Posted by Kevin Rakszawski on September 26, 2009 at 11:23:11:
In Reply to: Suboccipital Region and Vertebral Canal: True/False Part I posted by lae2 on September 22, 2009 at 15:47:38:
Here's my attempt at these questions.
1. The vertebral foramen transmits the spinal nerve from the spinal canal to the paravertebral region.
TRUE – if vertebral foramen is analogous to intervertebral foramen
2. The spinal canal has both bony and fibrous boundaries.
TRUE – its posterior boundary includes the bony lamina and fibrous ligamentum flavum
3. The ligamentum flavum is named for its fuscia appearance.
FALSE – it is named for its yellowish appearance
4. The obliques capitus inferioris rotates the head to the opposite side.
TRUE
5. The rectus capitus posterior major flexes the neck.
FALSE – it extends the neck at the atlantooccipital joint
6. There are 7 cervical nerves and 8 cervical vertebrae.
FALSE – there are 7 cervical vertebrae and 8 cervical nerves
7. Opliques capitis superioris rotates the head to the same side.
TRUE
8. The suboccipital nerve enters the back inferior to the occipital bone and superior to the atlas.
TRUE
9. At the superior nuchal line the greater occipital nerve is medial to the occipital artery.
TRUE
10. The nuchal ligament limits flexion of the neck.
TRUE – though I can’t find reference to this in Gray’s; discussed in online publications regarding resection of the nuchal ligament to increase flexion range
11. A lesion of the suboccipital nerve would make extension of the neck impossible.
TRUE – the suboccipital nerve innervates rectus capitis posterior major and minor, obliquus capitis superior and inferior, and semispinalis capitis – all of which “extend, rotate, and flex the head laterally” (not sure about this one)
12. A lesion of the occipital nerve would cause paraesthesia or anesthesia of the scapular region.
TRUE – from Gray’s: “Greater occipital neuralgia is a syndrome of pain and paraesthesiae felt in the distribution of the greater occipital nerve. The pathology lies at the dorsal root ganglion. A similar syndrome may be caused by upper facet joint arthritis involving the second cervical root.”
13. The ligamentum flavum extends between adjacent lamina.
TRUE – the ligamentum flavum functions to maintain upright posture
14. The interspinous ligament extends between adjacent pedicles. (of course not)
FALSE – it is continuous with the interspinalis muscles that connect two adjacent spinous processes
15. Cerebral spinal fluid is located immediately deep to ligamentum flavum, between it and dura mater.
FALSE – CSF is located deep to arachnoidia in the subarachnoid space
16. Spinal nerves can be anesthetized by injections into the epidural space.
TRUE – from Gray’s: “Local anaesthetics injected near the spinal nerves, just outside the intervertebral foramina, may spread up or down the epidural space to affect the adjacent spinal nerves or may pass to the opposite side.”
17. The posterior longitudinal ligament has lateral extensions that help to reinforce the intervertebral disk.
TRUE
18. The nuchal ligament can be considered an extension of the supraspinous ligament into the neck region.
TRUE
19. The vertebral artery lies on the superior surface of the transverse process of the axis in the groove for the vertebral artery.
FALSE – it lies on the superior surface of the transverse process of the ATLAS
20. The vertebral artery leaves the suboccipital triangle as it passes through the posterior atlantooccipital membrane.
FALSE – it pierces the dura mater to enter the vertebral canal and ascends into the cranial cavity through the foramen magnum
21. The greater occipital nerve enters the back inferior to the obliques capitus inferioris muscle.
TRUE – though would it be clearer to say it enters the suboccipital triangle instead of the back?
22. From superficial to deep the greater occipital nerve passes through trapezius, then semispinalis capitus, and finally, splenius capitus.
FALSE – I believe splenius capitis is superficial to semispinalis capitis