Quiz on the Systemic Anatomy of the Vertebral Column

1. How many vertebrae does the sacrum of an adult normally consist of?

• 4

  The sacrum is formed by five fused sacral vertebrae (S1–S5). Synostosis completes by the age of 25–30 years.

• 5

  The sacrum is formed by five fused sacral vertebrae (S1–S5). Synostosis completes by the age of 25–30 years.

• 6

  The sacrum is formed by five fused sacral vertebrae (S1–S5). Synostosis completes by the age of 25–30 years.

• 3

  The sacrum is formed by five fused sacral vertebrae (S1–S5). Synostosis completes by the age of 25–30 years.

• I find it difficult to answer

  The sacrum is formed by five fused sacral vertebrae (S1–S5). Synostosis completes by the age of 25–30 years.

2. How many physiological curvatures does the vertebral column of a normal adult have?

• 2 (cervical and lumbar)

  The vertebral column of a normal human has 4 physiological curves: cervical lordosis (forward bend), thoracic kyphosis (backward bend), lumbar lordosis (forward bend), and sacral kyphosis (backward bend).

• 3 (cervical, thoracic, and lumbar)

  The vertebral column of a normal human has 4 physiological curves: cervical lordosis (forward bend), thoracic kyphosis (backward bend), lumbar lordosis (forward bend), and sacral kyphosis (backward bend).

• 4 (two lordotic and two kyphotic)

  The vertebral column of a normal human has 4 physiological curves: cervical lordosis (forward bend), thoracic kyphosis (backward bend), lumbar lordosis (forward bend), and sacral kyphosis (backward bend).

• 5 (by the number of spine regions)

  The vertebral column of a normal human has 4 physiological curves: cervical lordosis (forward bend), thoracic kyphosis (backward bend), lumbar lordosis (forward bend), and sacral kyphosis (backward bend).

• I find it difficult to answer

  The vertebral column of a normal human has 4 physiological curves: cervical lordosis (forward bend), thoracic kyphosis (backward bend), lumbar lordosis (forward bend), and sacral kyphosis (backward bend).

3. What is the main anatomical and physiological function of the nucleus pulposus of the intervertebral disc?

• Providing mobility and flexibility of the vertebral column

  The nucleus pulposus is a jelly-like matter with high water content, functioning as a hydraulic shock absorber. It dampens axial (vertical) loads during movements and redistributes pressure evenly on the adjacent vertebrae and annulus fibrosus.

• Absorbing vertical loads and redistributing pressure between the vertebrae

  The nucleus pulposus is a jelly-like matter with high water content, functioning as a hydraulic shock absorber. It dampens axial (vertical) loads during movements and redistributes pressure evenly on the adjacent vertebrae and annulus fibrosus.

• Blood supply and innervation of the vertebral body

  The nucleus pulposus is a jelly-like matter with high water content, functioning as a hydraulic shock absorber. It dampens axial (vertical) loads during movements and redistributes pressure evenly on the adjacent vertebrae and annulus fibrosus.

• Protection of the spinal cord from the impact of cerebrospinal fluid

  The nucleus pulposus is a jelly-like matter with high water content, functioning as a hydraulic shock absorber. It dampens axial (vertical) loads during movements and redistributes pressure evenly on the adjacent vertebrae and annulus fibrosus.

• I find it difficult to answer

  The nucleus pulposus is a jelly-like matter with high water content, functioning as a hydraulic shock absorber. It dampens axial (vertical) loads during movements and redistributes pressure evenly on the adjacent vertebrae and annulus fibrosus.

4. Which ligament of the vertebral column attaches to the posterior surface of the vertebral bodies and intervertebral discs?

• Ligamentum supraspinale

  The posterior longitudinal ligament (lig. longitudinale posterius) runs on the posterior surface of the vertebral bodies within the vertebral canal along its entire length.

• Ligamentum flavum

  The posterior longitudinal ligament (lig. longitudinale posterius) runs on the posterior surface of the vertebral bodies within the vertebral canal along its entire length.

• Ligamentum longitudinale posterius

  The posterior longitudinal ligament (lig. longitudinale posterius) runs on the posterior surface of the vertebral bodies within the vertebral canal along its entire length.

• Ligamentum interspinale

  The posterior longitudinal ligament (lig. longitudinale posterius) runs on the posterior surface of the vertebral bodies within the vertebral canal along its entire length.

• I find it difficult to answer

  The posterior longitudinal ligament (lig. longitudinale posterius) runs on the posterior surface of the vertebral bodies within the vertebral canal along its entire length.

5. The anterior arch of the atlas articulates with:

• Body of the axis

  On the posterior surface of the anterior arch of the atlas, there is a facet for dens (fovea dentis), which articulates with the dens of the axis, forming the median atlantoaxial joint.

• Dens axis

  On the posterior surface of the anterior arch of the atlas, there is a facet for dens (fovea dentis), which articulates with the dens of the axis, forming the median atlantoaxial joint.

• Occipital condyles

  On the posterior surface of the anterior arch of the atlas, there is a facet for dens (fovea dentis), which articulates with the dens of the axis, forming the median atlantoaxial joint.

• Anterior tubercle of the axis

  On the posterior surface of the anterior arch of the atlas, there is a facet for dens (fovea dentis), which articulates with the dens of the axis, forming the median atlantoaxial joint.

• I find it difficult to answer

  On the posterior surface of the anterior arch of the atlas, there is a facet for dens (fovea dentis), which articulates with the dens of the axis, forming the median atlantoaxial joint.

6. Ligamentum flavum (yellow ligament) structurally belongs to:

• Dense regular fibrous connective tissue

  Ligamenta flava consist primarily of elastic fibers (up to 80%), which accounts for their yellow color and ability to return the spine to its original position after flexion.

• Elastic connective tissue

  Ligamenta flava consist primarily of elastic fibers (up to 80%), which accounts for their yellow color and ability to return the spine to its original position after flexion.

• Hyaline cartilage

  Ligamenta flava consist primarily of elastic fibers (up to 80%), which accounts for their yellow color and ability to return the spine to its original position after flexion.

• Fibrocartilage

  Ligamenta flava consist primarily of elastic fibers (up to 80%), which accounts for their yellow color and ability to return the spine to its original position after flexion.

• I find it difficult to answer

  Ligamenta flava consist primarily of elastic fibers (up to 80%), which accounts for their yellow color and ability to return the spine to its original position after flexion.

7. Which region of the vertebral column has a physiological kyphosis?

• Cervical

  Physiological kyphosis (posterior convexity) is characteristic of the thoracic and sacrococcygeal regions. The cervical and lumbar regions have physiological lordosis (anterior convexity).

• Lumbar

  Physiological kyphosis (posterior convexity) is characteristic of the thoracic and sacrococcygeal regions. The cervical and lumbar regions have physiological lordosis (anterior convexity).

• Thoracic

  Physiological kyphosis (posterior convexity) is characteristic of the thoracic and sacrococcygeal regions. The cervical and lumbar regions have physiological lordosis (anterior convexity).

• All listed sections have kyphosis

  Physiological kyphosis (posterior convexity) is characteristic of the thoracic and sacrococcygeal regions. The cervical and lumbar regions have physiological lordosis (anterior convexity).

• I find it difficult to answer

  Physiological kyphosis (posterior convexity) is characteristic of the thoracic and sacrococcygeal regions. The cervical and lumbar regions have physiological lordosis (anterior convexity).

8. The atlantooccipital joint based on the shape of surfaces, is classified as:

• Ball-and-socket

  The atlantooccipital joint is ellipsoid (condylar): the two convex occipital condyles articulate with the two concave superior articular facets of the atlas. Movements: flexion-extension and lateral tilts.

• Ellipsoid (condylar)

  The atlantooccipital joint is ellipsoid (condylar): the two convex occipital condyles articulate with the two concave superior articular facets of the atlas. Movements: flexion-extension and lateral tilts.

• Saddle-shaped

  The atlantooccipital joint is ellipsoid (condylar): the two convex occipital condyles articulate with the two concave superior articular facets of the atlas. Movements: flexion-extension and lateral tilts.

• Cylinder-shaped

  The atlantooccipital joint is ellipsoid (condylar): the two convex occipital condyles articulate with the two concave superior articular facets of the atlas. Movements: flexion-extension and lateral tilts.

• I find it difficult to answer

  The atlantooccipital joint is ellipsoid (condylar): the two convex occipital condyles articulate with the two concave superior articular facets of the atlas. Movements: flexion-extension and lateral tilts.

9. To which type of joints based on the shape of articular surfaces do zygapophyseal joints belong?

• Ball-and-socket joints.

  The zygapophyseal joints are formed by the superior and inferior articular processes of adjacent vertebrae. They are plane joints based on the shape of articular surfaces.

• Hinge joints.

  The zygapophyseal joints are formed by the superior and inferior articular processes of adjacent vertebrae. They are plane joints based on the shape of articular surfaces.

• Ellipsoid joints.

  The zygapophyseal joints are formed by the superior and inferior articular processes of adjacent vertebrae. They are plane joints based on the shape of articular surfaces.

• Planar joints

  The zygapophyseal joints are formed by the superior and inferior articular processes of adjacent vertebrae. They are plane joints based on the shape of articular surfaces.

• I find it difficult to answer

  The zygapophyseal joints are formed by the superior and inferior articular processes of adjacent vertebrae. They are plane joints based on the shape of articular surfaces.

10. Vertebral venous plexuses communicate with:

• Only with v. Azygos

  The spinal venous plexuses (internal and external) are valveless and widely anastomose with the veins of the cranial cavity, thoracic, abdominal cavities, and pelvis, creating a collateral drainage pathway.

• Only with the brain veins

  The spinal venous plexuses (internal and external) are valveless and widely anastomose with the veins of the cranial cavity, thoracic, abdominal cavities, and pelvis, creating a collateral drainage pathway.

• With the veins of the cranial cavity, thoracic, abdominal cavities, and pelvis

  The spinal venous plexuses (internal and external) are valveless and widely anastomose with the veins of the cranial cavity, thoracic, abdominal cavities, and pelvis, creating a collateral drainage pathway.

• Only with intercostal veins

  The spinal venous plexuses (internal and external) are valveless and widely anastomose with the veins of the cranial cavity, thoracic, abdominal cavities, and pelvis, creating a collateral drainage pathway.

• I find it difficult to answer

  The spinal venous plexuses (internal and external) are valveless and widely anastomose with the veins of the cranial cavity, thoracic, abdominal cavities, and pelvis, creating a collateral drainage pathway.

11. Transverse processes of the cervical vertebrae (C3–C7) have a distinctive anatomical feature:

• Bifid spinous process

  A characteristic feature of the cervical vertebrae (C1–C7) is the presence of foramen transversarium through which the vertebral artery passes at the level C1–C6.

• Foramen transversarium

  A characteristic feature of the cervical vertebrae (C1–C7) is the presence of foramen transversarium through which the vertebral artery passes at the level C1–C6.

• Superior articular fossa for ribs

  A characteristic feature of the cervical vertebrae (C1–C7) is the presence of foramen transversarium through which the vertebral artery passes at the level C1–C6.

• Accessory process

  A characteristic feature of the cervical vertebrae (C1–C7) is the presence of foramen transversarium through which the vertebral artery passes at the level C1–C6.

• I find it difficult to answer

  A characteristic feature of the cervical vertebrae (C1–C7) is the presence of foramen transversarium through which the vertebral artery passes at the level C1–C6.

12. Which region of the vertebral column contains the most vertebrae?

• Cervical (7)

  The thoracic section includes 12 vertebrae (Th1–Th12) — the largest number among all regions of the vertebral column.

• Lumbar (5)

  The thoracic section includes 12 vertebrae (Th1–Th12) — the largest number among all regions of the vertebral column.

• Thoracic (12)

  The thoracic section includes 12 vertebrae (Th1–Th12) — the largest number among all regions of the vertebral column.

• Sacral (5)

  The thoracic section includes 12 vertebrae (Th1–Th12) — the largest number among all regions of the vertebral column.

• I find it difficult to answer

  The thoracic section includes 12 vertebrae (Th1–Th12) — the largest number among all regions of the vertebral column.

13. In which plane are the articular processes of lumbar vertebrae predominantly oriented?

• In the frontal plane

  The articular processes of the lumbar vertebrae are oriented in the sagittal plane (the superior articular surfaces are turned inward, the inferior – outward). Such orientation provides free flexion and extension but restricts rotation in the lumbar region. For comparison: in the thoracic section, the articular processes are predominantly oriented in the frontal plane.

• In the sagittal plane

  The articular processes of the lumbar vertebrae are oriented in the sagittal plane (the superior articular surfaces are turned inward, the inferior – outward). Such orientation provides free flexion and extension but restricts rotation in the lumbar region. For comparison: in the thoracic section, the articular processes are predominantly oriented in the frontal plane.

• In the horizontal plane

  The articular processes of the lumbar vertebrae are oriented in the sagittal plane (the superior articular surfaces are turned inward, the inferior – outward). Such orientation provides free flexion and extension but restricts rotation in the lumbar region. For comparison: in the thoracic section, the articular processes are predominantly oriented in the frontal plane.

• In the oblique (diagonal) plane

  The articular processes of the lumbar vertebrae are oriented in the sagittal plane (the superior articular surfaces are turned inward, the inferior – outward). Such orientation provides free flexion and extension but restricts rotation in the lumbar region. For comparison: in the thoracic section, the articular processes are predominantly oriented in the frontal plane.

• I find it difficult to answer

  The articular processes of the lumbar vertebrae are oriented in the sagittal plane (the superior articular surfaces are turned inward, the inferior – outward). Such orientation provides free flexion and extension but restricts rotation in the lumbar region. For comparison: in the thoracic section, the articular processes are predominantly oriented in the frontal plane.

14. The transverse ligament of the atlas is a part of:

• Ligamentum apicis dentis

  Lig transversum atlantis — the horizontal part of the cruciform ligament of the atlas. The vertical part is formed by fasciculi longitudinales. The cruciform ligament holds the dens axis against the anterior arch of the atlas.

• Ligamentum cruciforme atlantis

  Lig transversum atlantis — the horizontal part of the cruciform ligament of the atlas. The vertical part is formed by fasciculi longitudinales. The cruciform ligament holds the dens axis against the anterior arch of the atlas.

• Membrana tectoria

  Lig transversum atlantis — the horizontal part of the cruciform ligament of the atlas. The vertical part is formed by fasciculi longitudinales. The cruciform ligament holds the dens axis against the anterior arch of the atlas.

• Ligg alaria

  Lig transversum atlantis — the horizontal part of the cruciform ligament of the atlas. The vertical part is formed by fasciculi longitudinales. The cruciform ligament holds the dens axis against the anterior arch of the atlas.

• I find it difficult to answer

  Lig transversum atlantis — the horizontal part of the cruciform ligament of the atlas. The vertical part is formed by fasciculi longitudinales. The cruciform ligament holds the dens axis against the anterior arch of the atlas.

15. Spinal nerves exit the vertebral canal through:

• Posterior sacral foramina

  Spinal nerves C1–L5 exit through the intervertebral foramina. Sacral nerves S1–S4 exit through anterior and posterior sacral foramina. Coccygeal nerve exits through hiatus sacralis.

• Only through intervertebral foramina

  Spinal nerves C1–L5 exit through the intervertebral foramina. Sacral nerves S1–S4 exit through anterior and posterior sacral foramina. Coccygeal nerve exits through hiatus sacralis.

• Foramen magnum

  Spinal nerves C1–L5 exit through the intervertebral foramina. Sacral nerves S1–S4 exit through anterior and posterior sacral foramina. Coccygeal nerve exits through hiatus sacralis.

• Intervertebral foramina — in the cervical and thoracic sections; anterior and posterior sacral foramina — in the sacral section

  Spinal nerves C1–L5 exit through the intervertebral foramina. Sacral nerves S1–S4 exit through anterior and posterior sacral foramina. Coccygeal nerve exits through hiatus sacralis.

• I find it difficult to answer

  Spinal nerves C1–L5 exit through the intervertebral foramina. Sacral nerves S1–S4 exit through anterior and posterior sacral foramina. Coccygeal nerve exits through hiatus sacralis.

16. Which structure forms the upper wall of the intervertebral foramen in the thoracic and lumbar regions of the spine?

• The body of the overlying vertebra

  The upper wall of the intervertebral foramen is formed by the inferior articular process of the overlying vertebra.

• Ligamentum flavum together with the articular capsule

  The upper wall of the intervertebral foramen is formed by the inferior articular process of the overlying vertebra.

• Inferior articular process of the overlying vertebra

  The upper wall of the intervertebral foramen is formed by the inferior articular process of the overlying vertebra.

• Ligamentum longitudinale posterius

  The upper wall of the intervertebral foramen is formed by the inferior articular process of the overlying vertebra.

• I find it difficult to answer

  The upper wall of the intervertebral foramen is formed by the inferior articular process of the overlying vertebra.

17. How many rudimentary vertebrae fuse to form the coccyx?

• 3–4

  The coccyx consists of 4–5 (usually 4) rudimentary coccygeal vertebrae (Co1–Co4/5). In adults, the first coccygeal vertebra may remain unfused with the others.

• 2–3

  The coccyx consists of 4–5 (usually 4) rudimentary coccygeal vertebrae (Co1–Co4/5). In adults, the first coccygeal vertebra may remain unfused with the others.

• 4–5

  The coccyx consists of 4–5 (usually 4) rudimentary coccygeal vertebrae (Co1–Co4/5). In adults, the first coccygeal vertebra may remain unfused with the others.

• 5–6

  The coccyx consists of 4–5 (usually 4) rudimentary coccygeal vertebrae (Co1–Co4/5). In adults, the first coccygeal vertebra may remain unfused with the others.

• I find it difficult to answer

  The coccyx consists of 4–5 (usually 4) rudimentary coccygeal vertebrae (Co1–Co4/5). In adults, the first coccygeal vertebra may remain unfused with the others.

18. The vertebral artery enters the foramen transversarium at the level:

• C7

  The vertebral artery (branch of a. subclavia) enters the foramen transversarium at the level of C6 and ascends successively through the foramina of C6–C1, then curves around the atlas and enters the cranial cavity through the foramen magnum.

• C3

  The vertebral artery (branch of a. subclavia) enters the foramen transversarium at the level of C6 and ascends successively through the foramina of C6–C1, then curves around the atlas and enters the cranial cavity through the foramen magnum.

• C6

  The vertebral artery (branch of a. subclavia) enters the foramen transversarium at the level of C6 and ascends successively through the foramina of C6–C1, then curves around the atlas and enters the cranial cavity through the foramen magnum.

• C1

  The vertebral artery (branch of a. subclavia) enters the foramen transversarium at the level of C6 and ascends successively through the foramina of C6–C1, then curves around the atlas and enters the cranial cavity through the foramen magnum.

• I find it difficult to answer

  The vertebral artery (branch of a. subclavia) enters the foramen transversarium at the level of C6 and ascends successively through the foramina of C6–C1, then curves around the atlas and enters the cranial cavity through the foramen magnum.

19. Syndesmosis as a type of continuous connection in the vertebral column is represented by:

• Intervertebral disc

  Syndesmosis is the connection of bones by means of dense fibrous connective tissue (ligaments, membranes). The ligaments of the spine (ligg. flava, supraspinale, interspinale, etc.) are classic examples of syndesmosis. An intervertebral disc is a symphysis (synchondrosis/symphysis), a zygapophyseal joint is a diarthrosis.

• Ligaments of the spine

  Syndesmosis is the connection of bones by means of dense fibrous connective tissue (ligaments, membranes). The ligaments of the spine (ligg. flava, supraspinale, interspinale, etc.) are classic examples of syndesmosis. An intervertebral disc is a symphysis (synchondrosis/symphysis), a zygapophyseal joint is a diarthrosis.

• Sacrococcygeal symphysis

  Syndesmosis is the connection of bones by means of dense fibrous connective tissue (ligaments, membranes). The ligaments of the spine (ligg. flava, supraspinale, interspinale, etc.) are classic examples of syndesmosis. An intervertebral disc is a symphysis (synchondrosis/symphysis), a zygapophyseal joint is a diarthrosis.

• With the zygapophyseal joint

  Syndesmosis is the connection of bones by means of dense fibrous connective tissue (ligaments, membranes). The ligaments of the spine (ligg. flava, supraspinale, interspinale, etc.) are classic examples of syndesmosis. An intervertebral disc is a symphysis (synchondrosis/symphysis), a zygapophyseal joint is a diarthrosis.

• I find it difficult to answer

  Syndesmosis is the connection of bones by means of dense fibrous connective tissue (ligaments, membranes). The ligaments of the spine (ligg. flava, supraspinale, interspinale, etc.) are classic examples of syndesmosis. An intervertebral disc is a symphysis (synchondrosis/symphysis), a zygapophyseal joint is a diarthrosis.

20. The musculus erector spinae consists of three parts. Which of them is located most laterally?

• M. spinalis

  M. erector spinae includes three longitudinal columns (medial to lateral): m. spinalis (medially) → m. longissimus (intermediate) → m. iliocostalis (laterally). M. semispinalis is part of the deep transversospinal layer.

• M. longissimus

  M. erector spinae includes three longitudinal columns (medial to lateral): m. spinalis (medially) → m. longissimus (intermediate) → m. iliocostalis (laterally). M. semispinalis is part of the deep transversospinal layer.

• M. iliocostalis

  M. erector spinae includes three longitudinal columns (medial to lateral): m. spinalis (medially) → m. longissimus (intermediate) → m. iliocostalis (laterally). M. semispinalis is part of the deep transversospinal layer.

• M. semispinalis

  M. erector spinae includes three longitudinal columns (medial to lateral): m. spinalis (medially) → m. longissimus (intermediate) → m. iliocostalis (laterally). M. semispinalis is part of the deep transversospinal layer.

• I find it difficult to answer

  M. erector spinae includes three longitudinal columns (medial to lateral): m. spinalis (medially) → m. longissimus (intermediate) → m. iliocostalis (laterally). M. semispinalis is part of the deep transversospinal layer.