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Dx Imaging II > Exam 1 Spinal Trauma > Flashcards

Exam 1 Spinal Trauma Flashcards

1
Q

What could cause a large anterior fragment with retropulsion of the posterior fragment?

A

burst fracture

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2
Q

What are some signs associated with a C5 burst fracture?

A

large anterior fragment and retropulsion of the posterior fragment

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3
Q

What is the mechanism of injury for a burst fracture?

A

axial compression

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4
Q

What are the findings associated with a chance fracture?

A

decreased anterior body height, step defect, zone of impaction and a horizontal radiolucent line traversing the neural arch

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5
Q

What is another name for a chance fracture?

A

lap seat belt fracture

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6
Q

Decreased anterior body height, step defect, zone of impaction and a horizontal radiolucent line traversing the neural arch:

A

chance fracture aka lap seat belt fracture

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7
Q

What can cause pathological fractures?

A

osteoporosis, lytic mets or multiple myeloma

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8
Q

What makes a fracture pathological?

A

decreased height across entire segment

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9
Q

AKA bursting fracture of C1:

A

Jefferson’s fracture

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10
Q

What are the findings associated with Jefferson’s fracture?

A

bilateral mass offset, increased ADI, radiolucency/gap in posterior arch

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11
Q

What makes a compression fracture new?

A

step defects and zone of impaction

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12
Q

What are the findings associated with a tear drop fracture of C2?

A

triangular osseous fragment at the ant-inf aspect of C2 with an increase in RPI

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13
Q

What is important in determining the type of teardrop fracture?

A

history and clinical presentation

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14
Q

What number do we use to determine if the transverse ligament is ruptured in a Jefferson’s fracture?

A

7mm

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15
Q

What do we do with new fractures?

A

orthopedic consult/specialized imaging

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16
Q

What do we do with old/stable fractures?

A

referral if clinically indicated

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17
Q

What do we do with old/unstable fractures?

A

orthopedic consult/specialized imaging

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18
Q

What is the aka for congenital spondylolisthesis?

A

dysplastic spondylolisthesis

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19
Q

How rare is congenital spondylolisthesis?

A

very rare

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20
Q

What is congenital spondylolisthesis?

A

malformation of sacrum and L-5, congenital predisposed, congenitally thin pars, never present at birth

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21
Q

What are the two types of spondylolisthesis someone could have?

A

spondylolytic or degenerative

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22
Q

Name the lines from anterior to posterior:

A

anterior body line, posterior body line (George’s), spinal laminar line, supraspinous line

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23
Q

Finding’s associated with spondylolytic spondylolisthesis of L5?

A

inverted napoleon hat

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24
Q

Do you need obliques with a grad 3 spondylolisthesis?

A

no, must be bilateral pars defect to be that anterior

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25
What does increased pedicle distance in the lumbars indicate?
bursting fracture
26
Considerable pubic diastasis and seperation,one or both SI joints seperated:
open book fracture or sprung pelvis
27
Avulsion fracture of the ASIS involves:
sartorius
28
Avulsion fracture of the AIIS involves:
rectus femoris
29
Avulsion fracture of the ischial tuberosity involves:
hamstrings
30
What avulsion fracture of the pelvis is most common?
ischial tuberosity fracture
31
What is degenerative spondylolisthesis?
degeneration of posterior joint, pars intact, MC: L-4, W>M, old age
32
What does the empty vertebra or ghost vertebra sign indicate?
chance fracture (horizontal splitting of neural arch)
33
Swelling in the skull?
hematoma
34
What does the patient need on a multilevel TVP fracture?
urinalysis (potential renal damage, looking for blood) and an orthopedic consult (new fracture)
35
What are the Wiltse classifications for spondylolisthesis?
Type I - Dysplastic (congenital)
36
What does deflection/deviation of the paraspinal line indicate?
SOL
37
When are obliques helpful?
less than 20% anterior displacement
38
What is a demoid cyst?
teratoma (glob of hair, teeth, and fat)
39
What is a tripod fracture?
separation of all three attachements of the zygoma to the rest of the face (aka zygomaticomaxillary complex fracture)
40
What is the Davis series?
7 view cervical set, acute and non-acute series
41
What is the order for an acute Davis series?
lateral, APOM, AP cervical, Lt and Rt oblique, Flexion and extension (swimmers if needed)
42
What do a posterior arch fracture, posterior joint arthrosis, cervical hypolordosis and degenerative retrolisthesis of C5 indicate?
extension injury
43
What are some radiographic features of a sever sprain?
widening of interspinous space (fanning), loss of parallelism between facet joints, horizontal displacement, angular displacement
44
What are some hyperflexion injuries of the cervical spine?
simple wedge fracture, bilateral interfacetal dislocation, flexion teardrop fracture, clay shoveler's fracture, anterior subluxation, dens fracture
45
What are some hyperflexion and rotation injuries of the cervical spine?
unilateral interfacetal dislocation and unilateral interfacetal fracture dislocation
46
What are some hyperextension injuries of the cervical spine?
avulsion of the anterior tubercle of C1, hyperextension fx dislocation, hyperextension dislocation, posterior arch fx, extension teardrop fx, hangman's fx, lamina fx, dens fx
47
Low T1 High T2:
new fracture
48
Irregularity of L5 pars without definite anterior displacement:
spondylolysis
49
Spondylolysis:
interruption of the pars
50
Spondylolysthesis:
anterior displacement
51
Prespondylolysthesis:
Spondylolysis w/o anterior
52
pseudospondylolysthesis:
anteriority w/o pars defect
53
Left cervical IVFs can be taken:
LAO RPO
54
Right cervical IVFs can be taken:
RAO LPO
55
Left lumbar IVFs can be taken:
RAO LPO
56
Right lumbar IVFs can be taken:
LAO RPO
57
If skull fractures are suspected?
CT
58
What % of skull fractures are detected on xray?
10%
59
AKA Hangman's fx?
traumatic spondylolisthesis or bilateral pedicle fracture
60
What are some abnormal vertebral alignment changes that might suggest spine trauma?
misalignment, loss of lordosis, acute kyphotic angulation, widened interspinous spaces, vertebral rotation, torticollis
61
What is the cause of hyperflexion mechanism?
whiplash type injury, partial bilateral facet dislocation
62
Hyperflexion of more than ______ may indicate instability.
11 degrees
63
Greater than _______ body offset may be a clue of instability.
3.5 mm
64
What are the etiologies of antero/retrolisthesis?
Fx, dislocation, ligamentous laxity, degenerative disease/joint disease, anatomic, physiologic
65
How long do spine Fx take to heal?
3-6 mos
66
What is the most common fracture of atlas?
posterior arch fracture (usually bilateral and vertical)
67
What are some abnoraml joints that might suggest spine trauma?
increased ADI, abnormal disc height, widened apophyseal joints
68
Normal ADI for adults and children?
3mm and 5mm
69
Signs of a blowout fracture?
orbital emphysema, inferior rectus into maxillary sinus, blood in floor of sinus
70
Hyperflexion of C4 with widened facets at C4/C5 and reversed curve at C4?
hyperflexion whiplash
71
Type I odontoid fx:
stable and rare
72
What are the etiological factors of an increased ADI?
normal variant, trauma, Down's syndrome, major upper cervical anomalies, inflammatory arthropathies (seropos and seroneg)
73
Most common cause of increased ADI?
rheumatoid arthritis (seropos)
74
Increased ADI, RPI, anterior offset of C1 spinal laminar line and atlantoaxial dislocation needs:
flexion, extension, orthopedic consult and MRI
75
What is Steele's rule of thirds?
divides ring of atlas in thirds, 1/3 cord, 1/3 odontoid, 1/3 potential space
76
Types of odontoid Fx:
Type I: stable/rare
77
Fx at tip of dens:
Type I
78
Fx at base of dens:
Type II
79
Fx into body of C2:
Type III
80
What does bow tie sign indicate?
unilateral facet dislocation of C4
81
Bow tie sign requires:
cervical obliques and orthopedic consult
82
What can cause Type I odontoid Fx?
apical or alar ligament avulsion fracture through tip of odontoid
83
AKA Clay Shoveler's fx:
spinous process fracture (double spinous sign)
84
Cause of clay shoveler's Fx:
avulsion fx in flexion injury
85
Lateral flexion injuries of the cervical spine?
unilateral fx lateral mass C1, transverse process fx, uncinate fx
86
What does double spinous sign indicate?
spinous fracture
87
What are some hyperextension-rotation injuries of the cervical spine?
pillar fx and pedicolaminar fx
88
Who is predisposed to have apophyseal avulsion fx of the pelvis?
adolescents in athletics, sprinters, long jumpers, hurdlers, gymnasts, etc
89
AKA Iliac wing fx:
duverney fx
90
RPI:
7mm
91
RTI:
22mm
92
facial fxs involving maxillary bone and surrounding structures in a bilateral and either horizontal, pyramidal or TV way
le fort fracture
93
What are the types of hyperflexion injuries (6)?
simple wedge compression, flexion teardrop, clay shovelers, anterior sublxation, dens fx, bilateral interfacetal dislocation
94
MC fx of thoracic and lumbars
compression fx (flexion mechanism)

Dx Imaging II (5 decks)

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