Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Artritis > Spinal Trauma > Flashcards

Spinal Trauma Flashcards

1
Q

must be cleared first for stability before

other views are attempted

A

Lateral cervical view

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

before ruling out

significant spinal injury don’t perform what views?

A

flexed and extended views

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

often required to fully

evaluate cervical spinal injury

A

Reconstructed CT scanning w/o contrast

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Prevertebral (retropharyngeal & retrotracheal) soft tissues
evaluation
(significant indicator of underlying cervical injury)

A

Adults: no more than 22-mm at C6-C7 and no more than 7-mm at C2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

soft tissue thickness at C2 should measure less than

A

50% of vertebral body width

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

At C6 or C7 soft tissues should measure less than the width of the

A

adjacent vertebral body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

is loss of cervical lordosis is a reliable

indication of injury?

A

NO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

seen in >20% of normal cervical radiographs

A

Absent lordosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

may cause flattening and/or reversal of lordosis

A

Post-traumatic cervical muscle spasm or

DDD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

A reliable way to evaluate alignment of C/S is to look at what 4-lines?

A
  1. Anterior vertebral line
  2. Posterior (George’s) vertebral line
  3. Spinal laminar line
  4. Posterior spinous process line
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

may strongly indicate disruption of the

PLL, capsular and interspinous ligaments

A

Posterior disc space widening and fanning of the spinous

processes esp. at C3-C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

may indicate marked rotational

deformity and facet dislocation

A

Abrupt change in facet orientation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

“double

SP sign” indicating

A

SP avulsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

C2-Odontoid normally it tilts ____ slightly

A

back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If the Odontoid leans more anterior, suspect

A

odontoid fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In adults C1-C2 distance on lateral view is approx.

A

2.5-mm
(should not
increase on flexion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In children the C1-C2 distance may be up to

A

5-mm and may change by 1-2-mm in flexion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In children C1 lateral masses may slightly

A

overhang

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what system can establish if the fracture is stable or unstable?

A

3-column Denis classification system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How can we establish if the fracture is stable or unstable?

A

stable fracture if only 1-column is injured

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

most spinal fractures may

involve some component of

A

flexion injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

S.C.I.W.O.R.A.

A

serious trauma including cord damage w/o radiographic

abnormality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

posterior arch, Jefferson “burst” fracture, anterior arch lateral
mass fractures

A

C1-atlas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Hangman’s, Odontoid process, teardrop fracture

A

C2-axis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

compression wedge or burst, flexion teardrop, pillar, isolated
lamina & TP, Clay Shoveler’s fractures

A

C3-C7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

potentially unstable upper cervical injury

A

Occipital condyle fracture

x-ray may miss this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Occipital condyle fractures may be encountered more frequently due to

A

MVA injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Usually associated with severe injuries to facial skeleton and the
skull due to significant trauma

A

Occipitovertebral dissociation (less common but often fatal)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

m/c fracture of the Atlas (>50%)

A

Bilateral fracture of the posterior arch of C1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Bilateral fracture of the posterior arch of C1 should not be confused with

A

Jefferson C1 fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

mechanism of a bilateral fracture of the posterior arch of C1

A

extension/compression of the C1 arch by the occiput

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

• Relatively stable injury but may have >80% association with other
cervical fractures

A

Bilateral fracture of the posterior arch of C1

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

burst fracture of C1

A

Jefferson fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

represents an osseous ring that ossifies between 3-6 years of
age (an may fracture)

A

burst fracture of C1 (Jefferson fracture)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

“diving head first”, compression of occipital condyles

into lateral masses of C1

A

burst fracture of C1 (Jefferson fracture)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

overhanging C1 masses, if >6-mm combined, suspect

A

transverse

ligament damage and marked instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

may occur due flexion or extension or a

combination of forces

A

Odontoid process fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

less common, involves avulsion of the tip. May be unstable

contrary to some views

A

Type 1 - Odontoid process fracture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

most common and most unstable through the base of the
odontoid process and may involve cruciate ligament.
(>23% missed cervical fractures)

A

Type 2 - Odontoid process fracture

40
Q

through the base into the body and lateral masses.

A

Type 3- Odontoid process fracture

41
Q

Can be
stable and carries best healing potential due to greater fracture surface
and vascularization.

A

Type 3- Odontoid process fracture

42
Q

not to be confused with Dens fracture

A

Mach line (effect)

43
Q

Not to be confused with Type 1 odontoid fracture.

A

Persistent ossiculum terminale.

44
Q

traumatic spondylolisthesis of C2.

A

Hangman’s fracture

(Most cases
related to MVA)

45
Q

Due to hyperextension and traction of the upper cervical spine leading to
b/l break of pars interarticularis of C2 and disruption of the discovertebral
junction

A

Hangman’s fracture

46
Q

vertebral artery

damage may occur If fracture line extends to the

A

foramina intertransversaria

47
Q

b/l break in pedicles and lamina of C2 and spondylolisthesis

of C2 body

A

spondylolisthesis of C2. (Hangman’s fracture)

48
Q

A sliver of bone may be noted at anterior C2 body due to associated extension
teardrop fracture caused by

A

avulsion of the Anterior Longitudinal

Ligament attachment

49
Q

hyperextension of the C/S may cause avulsion of the inferior-anterior corner of the
vertebral body

A

Extension teardrop fractures

unstable in extension

50
Q

Extension teardrop fractures can be associated with Hangman’s fracture, especially
in older patients due to

A

spondylosis

51
Q

one of the most severe injury of the cervical

spine, often causing anterior cervical cord syndrome and quadriplegia.

A

Flexion teardrop fracture (80% paralyzed on site)

52
Q

typically occurs from severe flexion and

compression, most commonly at C5-6

A

Flexion teardrop fracture

53
Q

Flexion teardrop fracture may cause

A

anterior cord damage due to posterior

displacement of vertebral body fragments

54
Q

fracture of antero-inferior vertebral body

A

(teardrop sign)

55
Q

Focal cervical kyphosis

A

fracture of antero-inferior vertebral body

56
Q
  • posterior cervical displacement above the level of injury
     Fanning of interspinous processes
     intervertebral disc space narrowing
     disruption of the spinolaminar line
     anterior dislocation of the facet joints
A

fracture of antero-inferior vertebral body (teardrop sign)

57
Q

seen on lateral radiographs as an oblique lucency

through the spinous process, usually of C7.

A

Clay Shoveller Fracture

58
Q

most typical mechanism of Clay Shoveller Fracture

A

sudden muscle contraction

occasionally direct blows to SP

59
Q

Hyperflexion injuries to the vertebral body resulting from axial loading

A

Compression “Wedge fracture”

60
Q

Compression “Wedge fracture” most commonly affecting the

A

anterior body aspect

61
Q

wedge fractures are considered a

A

single-column (i.e. stable) fracture

62
Q

Compression “Wedge fracture” may occur in the C/S but typically seen in the

A

thoracic and T/L region

63
Q

no posterior body retropulsion, wedging of the anterior body

typically of superior end-plate impaction

A

Compression “Wedge fracture”

stable and no neuro

64
Q

Compression “Wedge fracture” may share great

resemblance to

A

osteoporotic thoracic compression fracture

65
Q

more common in the thoracolumbar region and

considered stable.

A

Simple wedge fractures

66
Q

type of comminuted compression fracture which results
in disruption of the posterior vertebral body cortex with retropulsion of
fragments into spinal canal

A

Burst fractures

67
Q

When burst fractures involve the thoracolumbar level, it tends to occur between

A

T9 and

L5 level.

68
Q

result of high energy axial loading and nucleus is driven into the vertebral body below

A

burst fracture

69
Q

All patients with burst fracture require a

A

CT to assess

70
Q

burst of vertebral body fragments well demonstrated
on axial CT and
loss of posterior vertebral height on lateral radiographic views

A

burst fracture

71
Q

retropulsed fragments in the spinal canal

A

burst fracture

72
Q

Interpedicular distance widening

A

burst fracture

73
Q

comminuted fracture often with posterior displacement (retropulsion)
of fragments and potential cord damage

A

Burst fracture

74
Q

flexion distraction type of injury

A

Bilateral cervical facet dislocation

75
Q

Results from hyperflexion & traction and also reported buckling force to be
involved

A

facet dislocation

76
Q

If flexion/distraction injury occurs whilst cervical rotation is present- a
______ facet dislocation may occur.

A

unilateral

77
Q

may tear capsular ligaments leading to facet of the

above vertebra overriding or perched on the one below

A

Flexion/distraction force

78
Q

may be seen radiographically with

perched and dislocated facets

A

50% anterolisthesis of vertebral body

79
Q

Overriding facets may typically produce _______ appearance due to sudden facet ______ on lateral cervical view

A

“bow tie”, rotation

80
Q

Perched facet joint is a vertebral facet joint whose inferior articular
process appears to sit (perched) on the

A

ipsilateral superior articular

process of the vertebra below.

81
Q

Any further anterior subluxation will result in dislocation, becoming locked in this position leading to

A

“Jumped facets”

82
Q

will lead to overriding and “locked facets” frequently

seen in complete bilateral facet dislocation

A

“Jumped facets”

83
Q

commonly at C4-C7 with C6 (40%) cases

A

Cervical articular pillar fracture

84
Q

Fractures of the spinous process of a lower cervical vertebra (usually C7)

A

Clay-shoveler fracture

85
Q

usually an avulsion-pull fracture

A

Clay-shoveler fracture

often goes unrecognized

86
Q

seen on lateral views as an oblique lucency through the

spinous process, usually of C7

A

Clay-shoveler fracture

87
Q

flexion-distraction type injury of the spine that extends through to involve all three spinal columns

A

Chance (seat-belt) fracture

88
Q

Unstable injury and have a high association with intra-abdominal trauma
(esp. pancreatic and duodenal injury)

A

Chance (seat-belt) fracture

89
Q

occurs from a flexion injury of the vertebral body and distraction
type injury of the posterior elements

A

Chance (seat-belt) fracture

90
Q

back seat passenger restrained by a lap
seatbelt and involved in a motor vehicle accident or that of a person who
has fallen from a height

A

Chance (seat-belt) fracture

91
Q

TL junction (T12-L1) contributes to ___ % of cases of chance fracture

A

50%

92
Q

anterior wedge fracture of the vertebral body with horizontal
fracture through posterior elements or distraction of facet joints, disc and
spinous processes

A

chance (seat-belt) fracture

93
Q

modality of choice for chance fracture

A

CT scanning

94
Q

treatment for chance fracture

A

surgical or fibreglass plaster with some extension

95
Q

Radiographically anterior body narrowing and fracture through posterior elements

A

Chance (seat belt)

96
Q

Radiographic evaluation of “whiplash injury” is often

A

unrewarding

Artritis (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions