The Back Picture Cards

Question 1

Fracture of this lumbar vertebrae at the line as shown in the photo is usually a result of what?

Answer 1

Spondylolysis: fracture of the pars interarticularis as shown results in a “dog collar” (fracture of the dog’s neck as seen in an XR)

Question 2

What disease can result in the complication shown on this MRI?

Answer 2

Pott’s disease - abscess of the psoas major fascia

Question 3

Are dorsal and ventral primary rami mixed nerves?

Answer 3

Yeah!

Question 4

Also name its function

Answer 4

Anterior longitudinal ligament - prevents overextension

Question 5

Name the muscle, origin, insertion, innervation, and action.

Answer 5

Trapezius.

Originates on skull and C7-T12.

Inserts on lateral 1/3 of clavicle, the acromion, and scapular spine.

Innervation is spinal accessory nerve (CN XI).

Upper fibers can elevate the shoulder, lower fibers can depress the shoulder. Can also retract the scapula and extend the head.

Question 6

Name the muscle, origin, insertion, innervation, and action.

Answer 6

Latissimus dorsi

Originates on the spinous processes of T6-T12 , thoracolumbar fasica, and iliac crest.

Inserts on the intertubercular groove of the humerus.

Innervated by the thoracodorsal nerve.

Action is to extend and medially rotate the arm.

Question 7

Name the muscles, origins, insertions, innervations, and actions.

Answer 7

1. Rhomboid minor

Originates on spines of C7 and T1.

Inserts on medial border of scapula.

2. Rhomboid major

Originates on spines of T2-T5

Inserts on medial border of scapula

Both are innervated by the dorsal scapular nerve.

Both retract the scapula

Question 8

Name the muscles, origins, insertions, innervations, and actions.

Answer 8

1. Serratus posterior superior

Originates on spines of cervical and thoracic vertebrae.

Inserts on to ribs.

Action is to raise ribs during inspiration.

Innervated by intercostal nerves T1 and T2

2. Serratus posterior inferior

Originates on spines of lumbar and thoracic vertebrae.

Inserts on to ribs.

May aid in expiration.

Innervated by intercostal nerves T10 and T11

Question 9

Also, what does #2 cover up?

Answer 9

1. Dorsal rami of spinal nerves
2. Thoracolumbar fascia - covers deep back muscles

Question 10

Name the muscles, origins, insertions, innervations, and actions.

Answer 10

1. Splenius capitus

Origin is spines of T1-T4

Inserts on to the skull

2. Splenius cervicis

Origin is the same (T1-T4 spines)

Inserts on transverse processes of C2, C3

Both extend and rotate the head and neck.

Innervated by dorsal primary rami of spinal nerves (all deep back muscles are).

Question 11

Name the muscles, origins, insertions, innervations, and actions.

Answer 11

1. Erector spinae: spinalis

Inserts on spinous processes of vertebrae

2. Erector spinae: longissimus

Inserts on ribs between the tubercles and transverse processes in the lumbar region, and inserts on transverse processes in the cervical and thoracic regions.

3. Erector spinae: iliocostalis

Inserts on angles of lower ribs.

All have common origin: a broad tendon that attaches to the iliac crest, sacrum, and sacral and lumbar spinous processes.

Innervated by spinal nerve dorsal rami.

They extend the trunk.

Question 12

Answer 12

1. Psoas major
2. Iliacus
3. Erector spinae

Question 13

Name the muscles, origins, insertions, innervations, and actions for 1 and 3. Just name #2.

Answer 13

1. Transversospinalis: semispinalis
2. Erector spinae: spinalis
3. Transversospinalis: multifidius

The transversospinalis muscles originate on transverse processes.

They insert on spines of vertebrae above.

Action: extend trunk in a bilateral action, rotate unilaterally.

Innervated by dorsal rami of spinal nerves.

Question 14

Name the muscles, origins, insertions, innervations, and actions.

Answer 14

1. Rotatores

Originates on transverse processes of the cervical, thoracic, and lumbar vertebra (usually only fully developed in the thoracic region).

Insertions for long rotatores: spinous processes of vertebra one level above the origin. Short rotatores insert on spinous processes of adjacent vertebra.

2. Levator costarum

Origin is transverse processes of C7 to T11.

Insertion is the superior border and external surface of the subjacent rib between its tubercle and angle.

Innervation is by dorsal rami of spinal nerves.

Question 15

Also name its function

Answer 15

Supraspinous ligament - prevents hyperflexion of the spine

Question 16

Also name its function.

Answer 16

Intraspinous ligament - prevents hyperflexion of the spine.

Question 17

Answer 17

1. Iliolumbar ligament
2. Lumbosacral band of the iliolumbar ligament
3. Anterior sacroiliac ligament
4. Anterior longitudinal ligament

Question 18

Answer 18

1. Sacrospinous ligament
2. Sacrotuberous ligament
3. Posterior sacroiliac ligaments

Question 19

Answer 19

1. Pedicle
2. Lamina
3. Ligamentum flavum (Flavum Flav!)
4. Posterior longitudinal ligament - prevents hyperflexion of spine and protrusion of disks into the canal.

Question 20

What happened?

Answer 20

Spondylolisthesis

Question 21

Answer 21

1. Vertebral artery
2. Ascending cervical artery
3. Anterior spinal artery
4. Anterior segmental medullary artery
5. Posterior spinal arteries
6. Subclavian artery

Question 22

Answer 22

1. Sulcal branches of the anterior spinal artery
2. Radicular arteries
3. Anterior spinal artery
4. Anterior segmental medullary artery

Question 23

Answer 23

Posterior intercostal artery

Question 24

Answer 24

Internal vertebral venous plexus

Question 25

What is shown in green? What is it derived from?

Answer 25

Denticulate ligaments - derived from pia mater from cervical to T12, which help anchor the pia mater to the arachnoid and dura mater

Question 26

Answer 26

1. Dura mater
2. Dorsal root ganglion
3. Conus medullaris
4. Cauda equina
5. Filum terminale