Transitioning to the Suboccipital Triangle. Suboccipital Triangle
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1 Transitioning to the Suboccipital Triangle Syllabus p Suboccipital Triangle Borders -Rectus capitis posterior major -Obliquus capitis superior -Obliquus capitis inferior Contents -Vertebral artery -Suboccipital nerve 1
2 Innervation of the Suboccipital Region Suboccipital (C1) innervates suboccipital muscles Greater occipital (C2) supplies posterior scalp C3 supplies small area of lower scalp Blood Supply to the Suboccipital Region Occipital artery 2
3 A 29 year old man suffers from a stroke. A dissecting vertebral artery contributed to his stroke. This may in part be due to the course of the vertebral artery as it approaches the suboccipital triangle, which is bordered by the following muscles: A. Obliquus capitis superior, Obliquus capitis inferior, rectus capitis minor B. Obliquus capitis superior, rectus capitis minor, rectus capitis major C. Obliquus capitis superior, Obliquus capitis inferior, rectus capitis major D. Obliquus capitis superior, semispinalis cervicus, rectus capitis major E. Obliquus capitis inferior, rectus capitis minor, rectus capitis major B. Obliquus capitis s... A. Obliquus capitis s Obliquus capitis supe... Obliquus capitis supe... Obliquus capitis inferio.. Osteology Back -Gray s pp Gray s dissector, pp
4 Osteologic Landmarks (Back) Scapula (posterior) 4
5 The Vertebral Column Normal Curvatures of the Vertebral Column 5
6 Abnormal Curvatures of the Vertebral Column A 42 year old male goes running for one hour and subsequently complains of lower back pain and disoriented equilibrium. After a superficial examination of the back, you conclude that the runner is suffering from one of the following: 10 A. Lordosis B. Scoliosis C. Right side winged scapula D. Kyphosis E. Herniated intervertebral disc (L1) Lordosis Scoliosis Right side winged... Kyphosis Herniated intervertebr.. 6
7 Clinical Test for Scoliosis Components of Typical Vertebra 7
8 Cervical Vertebrae Distinctive Features of Cervical Vertebrae -Atlas (C1) -Axis (C2) -Foramen Transversarium -Small Body -Bifid Spinous Process Cervical Vertebrae 8
9 Cervical Vertebrae Cervical Vertebrae 9
10 Cervical Vertebrae CT scan of Cervical Vertebrae Distinctive Features of Thoracic Vertebrae Thoracic Vertebrae -Costal facets -Spinous processes point inferiorly -Vertebral body somewhat heart-shaped 10
11 Thoracic Vertebrae Thoracic Vertebrae 11
12 Thoracic Vertebrae CT-scan of Thoracic Vertebrae Distinctive Features of Lumbar Vertebrae Lumbar Vertebrae -Large Body -Short, stout spinous processes 12
13 Lumbar Vertebrae Lumbar Puncture 13
14 Lumbar Puncture Lumbar Puncture 14
15 Lumbar Puncture Dermatomes 15
16 Dermatomes Zygapophysial Joints 16
17 Ligaments -Ligamentum nuchae and Supraspinous ligament -Anterior and Posterior longitudinal ligaments -Ligamenta flava Ligamentum Nuchae 17
18 Supraspinous Ligament Anterior and Posterior Ligaments 18
19 Ligamenta Flava Intervertebral Discs 19
20 A 55 year old man was involved in a motorcycle accident and fractured one of his vertebra. The fracture impinged on the spinal cord and the man s breathing became erratic and stopped. Identify the approximate vertebral level of injury. 10 A. C3 B. C6 C. T2 D. T4 E. T7 C3 C6 T2 T4 T7 A 34 year old pregnant female develops lower back pain during the late stages of her pregnancy. The pain is due to an accentuated secondary curvature of her vertebrae in the lumbar region. This condition is referred to as: 10 A. Lordosis B. Scoliosis C. Right side winged scapula D. Kyphosis E. Herniated intervertebral disc (L1) Lordosis Scoliosis Right side winged... Kyphosis Herniated intervertebr.. 20
21 A young man is thought to have an infection that has spread into his CSF. A lumbar puncture is required. The needle is inserted at the following vertebral level: A. T12-L1 B. L1-L2 C. L3-L4 D. L4-L5 E. L5-S1 A 45 year old woman complains of lower back pain. She is diagnosed with a herniated disc between L5-S1 vertebrae. A tear has most likely occurred in the. A. Anulus fibrosus B. Anterior longitudinal ligament C. Ligamenta Flava D. Nucleus pulposus E. Interspinous ligament 10 Anulus fibrosus Anterior longitudinal... Ligamenta Flava Nucleus pulposus Interspinous ligament 21
22 Herniation of the Nucleus Pulposus 22
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