special studies

Question 1

what is an x-ray taken after a radio opaque substance is injected into subarachnoid space?

Answer 1

pyelography- high risk, less used

Question 2

what is the common substance used in myelography?

Answer 2

metrizamide

Question 3

what is CT better for?

Answer 3

bone

Question 4

what is MRI better for?

Answer 4

neural tissue and bone marrow

Question 5

what would you need to use with an obese patient who exceeds weight limits for CT and MRI?

Answer 5

pyelography

Question 6

what is a common complication of a patient with MRI?

Answer 6

internal metal objects

Question 7

what is a radiographic record after introduction of opaque material into a joint? not often used

Answer 7

arthrogram- MRI arthrography more common

Question 8

what is a type of radio nucleotide imaging that involves intravenous injection of radioactive compounds known to adhere to metabolically active bone?

Answer 8

bone scan- gamma detectors localize regions of uptake

Question 9

when is a bone scan used?

Answer 9

acute LBP where tumor, infection or occult fracture are suspected

Question 10

when is bone scan contraindicated?

Answer 10

pregnancy and breastfeeding

Question 11

what is ultrasound used for?

Answer 11

evaluation and location of space occupying soft tissue masses

Question 12

what is doppler ultrasound used for?

Answer 12

location of some vascular venous occlusions

Question 13

what is the study of electrical activity of muscles and associated muscle activity? involves placing needle electrodes into skeletal muscle and displayed on cathode ray oscilloscope and heard on the loud speaker?

Answer 13

EMG- electromyography

Question 14

what information can be obtained from EMG?

Answer 14

electric activity from needle inserted into muscle
electric activity of resting muscle with needle undisturbed
electric activity of motor unit during voluntary contractions

Question 15

what is used to evaluate the conductivity of a nerve from the point of stimulation to the muscle?

Answer 15

NVC- nerve conduction velocity

Question 16

what NVC occurs in neuropathy?

Answer 16

conduction rates less than 40 m/s

Question 17

what are normal NVC for median and ulnar nerves and common peroneal?

Answer 17

median and ulnar- 50-60 m/s

common peroneal- 45-50 m/s

Question 18

When are electrophysiologic tests used?

Answer 18

patients with sciatica to evaluate spinal cord, nerve roots and peripheral nerves 
myelopathy
radiculopathy
neuropathy
myopathy

Question 19

what is used to assess acute and chronic nerve root dysfunction, myelopathy, myopathy?

Answer 19

EMG

Question 20

what test measures sensory conduction through nerve roots and used for cervical and lumbar neuropathies?

Answer 20

H reflex

Question 21

what test is for motor conduction through nerve roots, assess proximal neuropathies?

Answer 21

F wave response

Question 22

what assesses acute and chronic recruitment patterns during static and dynamic pass using surface electrodes instead of needle insertion?

Answer 22

surface EMG

Question 23

what assesses sensory neurons in peripheral and spinal cord pathways?

Answer 23

sensory evoked potentials

Question 24

what is used to assess acute and chronic peripheral entrapment neuropathies that may mimic radiculopathies?

Answer 24

nerve conduction studies

Question 25

when would you most likely use EMG/NCV?

Answer 25

LBP problems with confusing clinical picture or severe leg symptoms lasting more than 3-4 weeks

Question 26

what info does EMG/NCV provide when using the tests?

Answer 26

1 presence or absence of radiculopathy or neuropathy as cause of sx
2 provide info on specific nerve roots that may be compromised
3 differentiate between acute and chronic nerve root dysfunction

Question 27

what are SEPs most useful for?

Answer 27

assessing spinal stenosis and spinal cord myelopathy

SEP- sensory evoked potential

Question 28

what is EEG used for?

Answer 28

measuring electrical activity of the brain

Question 29

what is used for inter cranial aneurysms, vascular disorders, hematoma and tumors?

Answer 29

angiography

Question 30

what is thermography used for?

Answer 30

measuring temp differences on each side of body
presence or absence of radiculopathy (NRC)
RSD