Exam 1 Flashcards
Impressions/Diagnosis
listed numerically in order of clinical significance. brief short statements
Findings
written description of what you see in full sentence paragraph. Utilizing ABCS
Odontoid Mach Affect
Looks like a transverse fracture
Diagnosis: Burst (bursting) Fracture
Finding:
Lateral mass of atlas sits over the margin of C2 on both sides in A-P open mouth film. (four fractures)
Cervical films are taking at either 72” or 40”. Which are the only two that are taking at 72”?
(Any film taken where there is an airgap between the patient and the film)
Lateral Cervical and Oblique Cervical
On lateral cervical films we should be able to draw a line from the Clivus to:
Harris’ Ring
Uncinate should not project superiorly beyond which part of the segment above?
Inferior margin (would indicate arthritic changes)
Oblique films are named by:
The patient’s position against the box
The ideal oblique film is which?
Anterior oblique for cervical (want to shoot into the concavity of the curve and the x-ray diverges)
Anterior recumbent for lumber
Primary anatomy desired to see in Oblique film?
Pedicles and IVF: Cervical
Scotty Dog: Lumbar
CAOS
Cervical anterior oblique same side
2 things that can narrow IVF in cervicals
uncinate, superior articular process
Cervical IVF is seen on:
Thoracic/Lumber IVF is seen on:
Oblique
Lateral
If we cannot see T1 what should we name the vertabra that we think is T6 on the exam
mid thoracic
Diagnosis/ Impression: Arthritic Changes
Findings:
Example.. Decreased in body height. Loss of definition of superior cortico bone and increased whiteness on anterior portion.
Oblique Lumber Point of Interest
Scotty Dog
Oblique Lumbar Patient Position
Anterior recumbent
Scotty Dog Eyes
pedicle
scotty dog ear
superior articular facet
scotty dog nose
transverse process
scotty dog neck
pars interarticularis
scotty dog body
lamina
scotty dog front leg
inferior articular process
Normal Sella Turcica Measurements
16mm across, 12mm deep
Martin’s basilar angle reference points
nasion to center of sella to the basion
Martin’s Basilar Angle normal degree range
137-152 degrees
What does a Martin’s Basilar Angle detect if greater than 152 degrees?
Platybasia (flat base)
Congenital mal development of the sphenoid and/or occipital bones, bone softening disease
Chamberlain’s Line reference points:
Hard palate to the opisthion
Chamberlain’s Line detects:
basilar impression
Basilar impression is detected with Chamberlain’s line if the odontoid extends more than ____mm above this line
7
McGregor’s Line reference points:
hard palate to inferior occiput (longer than Chamberlain’s)
The odontoid should not extend _____mm-____mm above McGregor’s line.
8-10
Reasons for Basilar Invagination
Paget’s disease
Osteomalacia
Fibrous dysplasia
Rheumatoid arthritis
When a segment is posterior relative to the segment below
Retrolisthesis
When a segment is anterior relative to the segment below
Anterolisthesis aka spondylolesthis
Normal measurement of ADI in adults
3 mm
Normal measurement of ADI in children
5 mm
Reference points for measuring the Atlantodental Interspace
posterior surface of anterior tubercle to anterior surface of odontoid
MC cause of weak ADI
Rheumatoid Arthritis
Causes of irregular measurement of ADI
Rheumatoid Arthritis Down Syndrome Trauma Inflammation Arthritis (Also consider flexion/extension views)
Atlantoaxial “overhang” is common in _____, but suggests a fracture of atlas in ______
1 year old child
adults
A burst fracture will injure which ligament
Transverse Ligament
Cervical Lordosis depth Method average measurement
8-12 mm
What reference points do we measure in the cervical lordosis depth method?
tip of odontoid to posterior surface of C7 (then measure the depth of C4) 8-10mm= hyperlordotic
Normal measurement for Harrison posterior tangent method
34 degrees with 9 degrees of deviation. Measurement of hypo/hyperlordosis
Ruth Jackson Stress lines should intersect at which levels during flexion?
C5/C6
Ruth Jackson Stress Lines should intersect at which levels during extension?
C4/C5
Ruth Jackson Stress Lines are drawn from the posterior aspects of which two vertebra?
C2 and C7
Sagittal Canal Measurement
Anterior line:
Posterior line:
posterior vertebral body
spinolaminar line
Sagittal Canal normal measurement
12-16mm
stenosis
Retropharyngeal space normal measurement (at C2):
Retrotracheal space normal measurement (at C6)
Significance of pre-vertebral soft tissue spaces (retropharyngeal and retrotracheal spaces)
edema
hemorrhage
pus
tumor
How to find angle of thoracic spine kyphosis
2 lines drawn from superior endplate of T1 & inferior endplate of T12
Vertical perpendicular lines are then drawn and the angle of intersection should be near 30 degrees.
How to figure out the angle of lumbar spine lordosis:
lateral lumbar film: 2 lines drawn along superior endplate of L1 and base of sacrum.
Vertical perpendicular lines are then drawn to form an angle (normal 50-60 degrees
How to find lumbosacral (Ferguson’s Angle)
First line drawn across sacral base. Second line parellel to ground (or bottom of film) Angle 26-57 degrees.
