Flashcards in Thoracic spine Deck (66)
What do articulations of the thorax allow?
ﬂexibility to accommodate actions of respiration and trunk mobility
What does the thorax provide stability for?
movements of neck and upper extremities
What is the goal of t-spine radiographic examination?
identify or exclude anatomic abnormalities or disease processes of spine
What is the sternum examined for?
assess fracture, inﬂammatory processes, or other pathology
What is the SC joint examined for?
assess joint separation or other pathology of joint
What are the routine projections for thoracic spine?
Swimmer's lateral view of upper thoracic region:
Lateral view with patient’s arm placed overhead, to remove superimposition of shoulder from obscuring lower cervical and upper thoracic vertebrae
- Demonstrate facet joints
- Not included in routine projections, b/c thoracic facet joints rarely involved in pathology
Thoracolumbar or other coned views:
- Coned view close-up view of designated area
- Cone refers to circular aperture attachment on x-ray tube which limits exposure ﬁeld
How is radiographic evaluation of the ribcage done?
in sections- only those sections where history and symptoms define region are radiographed
How are rib sections radiographed?
AP or PA
AP or PA of ribs:
projection for posterior or anterior ribs
Oblique view of ribs:
projections for axillary ribs
Why is a PA chest film often included in trauma?
to rule out possible pneumothorax or hemothorax
What does the AP view of the thorax view demonstrate?
thoracic vertebral bodies
Alignment of pedicles
Costovertebral joints and posterior ribs
What is the interpedicular distance?
width b/w opposing paired pedicles
normally 20mm in t-spine
Spinous process interval:
Intervals b/w each spinous process from vertebra above vertebra below compared
What can an increase in interval distance at one level indicate?
torn posterior ligament complex
What does the lateral thoracic spine view demonstrate?
thoacic vertebral bodies
What does the anterior vertebral body line represent?
connected anterior borders of vertebral bodies forms smooth, continuous curve
What does the posterior vertebral body line represent?
connected posterior borders of vertebral bodies, forms continuous curve parallel to ALL
What does the spinolaminar line represent?
junctions of laminae at spinous processes forms continuous curve parallel to ALL and PLL
Why is t-spine the most commonly injured?
b/c of flexion forces
Where are the most commonly injured sites?
C to T
T to L
Why are the transitional sites predisposed to injury?
b/c they are junctions b/w relatively immobile thoracic spine and more ﬂexible cervical/lumbar spines
Where is incidence of acute injury highest?
in T/L vertebrae
12th thoracic and 1st lumbar
What injury is most common in T/L vertebrae?
compression fractures and fracture-dislocations
Neurological injury complicate what percentage of fractures at T/L level?
MRI is the primary modality to evaluate what?
degree of neural compromise, cord edema, cord contusion, epidural hematoma, nerve root involvement, or ligamentous disruption