neck radiology Flashcards by Emily Fothergill

what are some landmarks and corresponding vertebrae on the back?

C7=prominent
T3=spine of scapula
T7=inferior angle of scapula
L4=iliac crest

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what causes whiplash and treatment?

acceleeration-deceleration injury
now called whiplash associated disorders
no structural pathology
rest, analgesia, early physical therapy
acute=full recovery, chronic=residucal long term pain, disability

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what should you look for in a normal cervical spine XR?

anterior vertebral body line, posterior vertebral body line, distance between C1 and odontoid less than 5mm, look at distance between airway and vertebral bodies-step at C5 to further away

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what does neck muscle spasm look like on XR?

striaght-loss of lordosis

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how does facet joint dislcoation present on XR?

often in contact sports
can have bifacet or unifacet (small movement can cause bifacet and spinal cord injury)
comes over front of one below and not behind, 25% slip in vertebral body
AP view: rotation
use CT for more detail

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what is a jefferson fracture?

C1 burst fracture, caused by axial loading, fractures on anterior and posterior arch

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what causes a lateral mass fracture of C1?

axial loading and rotation

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what causes and anterior or psoterior arch fracture C1?

axial loading and flexion or extension

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how can odontoid peg fracture be viewed and tx/

open mouth and XR through
worse if at base
collar, halo, internal fixation

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common MOI cervical facet dislocation?

flexion-distraction

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what happens in a stinger injury?

brachial plexus stretched, tingling and burning down arm

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where is M in brachial plexus?

in front of axillary artery

musculocutaneos latera, median middle, ulnar medial

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what can cause intervertrbal disc degeneration?

dehydration as age, begin to crack

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what is an intervertebral disc prolapse?

bulges out

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what is intervertrbal disk extrusion?

nucleus prolapses thriguh

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what is intervertrbal disc sequestration?

nucleus prolapses into spinal cord

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what is clay shovelers fractures?

fracture of spinous process

repetitive flexion extension

what is a teardrop fracture?

fracture anterior cervical spine

damage of ligaments, often unstable

what is hangmans fracture?

neck pulled up and away, fractue of upper cervical spine

when does disc degeneration cause nerve root compression?

if goes sideaways into root

what sport is cervical intervertebral disc degeneration common in?

rugby, others that require pwerful necks

what can be seen on XR in cervical intervertebral disc degeneration

more angulat, osteophytes (syndesmaphytes in spine)-can cause problems with swallowing or impact spinal cord and nerve roots

what is spinal shock

injury to spinal cord, goes into complete paralysis, often resolves. means cant determine if complete injury and wont recover or incomplete-some recovery untiul spinal shock ended

what is bulbocavernosus reflex?

S2-4: roots tug on urinary catheter causes reflex contraction of anal sphincter
if intact then spinal shock has ended

what are some common thoracolumbar spine injuries?

chronic overuse: anterior (intervertebral disc degeneration, cauda equina syndrome), posterior (spondylolysis, spondylolisthesis, berlottis syndrome) high energy: fractures, spinal cord injury

what age does thoracolumbar intervertebral disc degeneration occur?

30-50 in recreational athletes | 20-35 in elite

what is the presentation and cause of thoracolumbar intervertebral disc degeneration/

repetitive compression with torsion (tennis, golf, skiing, snowboarding) back pain: annulus tear leg pain: herniation of disc

what is the cause and presentation and mx cauda equina syndrome?

disc comrpessing cauda equina bladder and bowel affected, loss of anal tone, loss of peri-anal sensation, pain, loss of myotomal power, loss dermatomal sensation, loss reflexes MRI and theatre

what is spondylolysis, cause and imaging?

stress reaction of pars interarticularis fravture due to combined flexion, extension and rotation against resistance 80% bilateral, L5 most common, then L4 higher incidence in athletes-throwing sports, gymnasts, rowing XR: rotated view=scottie dog sign, fracture is on collar

what is spondylolisthesis and imaging>

when spondylolysis starts to move becomes spondylolisthesis can see on lateral view on XR MRI: effect on nerve root, usually effects root above

what is berollis syndrome?

congenital anomaly between the transverse processes and L5 and sacrum-fused together causes back pain, hyperextension=irritation of pseudoarticulation, increased rate L4/5 problems XR: transverse process L5 attached to sacrum

which sports commonly cause high energy thoracolumbar spine fractures?

horse riding, snowboarding , paragliding

where to high energy thoracolumbar spine fractures commonly occur?

thoracolumbar junction: T11-L2 | may injure spinal cord too

what are the different types of high energy thoracolumbar spine fracture?

simple fracture: posterior part of vertebral body is intact so stable burst fracture: fragments pushed in all directions retropulsed fragment: in burst fracture, goes back, needs reducing and fixed

what imagin can be used to see the spinal cord?

MRI: look for signal, increased suggests damaged

what are the features of spinal cord injury at C4?

quadriplegia (paralysis from neck down)/tetraplegia

what are the features of spinal cord injury at C6?

partial paralysis of hands, arms and lower body

what are the features of spinal cord injury at T6?

paraplegia (cant move lower half of body), paralysis below chest

what is the dermatome supply to nipple and umbilicus?

T4 | T10

what are the nerve supplies to the reflexes: triceps, brachioradialis/biceps, patella, ankle?

C6-7 C5-6 L2-4 S1