Exam 3 L-Spine Flashcards
is the cervical spine lordotic or kyphotic?
lordotic
is the thoracic spine lordotic or kyphotic?
kyphotic
is the lumbar spine lordotic or kyphotic?
lordotic
is the pelvis lordotic or kyphotic?
kyphotic
what are the primary curves of the spine?
thoracic and pelvic
what are the secondary curves of the spine?
cervical and lumbar
_______ curves are present at birth
primary
_______ curves develop after birth
secondary
where does the spinal cord begin and end?
begins at C2 and extends to L1 or L2
how many cervical nerves are there?
8 pair
how many thoracic nerves are there?
12 pair
how many lumar nerves are there?
5 pair
how many sacral nerves are there?
5 pair
how many coccygeal nerves are there?
1 pair
how many spinal nerves are there?
31 pairs
the conus medullaris is where
the spinal cord ends
where do spinal punctures enter?
subarachnoid space
what are the layers of the meninges?
dura matter, arachnoid, pia mater
strong fibrous membrane sheath
dura matter
thin transparent sheath
arachnoid
highly vascular & adheres to cord itself
pia mater
which way are the articular facets oriented on lumbar vertebrae?
parasagittally
what is a short thick process that extends posteriorly?
pedicle
what forms the zygapophyseal joints?
superior and inferior articular processes
what kind of joint is the zygapophyseal?
semi-moveable, amphiarthrodial
a bony defect occurring in the pars interarticularis
characterized by anterior displacement of one vertebrae over another
generally the L5 over the sacrum
spondylolysis
entire intervertebral disc pushing out towards spinal cord
bulging disc
nucleus pushing out towards spinal cord
herniated disc
where do you center for AP lumbar spine?
1.5 inches above iliac crest
what is at the level of the iliac crests
L4-L5 disc space
what needs to be included on AP lumbar spine?
T12 to SI joints
what might cause a radiolucent line across L2?
fracture (psoas muscle, bowel)
where do you center for a lateral lumbar spine?
1.5 inches above iliac crest
what breathing instructions do you give for a lateral lumbar spine?
breath all air out and hold, image on expiration to raise diaphragm
how should the CR be oriented for a lateral lumber spine?
perpendicular if spine if horizontal
if spine is not horizontal on a lateral lumbar spine how should the CR be oriented?
angle 5-8 degrees caudal
where should you center for L5-S1 spot projection?
center on coronal plane 2 inches posterior to ASIS and 1.5 inches inferior to the iliac crest
how should the CR be oriented for L5-S1 spot projection?
parallel with the interiliac line, 5 degrees caudal
when imaging AP oblique lumbar spine which zygapophyseal joints are you looking at?
the ones closest to the IR
where should you center and where should the CR be for oblique lumbar spine?
1.5 inches above the iliac crest and 2 inches medial to elevated ASIS
when imaging AP oblique cervial spine which zygapophyseal joints are you looking at?
the ones furthest from the IR
when imaging AP oblique thoracic spine which zygapophyseal joints are you looking at?
the ones furthest from the IR
when imaging AP oblique SI joint which joint are you looking at?
the one furthest from the IR
where should the pedicle be projected on AP oblique spine?
middle of vertebral body (the eye)
if the pedicle (eye) is on the anterior portion of the vertebral body the patient is _____ rotated
under
if the pedicle (eye) is on the posterior portion of the vertebral body the patient is _____ rotated
over
how should the CR be oriented for AP axial Lumbosacral junction and SI joints?
centered 1.5 inches superior to pubic symphysis and angled 30-35 degrees cephalic
what patient position for oblique SI joint and where does the CR enter?
elevate affected side 25-30 degrees and center 1 inch medial to elevated ASIS
what does the PA projection (Chamberlain view) demonstrate? what images?
abnormal sacroiliac motion by showing the relationship of the pubic bones
2 PA projections with pt upright and altering weight bearing limbs
center to pubic symphysis
how should the CR be oriented for AP sacrum?
centered 2 inches superior to pubic symphysis and angled 15 degrees cephalic
how should the CR be oriented for AP coccyx?
center 2 inches superior to pubic symphysis and angled 10 degrees caudal
what should you see on a lateral sacrum/coccyx image?
superimposition of ischia, short scale contrast
how should the CR be oriented for lateral sacrum?
perpendicular and 3.5 inches posterior to the ASIS
how should the CR be oriented for lateral coccyx?
perpendicular 2 inches inferior from sacrum centering (3.5 inches posterior to ASIS)
what is it called when contrast media is injected into the subarachnoid space betwen L2-L3 or L3-L4?
myelogram
what are the 3 peak categories of spinal column injuries?
C1-C2
C5-C7 (40% of injuries)
T12-L2
lesions involving the thoracic vertebrae or below
paraplegia
cervical lesions below C4. lesions above C4 will additionally lead to respiratory compromise from paralysis of the diaphragm
quadriplegia
total loss of sensation and function below the level of injury
complete spinal cord injury
partial loss of sensation below the level of injury
incomplete spinal cord injury
most common age for spinal cord injuries
33
most frequent age for spinal cord injuries
19
more than 1/2 of spinal cord injures are
quadriplegia
anterior wedging of vertebral body
flexion fracture
results in small avulsion fractures of the anteroinferior or anterosuperior margin of the vertebral body
extension fracture
burst-like fractures of the vertebral body with displacement of the fragments
compression fracture
pulling-apart forces result in horizontal fractures through the neutral arch and posterior aspect of vertebral body
distraction fracture
how many bones does the sacrum have?
5 bones
how many bones does the coccyx have?
3-5 bones
the average adolescent spine has ___ bones
33
at what age are the spinal curves fully developed?
6
congenital malformation of the spine in which only half of a vertebral body develops. developmental failure of one of the lateral vertebral chondrification centers
hemivertebrae
congenital deformity of the vertebral column in which the laminae fail to unite posteriorly at the midline
spina bifida occulta “open spine”
what is the mildest form of spina bifida?
spina bifida occulta
what is the most severe type of spina bifida?
spina bifida myelomeningocele
misalignment or partial dislocation; one or more vertebrae move out of position and create pressure on or irritate spinal nerves
vertebral subluxation
a surgical procedure in which the lamina of the vertebra is removed or trimmed (spinous process is also removed)
laminectomy
what is the reason for a laminectomy?
to relieve pressure on the spinal cord or on the nerve roots that emerge from the spinal canal
__% of people’s cord ends at L1 or above
__% of people’s cord ends at L1-L2
__% of people’s cord ends at L3
3%
94%
3%
excessive curvature in the lumbar portions of the spine which gives a swayback apperance
lordosis
a curvature of the upper spine, a spinal deformity that can result from trauma, developmental problems, or degenerative disease, can occur at any age, rare at birth
kyphosis
lateral or sideways curving of the spine
scoliosis
problem with the formation of vertebrae or fused ribs during prenatal development
congenital scoliosis
caused by muscular weakness or paralysis due to diseases
neuromuscular scoliosis
unknown cause and appears in a previously straight spine
idiopathic scoliosis
chronic inflammatory disease that causes arthritis of the spine and SI joints. it is a systemic rheumatic disease and can affect other joints and cause inflammation of the eyes lungs and kidneys
always manifest in SI joints first and then in the spine
ankylosing spondylitis
herniations of the intervertebral disc through the vertebral end-plate caused by trauma
schmorl’s nodes
