Imaging the Spine Flashcards

1
Q

What do x-rays show?

A

Bone outlines

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2
Q

What do CT scans show?

A

Bone outlines in more detail and some soft tissue structures

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3
Q

What do MRI scans show?

A

Bone outlines in less details but show bone marrow, discs, ligaments, the spinal cord and nerves (e.g all soft tissue structures)

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4
Q

What can be used to image bones?

A

X-ray, CT and MRI

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5
Q

What can be used to image soft tissues?

A

CT and especially MRI

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6
Q

What helps to form the natural smooth curve of the spine?

A

Cervical lordosis, thoracic kyphosis and lumbar lordosis

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7
Q

What can be used to show the normal curvature of the spine?

A

CT and MRI

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8
Q

What are the common features of the 3rd to 7th C vertebrae, 12 T vertebrae and 5 L vertebrae?

A

Vertebral body

Posterior arch = 2 pedicles, 2 laminae, 1 spinous process, 2 transverse processes

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9
Q

Where is the neural foramen located?

A

Inferior to the pedicle

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10
Q

What forms facet joints?

A

The anterior and posterior projections of the articular processes between the pedicles and laminae

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11
Q

What view can be used to identify normal anatomical features?

A

AP view

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12
Q

What is unusual about C1?

A

Has no vertebral body = comprises anterior and posterior arches, united by two large vertebral masses, articulates with occipital bone and C2

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13
Q

What is unusual about C2?

A

Has odontoid process = projects superiorly into C1, anterior to the spinal canal, where it forms a joint with C! anterior arch

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14
Q

When are CT scans used to image spinal trauma?

A

When x-ray shows feature but more detail is needed and to check if any more injuries are present
When is x-ray is normal but there is high clinical suspicion

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15
Q

What are the functions of the intervertebral ligaments?

A

Tether vertebrae together and are responsible for spinal stability

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16
Q

How can x-rays and CT scans be used to image the intervertebral ligaments?

A

Not visible on these imaging modalities = seeing normal vertebral alignment on these tests implies intact ligaments and a stable spine

17
Q

What is the only imaging test that shows ligaments?

A

MRI = normal ligaments appear black, damaged ligaments are light

18
Q

When are MRI scans used to image spinal trauma?

A

Occasionally to provide detail of spinal ligaments
In patients with neurological deficit which isn’t explained by CT or x-ray
Show soft tissue abnormalities = acute prolapsed disc, epidural haematoma, spinal cord damage

19
Q

What are x-ray and CT features of vertebral tumours?

A

Bone sclerosis = increased bone density
Bone destruction = reduced bone density
Vertebral collapse

20
Q

What are features of vertebral tumours unique to MRIs?

A
Early = bone marrow infiltration
Late = extradural mass and spinal cord compression
21
Q

What is the function of intervertebral discs?

A

Cushion vertebrae from stress

22
Q

What may happen to intervertebral discs as a prelude to disease?

A

May dehydrate

23
Q

What may happen to a dehydrated intervertebral disc?

A

Disc material may herniate through disc lining into spinal canal and may press on spinal nerve, causing sciatica

24
Q

How do prolapsed intervertebral discs present on x-rays?

A

May show narrowing of disc space

25
Q

What kind of prolapsed disc is visible on CT scans?

A

Lower lumbar scans

26
Q

What is the best modality for imaging the intervertebral discs?

A

MRI = shows all disc prolapses and preceding disc dehydration

27
Q

How effective are the imaging techniques for capturing the spinal cord?

A

Invisible on x-rays
Poorly shown on CT
Only adequately shown on MRI

28
Q

What are some causes of spinal cord disease?

A

Trauma, tumour, demyelination, ischaemia