CLINICAL ANATOMY EXAMINATION
Section I: Vertebral Column, Back, and Spinal Cord
Course: Advanced Clinical Human Anatomy Total Questions: 67 MCQs
Time Allowed: 90 Minutes Format: Single Best Answer
INSTRUCTIONS: Select the single best answer for each of the following clinical vignette multiple-choice questions. Mark your
chosen answer clearly. This paper is presented in standard high-contrast monochrome formatting for clinical assessment purposes.
MULTIPLE CHOICE QUESTIONS
1. A 55-year-old man with severe coughing is admitted to the hospital. Radiographic examination reveals tuberculosis of
the right lung, with extension to the thoracic vertebral bodies of T6 and T7, producing a "gibbus deformity." Which of
the following conditions is most likely also to be confirmed by radiographic examination?
A. Lordosis
B. Kyphosis
C. Scoliosis
D. Spina bifida
E. Osteoarthritis
2. A 68-year-old man is admitted to the hospital due to severe back pain. Radiographic examination reveals severe
osteoporosis of the vertebral column, with crush fractures of vertebrae L4 and L5. Which of the following parts of the
vertebrae are most likely to be fractured in this patient?
A. Spinal process
B. Vertebral bodies
C. Transverse process
D. Superior articular process
E. Intervertebral disk
3. A 45-year-old man is admitted to the hospital because of severe pain in the back and lower limb. Radiographic
examination reveals spinal stenosis syndrome. Which of the following conditions is most likely to be confirmed by MRI
examination?
A. Hypertrophy of supraspinous ligament
B. Hypertrophy of interspinous ligament
C. Hypertrophy of ligamentum flavum
D. Hypertrophy of anterior longitudinal ligament
E. Hypertrophy of nuchal ligament
Anatomy & Clinical MCQs — Practice Examination Page 1 of 17
,4. A 35-year-old man is admitted to the hospital after a severe car crash. Radiographic examination reveals an injury to
the dorsal surface of the neck and a fracture in the medial border of the right scapula. During physical examination the
patient presents with the scapula retracted laterally on the affected side. Which of the following nerves has most likely
been injured on that side?
A. Axillary
B. Long thoracic
C. Dorsal scapular
D. Greater occipital
E. Suprascapular
5. A 64-year-old man arrived at the clinic with a severely painful rash and skin eruptions that are localized entirely on
one side of his body, closely following the dermatome level of spinal nerve C7. The patient was diagnosed with herpes
zoster virus. In what structure has the virus most likely proliferated to cause the patient's current condition?
A. The sympathetic chain
B. The dorsal root ganglion of the C7 spinal nerve
C. The lateral horn of the C7 spinal cord segment
D. The posterior cutaneous branch of the dorsal primary ramus of C7
E. The ventral horn of the C7 spinal cord segment
6. A 45-year-old woman states that she has experienced moderate pain for 2 years over her left lower back, pain that
radiates to her left lower limb. She states that after lifting a case of soft drinks, the pain became intense. She was
admitted to the emergency department. Radiographic examination revealed disk herniation between vertebral levels L4
and L5. Which of the following nerves was most likely affected by the disk herniation?
A. L1
B. L2
C. L3
D. L4
E. L5
7. A 3-year-old child is admitted to the emergency department with severe headache, high fever, malaise, and confusion.
Radiographic and physical examinations reveal that the patient suffers from meningitis. A lumbar puncture is ordered.
Which vertebral level is the most appropriate location for the lumbar puncture?
A. T12-L1
B. L1-2
C. L2-3
D. L4-5
E. L5-S1
8. When a lumbar puncture is performed to sample cerebrospinal fluid, which of the following external landmarks is
the most reliable to determine the position of the L4 vertebral spine?
A. The inferior angles of the scapulae
B. The iliac crests
C. The lowest pair of ribs bilaterally
D. The posterior superior iliac spines
E. The posterior inferior iliac spines
Anatomy & Clinical MCQs — Practice Examination Page 2 of 17
, 9. A 39-year-old male presents with severe neck pain after a whiplash injury, sustained when his car was struck from
behind. Radiographic studies reveal trauma to the ligament lying on the anterior surface of the cervical vertebral
bodies. Which ligament is this?
A. Anterior longitudinal ligament
B. Ligamentum flavum
C. Nuchal ligament
D. Posterior longitudinal ligament
E. Transverse cervical ligament
10. A 65-year-old male complains of severe back pain and inability to move his left lower limb. Radiographic studies
demonstrate the compression of nerve elements at the intervertebral foramen between vertebrae L5 and S1. Which
structure is most likely responsible for this space-occupying lesion?
A. Anulus fibrosus
B. Nucleus pulposus
C. Posterior longitudinal ligament
D. Anterior longitudinal ligament
E. Ligamentum flavum
11. A 27-year-old man is admitted to the emergency department after a car crash. Physical examination reveals
weakness in medial rotation and adduction of the humerus. Which of the following nerves was most probably injured?
A. Thoracodorsal
B. Axillary
C. Dorsal scapular
D. Spinal accessory
E. Radial
12. A 39-year-old woman complains of an inability to reach the top of her head to brush her hair. History reveals that
she had undergone a bilateral mastectomy procedure 2 months earlier. Physical examination demonstrates winging of
both of her scapulae. Which nerves were most likely damaged during surgery?
A. Axillary
B. Spinal accessory
C. Long thoracic
D. Dorsal scapular
E. Thoracodorsal
13. A 19-year-old man is brought to the emergency department after dislocating his shoulder while playing football.
Following treatment of the dislocation, he cannot initiate abduction of his arm. An MRI of the shoulder shows a torn
muscle. Which muscle was most likely damaged by the injury?
A. Coracobrachialis
B. Long head of the triceps
C. Pectoralis minor
D. Supraspinatus
E. Teres major
Anatomy & Clinical MCQs — Practice Examination Page 3 of 17
Section I: Vertebral Column, Back, and Spinal Cord
Course: Advanced Clinical Human Anatomy Total Questions: 67 MCQs
Time Allowed: 90 Minutes Format: Single Best Answer
INSTRUCTIONS: Select the single best answer for each of the following clinical vignette multiple-choice questions. Mark your
chosen answer clearly. This paper is presented in standard high-contrast monochrome formatting for clinical assessment purposes.
MULTIPLE CHOICE QUESTIONS
1. A 55-year-old man with severe coughing is admitted to the hospital. Radiographic examination reveals tuberculosis of
the right lung, with extension to the thoracic vertebral bodies of T6 and T7, producing a "gibbus deformity." Which of
the following conditions is most likely also to be confirmed by radiographic examination?
A. Lordosis
B. Kyphosis
C. Scoliosis
D. Spina bifida
E. Osteoarthritis
2. A 68-year-old man is admitted to the hospital due to severe back pain. Radiographic examination reveals severe
osteoporosis of the vertebral column, with crush fractures of vertebrae L4 and L5. Which of the following parts of the
vertebrae are most likely to be fractured in this patient?
A. Spinal process
B. Vertebral bodies
C. Transverse process
D. Superior articular process
E. Intervertebral disk
3. A 45-year-old man is admitted to the hospital because of severe pain in the back and lower limb. Radiographic
examination reveals spinal stenosis syndrome. Which of the following conditions is most likely to be confirmed by MRI
examination?
A. Hypertrophy of supraspinous ligament
B. Hypertrophy of interspinous ligament
C. Hypertrophy of ligamentum flavum
D. Hypertrophy of anterior longitudinal ligament
E. Hypertrophy of nuchal ligament
Anatomy & Clinical MCQs — Practice Examination Page 1 of 17
,4. A 35-year-old man is admitted to the hospital after a severe car crash. Radiographic examination reveals an injury to
the dorsal surface of the neck and a fracture in the medial border of the right scapula. During physical examination the
patient presents with the scapula retracted laterally on the affected side. Which of the following nerves has most likely
been injured on that side?
A. Axillary
B. Long thoracic
C. Dorsal scapular
D. Greater occipital
E. Suprascapular
5. A 64-year-old man arrived at the clinic with a severely painful rash and skin eruptions that are localized entirely on
one side of his body, closely following the dermatome level of spinal nerve C7. The patient was diagnosed with herpes
zoster virus. In what structure has the virus most likely proliferated to cause the patient's current condition?
A. The sympathetic chain
B. The dorsal root ganglion of the C7 spinal nerve
C. The lateral horn of the C7 spinal cord segment
D. The posterior cutaneous branch of the dorsal primary ramus of C7
E. The ventral horn of the C7 spinal cord segment
6. A 45-year-old woman states that she has experienced moderate pain for 2 years over her left lower back, pain that
radiates to her left lower limb. She states that after lifting a case of soft drinks, the pain became intense. She was
admitted to the emergency department. Radiographic examination revealed disk herniation between vertebral levels L4
and L5. Which of the following nerves was most likely affected by the disk herniation?
A. L1
B. L2
C. L3
D. L4
E. L5
7. A 3-year-old child is admitted to the emergency department with severe headache, high fever, malaise, and confusion.
Radiographic and physical examinations reveal that the patient suffers from meningitis. A lumbar puncture is ordered.
Which vertebral level is the most appropriate location for the lumbar puncture?
A. T12-L1
B. L1-2
C. L2-3
D. L4-5
E. L5-S1
8. When a lumbar puncture is performed to sample cerebrospinal fluid, which of the following external landmarks is
the most reliable to determine the position of the L4 vertebral spine?
A. The inferior angles of the scapulae
B. The iliac crests
C. The lowest pair of ribs bilaterally
D. The posterior superior iliac spines
E. The posterior inferior iliac spines
Anatomy & Clinical MCQs — Practice Examination Page 2 of 17
, 9. A 39-year-old male presents with severe neck pain after a whiplash injury, sustained when his car was struck from
behind. Radiographic studies reveal trauma to the ligament lying on the anterior surface of the cervical vertebral
bodies. Which ligament is this?
A. Anterior longitudinal ligament
B. Ligamentum flavum
C. Nuchal ligament
D. Posterior longitudinal ligament
E. Transverse cervical ligament
10. A 65-year-old male complains of severe back pain and inability to move his left lower limb. Radiographic studies
demonstrate the compression of nerve elements at the intervertebral foramen between vertebrae L5 and S1. Which
structure is most likely responsible for this space-occupying lesion?
A. Anulus fibrosus
B. Nucleus pulposus
C. Posterior longitudinal ligament
D. Anterior longitudinal ligament
E. Ligamentum flavum
11. A 27-year-old man is admitted to the emergency department after a car crash. Physical examination reveals
weakness in medial rotation and adduction of the humerus. Which of the following nerves was most probably injured?
A. Thoracodorsal
B. Axillary
C. Dorsal scapular
D. Spinal accessory
E. Radial
12. A 39-year-old woman complains of an inability to reach the top of her head to brush her hair. History reveals that
she had undergone a bilateral mastectomy procedure 2 months earlier. Physical examination demonstrates winging of
both of her scapulae. Which nerves were most likely damaged during surgery?
A. Axillary
B. Spinal accessory
C. Long thoracic
D. Dorsal scapular
E. Thoracodorsal
13. A 19-year-old man is brought to the emergency department after dislocating his shoulder while playing football.
Following treatment of the dislocation, he cannot initiate abduction of his arm. An MRI of the shoulder shows a torn
muscle. Which muscle was most likely damaged by the injury?
A. Coracobrachialis
B. Long head of the triceps
C. Pectoralis minor
D. Supraspinatus
E. Teres major
Anatomy & Clinical MCQs — Practice Examination Page 3 of 17
