Spinal cord – gross structure MCQs With Answer

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The spinal cord – gross structure MCQs With Answer provides B. Pharm students a concise, clinically relevant review of spinal cord anatomy. This introduction highlights key concepts such as segments, cervical and lumbar enlargements, gray and white matter organization, meninges, spinal nerves, blood supply (including the artery of Adamkiewicz), and clinically important regions like the conus medullaris and cauda equina. Understanding these macroscopic features is essential for safe procedures (lumbar puncture, epidural anesthesia), interpreting spinal cord pathologies (syringomyelia, Brown-Séquard), and linking neuroanatomy to pharmacologic interventions. Now let’s test your knowledge with 50 MCQs on this topic.

Q1. Which vertebral level typically corresponds to the adult conus medullaris?

  • T6
  • T12
  • L1
  • S2

Correct Answer: L1

Q2. The spinal cord enlargement that supplies the lower limbs is called:

  • Cervical enlargement
  • Brachial plexus
  • Lumbar enlargement
  • Sacral enlargement

Correct Answer: Lumbar enlargement

Q3. The denticulate ligaments are extensions of which meningeal layer?

  • Pia mater
  • Arachnoid mater
  • Dura mater
  • Epidural fat

Correct Answer: Pia mater

Q4. Which artery is primarily responsible for the anterior two-thirds blood supply of the spinal cord?

  • Posterior spinal artery
  • Anterior spinal artery
  • Vertebral artery
  • Segmental spinal artery

Correct Answer: Anterior spinal artery

Q5. The central canal of the spinal cord is lined by what type of cells?

  • Endothelial cells
  • Ependymal cells
  • Microglia
  • Schwann cells

Correct Answer: Ependymal cells

Q6. Which funiculus contains the dorsal columns that transmit fine touch and proprioception?

  • Anterior funiculus
  • Lateral funiculus
  • Posterior funiculus
  • Ventral funiculus

Correct Answer: Posterior funiculus

Q7. The dorsal root ganglion contains the cell bodies of which neurons?

  • Motor neurons
  • Preganglionic sympathetic neurons
  • Primary sensory neurons
  • Interneurons

Correct Answer: Primary sensory neurons

Q8. Which spinal cord region typically has a lateral horn containing sympathetic preganglionic neurons?

  • Cervical segments
  • Thoracic segments
  • Lumbar enlargement
  • Sacral segments

Correct Answer: Thoracic segments

Q9. The artery of Adamkiewicz most commonly arises from which side and which vertebral level?

  • Left side, lower thoracic or upper lumbar
  • Right side, cervical
  • Left side, sacral
  • Right side, thoracic

Correct Answer: Left side, lower thoracic or upper lumbar

Q10. Which structure anchors the spinal cord inferiorly to the coccyx?

  • Filum terminale
  • Denticulate ligament
  • Anterior median fissure
  • Posterior longitudinal ligament

Correct Answer: Filum terminale

Q11. The posterior median sulcus is located on which surface of the spinal cord?

  • Anterior surface
  • Posterior surface
  • Lateral surface
  • Ventral surface

Correct Answer: Posterior surface

Q12. Which tract is located in the lateral funiculus and carries motor fibers from cortex to spinal motor neurons?

  • Spinothalamic tract
  • Dorsal column tract
  • Lateral corticospinal tract
  • Vestibulospinal tract

Correct Answer: Lateral corticospinal tract

Q13. In a lumbar puncture for CSF sampling in adults, the needle is commonly inserted at which interspace?

  • C1–C2
  • T10–T11
  • L3–L4
  • S1–S2

Correct Answer: L3–L4

Q14. The gray commissure contains which structure connecting the two sides of gray matter?

  • Anterior white commissure
  • Central canal
  • Pia mater bridge
  • Dorsal root entry zone

Correct Answer: Central canal

Q15. Which condition is characterized by a fluid-filled cavity within the spinal cord?

  • Multiple sclerosis
  • Syringomyelia
  • Brown-Séquard syndrome
  • Transverse myelitis

Correct Answer: Syringomyelia

Q16. Which spinal region has the highest proportion of white matter relative to gray matter?

  • Cervical region
  • Thoracic region
  • Lumbar region
  • Sacral region

Correct Answer: Cervical region

Q17. Roots that carry motor fibers from the spinal cord to muscles are called:

  • Dorsal roots
  • Ventral roots
  • Sensory roots
  • Denticulate roots

Correct Answer: Ventral roots

Q18. The dorsal column is subdivided into which two fasciculi in the cervical and upper thoracic cord?

  • Fasciculus proprius and gracilis
  • Fasciculus gracilis and cuneatus
  • Cuneatus and proprius
  • Gracilis and spinocerebellar

Correct Answer: Fasciculus gracilis and cuneatus

Q19. Which spinal reflex arc element is located in the dorsal horn?

  • Motor neuron cell bodies
  • Interneuron receiving sensory input
  • Neuromuscular junction
  • Muscle spindle

Correct Answer: Interneuron receiving sensory input

Q20. The epidural space contains which of the following?

  • Cerebrospinal fluid
  • Dura mater only
  • Fat and internal vertebral venous plexus
  • Pia mater

Correct Answer: Fat and internal vertebral venous plexus

Q21. Which clinical sign suggests involvement of the corticospinal tract in spinal cord disease?

  • Loss of pain and temperature only
  • Flaccid paralysis with absent reflexes chronically
  • Upper motor neuron signs such as spasticity and hyperreflexia
  • Isolated autonomic dysfunction

Correct Answer: Upper motor neuron signs such as spasticity and hyperreflexia

Q22. The segmental organization of the spinal cord means:

  • Each vertebra contains one spinal segment
  • Nerve roots arise at fixed vertebral levels only
  • Spinal cord is divided into segments giving rise to paired spinal nerves
  • Segments fuse in adulthood eliminating nerve roots

Correct Answer: Spinal cord is divided into segments giving rise to paired spinal nerves

Q23. Which structure forms the roof of the spinal canal and contributes to the posterior boundary of the epidural space?

  • Vertebral body
  • Laminae and ligamentum flavum
  • Anterior longitudinal ligament
  • Denticulate ligament

Correct Answer: Laminae and ligamentum flavum

Q24. Which tract carries pain and temperature from the opposite side of the body to the thalamus?

  • Dorsal column–medial lemniscus
  • Spinothalamic tract
  • Corticospinal tract
  • Dorsal spinocerebellar tract

Correct Answer: Spinothalamic tract

Q25. Segmental arterial branches that enter the vertebral canal and supply the spinal cord are called:

  • Radicular arteries
  • Cerebellar arteries
  • Anterior communicating arteries
  • Posterior cerebral arteries

Correct Answer: Radicular arteries

Q26. Which region of gray matter contains motor neurons for distal limb muscles (e.g., hand muscles)?

  • Lamina I–II
  • Lamina VII
  • Lateral motor column in cervical enlargement
  • Dorsal horn laminae

Correct Answer: Lateral motor column in cervical enlargement

Q27. A hemisection of the spinal cord (Brown-Séquard syndrome) typically produces which combination below?

  • Ipsilateral loss of pain and contralateral motor loss
  • Ipsilateral loss of proprioception and motor, contralateral loss of pain and temperature
  • Only autonomic dysfunction
  • Bilateral loss of fine touch only

Correct Answer: Ipsilateral loss of proprioception and motor, contralateral loss of pain and temperature

Q28. Which layer of meninges is avascular and closely applied to the inner surface of the dura mater?

  • Pia mater
  • Arachnoid mater
  • Dura mater
  • Endoneurium

Correct Answer: Arachnoid mater

Q29. The posterior root entry zone is primarily associated with which functional fibers?

  • Motor efferents
  • Autonomic efferents
  • Sensory afferents
  • Preganglionic parasympathetic fibers

Correct Answer: Sensory afferents

Q30. Which vertebral level typically marks the end of the subarachnoid space suitable for lumbar puncture in adults?

  • T12
  • L1
  • S2
  • Coccyx

Correct Answer: S2

Q31. In cross-section, white matter is organized into which main columns?

  • Dorsal, lateral, and ventral funiculi
  • Anterior commissure only
  • Gray commissure only
  • Spinous and transverse columns

Correct Answer: Dorsal, lateral, and ventral funiculi

Q32. Which clinical syndrome results from damage to the central cervical spinal cord, often affecting upper limbs more than lower limbs?

  • Brown-Séquard syndrome
  • Anterior cord syndrome
  • Central cord syndrome
  • Cauda equina syndrome

Correct Answer: Central cord syndrome

Q33. Where are alpha motor neuron cell bodies predominantly located in the spinal cord?

  • Dorsal horn
  • Lateral horn
  • Ventral horn
  • Central canal

Correct Answer: Ventral horn

Q34. The spinocerebellar tracts primarily convey what type of information?

  • Pain and temperature
  • Conscious touch
  • Unconscious proprioception from muscles and joints
  • Autonomic signals

Correct Answer: Unconscious proprioception from muscles and joints

Q35. Which of the following best describes the cauda equina?

  • A bundle of spinal cord segments below the conus medullaris
  • A continuation of the brainstem
  • A collection of nerve roots descending within the vertebral canal
  • The dural sac only

Correct Answer: A collection of nerve roots descending within the vertebral canal

Q36. The posterior inferior cerebellar artery infarct is most likely to affect which spinal-related pathway?

  • Lateral corticospinal tract in thoracic cord
  • Dorsal column at lumbar levels
  • Spinothalamic tract at cervical levels
  • Spinocerebellar and vestibular connections in the brainstem affecting coordination

Correct Answer: Spinocerebellar and vestibular connections in the brainstem affecting coordination

Q37. The primary clinical significance of the epidural venous plexus is:

  • It supplies CSF production
  • It is a common site of metastasis and can transmit infection
  • It anchors the spinal cord laterally
  • It produces myelin

Correct Answer: It is a common site of metastasis and can transmit infection

Q38. Which fibers cross the midline in the anterior white commissure?

  • Dorsal column fibers
  • Lateral corticospinal fibers
  • Spinothalamic fibers (pain/temp) shortly after entering
  • Motor fibers to ipsilateral muscles

Correct Answer: Spinothalamic fibers (pain/temp) shortly after entering

Q39. The term “segmental level” in the spinal cord refers to:

  • The vertebral bone level corresponding to cord structures
  • The relationship between nerve roots and dermatomes/myotomes
  • The numbered lumbar vertebrae only
  • The level of skin incision for laminectomy

Correct Answer: The relationship between nerve roots and dermatomes/myotomes

Q40. Which feature helps prevent excessive lateral movement of the spinal cord within the dural sac?

  • Filum terminale only
  • Denticulate ligaments attaching pia to dura
  • Arachnoid trabeculae alone
  • Ligamentum flavum

Correct Answer: Denticulate ligaments attaching pia to dura

Q41. In spinal shock immediately after cord transection, which of the following is typically observed?

  • Hyperreflexia below the lesion
  • Flaccid paralysis and areflexia initially
  • Immediate spasticity
  • Persistent bowel and bladder control

Correct Answer: Flaccid paralysis and areflexia initially

Q42. The area where dorsal root fibers enter and ventral root fibers exit the spinal cord is called:

  • Anterior median fissure
  • Lateral recess
  • Root entry/exit zone
  • Central canal

Correct Answer: Root entry/exit zone

Q43. Which dermatome level corresponds approximately to the umbilicus?

  • T4
  • T10
  • L1
  • T12

Correct Answer: T10

Q44. In the thoracic spinal cord, which funiculus is relatively small due to fewer ascending/descending fibers?

  • Cervical funiculus
  • Posterior funiculus
  • Lateral funiculus
  • Ventral horn

Correct Answer: Posterior funiculus

Q45. Which pathology often results from syrinx expansion and initially causes a cape-like loss of pain and temperature over shoulders and arms?

  • Spinal epidural abscess
  • Syringomyelia
  • Anterior spinal artery syndrome
  • Multiple sclerosis

Correct Answer: Syringomyelia

Q46. Which of the following best describes the function of the ventral rootlets?

  • Convey sensory information into the cord
  • Carry motor signals from the cord to peripheral muscles
  • Transmit cerebrospinal fluid
  • Form the filum terminale

Correct Answer: Carry motor signals from the cord to peripheral muscles

Q47. Which spinal segments contribute primarily to the brachial plexus?

  • L1–L4
  • C5–T1
  • T10–L2
  • S2–S4

Correct Answer: C5–T1

Q48. Which syndrome results from occlusion of the anterior spinal artery affecting motor and pain/temperature pathways while sparing dorsal columns?

  • Posterior cord syndrome
  • Central cord syndrome
  • Anterior cord syndrome
  • Brown-Séquard syndrome

Correct Answer: Anterior cord syndrome

Q49. The quantity of white matter decreases caudally because:

  • Columns degenerate naturally with age
  • There are fewer ascending and descending fibers reaching lower segments
  • The dura mater thickens
  • CSF volume increases

Correct Answer: There are fewer ascending and descending fibers reaching lower segments

Q50. For intrathecal drug delivery (e.g., spinal analgesia), the drug is deposited into which space?

  • Epidural space
  • Subdural space
  • Subarachnoid space (CSF)
  • Periosteal space

Correct Answer: Subarachnoid space (CSF)

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