Bones

Question 1

thoracic spine

Answer 1

-T1-T12 must be visible with C7/T1 and T12/L1
-should see pedicles, spinous processes, and vertebral bodies

Question 2

landmarks

Answer 2

-T3- clavicle
-T4/5- bifurcation of the trachea
-T12- rib 12
-intervertebral spaces increase in size (except L5/sacral is narrower than L4/L5)

Question 3

lumbar spine

Answer 3

-T11/12 with full T12 body view
-L1-L5
-you should see vertebral bodes, facet joints, pedicles, transverse processes (covered by gas usually)

Question 4

reasons for height loss

Answer 4

-degenerated disc - rheumatologic, arthritis -> can fracture easy bc unstable
-bulging disc- compression of soft tissue
-herniated disc- paresthesia
-thinning disc- chronic trauma
-disc degeneration with osteophyte formation

MAY INDICATE COMPRESSION FRACTURE

Question 5

burst fracture

Answer 5

-this is a type of compression fracture
-high energy axial loading spinal trauma
-MC thoracolumbar spine
-locate pedicles columns and compare -> widening of interpediculate distance
-unstable
-retropulsion of posterior cortex fragments into spinal canal
-ALWAYS involves posterior vertebral body

Question 6

chance fracture

Answer 6

-wide spinous process distance
-horizontal fracture through spinous process, pedicles, and vertebral body
-unstable
-flexion-distraction injury mechanism
-distraction of middle and posterior columns with or without compression of anterior column
-affects only one vertebrae

-check for:
-wide interspinous
-assoc fractures: interpedicle distance and processes
-pedicles, spinal, transverse process

Question 7

vertebral columns

Answer 7

-Anterior column: anterior longitudinal ligament, anterior annulus, anterior2/3rd of the vertebral body
-Middle column: posterior 1/3rd of the vertebral body, posterior annulus, and posterior longitudinal ligament
-Posterior column: posterior elements (pedicles, facets, lamina, spinous process) and posterior ligamentous complex

Question 8

instablility

Answer 8

-when 2 or 3 columns are disrupted
-when at least 2 columns are intact -> stable

Question 9

sprain vs strain

Answer 9

-sprain- injury to bands of tissue that connect bones
-strain- injury to muscle or band of tissue that attaches muscle to bone

Question 10

common flexion injuries

Answer 10

-hyperflexion sprain (anterior or subluxation)- posterior ligament rupture -> anterior and middle columns are unaffected -> STABLE
-simple wedge (STABLE)
-unstable wedge- anterior and posterior column injury
-unilateral interfacetal dislocation
-bilateral interfacetal dislocation- extreme flexion, UNSTABLE, high incidence cord damage
-flexion teardrop #

Question 11

flexion + other force (rotation or axial loading)

Answer 11

-unilateral interfacet dislocation- flexion and rotation
-flexion teardrop fracture- extreme flexion with axial loading, unstable, high incidence cord damage
-anterior atlantoaxial dislocation