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Radiology > Spine > Flashcards

Spine Flashcards

1
Q

Modalities for spine imaging.

A

Plain films
CT
MRI
Myelography

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2
Q

What is when contrast is put in the spinal canal?

A

CT myelogram

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3
Q

what can happen with neck chiropractic manipulation?

A

Dissection of vertebral arteries

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4
Q

how many views should you get for trauma?

A

At least 2 views

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5
Q

For a cervical spine, what spinal levels should you get imaging done to at least

A

T1

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6
Q

What is the views for cervical spine usually?

A

cross table lateral to top of T1
AP
open mouth odontoid (C1 and C2)

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7
Q

If you cant see T1 what should you do?

A 
Pull down the shoulder (gently) 
Swimmers view (have pts arm up so you can see C1 and C2)
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8
Q

A cross tabel lateral x-ray will show how much of cervical spine injuries?

A

85-90%

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9
Q

In alignment of cervical spine, where does the first line merge?

A

With the anterior aspect of the peg

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10
Q

In alignment of cervical spine, where does the second line merge?

A

With the posterior aspect of the peg

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11
Q

What should the distance b/w the anterior arch of C1 and the odontoid peg be in adults?

A

3 mm in adults

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12
Q

What should the distance b/w the anterior arch of C1 and the odontoid peg be in children?

A

5 mm in children

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13
Q

What is the name for the ring of C1?

A

Harris ring

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14
Q

Distances between spinous processes should be what?

A

Roughly equal

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15
Q

What can mimic a fracture on the base of the peg? (Mach effect)

A

Incisors
Occiput
Soft tissues

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16
Q

When should you use the swimmer’s view?

A

when the shoulders limit evaluation of the lower C spine and it’s relationship with T1

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17
Q

What type movement causes a odontoid fracture?

A

Hyperflexion

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18
Q

What are the 5 unstable fractures?**

A 
Jefferson fracture
Hangman’s fracture
Flexion teardrop
Extension teardrop
Bilateral locked facets.
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19
Q

What is an avulsion fracture of spinous process of C6 or C7 called?

A

Clay Shoveler’s Fracture

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20
Q

How does a clay shoveler’s fracture occur?

A

Results of rotation of trunk relative to neck

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21
Q

What causes a Jefferson fracture?

A

Axial loading force on occiput of the head
Ex- diving into a shallow pool
usually not associated w/ neurologic defect

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22
Q

What is a hyperextension injury most common at C2. Not associated w/ neurologic deficit.

A

Hangmans fracture

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23
Q

What type of liagmentous injury is an unstable fracture?

A

Locked facets (50% subluxation)

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24
Q

What is a visual sign of a unilateral locked facet?

A

Spinous processes do not line up on a frontal film

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25
What are the three types of odontoid fractures?
Type 1- Tip Type 2- waist Type 3- base (Type 2 and 3 are unstable)
26
What causes a flexion teardrop fracture?
Combination of flexion and compression | fragment comes from the anteroinferior aspect of the body
27
What causes an extension tear drop fracture?
Hyperextension causes a triangular fragment to be avulsed off the antero-inferior corner of the vertebral body
28
Which teardrop fracture is associated with neurological damage?
flexion- teardrop fracture
29
When is an injury to the thoracic spine considered unstable?
An injury to the thoracic spine is unstable if two of the three columns are disrupted. If middle is involved, anterior or posterior often is too
30
What is a wedge fracture?
Vertebral body that is compressed and looks like a wedge
31
Where do most wedge fracture occur?
T11, T12, L2 | although verbally he said it is more likely L1 and L2
32
In what type fracture are there Vertebral body explodes outward Loss of concavity of the posterior vertebral cortex
burst fracture
33
Is there neurological deficit with a burst fracture?
yes, high probability
34
What causes chance fracture?
Seat belts w/o shoulder aspect | Horizontal fracture though vertebral body, laminae, pedicles, and spinous process
35
if you find a fracture in one part of the cervical spine is there a possibility that you could have a second fracture?
yes
36
These are all things you should look for after what? Loss of height or wedging Fragments of bone detached from the anterior Aspect of a vertebral body More than one abnormality Posterior cortex should be slightly concave
MVA
37
What is a procedure that supports a compressed vertebral body?
Vertebroplasty (super glue) | kyphoplasty (balloon)
38
What is this type of pain: sharp, shooting and confined pain confined to a narrow band. Originates from a irritation of the spinal nerve or its roots.
Radicular
39
What is a conduction block associated with numbness or weakness in the nerve roots distribution?
randiculopathy
40
What is this- "deeper and broader with an aching quality. Difficult to localize. Different senory neurons are involved for what ever reason. Use pain diagram?"
referred pain
41
What is a good imaging place to start with degenerative changes?
X-rays
42
What is myelography mostly used for now?
Individuals who can't undergo an MRI
43
bony things are better seen with what type of imaging technique?
CT
44
What is your imaging of choice for degenerative changes?
MRI
45
what is when a "marshmallow is squeezed and pushed out" Annular fibers have gotten lax and the marshmallows expands
Disc bulge
46
What is when there is a focal part of a disc bulge?
Disc protrusion
47
What is where the length of the disc material extending beyond its margin is greater than the waist?
Disc extrusion
48
Do nerve roots like to be touched?
No
49
What is the name of this syndrome; Bilateral lower extremity symptoms Pain and/or weakness Saddle anethesis Urinary incontinence
Cauda equina syndrome
50
What may cause cauda equina syndrome?
Disc herniations
51
What do you do for cauda equina syndrome?
Immediate imaging and treatment!!
52
Fracture than maybe acute or chronic that extends from the inferior facet across the pars interarticularis to the superior facet
Spondolysis
53
Forward displacement of the vertebra upon one another.
Spondolisthesis
54
What improves spinal stenosis?
Flexion, sitting, riding a bike, walking up hill
55
When is spinal stenosis worse?
Extension
56
What is the clinical presentation of spinal stenosis?
Back pain and sciatica
57
Why do you often image a post operative spine?
no relief of symptoms patient didn't get the results they expected (not operated at on right level) Lawsuits
58
What 4 problems are associated with neurological deficit?
flexion teardrop fracture locked facets (85% neurologic deficits) Unilateral locked facets (30% neurologic deficits) Burst Fracture
59
What are 2 key things in identifying whiplash?
sprain or intervertebral disk injury WITHOUT fracture/dislocation Normal curvature reduced/reversed
60
Is a posterior neural arch fracture more likely to occur bilaterally or unilaterally?
bilaterally
61
What don't you do an oblique view for the cervical spine trauma?
because the patient has to turn their head
62
Whats the main difference between flexion teardrop and extension teardrop?
flexion is associated with neurological deficit (70%) and extension is not
63
What can a burst fracture sometimes be mistaken for?
anterior wedge fracture
64
In plain films, what are oblique radiographs good for evaluating?
foraminal stenosis
65
What imaging technique is good for spinal canal stenosis?
myelography
66
What are some causes of disc degeneration?
disk space narrowing, dehydration, annular fissures, subchondral marrow changes, osteophyte formation
67
T/F: Spondolysis never leads to spondylolisthesis.
False: spondolysis may lead to spondylolisthesis

Radiology (11 decks)

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