i.e. what two basic types of joints?

 

7)   What ligaments are associated with the spinal column?  Where are they located?  What role do they play in preventing specific dislocations or controlling movements? 

 

a)    Anterior longitudinal ligament

b)    Posterior longitudinal ligament

c)    Ligamentum flavum

d)    Interspinous ligament

e)    Supraspinous ligament

f)     Ligamentum nuchae

 

7) With regard to intervertebral disks:

 

a)    Where are they located?

b)    What are they composed of?

c)    What is the significance of their shape?

d)    What ligaments are associated with them?

e)    Describe their appearance in a radiograph

f)     What is a herniated disk?  Which direction do they herniate?  Why?

g)    Where do herniations usually occur?  Where does the pain radiate?  Why?

g)    What is the role of the disk in determining the height of an individual?

h)    Why does a person’s height change during the day?  With age?

i)     Describe the blood supply and innervation of a typical disk.

i)     What is the relationship of a disk an intervertebral foramen?  Spinal nerve?

       Spinal nerve roots?

 

8.  With regard to zygopophyseal (facet) joints:

 

a)    Where are they located?

b)    Can they be seen in radiographs?  Which regions?

c)    What role do they play in allowing or limiting motions?

 

9)  With regard to the deep muscles of the back:

 

a)    What are the two major subdivisions?

b)    What are the names of the muscles in each subdivision?

c)    What is their innervation?

d)    Why are they important in flexion as well as extension?

 

10.  What are functional components of spinal nerves?  Define what is meant by the following terms:

 

a)    afferent

b)    efferent

c)    visceral

e)    somatic

f)     motor

g)    sensory

 

11.  Why are the terms motor and sensory not always synonymous with afferent and efferent?

 

12.  What functional components are associated with a typical spinal nerve?  How are they usually designated (abbreviated)?  What is meant by the term typical spinal nerve ?  Which spinal nerves do not have four functional components?  Why?  How do the rami and branches of these nerve acquire the GVE component?

 

13   Draw a diagram of a cross-section through the spinal cord and label the basic parts.  Add the dorsal and ventral roots, dorsal root ganglion, and primary rami.  Show the association of the rami with the sympathetic chain as represented by the T1-L3 spinal nerves.  Illustrate the association at other spinal nerves (C1-C8; L4-S5). 

 

14.  Discuss the significance of each functional component and describe the signs and symptoms associated with the interruption of each component.

 

15.  Discuss the signs and symptoms associated with a nerve lesion at each of the following locations.

 

a)         dorsal root

b)         ventral root

c)         spinal nerve

d)         dorsal root ganglion

e)         dorsal (posterior) ramus

f)          ventral (anterior) ramus

 

16. Where are all dorsal root ganglia located relative to the vertebral canal?  intervertebral foramen?  Spinal nerve?

 

17.  Define and describe a dermatome.  Why would a lesion of one spinal nerve not produce complete anesthesia over a single dermatome?

 

18.  Define the following:  rami communicantes; ramus communicans; white ramus communicans; gray rami communicantes; splanchnic; preganglionic fiber; postganglionic fiber; synapse. 

 

19.  Diagram the arterial blood supply of the spinal cord (nice diagram in Netter’s atlas).

 

20.  What is the vertebral venous plexus?  Why is it clinically important?

 

21.  What are meninges?  Define each of the three layers.  Diagram a cross-section through the spinal cord and spinal canal and illustrate the position of the different layers.

 

22.  Discuss the organization of the dura mater in the spinal canal; where does it begin and end?  What does the dural sac contain?  How is it anchored?  What is its relation to spinal nerve roots?  Denticulate ligaments? 

 

23.  Draw and discuss the organization of the spinal canal in terms of epidural, subdural and subarachnoid spaces. 

 

24.  Where is the CSF in the spinal canal produced?  Is it continuous with the CSF in the cranial cavity?  Clinical significance?

 

25.   How can the spinal canal be surgically approached? 

 

26.    How is a spinal tap done?  What are the possible routes?

 

27.    Why can spinal taps be done in the lower lumbar region without risk of damage to the spinal cord?