7b. Trauma Evaluation - Spine

Question 1

what should the predental space be in adults

Answer 1

no more than 3mm

Question 2

what should the predental space be in children

Answer 2

no more than 5mm

Question 3

what should C2-3 subluxation be in adults

Answer 3

no more 3mm

Question 4

what should C2-3 subluxation be in children

Answer 4

no more than 5mm

Question 5

what should the prevertebral soft tissue measurement in adults at C3

Answer 5

up to 7mm

Question 6

what should the prevertebral soft tissue measurement in adults at C7

Answer 6

21mm

Question 7

what should the prevertebral soft tissue measurement in children

Answer 7

1/2 to 2/3 of AP vertebral body

Question 8

what is the predental space

Answer 8

space infront of peg ant portion of C1

Question 9

what are the 4 contour lines

Answer 9

AVL
PVL
SLL
PSP

Question 10

what is the AVL contour line

Answer 10

anterior cortical surfaces of vertebral bodies

Question 11

what is the PVL contour line

Answer 11

posterior cortical surfaces of vertebral bodies

anterior margin of spinal canal

Question 12

what is the SLL contour line

Answer 12

spino laminar line

posterior boundary of spinal canal

Question 13

what is the PSP contour line

Answer 13

posterior spinous process

Question 14

what are the 4 things to check in a lateral spine xray

Answer 14

alignment = vert body rotation, loss of spinal curves and disrupted contour lines

bones = pathologies

cartilage = predental space, disc spaces, facet joints

soft tissues = prevertebral space

Question 15

what are the 4 things to check in a AP spine xray

Answer 15

Alignment = Spinous processes line and pedicle lines

Bones = where, which, pathologies?

cartilage = disk space and unconvertable joints

soft tissue = tracheal deviation

Question 16

what are the 3 osteoligamentous columns of the spine

Answer 16

Anterior

middle

posterior

Question 17

where is the anterior osteoligamentous columns of the spine

Answer 17

AVL, anterior 2/3 of vertebral body and annulus fibrosis

Question 18

where is the posterior osteoligamentous columns of the spine

Answer 18

posterior bony complex (posterior arch)

pedicles, laminae, posterior ligamentous complex (supraspinatus ligament, capsule and ligamentum flavum)

Question 19

where is the middle osteoligamentous columns of the spine

Answer 19

PVL, posterior 1/3 of vertebral body and annulus fibrosis

Question 20

is it a stable fracture when only one column is involved

Answer 20

yes

Question 21

is it a stable fracture when 2 non adjacent columns are involved

Answer 21

yes

Question 22

is it a stable fracture when 3 columns are involved

Answer 22

no

Question 23

is it a stable fracture when 2 adjacent columns are involved

Answer 23

no

Question 24

is it a stable fracture when the middle column is involved

Answer 24

no

Question 25

what are the 4 fractures of the cervical spine

Answer 25

C1 C2 wedge and burst clay shovellers

Question 26

what dislocation occurs in the cervical spine

Answer 26

atlanto axial

Question 27

what is a jeffersons fracture

Answer 27

burst fracture of C1 ring

Question 28

what causes a jeffersons fracture

Answer 28

axial loading

Question 29

what is the most common C1 fracture

Answer 29

jeffersons fracture

Question 30

what happens to the lateral masses in a jeffersons fracture in the peg view

Answer 30

lateral masses move outwards

Question 31

what happens to the predental space in the lateral image when there is a jeffersons fracture

Answer 31

increased perdental space

Question 32

is the jeffersons fracture a stable or unstable fracture

Answer 32

unstable

Question 33

what kind of C1 fracture can result in a normal predental space

Answer 33

posterior neural arch fracture

Question 34

what is a hangmans fracture

Answer 34

bilateral pedicle/interarticularis fracture of C2

Question 35

how many types of odontoid fractures are there

Answer 35

3

Question 36

what is the hangmans fracture caused by

Answer 36

C2 body pushed up secondary to hyperextension, axial loading/rapid deceleration

Question 37

what is the hangmans fracture

Answer 37

fracture through pedicles of C2

Question 38

is the hangman fracture stable

Answer 38

no

Question 39

what is anterolisthesis

Answer 39

slippage of one vertebrae over the others

Question 40

what is a type 1 odontoid fracture

Answer 40

usually oblique at the upper part/tip of the peg

Question 41

what is a type 2 odontoid fracture

Answer 41

transverse through base/neck of peg fracture

Question 42

is type 2 odontoid fracture stable

Answer 42

very unstable

Question 43

what is a type 3 odontoid fracture

Answer 43

through body of odontoid extending into body of axis

Question 44

what are wedge fractures caused by

Answer 44

hyperflexion force

Question 45

what is a wedge fracture

Answer 45

Squashing of other 2 vertebra on either side so affected vert is squashed into point form and loses square shape compression fracture of the vertebral body compressing the anterior component

Question 46

what is a burst fracture caused by

Answer 46

hyperflexion

Question 47

what is a burst fracture

Answer 47

unstable compression fracture through entire vertebral body creating fragments anterior fragment pushed forwards and posterior fragment pushed backwards into vertebral canal

Question 48

what is a clay shovellers fracture caused by

Answer 48

hyperflexion and rotation

Question 49

where does the clay shovellers fracture occur

Answer 49

C7/6 spinous process

Question 50

what is a sign of clay shovellers fracture in the AP image

Answer 50

ghosting of spinous process in Ap view

Question 51

what holds the dens against the anterior atlas

Answer 51

transverse ligament attaches media sides lateral masses

Question 52

what could transverse ligament damage result in

Answer 52

movement potential neurological catastrophe

Question 53

what is a chance fracture and where does it occur

Answer 53

horizontal fracture through the spinous process, laminar, pedicles and vertebral body all 3 columns, lower spine

Question 54

what are the 3 important things to assess for a burst fracture of C1

Answer 54

joint spaces on both sides should be equal and symmetrical lateral masses of C1 should align with C2 increased predental space is seen inconsistently on lateral image

Question 55

what is a chance fracture caused by

Answer 55

flexion/extension injury