Test Bank For A Modern Atlas for
Implantable Devices of the Spine,
Brain, and Nerve
For Pain, Movement Disorders, and Nerve
Dysfunction
o 1st Edition - June 2, 2026
o Latest edition
o Editors: Timothy R. Deer, Jason E. Pope
,Chapter 1: Anatomy of the Cervical Spine
1. A clinician planning percutaneous cervical spinal cord stimulator (SCS) lead placement
must account for the typical cervical spinal cord position within the canal. Which
statement best describes this relationship?
A. The cord occupies the posterior half of the canal at all cervical levels
B. The cord lies more anteriorly within the canal, especially in the cervical region
C. The cord is centered equidistant from anterior and posterior elements
D. The cord contacts the ligamentum flavum during extension
Correct Answer: B
Rationale: In the cervical spine, the spinal cord lies relatively anterior within the spinal
canal, increasing the importance of posterior epidural space awareness during lead
placement.
2. Which anatomical feature distinguishes typical cervical vertebrae (C3–C6) from thoracic
vertebrae?
A. Presence of costal facets
B. Bifid spinous processes
C. Large vertebral bodies
D. Absence of transverse processes
Correct Answer: B
Rationale: Typical cervical vertebrae have bifid spinous processes, unlike thoracic
vertebrae, which articulate with ribs.
3. During cervical epidural access, which ligament is traversed immediately before entering
the epidural space?
A. Anterior longitudinal ligament
B. Posterior longitudinal ligament
C. Ligamentum flavum
D. Interspinous ligament
Correct Answer: C
Rationale: The ligamentum flavum forms the posterior boundary of the epidural space
and is a key tactile landmark during epidural access.
4. A patient undergoing cervical neuromodulation is at risk for vertebral artery injury.
Through which structure does the vertebral artery typically pass?
A. Spinous process
B. Intervertebral foramen
C. Transverse foramen
D. Vertebral body
Correct Answer: C
Rationale: The vertebral artery ascends through the transverse foramina of the cervical
vertebrae, usually from C6 to C1.
5. Which joint primarily allows rotation at the C1–C2 level?
A. Uncovertebral joint
B. Facet (zygapophyseal) joint
C. Atlantoaxial joint
D. Intervertebral disc
Correct Answer: C
, Rationale: The atlantoaxial joint between C1 and C2 allows significant axial rotation of
the head.
6. A clinician reviewing imaging for cervical lead placement notes no intervertebral disc at
a specific level. Which level is this?
A. C2–C3
B. C1–C2
C. C7–T1
D. C3–C4
Correct Answer: B
Rationale: There is no intervertebral disc between the atlas (C1) and axis (C2).
7. Which ligament limits cervical flexion and runs along the posterior aspect of vertebral
bodies within the canal?
A. Ligamentum flavum
B. Posterior longitudinal ligament
C. Nuchal ligament
D. Interspinous ligament
Correct Answer: B
Rationale: The posterior longitudinal ligament runs inside the spinal canal and limits
flexion.
8. The uncovertebral joints are unique to which spinal region and have what clinical
relevance?
A. Lumbar; increase flexion
B. Thoracic; stabilize ribs
C. Cervical; influence foraminal size
D. Sacral; transmit weight
Correct Answer: C
Rationale: Uncovertebral joints are unique to the cervical spine and can affect foraminal
dimensions, relevant to nerve root compression.
9. When targeting cervical nerve roots, which anatomical relationship is most accurate?
A. Nerve roots exit above their corresponding vertebra
B. Nerve roots exit below their corresponding vertebra
C. All cervical nerve roots exit below C7
D. Cervical nerve roots exit through the transverse foramen
Correct Answer: A
Rationale: Cervical nerve roots C1–C7 exit above their corresponding vertebrae.
10. Which structure forms the anterior boundary of the spinal canal?
A. Lamina
B. Pedicle
C. Vertebral body and posterior longitudinal ligament
D. Ligamentum flavum
Correct Answer: C
Rationale: The posterior vertebral body and posterior longitudinal ligament define the
anterior canal boundary.
11. A clinician must avoid excessive lateral advancement of a needle at the cervical level due
to proximity to which structure?
A. Carotid artery
, B. Vertebral artery
C. Jugular vein
D. Subclavian artery
Correct Answer: B
Rationale: The vertebral artery lies laterally within the transverse foramina, posing a risk
during lateral advancement.
12. Which cervical vertebra is characterized by a prominent spinous process palpable at the
base of the neck?
A. C5
B. C6
C. C7
D. T1
Correct Answer: C
Rationale: C7, the vertebra prominens, has a long, non-bifid spinous process.
13. The primary function of the cervical facet joints is to:
A. Absorb axial load
B. Protect the spinal cord
C. Guide and limit motion
D. Anchor spinal ligaments
Correct Answer: C
Rationale: Facet joints guide cervical motion and limit excessive movement.
14. Which meningeal layer is most closely associated with the epidural space?
A. Pia mater
B. Arachnoid mater
C. Dura mater
D. Endosteum
Correct Answer: C
Rationale: The epidural space lies external to the dura mater.
15. During cervical SCS lead placement, which space is the intended target?
A. Subdural space
B. Subarachnoid space
C. Epidural space
D. Intramedullary space
Correct Answer: C
Rationale: Cervical SCS leads are placed in the epidural space to modulate dorsal
column pathways.
16. Which structure connects the laminae of adjacent vertebrae?
A. Interspinous ligament
B. Ligamentum flavum
C. Nuchal ligament
D. Anterior longitudinal ligament
Correct Answer: B
Rationale: The ligamentum flavum spans between adjacent laminae.
17. A lesion affecting the dorsal columns at the cervical level would most likely impair
which function?
A. Motor strength
Implantable Devices of the Spine,
Brain, and Nerve
For Pain, Movement Disorders, and Nerve
Dysfunction
o 1st Edition - June 2, 2026
o Latest edition
o Editors: Timothy R. Deer, Jason E. Pope
,Chapter 1: Anatomy of the Cervical Spine
1. A clinician planning percutaneous cervical spinal cord stimulator (SCS) lead placement
must account for the typical cervical spinal cord position within the canal. Which
statement best describes this relationship?
A. The cord occupies the posterior half of the canal at all cervical levels
B. The cord lies more anteriorly within the canal, especially in the cervical region
C. The cord is centered equidistant from anterior and posterior elements
D. The cord contacts the ligamentum flavum during extension
Correct Answer: B
Rationale: In the cervical spine, the spinal cord lies relatively anterior within the spinal
canal, increasing the importance of posterior epidural space awareness during lead
placement.
2. Which anatomical feature distinguishes typical cervical vertebrae (C3–C6) from thoracic
vertebrae?
A. Presence of costal facets
B. Bifid spinous processes
C. Large vertebral bodies
D. Absence of transverse processes
Correct Answer: B
Rationale: Typical cervical vertebrae have bifid spinous processes, unlike thoracic
vertebrae, which articulate with ribs.
3. During cervical epidural access, which ligament is traversed immediately before entering
the epidural space?
A. Anterior longitudinal ligament
B. Posterior longitudinal ligament
C. Ligamentum flavum
D. Interspinous ligament
Correct Answer: C
Rationale: The ligamentum flavum forms the posterior boundary of the epidural space
and is a key tactile landmark during epidural access.
4. A patient undergoing cervical neuromodulation is at risk for vertebral artery injury.
Through which structure does the vertebral artery typically pass?
A. Spinous process
B. Intervertebral foramen
C. Transverse foramen
D. Vertebral body
Correct Answer: C
Rationale: The vertebral artery ascends through the transverse foramina of the cervical
vertebrae, usually from C6 to C1.
5. Which joint primarily allows rotation at the C1–C2 level?
A. Uncovertebral joint
B. Facet (zygapophyseal) joint
C. Atlantoaxial joint
D. Intervertebral disc
Correct Answer: C
, Rationale: The atlantoaxial joint between C1 and C2 allows significant axial rotation of
the head.
6. A clinician reviewing imaging for cervical lead placement notes no intervertebral disc at
a specific level. Which level is this?
A. C2–C3
B. C1–C2
C. C7–T1
D. C3–C4
Correct Answer: B
Rationale: There is no intervertebral disc between the atlas (C1) and axis (C2).
7. Which ligament limits cervical flexion and runs along the posterior aspect of vertebral
bodies within the canal?
A. Ligamentum flavum
B. Posterior longitudinal ligament
C. Nuchal ligament
D. Interspinous ligament
Correct Answer: B
Rationale: The posterior longitudinal ligament runs inside the spinal canal and limits
flexion.
8. The uncovertebral joints are unique to which spinal region and have what clinical
relevance?
A. Lumbar; increase flexion
B. Thoracic; stabilize ribs
C. Cervical; influence foraminal size
D. Sacral; transmit weight
Correct Answer: C
Rationale: Uncovertebral joints are unique to the cervical spine and can affect foraminal
dimensions, relevant to nerve root compression.
9. When targeting cervical nerve roots, which anatomical relationship is most accurate?
A. Nerve roots exit above their corresponding vertebra
B. Nerve roots exit below their corresponding vertebra
C. All cervical nerve roots exit below C7
D. Cervical nerve roots exit through the transverse foramen
Correct Answer: A
Rationale: Cervical nerve roots C1–C7 exit above their corresponding vertebrae.
10. Which structure forms the anterior boundary of the spinal canal?
A. Lamina
B. Pedicle
C. Vertebral body and posterior longitudinal ligament
D. Ligamentum flavum
Correct Answer: C
Rationale: The posterior vertebral body and posterior longitudinal ligament define the
anterior canal boundary.
11. A clinician must avoid excessive lateral advancement of a needle at the cervical level due
to proximity to which structure?
A. Carotid artery
, B. Vertebral artery
C. Jugular vein
D. Subclavian artery
Correct Answer: B
Rationale: The vertebral artery lies laterally within the transverse foramina, posing a risk
during lateral advancement.
12. Which cervical vertebra is characterized by a prominent spinous process palpable at the
base of the neck?
A. C5
B. C6
C. C7
D. T1
Correct Answer: C
Rationale: C7, the vertebra prominens, has a long, non-bifid spinous process.
13. The primary function of the cervical facet joints is to:
A. Absorb axial load
B. Protect the spinal cord
C. Guide and limit motion
D. Anchor spinal ligaments
Correct Answer: C
Rationale: Facet joints guide cervical motion and limit excessive movement.
14. Which meningeal layer is most closely associated with the epidural space?
A. Pia mater
B. Arachnoid mater
C. Dura mater
D. Endosteum
Correct Answer: C
Rationale: The epidural space lies external to the dura mater.
15. During cervical SCS lead placement, which space is the intended target?
A. Subdural space
B. Subarachnoid space
C. Epidural space
D. Intramedullary space
Correct Answer: C
Rationale: Cervical SCS leads are placed in the epidural space to modulate dorsal
column pathways.
16. Which structure connects the laminae of adjacent vertebrae?
A. Interspinous ligament
B. Ligamentum flavum
C. Nuchal ligament
D. Anterior longitudinal ligament
Correct Answer: B
Rationale: The ligamentum flavum spans between adjacent laminae.
17. A lesion affecting the dorsal columns at the cervical level would most likely impair
which function?
A. Motor strength
