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302 MEDIMAGE > 7c. Spine Pathologies > Flashcards

7c. Spine Pathologies Flashcards

1
Q

what are the 3 things that bones should be examined for

A

examined for fractures collapse/height/avulsion
parallel facet joints
abnormal calcification

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2
Q

what should be examined for disc spaces

A

examine for symmetry/normality of the intervertebral discs between each vertebra

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3
Q

what are the spaces that should be checked for dens view of C spine

A

height of disk symmetrical on both sides

distance between medial sides of lat masses and peg are equal on both sides

check if lateral aspect of C1 and 2 aligned

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4
Q

what are the lines to be checked for alignment of vertebral bodies and processes

A

anterior and posterior vertebral lines

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5
Q

what may widening prevertebral soft tissue indicate

A

pus or blood build up in the neck leading to swelling of tissue

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6
Q

what is the max prevert soft tissue space distance in C3

A

max 5mm

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7
Q

what is the max prevert soft tissue space distance in C2

A

<7mm anterior to C2

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8
Q

what is the max prevert soft tissue space distance in C7

A

<2cm anterior to C7

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9
Q

what is retropharyngeal infection and what does it look like

A

collection of pus and space gets larger and pushes out anteriorly and can obstruct airway by retropharyngeal mass/infection

anterior to C2/3 there is an increase in prevertebral soft tissue space

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10
Q

what is scoliosis

A

side to side curvature of the spine

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11
Q

what is kyphosis

A

AP curvature of spine

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12
Q

what are the 3 causes of scoliosis

A

idiopathic, associated with cerebral palsy and muscular dystrophy

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13
Q

what are the 3 causes of kyphosis

A

idiopathic, fractures, osteoporosis

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14
Q

how can kyphosis impact the spinal cord

A

spinal cord stretches around the deformity/kyphotic angle and can result in impingement

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15
Q

what is spina bifida occulta

A

small defect of posterior elements of a vertebra

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16
Q

what is spina bifida - myelomeningocele

A

spinal canal remains open along several vertebrae in the lower/middle back

both the membranes and the spinal cord or nerves exposed in sac

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17
Q

what is spina bifida - meningocele

A

no cord protruding just fluid in sac

Fluid filled sac at back with no neural tissue often occur below level of where you have spinal cord like in sacrum

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18
Q

what is a cause of spina bifida

A

Deficiency of folic acid

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19
Q

what is multiple sclerosis

A

autoimmune disease response that destroys myelin sheath that insulates nerve fibres

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20
Q

what does multiple sclerosis affect

A

brain and spinal cord

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21
Q

where can lesions of multiple sclerosis develop

A

brain, optic nerves and spinal cord

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22
Q

metastases has what appearance on xrays

A

increased bone signal

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23
Q

what do sclerotic metastases do to the bone strength and what does this mean for #

A

retain strength in bone so unlikely fracture, increases bone density

24
Q

what do lytic metastases do to the bone strength

A

decrease density and destroy bone

25
Q

what can metastases do to the spinal cord

A

can encroach on spinal cord and cause spinal cord compression

26
Q

if the metastases are high signal and bright but the spinal canal is dark what MRI type is it

A

T1 as its contrast enhanced and metastases have higher water content

27
Q

will there be a difference between pre and post contrast for metastases in MRI T2

A

no

28
Q

what is multiple myeloma

A

white blood cell malignancy and deposits widely in bone

29
Q

what appearance does multiple myeloma have for bone on images

A

moth eaten appearance

30
Q

what does multiple myeloma do to the bone in the spine

A

Spine taken over by tumor and destroys bone and replaced bone so bone becomes weaker and collapse on itself, vert reduced in height and tumor replacement between bony fragments

31
Q

what other condition resembles multiple myeloma

A

osteoporosis

32
Q

what is ewing sarcoma

A

aggressive primary bone tumor, locally invasive and has soft tissue mass

33
Q

what do patients present with for ewings sarcoma

A

swelling and pain at site of tumor

34
Q

what is characteristic of ewing sarcoma on images

A

soft tissue mass expands into the spinal canal

35
Q

what are bone hemangiomas

A

benign malformed vascular lesions

36
Q

where do bone hemangiomas occur most frequently

A

occur most frequently in vertebral column, commonly in L spine

37
Q

what are bone hemangiomas seen as on images

A

bright round spot

38
Q

what are 3 characteristic features of OA in the vertebral column

A

bony spur/osteophyte

vertebral/intervertebral height loss

nerve root entrapment/compression

39
Q

what is typical of TB in the spine

A

collection of fluid ant to vert itself and collection post compressing spinal cord (ant collect is typical of TB)

40
Q

what is gibbous TB

A

Gibbous is acute angulation/kyphosis of sp cord due to TB

41
Q

what is osteoporosis in the spine

A

compression fracture risk and greatly reduced bone density

42
Q

why does osteoporosis in the spine increase fracture risk and what results

A

Once structure of vertebrae itself becomes frail it can collapse on itself, lose height ant but post mostly fine -> kyphosis results (wedge fractures)

43
Q

what does a osteoporotic vertebra create in the lateral veiw

A

wedge shape

44
Q

what is a slipped disk

A

intervertebral disk has defect and soft centre of disk protrudes into spinal canal and can compress nerve roots emerging from spinal cord or compress spine

45
Q

what is disc herniation

A

height of disc reduced so less space for spinal nerve

content of disc squished posteriorly and impinges on nerve as it exits foramina

46
Q

what are the most common areas for disk herniation

A

L3-5 commonly

C spine second most common area of spine

47
Q

what is spinal stenosis

A

reduce space for spinal cord

48
Q

what is the 3 most common cause of spinal stenosis

A

disc herniation
thickening of ligamentum flavum
OA

49
Q

what scan is needed if suspect a Cspine injury

A

CT scan

50
Q

what is a tear drop # caused by

A

hyperflexion injury

head acutely flexed forwards causing compression of vert so ant part breaks off (hyperflex injury)

51
Q

what is a burst fracture

A

Fragments of bone going ant and post that can protrude into the spinal canal and can impinge on sp cord

52
Q

why is a C2 dens fracture so unstable

A

once dens #s, only ligament holds C1 and 2 together so very unstable

53
Q

what can be seen in a sagittal view for a C2 dens #

A

small collection of blood could be ant to dens

54
Q

why is C2 body # deadly

A

because it can cut straight through the spinal cord that could kill the patient

55
Q

what is a jefferson fracture

A

compression fracture of C1 bony ring

56
Q

what 3 things to be checked in a jefferson fracture

A

check height which is equal both sides, distance betw dens and med border of lat masses, Lateral masses movement

57
Q

what is spondylolithesis

A

both or one of pars in the vert

Vert body slipped ant to lower levels and can cause compression of nerve roots

302 MEDIMAGE (20 decks)

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