Normal Spine Radiology 6/18

Question 1

Describe Cervical spine

Answer 1

• 7 vertebral body segments
• usually lordosis
• neck

Question 2

Describe Thoracic spine

Answer 2

• 12 vertebral body segments that articulate with ribs

- kyphosis

Question 3

Describe Lumbar spine

Answer 3

• 5 vertebral body segments (usually can have transitional vertebral body)
• lordosis
• low back

Question 4

Describe Sacrum

Answer 4

• 5 vertebral body segments that fuse anteriorly and posteriorly
• no or small intervertebral disks
• have anterior and posterior neural foramina

Question 5

Describe Coccyx

Answer 5

variable (3-5) segments fused

Question 6

Vertebral body

Answer 6

Including superior and inferior endplates

Question 7

Which direction do pedicles extend?

Answer 7

Posteriorly

Question 8

Laminae

Answer 8

joine two pedicles posteriorly

Question 9

vertebral arch

Answer 9

formed by pedicles and laminae

Question 10

transverse process

Answer 10

extend laterally; most in C-spine have foramina for vertebral arteries

Question 11

spinous process

Answer 11

midline, extends posteriorly, can be bifid

Question 12

superior and inferior articular processes

Answer 12

project from the junctions of the lamina and pedicle on either side. their orientation changes somewhat at different levels of spine

Question 13

facet joints

Answer 13

formed from neighboring articular processes (inferior articular process of vertebra above articulating with the superior articular process of the vertebra below) and are synovial joints

Question 14

osteoarthritis

Answer 14

a degenerative joint disease. can occur at facet joints

Question 15

intervertebral disc

Answer 15

between the vertebral bodies and contain a soft core (nucleus pulposus_ and tougher outer rim called annulus fibrosis

Question 16

intervertebral (neural) foramina

Answer 16

nerves and vessel course through to exit the canal and go to the body

Question 17

spinal canal

Answer 17

contains spinal cord, nerve roots, cerebrospinal fluid contained by dura in the thecal sac. also fat and vessels

Question 18

conus medullaris

Answer 18

termination of the spinal cord, usually around thoracolumbar junction

Question 19

cauda equina

Answer 19

nerve roots in thecal sac surrounded by cerebrospinal fluid in lumbosacral region

Question 20

anterior longitudinal ligament

Answer 20

connects anterior vertebral bodies

Question 21

posterior longitudinal ligament

Answer 21

connects posterior vertebral bodies

Question 22

ligamentum flavum

Answer 22

connect laminae, when enlarged can contribute to canal stenosis

Question 23

intertransverse, interspinous, and supraspinous ligaments exist.

Answer 23

supra: connects all spinous processes

Question 24

describe C1

Answer 24

(atlas)

• no body
• 2 lateral masses that articulate with occipital condyles of the skull above and with the facets of C2 below
• lateral masses are linked by anterior and posterior arches
• no spinous process - tubercles instead
• transverse processes have foramina or grooves for the vertebral arteries

Question 25

Describe C2

Answer 25

(axis) | - has a dens

Question 26

another name for dens. describe it.

Answer 26

odontoid process - tooth-like process that extends superiorly from the body just posterior to the anterior arch of C1 and is held in place posteriorly by transverse ligament. allows C1 and skull to rotate.

Question 27

What condition has loose transverse ligament?

Answer 27

Down's syndrome

Question 28

where is largest spinous process

Answer 28

C7

Question 29

through what do vertebral arteries travel in the spine?

Answer 29

foramina of several transverse processes of cervical spine

Question 30

with which vertebra do ribs articulate?

Answer 30

thoracic

Question 31

which are largest vertebral segments

Answer 31

lumbar, for weight bearing

Question 32

articulations of sacrum? | joint formed?

Answer 32

laterally articulates with iliac bone to form sacroiliac joint

Question 33

Plain film imaging for spine used for:

Answer 33

screening, often 1st line

Question 34

what is CT scan used for in spine?

Answer 34

better for bony inJury, bony degenerative changes, some bone tumors

Question 35

what is MRI best for in spine?

Answer 35

better for imaging disc, soft tissues, including ligaments and spinal cord. better for bone marrow abnormalities and metastases

Question 36

what is myelography (followed by CT) ?

Answer 36

inject contrast into thecal sac through a lumbar puncture. image with plain films and CT

Question 37

What is nuclear medicine used for in spine?

Answer 37

- bone scars, screening for bony metastatic disease. - work up of bony tumors - sacral stress fractures - spondylolysis

Question 38

ALL VERTEBRAE SHOULD LINE UP

Answer 38

ALL VERTEBRAE SHOULD LINE UP

Question 39

Plain film images used of cervical spine:

Answer 39

usually 5 images: AP, lateral, 2 obliques, open mouth odontoid to look at dense and C1 lateral masses

Question 40

CT images used of cervical spine:

Answer 40

images obtained axially, reformatted in sagittal and coronal planes

Question 41

Which MRI images of cervical spine are used?

Answer 41

sagittal and axial, sometimes coronal, multi-sequence

Question 42

what is the size of intervertebral disk space at C2?

Answer 42

distance of soft tissue should be less than 5mm

Question 43

what is the size of intervertebral disk space at C5?

Answer 43

distance of soft tissue should be less than 22mm

Question 44

Name the cervical spine lines

Answer 44

prevertebral, anterior spinal line, posterior spinal line, spinolaminal line, and spinous process line

Question 45

What indicates degenerative disk disease on a scan?

Answer 45

narrowing of disk space

Question 46

what is open mouth odontoid (OMO) used to ID?

Answer 46

Lateral masses of C1 and odontoid process (dens) of C2

Question 47

what is a common cervical location for fracture?

Answer 47

lateral masses of C1

Question 48

what passes through C1 transverse foramina?

Answer 48

vertebral arteries

Question 49

MRI T1 vs T2

Answer 49

T1: fluid is dark T2: fluid is bright

Question 50

Plain film images used for Thoracic spine:

Answer 50

AP, lateral, and Swimmer's view for cervicothoracic junction

Question 51

What is Swimmer's view and what is it used to see?

Answer 51

it is a lateral view but the patient's one arm is up. it is use to see C7, T1 and T2 (the cervicothoracic junction)

Question 52

CT image planes used for Thoracic spine?

Answer 52

same as for cervical. images obtained axially, reformatted in sagittal and coronal planes. lots of radiation

Question 53

what are the plain film views used for Lumbar spine?

Answer 53

usually get lateral, AP, and cone down lateral +/- obliques

Question 54

what do obliques have in lumbar spine?

Answer 54

scotty dog

Question 55

What is scotty dog? where is it found?

Answer 55

- good for finding site of spondylolysis - fracture of the pars interarticularis. parts: - face - pedicle of L4 - ears - superior articular process of L4 - legs - inferior articular process of L3 - NECK - pars interarticularis

Question 56

what CT planes are used for Lumbar spine?

Answer 56

same as for cervical and thoracic. images obtained axially, reformatted in sagittal and coronal planes. lots of radiation

Question 57

pars interarticularis

Answer 57

neck of scotty | between inferior articular process of L3 and superior articular process of L4

Question 58

what is the benefit of a myelogram (+CT)

Answer 58

can see nerve roots, nerve spaces, cauda equina, spinal cord etc. vs more vague outlines of bones in solo CT scan.