Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

(3) Musculoskeletal Imaging > S1_L4: Cervical Spine Trauma, Injury, & Conditions > Flashcards

S1_L4: Cervical Spine Trauma, Injury, & Conditions Flashcards

1
Q

Modified TF
A. Stable injuries to the spinal cord or nerves present with significant displacement and involve neurological damage.
B. Unstable injuries are protected from significant joint or bone displacement by the posterior ligaments.

A

FF

A: Unstable
B. Stable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Stable vs Unstable spinal cord or nerve injuries

  1. Unilateral facet joint dislocations
  2. Fracture dislocations
  3. Traumatic disk herniations
  4. Compression fractures
  5. Bilateral facet joint dislocations

A. Stable injury
B. Unstable injury

A
  1. A
  2. B
  3. A
  4. A
  5. B
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Modified TF
A. The most frequently injured segment of the spinal cord in adults is C1-C2.
B. The most frequently injured segment of the spinal cord in children is C6-C7.

A

FF

A: children -> C1-C2
B: adults -> C6-C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

TRUE OR FALSE: Spinal Cord Injury Without Radiological Abnormalities (SCIWORA) is predominant in children due to the inherent elasticity of the pediatric spine.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

TRUE OR FALSE: In adults, acute disk prolapse and/or excessive bucking of the ligamentum flavum into the canal can result in anterior cord syndrome.

A

False, it can result in central cord syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Modified TF
A. The most mobile area of the cervical spine is between C5-C6.
B. The C1-C2 segment may not be fully ossified in children, increasing the risk of injury to this spinal cord segment.

A

FT

A: most mobile area is C6-C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

TRUE OR FALSE: The cervical spine will suffer injury if forced past the extreme end ranges of motion.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Radiologic Signs of Cervical Trauma (Yes or No)

  1. Acute lordotic angulation
  2. Reversal of lordosis
  3. Rotation of vertebrae
  4. Narrowed intervertebral space
A
  1. No, its acute kyphotic angulation
  2. Yes, d/t muscle spasm
  3. Yes
  4. No, widened intervertebral space
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Radiologic Signs of Cervical Trauma (Yes or No)

  1. Step offs in vertebral alignment
  2. Facet disarticulation
  3. Widened/narrowed interspinous space
  4. Narrowed/widened intervertebral disk space
A
  1. Yes
  2. Yes
  3. Yes
  4. Yes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Modified TF
A. Jefferson fracture is a burst fracture of the atlas (C1) that can be caused by head diving first into shallow water or trauma/hit by heavy objects.
B. This fracture is associated with neurological deficit.

A

TF

B: It is not associated with neurological deficit.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Modified TF
A. The wedge fracture is mostly seen in the thoracic spine, but may also seen in the cervical region.
B. The hangman’s fracture is a fracture of the (B) pars articularis of the axis (C2).

A

TT

Note: Wedge fracture is relatively stable, usually without neurologic deficits. It becomes serious if it affects adjacent vertebra and with 50% kyphosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Modified TF
A. The burst fracture is a compression fracture related to high energy axial loading or spinal trauma which causes disruption of the vertebral body cortex with retropulsion into the spinal canal.
B. This fracture commonly affects the cervical area.

A

TF

B: Commonly affects the lumbar area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Modified TF
A. Hangman’s fracture is also known as the traumatic spondylolisthesis of the axis.
B. Hangman’s fracture is caused by hyperextension and distraction forces.

A

TT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Modified TF
A. Type II dens fracture is located at the junction of the base to the body of C2.
B. It is the most common and most difficult fracture to heal.

A

TT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Modified TF
A. The mechanism of injury of a burst fracture is a high energy compression injury but the IV disk is driven into the vertebral body above.
B. This fracture typically occurs when falling from a height, often landing on the feet; from a MVA.

A

FT

A: high energy compression injury but the IV disk is driven into the vertebral body below

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Modified TF
A. The teardrop fracture occurs in patients with whiplash injury.
B. Its mechanism of injury is severe flexion & compression forces.

A

TT

Note: It can be a result of diving, deceleration injury during MVA, and with more severe injuries, usually there is a structural failure on the anterior part of vertebral shearing and compression fracture along with the anterior vertebral body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Modified TF
A. The teardrop fracture has a classic circular shape in imaging.
B. It usually comes with extensive ligamental injuries and spinal instability.

A

FT

A: triangular shape

Note: It is better to also image the soft tissues due to the extensive ligamental injuries.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Modified TF
A. Teardrop fracture is associated with spinal cord injury that is common in anterior cord syndrome and hemiplegia.
B. This fracture is not to be confused with extension teardrop fractures occurring in higher cervical spine segments and considered less severe.

A

FT

A: common in anterior cord syndrome and quadriplegia

Note: Extension teardrop fractures affect the spinous processes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Modified TF
A. Clay shoveler’s fracture is a fracture of the vertebral spinous processes.
B. This fracture is usually due to MVA, sudden muscle contractions, and direct blows to the cervical spine.

A

TT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Modified TF
A. Unilateral facet joint dislocation is also known as doubly locked vertebral injury.
B. Doubly locked vertebral injury is an unstable injury due to complete ligamentous disruption that extends anteriorly (extreme form of anterior subluxation).

A

FT

A: Bilateral facet joint dislocation is also known as doubly locked vertebral injury.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Modified TF
A. Wedge fracture is a vertebral body compression fracture occurring laterally.
B. It is considered serious when the fracture affects adjacent vertebrae and when the wedging is 50% severe hyperkyphosis or kyphosis of the cervical spine.

A

FT

A: It is a vertebral compression fracture occurring anteriorly (anterior is more common than lateral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Modified TF
A. Wedge fracture can be seen with a bowtie configuration of the facets.
B. Bilateral facet joint dislocation occurs due to severe displacement of the spine anteriorly.

A

FT

A: Bilateral facet joint dislocation can be seen with a bowtie configuration of the facets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Modified TF
A. Wedge fractures may be due to pathologic processes, such as osteoporosis and tumors.
B. Wedge fractures require immediate care.

A

TT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Modified TF
A. Jefferson fracture is a 4-part fracture with fractures to the anterior and posterior arches of the atlas.
B. It occurs due to axial loading along the axis of the cervical spine when the occipital condyles are being driven into the lateral masses of the atlas.

A

TT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Modified TF
A. Hyperflexion sprains occur due to disruption of the anterior ligament complex.
B. It can result to transient facet joint dislocation, avulsion fracture of the spinous processes, and impaction fracture of the anterior vertebral bodies.

A

FT

A: Hyperflexion sprains occur due to disruption of the posterior ligament complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Modified TF
A. Hyperflexion sprains involve all of the posterior ligaments and the facet joint capsules.
B. With extreme force, injury to the posterior nucleus pulposus and posterior aspect of the intervertebral disk can occur.

A

TF

B: With extreme force, injury to the posterior annulus fibrosus and posterior aspect of the intervertebral disk can occur.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Modified TF
A. Hyperlordotic angulation can be seen on the lateral radiograph in hyperflexion sprains.
B. Also, the vertebral segments will no longer align in the normal kyphotic curve.

A

FF

A: Hyperkyphotic angulation
B: vertebral segments will no longer align in the normal lordotic curve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

TRUE OR FALSE: If the hyperflexion sprain does not show on the AP radiograph, lateral flexion and extension stress films should be obtained.

A

True

Note: It is important to also screen for associated fractures.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Modified TF
A. Hyperextension sprains may occur as an isolated injury.
B. It may also occur as a rebound action of the head and neck following hyperflexion.

A

TT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Modified TF
A. Severe hyperextension sprains can disrupt the anterior ligaments and soft tissues.
B. This may result in a transient subluxation of the anterior segments.

A

TF

B: may result in a transient subluxation of the posterior segments.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

TRUE OR FALSE: Following hyperextension sprains, associated fractures can occur as the extension force converts into a compressive force due to the neck extensors.

A

False, the extension force converts into a compressive force due to the neck flexors.

31
Q

Modified TF
A. Viewing hyperextension sprains in the lateral view may demonstrate vertebral malalignment 2º to IV disk disruption.
B. Lateral flexion and extension tests are also obtained to evaluate joint stability.

A

TT

Note: Routine radiographs are important to screen for associated fractures.

32
Q

Modified TF
A. Immobilization is the treatment for cervical spine sprains.
B. Soft or rigid cervical collars immobilize the spine, allowing tissues to heal.

A

TT

Note: Usually in fractures and sprains, PTs wait for the area to heal, then mobilize the healing area.

33
Q

Modified TF
A. In rehabilitating cervical spine sprains, focus is on restoring normal posture, joint arthrokinematics, active ROM, and strength.
B. For the acute stages, pain medications and modalities are used.

A

TT

Note: If there is a sprain in an area, a common finding is muscle guarding.

34
Q

Modified TF
A. Acute anterior IV disk herniations present with neurologic symptoms.
B. IV disks that herniate and do not cause neural compression are more common.

A

FT

A: Acute anterior IV disk herniations cause no neurologic symptoms

35
Q

Modified TF
A. Traumatic injury to the cervical spine may cause a posterior or lateral disk herniation resulting in neural compression.
B. MRI is definitive for a diagnosis of acute cervical disk pathology.

A

TT

Note: Conventional radiographs (x-rays) are of little diagnostic value for acute, but chronic disk herniations lead to degenerative changes that are seen in x-rays.

36
Q

Modified TF
A. In treating IV disk herniations, NSAIDs and steroids are medications for the inflammation.
B. Other treatments include traction, joint mob, soft tissue techniques, and pain modalities.

A

TT

Note: Cervical traction may or may not work on different patients. PTs must gauge the effectivity per condition.

37
Q

Modified TF
A. Anterior cervical discectomy with or without bone grafts and plating is a surgical treatment for IV disk herniations.
B. Laminectomy with or without foraminotomy may also be performed.

A

TT

38
Q

Modified TF
A. Os odontoideum is the failure of the dens to fully fuse with the body of C1.
B. Possible atlanto-axial instability can occur.

A

FT

A: Os odontoideum is the failure of the dens to unite with the body of C2

39
Q

Modified TF
A. Os odontoideum is associated with Morquio and Klippel Feil syndromes.
B. Os odontoideum is present in 20% cerebral palsy cases.

A

TF

B: Os odontoideum is present in 20% Down syndrome cases

40
Q

Modified TF: Os odontoideum
A. On the radiograph, the dens separated from the body by a radiolucent cleft.
B. Extension film is required to assess for atlanto-axial instability.

A

TF

B: Lateral flexion film

41
Q

Cervical spine anomalies

  1. Possible source of compression for thoracic outlet syndrome
  2. Failure of laminae to unite and form a spinous process

A. Os odontoideum
B. Block vertebra
C. Sprengel’s deformity
D. Spina bifida occulta
E. Cervical ribs

A
  1. E
  2. D
42
Q

Cervical spine anomalies

  1. Congenital elevation of the scapula
  2. Two adjacent vertebrae fused at birth
  3. Present in 25% of Klippel Feil syndrome cases

A. Os odontoideum
B. Block vertebra
C. Sprengel’s deformity
D. Spina bifida occulta
E. Cervical ribs

A
  1. C
  2. B
  3. C
43
Q

Cervical spine anomalies

  1. Extra bone projecting from and sometimes forming a joint with transverse processes
  2. Partial or complete fusion of vertebral bodies, facets, and spinous processes

A. Os odontoideum
B. Block vertebra
C. Sprengel’s deformity
D. Spina bifida occulta
E. Cervical ribs

A
  1. E
  2. B
44
Q

Cervical spine anomalies

  1. Usually of no clinical significance
  2. No motions at the fused segments, excessive compensatory motions at the adjacent free joints with resultant degenerative changes

A. Os odontoideum
B. Block vertebra
C. Sprengel’s deformity
D. Spina bifida occulta
E. Cervical ribs

A
  1. D
  2. B
45
Q

Occurs most commonly at C2-C3, C5-C6

A. Os odontoideum
B. Block vertebra
C. Sprengel’s deformity
D. Spina bifida occulta
E. Cervical ribs

A

B. Block vertebra

46
Q

Associated with scoliosis, block vertebrae, spina bifida occulta, hemivertebrae, and cervical ribs.

A. Os odontoideum
B. Block vertebra
C. Sprengel’s deformity
D. Spina bifida occulta
E. Cervical ribs

A

C. Sprengel’s deformity

47
Q

TRUE OR FALSE: Cervical ribs occur most commonly at C6, and are often bilateral but asymmetric in size and shape.

A

False, occur most commonly at C7

48
Q

Modified TF
A. In spina bifida occulta, the spinous process is malformed at the involved level.
B. A vertically oriented radiolucent cleft is also seen between the laminae.

A

TT

49
Q

Modified TF
A. On a radiograph, the cervical rib projects caudally from the cervical transverse process.
B. A joint may form at the proximal end of the rib.

A

TF

B: distal end

Note: A fibrous band anchoring would not appear on radiograph but may compress the neurovascular bundle (brachial plexus)

50
Q

TRUE OR FALSE: In 30-40% of cases of Sprengel’s deformity, an omovertebral bone appears as a bony bar projecting from the lamina of C5 to the vertebral border of the scapula.

A

False, omovertebral bone appears as a bony bar projecting from the lamina of C7 to the vertebral border of the scapula.

51
Q

Modified TF
A. In block vertebra, the spinous processes may be fused or malformed.
B. A radiographic feature of this anomaly is small AP diameter of bodies with indented fused intervertebral space.

A

TT

Note: The facets fuse in 50% of cases

52
Q

Modified TF
A. Cervical arthroplasty involves placement of an artificial disk made up of polyethylene core between two metal endplates.
B. The core acts as a spacer so that it pivots in a way that mimics the movement between 2 vertebrae.

A

TT

53
Q

Modified TF
A. Anterior cervical discectomy and fusion is a standard cervical treatment.
B. It provides neural decompression and relief of radicular symptoms.

A

TT

Note: Long term disadvantage is accelerated degenerative changes in the segment above the fused level. Since the hypermobile area is fused, the segment above will compensate for the loss of movement for the segment below.

54
Q

Modified TF
A. Degenerative joint disease involves osteoarthritic changes of the facet joints.
B. Common findings for DJD are articular cartilage thinning, subchondral sclerosis, and osteophyte formation.

A

TT

55
Q

Modified TF
A. Degenerative disk disease is usually seen in patients >50 years old.
B. This condition may include dehydration, nuclear herniation, annular protrusion, and fibrous replacement of the annulus.

A

FT

A: Degenerative disk disease is usually seen in patients >60 years old

56
Q

Degenerative disk disease findings

  1. Schmorl’s nodes
  2. Decreased height is seen in the lateral view
  3. Dehydration of the disk

A. Conventional radiograph (x-ray)
B. MRI
C. Both

A
  1. C (On x-ray, Schmorl’s nodes are identified as radiolucent focal defects in the vertebral endplates)
  2. A
  3. B
57
Q

Degenerative disk disease

Nitrogen gases accumulate in the dehydrated fissures of the disk.

A. Vacuum phenomenon
B. Schmorl’s nodes
C. Decrease in disk height

A

A. Vacuum phenomenon

58
Q

TRUE OR FALSE: Degenerative disk disease may present with osteophyte formation at the uncovertebral joints and eventually around the entire vertebral end plates.

A

True

59
Q

Degenerative disk disease

Intravertebral herniation of the nucleus pulposus through the vertebral endplate to the spongiosa of the vertebral body

A. Vacuum phenomenon
B. Schmorl’s nodes
C. Decrease in disk height

A

B. Schmorl’s nodes

60
Q

TRUE OR FALSE: Decrease in IV disk height in DDD leads to decreased friction in the uncovertebral joints which leads to osteophyte formation and eventually around the entire endplates.

A

False, decrease in IV disk height in DDD leads to increased friction in the uncovertebral joints

61
Q

Modified TF
A. Degenerative joint disease may develop in isolation or with DDD and foraminal encroachment.
B. Facet joints are at risk due to decreased mobility, postural strains, and repetitive occupational or recreational actions.

A

TF

B: Facet joints are at risk due to increased mobility, postural strains, and repetitive occupational or recreational actions.

62
Q

Modified TF
A. On the lateral or oblique view (x-ray), DJD shows subchondral sclerosis, decreased joint space, and osteophytosis.
B. Widening of the neural foramina may also be observed.

A

TF

B: Narrowing of the neural foramina may also be observed.

63
Q

Modified TF
A. Rehabilitation of degenerative diseases include cervical traction, ultrasound, and hot/cold modalities.
B. Therapeutic exercises are also used to balance muscle strength and flexibility.

A

TT

63
Q

Modified TF
A. Degenerative changes may still be reversed.
B. Segmental mobilization techniques is one of the treatment methods used for degenerative cases.

A

FT

A: Cannot be reversed

64
Q

TRUE OR FALSE: Promoting proper posture and patient education in occupational and leisure activity accommodations that decrease stressful posture or maladaptive behaviors are important aspects of rehabilitation of degenerative cases.

A

True

65
Q

TRUE OR FALSE: On imaging for cervical spine spondylosis, osteophytes are visible on AP, lateral, or oblique views as radiolucent irregularities at vertebral joint margins.

A

False, osteophytes are visible on AP, lateral, or oblique views as radiodense irregularities at vertebral joint margins

66
Q

Modified TF
A. Cervical spine spondylosis is the formation of osteophytes in response to a degenerative disk disease.
B. This formation predominantly occurs at the points in the curvature of the spine farthest from the CoG line as a result of greater segmental mobility.

A

TT

67
Q

Modified TF
A. Cervical spine spondylosis can contribute to foraminal encroachment.
B. It occurs most commonly at C4-C5, C5-C6.

A

TT

68
Q

TRUE OR FALSE: Osteophyte formation may be the body’s attempt to repair friction damage or to protect itself from friction damage.

A

True

69
Q

TRUE OR FALSE: Neck pain is one of the cardinal signs of an intervertebral disk herniation.

A

False, neck pain must not be used to confirm diagnosis. More often than not, it is a coincidental finding.

70
Q

Modified TF
A. Soft collars are used to immobilize the cervical spine.
B. Rigid collars are for proprioceptive fractures.

A

FF

A: Rigid
B: Soft

71
Q

Modified TF
A. Anterior disk herniations do not present with neurologic symptoms.
B. Posterior disk herniations usually presents with neurologic symptoms.

A

TT

72
Q

Spinal anomalies usually consist of one or more of the following, except:
A. Arrested development
B. Failure to develop
C. Development of accessory bones
D. Symmetrical structural development
E. None

A

D. Symmetrical structural development

It should be asymmetrical structural development

73
Q

TRUE OR FALSE: Mobilization, manipulation, manual resistance, or traction applied without prior knowledge of the anomaly may lead to paralysis, neurologic deficit, and death.

A

True

74
Q

TRUE OR FALSE: Sprengel’s deformity presents with a bone connecting the lamina of T1 to the vertebral border of the scapula producing difficulty in movement.

A

False, it presents with a bone connecting the lamina of C7 to the vertebral border of the scapula producing difficulty in movement.

(3) Musculoskeletal Imaging (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions