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Imaging II > Lumbar spine > Flashcards

Lumbar spine Flashcards

1
Q

What is the goal of the lumbar spine radiograph?

A

identify or exclude anatomic abnormalities or disease processes of spine

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2
Q

What are the routine projects of the lumbar spine?

A

AP

Lateral views

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3
Q

What additional views may be needed?

A

right and left oblique

coned lateral view of lumboscral articulation

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4
Q

What does the right posterior oblique (RPO) and left posterior view (LPO) views demonstrate?

A

right: right sided structures
left: left sided structurers

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5
Q

What does the posterior oblique views image?

A

downside” facet joints closest to image receptor

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6
Q

What might the anterior oblique position be used for?

A

upside” facet joints farther from image receptor

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7
Q

Nose of scottie dog

A

transverse provess

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8
Q

Eye of scottie dog:

A

pedicle

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9
Q

Ear of scottie dog:

A

superior articular process

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10
Q

Neck of scottie dog:

A

pars interarticularis

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11
Q

Foreleg of scottie dog:

A

interior articular process

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12
Q

Body of scottie dog:

A

lamina and spinous process

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13
Q

Tail of scottie dog:

A

superior articular process of opposite side

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14
Q

Hind leg of scottie dog:

A

inferior articular process of opposite side

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15
Q

What is the imagining of choice for evaluating trauma patients?

A

CT

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16
Q

What can help localize injuries?

A

AP and lateral radiographs

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17
Q

If CT is normal, is an MRI necessary and why/why not?

A

no- b/c isolated ligamentous injuries rare in lumbar spine

18
Q

What is the predominant site of vertebral fractures?

A

Thoracolumbar junction (T11–L2)

19
Q

What is spondylolysis a defect of?

A

at pars interarticularis

20
Q

What can a defect be?

A

Congenital (rare)
Traumatic
Stress fracture caused by chronic strain

21
Q

What is the most common lumbar injury?

A

Stress fracture caused by chronic strain

22
Q

What is spondylolosthesis?

A

forward displacement of one vertebra upon stationary vertebra beneath it
can also be called anterolisthesis

23
Q

What is retrolisthesis?

A

posterior displacement of a vertebra

24
Q

What percentage of patients have spondylolisthesis?

A

5-10%

25
Q

Who is typically affected by spondylolisthesis?

A

children and adolescents

more apparent in those involved in athletics

26
Q

What levels are most often involved in spondylolisthesis?

A

lower lumbar

L4-L5, L5-S1

27
Q

Spondylolisthesis can also result from:

A

Congenital or developmental aberrations
Pathological processes
Degenerative changes

28
Q

What is the usual clinical presentation of Spondylolisthesis?

A

Patient c/o pain after athletic activities or physical labor

29
Q

What action reduces pain?

A

lumbar flexion- which reduces displacement

30
Q

What can palpation of spinous process reveal?

A

rotation or deep depression

31
Q

What is rotation of SP correlated with?

A

asymmetrical slip (result of unilateral spondylolysis)

32
Q

What is palpable depression over SP a sign of?

A

sign of spondylolisthesis

33
Q

What does the radiologic presentation of SP distinguish between?

A

degenerative and fracture spondylolistheses

34
Q

What happens in degenerative spondylolosthesis?

A

entire vertebra slips forward as a unit

35
Q

What is a step-off of SP?

A

below level of slip

36
Q

What is conservative treatment of spondylolosthesis?

A

restriction of activities that load spine in extension

37
Q

What is spinal stenosis?

A

narrowing or constriction of spinal canal secondary to adjacent soft tissue or bony enlargement

38
Q

What structures can be compromised by spinal stenosis?

A

spinal cord, thecal sac enclosing CSF and dural membranes that enclose thecal sac

39
Q

How is spinal stenosis classified?

A

by etiology or by anatomic region involved

40
Q

How is etiology divided?

A

congenitial

acquired

Imaging II (10 decks)

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