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Flashcards in Spine Deck (34)
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1
Q

Standing Lateral Cervical View

A

head in neutral beam to center of C4
Demonstrates vertebral bodies, apophyseal joints, spinous processes, intervertebral disk
C7 should ALWAYS be demonstrated

2
Q

Table Lateral C View

A

Supine with head in neutral, beam directed 2.5-3 cm caudal to mastoid tip

3
Q

5 contour lines of cervical spine

A
Retropharyngeal space <7mm
Retrotracheal space <22mm adults or <14mm children
1 anterior vertebral line
2 posterior vertebral line
3 spinolaminar line
4 posterior spinous line
5 clivus-odontoid line
4
Q

Chmerlain Line

A

posterior margin of foramen magnum to dorsal margin of the hard palate
Odontoid process shoud not project above this line more than 3mm or it indicates AA impaction

5
Q

McRae Line

A

line btwn anterior and posterior margin of foramen magnum

Odontoid process should be just below or is indicates AA impaction

6
Q

AP Cervical View

A

pt supine or standing
beam directed at C4 at 15-30 degrees cephalad
Demonstrates C3-C7 vertebral bodies and intervertebral spaces
C1-C2 not adequately viewed

7
Q

Open Mouth View

A

Pt opens mouth as wide as possible beam directed at midpoint of open mouth
Demonstrates C1-C2

8
Q

Fuchs View

A

Pt. supine w/ neck hyperextended, beam directed vertically just below chin
Demonstrates Odontoid

9
Q

Oblique View

A

Pt rotated 45 degrees with beam directed at C4 15-20 degrees cephalad (R rotation demonstrates L foramina)
Demonstrates Foramina and apophyseal joints

10
Q

Swimmers View

A

Pt prone with 1 arm abducted 180 degrees and other at side, beam directed horizontally at axilla
Demonstrates C7, T1, T2

11
Q

Occipital Condyle Fx Types

A

See Image

12
Q

Jefferson Fx

A

MOI axial load to head and occipital condyles causing symetrical fxs of anterior and posterior arches of C1 and disruption of transverse ligaments

13
Q

Odontoid Fx Types

A

Type 1 - through part of odontoid
Type 2 - whole odontoid breaks off
Type 3 - Fx below odontoid

14
Q

Hangman’s Fx

A

MOI - Hyperextension and distraction

Fx identified through the pedicles of C2 and associated ligament disruption

15
Q

Burst Fx

A

Seen at C3-C7
Nuleolus pulposes driven through Fx vertebral plate into vertebral body causing comminuted Fx
CT is best for imaging these

16
Q

Teardrop Fx

A

MOI - Compression and Flexion
Most severe and unstable C spine injury
Posterior displacement of spinal canal, Fx of posterior elements and disruption of soft tissue
Best viewed with Lateral radiograph

17
Q

Clay-Shovelers Fx

A

MOI - Acute powerful flexion or direct blow to C spine
Stable Fx with posterior ligament complex intact
Best view - lateral

18
Q

Compression (wedge) Fx

A

MOI - Hyperflexion of C-spine
Anteriro compression of vertebral body
Posterior ligament complex stretched
Best view - lateral

19
Q

C Spine Step 1

A

Age over 65
Dangerous Mechanism
Numbness or tingling in extremities

Yes to any = Xray

20
Q

Dangerous Mechanism Definition

A

Fall from 3 ft or higher
Bicycle collision
Axial load to the head
MVA involving high speed, rollover or ejection

21
Q

C Spine Step 2

A
Simple rear-end MVA
Pt ambulatory at any time since injury
Delayed onset of neck pain
Pt in sitting position in ER
No midline cervical tenderness
No to all? Xray
22
Q

C Spine Step 3

A

Able to actively rotate 45 degrees each way?

No? Xray

23
Q

Thoracic AP

A

Supine with *knees flexed
Beam directed vertically 3cm above xiphoid process
Demonstrates vertebral endplates, pedicles and intervertebral disks

24
Q

Thoracic Lateral View

A

Pt standing with arms elevated beam directed at T6 with 10 degrees cephalad

25
Q

AP Lumbar View

A

Pt supine with knees flexed to eliminate lordosis beam directed at center of abdoment at level of iliac crests
Demonstrates: Vertebral bodies and end plates, transverse processes, intervertebral disk space, spinous process, pedicles

26
Q

Cupids Bow

A

Characteristic configuration of end plates of L3-L5
Demonstrated on inferior aspects
Absence indicates possible compression Fx

27
Q

Lateral View of Lumbar

A

Pt in sidelying with knees and hips flexed to eliminate lordotic curve, beam vertical at L3
Demonstrates: Vertebral bodies, Pedicles, Spinous Processes, Intervertebral foramina, disk space

28
Q

Oblique view of Lumbar

A

Pt 45 degrees from prone beam directed at L3
Demonstrates: Facets, Superior-Inferior articular process, Pedicles, Pars interarticularis
“Scotty Dog”

29
Q

Lumbar Burst Fx

A

MOI: Axial compression or a combo of compression w/rotation or anterior or lateral flexion
Hallmark: Widening of interpediculate distance

30
Q

Seatbelt Fx

A

Horizontal splitting of the vertebra beginning in spinous process or lamina and extending through the pedicles and vertebral bodies

31
Q

Spondylolysis

A

Defect in the pars interarticularis
Andvanced form - Spondylolisthesis
90% occur at L4-L5 or L5-S1

32
Q

Spinous process sign

A

true spondy has defect in pars interarticularis

33
Q

Grading a Spondy

A

Divide vertebral body into 4. Grade 1-4 based on how many quarters have slipped off

34
Q

Spondylosis Deformans

A

degenerative condition, large osteophytes on anterior aspect of adjacent vertebral bodies
Anterior disk herniation