DDX
What injury is caused by flexion + rotation or vertebral compression?
Disc Herniation
What joint performs Flexion/Extension of the neck?
Atlanto-occipital Joint
Primary/Kyphosis
The extrinsic back muscles are innervated by...
The Rectus Capitis Posterior Major inserts onto this part of the occipital bone
Inferior Nuchal Line
A 17-year-old female soccer player presents with progressive back pain and uneven shoulders. She denies trauma but notices her clothes fitting unevenly. Examination reveals an asymmetrical waistline and a prominent rib hump on the right when bending forward. Neurological examination is normal. What is the most likely diagnosis?
Idiopathic Scoliosis
At what spinal levels would you find Luschka's Joints?
C3-C6
Where do nerves pinch during a disc herniation?
Intervertebral Foramen
Fetal curvature (in the womb) is classified as what type of curve?
This suboccipital muscle originates from the posterior tubercle of the atlas (C1) and helps with head extension
Rectus Capitis Posterior Minor
A 50-year-old construction worker presents with sudden-onset low back pain after lifting a heavy box. He describes sharp, localized pain but denies radiation to the legs or numbness. Physical exam reveals mild tenderness over the lumbar spine with normal straight leg raise test and normal reflexes. What is the most likely diagnosis?
Bulged disc, Lumbar compression fracture, Lumbar ligament sprain
What excessive movement do uncinate processes prevent?
Excessive lateral flexion
A lumbar puncture would go through which layers? (starting at the skin heading anteriorly)
Skin, Supraspinous Ligament, Interspinous Ligament, Ligamentum Flavum, Epidural Space, Dura Mater, Arachnoid Mater, Subarachnoid Space
Which of the back muscles work primarily for proprioception?
Serratus Posterior Superior/Inferior, Multifidus, Rotatores, Semispinalis
Both the Obliquus Capitis Superior and Rectus Capitis Posterior Major share this action, allowing for subtle head movement (name movement and joint)
Extension of the head at the atlanto-occipital joint
What is the most likely mechanism of injury for a P.L.L (posterior longitudinal ligament) sprain?
Hyperflexion
Injury to this ligament, located between the vertebrae, can lead to hypermobility and is a common site for sprains in whiplash injuries.
Interspinous Ligament
The extension of Pia Mater is called ____ and it anchors the spinal cord _____
Filum Terminale, Inferiorly
This embryonic division of the myotome gives rise to the deep muscles of the back, including the erector spinae
Epimere
What does the Suboccipital Nerve innervate?
All 4 suboccipital muscles
A 42-year-old male involved in a high-speed rear-end motor vehicle accident initially reports mild neck pain but is otherwise stable. A few hours later, he develops difficulty breathing and worsening neck stiffness. Neurological examination reveals mild weakness in the upper limbs but normal lower limb function. What is the most likely diagnosis?
(double points if you get both answers)
Hangman’s fracture and Cervical disc herniation
The “open mouth” X-ray view is specifically used to diagnose fractures of this cervical vertebra.
C1 (Atlas)
If a patient were to have right-sided spinal cord damage, what would be affected?
(Hint: think pathways up right and left side of the spinal cord)
Right general sensory/motor control
Left pain/temperature response
Epaxial (intrinsic) muscles are innervated by this division of the spinal nerve
Dorsal Rami
What is the main blood supply to the Suboccipital muscles?
Vertebral Artery