9. Cervical spine radiology.pdf

Question 1

Lordosis of the cervical spine, function and cause?

Answer 1

Function: Shock absorption

Result of:
Static factors= Bone shape and disc shape
Dynamic factors: Muscle and ligaments

Question 2

How does cervical spine meet skull?

Answer 2

Superior articular facets on ATLAS for the occipital condyle

Question 3

Disc composition?

Answer 3

Nucleus pulposus

Annulus fibrosus

Question 4

Joints of cervical spine

Answer 4

1. IV joint: 2ndary cartilaginous joint with hyaline cartilage and disc of fibrous cartilage.
2. Facet joint: Synovial, hyaline cartilage

Question 5

Where do cervical movements occur?

Answer 5

C0-1

• Flexion and extension
• Lateral flexsion

C1-2

• Rotation
• Flexion and extensioon

C3-7

• Lateral flexion
• Rotatio

Question 6

What are the ligaments of the C0-2 vertbrae?

Answer 6

Cruciform, apical and ala ligaments

Membrane tectoria

Question 7

Pre-vertebral fascia:
-Function?
-Extent?
Covers which structures?

Answer 7

Allows glading
Extends down to T3
Covers:
-Floor of the posterior triangle
-Cervical and brachial plexus
-3rd part of the subclavian artery

Question 8

At ehich vertbral level does the vertebral artery and vein enter the foramen transversarium?

Answer 8

C7 - vein

C6 - artery as it’s wider

Question 9

Does the person need a cervical spine x-ray

Answer 9

No, if alert and stable, and:
• <65 years old
• Not serious mechanism of injury
• No tingling/sensory symptoms
• Was involved in rear-end shunt
• Sitting up
• Ambulatory since injury
• Delayed onset neck pain
• No cervical midline tenderness
• Able to rotate head 45 degrees either way.

Question 10

Dangerous Mechanisms of Spine Injury

Answer 10

• Fall >1m or 5 stairs
• Axial load to head (eg diving)
• RTA at high speed (>100km/hr), rollover or
ejection
• Bicycle accidents
• Other motorised vehicle accidents

Question 11

Main 4 Mechanisms of cervical Injury

Answer 11

Flexion
Extension
Compression
Combination

Question 12

The distance between the anterior margin of the peg and the posterior aspect of arch of C1 = __ mm

Answer 12

The distance between the anterior margin of the peg and the posterior aspect of arch of C1 = 3 mm

Question 13

Flexion as a mechanism of injury to the cervical spine?

Answer 13

Flexion = Extreme kyphosis

Leads to:

• teardrop fragments
• Anterolisthesis (upper vertbebral body slipping onto lower body)
• Narrow disc space above involved disc

Question 14

Compression (burst) as a mechanism of injury to the cervical spine?

Answer 14

I.e. severe compressive force that explodes the vertebra

• -> Disruption of the posterior body line
• -> Widening of the interpedicular distance

Question 15

Extension as a mechanism of injury to the cervical spine?

Answer 15

Wide disc space below the involved vertebra

• -> Triangular avulsion fracture inferiorly (tearing)
• -> Retrolisthesis (A retrolisthesis is a posterior displacement of one vertebral body )
• -> Neural arch and/or pillar fracture

Question 16

Anterior spinal cord syndrome may affect ____-____ level, usually vascular

Answer 16

Anterior spinal cord syndrome may affect T8-T12 level, usually vascular

Question 17

Lesions of lumbar spine usually…

Answer 17

LMN

Question 18

Cauda equine lesion may cause _____ ______, affect sphincters

Answer 18

Cauda equine lesion may cause saddle anaesthesia, affect sphincters

Question 19

Commonest root lesion of lumbar-sacral spine?

Answer 19

L4/5 (leading to foor drop)
L5/S1 (leads to big toe extension is L5, ankle reflex is S1)

Note: knee reflex is L3/4

Question 20

Lumbar stenosis, canal is narrow, may present with…

Answer 20

• Lumbar stenosis, canal is narrow, may present with reduced walking distance and pain on walking.