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Diagnostic Imaging II Exam One > Other Cervical Fractures > Flashcards

Other Cervical Fractures Flashcards

1
Q

What is the most common overall injury to the axial skeleton?

A

Compression fractures

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2
Q

What mechanism usually causes compression fractures?

A

Hyperflexion

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3
Q

What body changes do we see with a compression fracture?

A

Decreased anterior 1-2/3 body height with preservation of posterior body height

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4
Q

Which endplate is usually affected by a compression fracture?

A

Superior endplate (depression)

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5
Q

Are compression fractures considered stable or unstable?

A

Stable until body is reduced by over 40% or more (then unstable)

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6
Q

What are the 3 most common causes of a pathological compression fracture?

A

1 osteoporosis 2 lytic metastasis 3 multiple myeloma

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7
Q

A present zone of impaction and/or step defect is indicative of a new or old compression fracture?

A

NEW

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8
Q

How can an MRI help figure out if a compression fracture is new or old?

A

Presence of marrow edema = new fracture

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9
Q

How can we tell a step defect from a limbus?

A

Step defects are displaced from the anterior margin

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10
Q

What happens to step defects after the healing process?

A

Round out and disappear

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11
Q

What type of force usually causes a burst fracture?

A

Axial compression

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12
Q

Which version of a teardrop fracture causes the most neurologic deficit?

A

Flexion teardrop

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13
Q

What is the major patient complaint seen with unilateral facet dislocation?

A

Inability to look to one side

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14
Q

Which mechanism is responsible for unilateral facet dislocation?

A

Flexion rotation

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15
Q

What specific anatomy is dislocated with a unilateral facet dislocation?

A

Interior articular process dislocates into IVF

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16
Q

What type of body displacement can be seen with a unilateral facet dislocation, and on which X-ray view can this be seen?

A

Anterior body displacement (25%), lateral X-ray

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17
Q

What X-ray sign is associated with a unilateral facet dislocation due to the fact that the articular pillars are not superimposed upon each other?

A

“Bow-tie” sign

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18
Q

What area of the vertebrae experience decreased length that can be seen on a lateral film with a unilateral facet dislocation?

A

Laminae (at segment level and up)

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19
Q

What direction of spinous rotation can be seen on the AP view with a unilateral facet dislocation?

A

Rotation toward side of dislocation

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20
Q

What X-ray view confirms a unilateral facet dislocation?

A

Obliques (to see IVF)

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21
Q

What CT sign can be seen with a unilateral facet dislocation?

A

Inverted hamburger sign

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22
Q

Inverted hamburger sign is associated with what condition and can be seen on what type of imaging?

A

Unilateral facet dislocation; CT

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23
Q

Are neurological deficits more common with unilateral or bilateral facet dislocations?

A

Bilateral (high incidence)

24
Q

What is the #1 worst injury to the cervical spine? #2?

A 
#1 = flexion teardrop
#2 = bilateral facet dislocation
25
Q

What mechanism causes bilateral facet dislocation injuries?

A

Hyperflexion

26
Q

What levels are most commonly associated with bilateral facet dislocation and why?

A

C4-C7 (areas of stress)

27
Q

How is the interspinous space affected by bilateral facet dislocation?

A

Increased

28
Q

What sign on CT can be seen with bilateral facet dislocation?

A

Bilateral inverted hamburger sign

29
Q

In which direction is the body likely to displace (50%) with bilateral facet dislocation?

A

Anteriorly

30
Q

What mechanism is responsible for a flexion teardrop fracture?

A

Flexion

31
Q

What is the most common location for flexion teardrop fracture?

A

C4-C7

32
Q

What is the most common location for an extension teardrop fracture?

A

C2*/C3

33
Q

Buckling of which ligament is associated with extension teardrop fractures?

A

Ligamentum flavum

34
Q

What age population is likely to have extension teardrop fractures and why?

A

Elderly: falling due to orthostatic hypotension

35
Q

Which is located higher in the spine: flexion or extension teardrop fractures? Lower?

A 
Higher = extension
Lower = flexion
36
Q

What is another name for a Clay Shoveler’s fracture?

A

Root puller’s fracture

37
Q

What are the usual locations for a clay shoveler’s fracture?

A

C7, C6 and T1

38
Q

What general type of fracture is a clay shoveler’s fracture?

A

Avulsion

39
Q

What causes a clay shoveler’s fracture?

A

Muscles rip spinous off during hyperflexion

40
Q

What mechanism usually causes a clay shoveler’s fracture?

A

Hyperflexion

41
Q

In what direction does the fragment involved with a clay shoveler’s fracture usually displace?

A

Inferiorly

42
Q

The double spinous sign on X-ray is associated with which injury?

A

Clay shoveler’s fracture

43
Q

What is the differential diagnosis for a clay shoveler’s fracture?

A

Secondary ossification center on spinous

44
Q

What would it mean if the tip of a spinous on X-ray appears to be displaced but has smooth edges and cortex?

A

Probably just a failure to ossify (not fracture)

45
Q

On which X-ray view do we see the double spinous sign?

A

AP cervical

46
Q

In other areas of the spine besides the cervical region, what mechanism causes spinous fractures?

A

Extension (or direct trauma)

47
Q

What is a good way to differentiate clay shoveler’s fractures from a simple spinous fracture that could be due to other causes?

A

Know the unique levels for clay shoveler’s: C7, C6, and T1

48
Q

What is the mechanism of injury for laminar fractures?

A

Hyperextension

49
Q

What is the likely area for laminar fractures?

A

Lower cervicals

50
Q

What is a laminar buckle fracture?

A

“Fracture” that occurred on a mostly cartilaginous lamina that bent it instead of broke it (think peds)

51
Q

What is the usual location for a pillar fracture?

A

C4-C7

52
Q

What is the mechanism associated with pillar fractures?

A

Extension/compression

53
Q

Why are pillar fractures difficult to see on X-ray?

A

Pillar naturally diminish during transition into thoracics from cervicals.

54
Q

What types of fractures can occur via a lateral flexion mechanism?

A

Unilateral (or lateral mass of C1), transverse process, or uncinate process fracture

55
Q

Why are unilateral, lateral mass, transverse process, and uncinate process fractures rare?

A

Lateral flexion mechanism is uncommon

56
Q

Which mechanism of injury creates posterior ligament stress following whiplash? Anterior ligament stress?

A 
Posterior = hyperflexion
Anterior = hyperextension
57
Q

What causes the widened interspinous spaces seen with whiplash injury?

A

Disrupted ligaments

Diagnostic Imaging II Exam One (5 decks)

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