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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
Q

What does increased pedicle distance in the lumbars indicate?

A

bursting fracture

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26
Q

Considerable pubic diastasis and seperation,one or both SI joints seperated:

A

open book fracture or sprung pelvis

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27
Q

Avulsion fracture of the ASIS involves:

A

sartorius

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28
Q

Avulsion fracture of the AIIS involves:

A

rectus femoris

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29
Q

Avulsion fracture of the ischial tuberosity involves:

A

hamstrings

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30
Q

What avulsion fracture of the pelvis is most common?

A

ischial tuberosity fracture

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31
Q

What is degenerative spondylolisthesis?

A

degeneration of posterior joint, pars intact, MC: L-4, W>M, old age

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32
Q

What does the empty vertebra or ghost vertebra sign indicate?

A

chance fracture (horizontal splitting of neural arch)

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33
Q

Swelling in the skull?

A

hematoma

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34
Q

What does the patient need on a multilevel TVP fracture?

A

urinalysis (potential renal damage, looking for blood) and an orthopedic consult (new fracture)

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35
Q

What are the Wiltse classifications for spondylolisthesis?

A

Type I - Dysplastic (congenital)

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36
Q

What does deflection/deviation of the paraspinal line indicate?

A

SOL

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37
Q

When are obliques helpful?

A

less than 20% anterior displacement

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38
Q

What is a demoid cyst?

A

teratoma (glob of hair, teeth, and fat)

39
Q

What is a tripod fracture?

A

separation of all three attachements of the zygoma to the rest of the face (aka zygomaticomaxillary complex fracture)

40
Q

What is the Davis series?

A

7 view cervical set, acute and non-acute series

41
Q

What is the order for an acute Davis series?

A

lateral, APOM, AP cervical, Lt and Rt oblique, Flexion and extension (swimmers if needed)

42
Q

What do a posterior arch fracture, posterior joint arthrosis, cervical hypolordosis and degenerative retrolisthesis of C5 indicate?

A

extension injury

43
Q

What are some radiographic features of a sever sprain?

A

widening of interspinous space (fanning), loss of parallelism between facet joints, horizontal displacement, angular displacement

44
Q

What are some hyperflexion injuries of the cervical spine?

A

simple wedge fracture, bilateral interfacetal dislocation, flexion teardrop fracture, clay shoveler’s fracture, anterior subluxation, dens fracture

45
Q

What are some hyperflexion and rotation injuries of the cervical spine?

A

unilateral interfacetal dislocation and unilateral interfacetal fracture dislocation

46
Q

What are some hyperextension injuries of the cervical spine?

A

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
Q

Low T1 High T2:

A

new fracture

48
Q

Irregularity of L5 pars without definite anterior displacement:

A

spondylolysis

49
Q

Spondylolysis:

A

interruption of the pars

50
Q

Spondylolysthesis:

A

anterior displacement

51
Q

Prespondylolysthesis:

A

Spondylolysis w/o anterior

52
Q

pseudospondylolysthesis:

A

anteriority w/o pars defect

53
Q

Left cervical IVFs can be taken:

A

LAO RPO

54
Q

Right cervical IVFs can be taken:

A

RAO LPO

55
Q

Left lumbar IVFs can be taken:

A

RAO LPO

56
Q

Right lumbar IVFs can be taken:

A

LAO RPO

57
Q

If skull fractures are suspected?

A

CT

58
Q

What % of skull fractures are detected on xray?

A

10%

59
Q

AKA Hangman’s fx?

A

traumatic spondylolisthesis or bilateral pedicle fracture

60
Q

What are some abnormal vertebral alignment changes that might suggest spine trauma?

A

misalignment, loss of lordosis, acute kyphotic angulation, widened interspinous spaces, vertebral rotation, torticollis

61
Q

What is the cause of hyperflexion mechanism?

A

whiplash type injury, partial bilateral facet dislocation

62
Q

Hyperflexion of more than ______ may indicate instability.

A

11 degrees

63
Q

Greater than _______ body offset may be a clue of instability.

A

3.5 mm

64
Q

What are the etiologies of antero/retrolisthesis?

A

Fx, dislocation, ligamentous laxity, degenerative disease/joint disease, anatomic, physiologic

65
Q

How long do spine Fx take to heal?

A

3-6 mos

66
Q

What is the most common fracture of atlas?

A

posterior arch fracture (usually bilateral and vertical)

67
Q

What are some abnoraml joints that might suggest spine trauma?

A

increased ADI, abnormal disc height, widened apophyseal joints

68
Q

Normal ADI for adults and children?

A

3mm and 5mm

69
Q

Signs of a blowout fracture?

A

orbital emphysema, inferior rectus into maxillary sinus, blood in floor of sinus

70
Q

Hyperflexion of C4 with widened facets at C4/C5 and reversed curve at C4?

A

hyperflexion whiplash

71
Q

Type I odontoid fx:

A

stable and rare

72
Q

What are the etiological factors of an increased ADI?

A

normal variant, trauma, Down’s syndrome, major upper cervical anomalies, inflammatory arthropathies (seropos and seroneg)

73
Q

Most common cause of increased ADI?

A

rheumatoid arthritis (seropos)

74
Q

Increased ADI, RPI, anterior offset of C1 spinal laminar line and atlantoaxial dislocation needs:

A

flexion, extension, orthopedic consult and MRI

75
Q

What is Steele’s rule of thirds?

A

divides ring of atlas in thirds, 1/3 cord, 1/3 odontoid, 1/3 potential space

76
Q

Types of odontoid Fx:

A

Type I: stable/rare

77
Q

Fx at tip of dens:

A

Type I

78
Q

Fx at base of dens:

A

Type II

79
Q

Fx into body of C2:

A

Type III

80
Q

What does bow tie sign indicate?

A

unilateral facet dislocation of C4

81
Q

Bow tie sign requires:

A

cervical obliques and orthopedic consult

82
Q

What can cause Type I odontoid Fx?

A

apical or alar ligament avulsion fracture through tip of odontoid

83
Q

AKA Clay Shoveler’s fx:

A

spinous process fracture (double spinous sign)

84
Q

Cause of clay shoveler’s Fx:

A

avulsion fx in flexion injury

85
Q

Lateral flexion injuries of the cervical spine?

A

unilateral fx lateral mass C1, transverse process fx, uncinate fx

86
Q

What does double spinous sign indicate?

A

spinous fracture

87
Q

What are some hyperextension-rotation injuries of the cervical spine?

A

pillar fx and pedicolaminar fx

88
Q

Who is predisposed to have apophyseal avulsion fx of the pelvis?

A

adolescents in athletics, sprinters, long jumpers, hurdlers, gymnasts, etc

89
Q

AKA Iliac wing fx:

A

duverney fx

90
Q

RPI:

A

7mm

91
Q

RTI:

A

22mm

92
Q

facial fxs involving maxillary bone and surrounding structures in a bilateral and either horizontal, pyramidal or TV way

A

le fort fracture

93
Q

What are the types of hyperflexion injuries (6)?

A

simple wedge compression, flexion teardrop, clay shovelers, anterior sublxation, dens fx, bilateral interfacetal dislocation

94
Q

MC fx of thoracic and lumbars

A

compression fx (flexion mechanism)

Dx Imaging II (5 decks)

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