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Fundamentals of Imaging > Spinal Trauma > Flashcards

Spinal Trauma Flashcards

1
Q

In the cervical spine, what radiographic view must be cleared first for stability before other views are attempted?

A

Lateral cervical view

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2
Q

What views should you NOT perform before ruling out spinal injury?

A

Flexed and extended views

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3
Q

What kind of imaging is often required to fully evaluate cervical spinal injury?

A

Reconstructed CT scanning w/out contrast

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4
Q

What kind of imaging will provide information about neurological and soft tissue damage?

A

MRI

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5
Q

What is the upper limit of soft tissue evaluation of C6-C7?

A

22mm

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6
Q

What is the upper limit of soft tissue evaluation of C2?

A

7mm

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7
Q

How much of the soft tissue thickness at C2 should be less than in relation to the vertebral body width?

A

<50% of vertebral body width

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8
Q

T/F: Loss of cervical lordosis is not a reliable indication of injury?

A

True

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9
Q

What are the 4 lines to reliably evaluate the cervical spine?

A

Anterior vertebral line
Posterior (George’s) vertebral line
Spinal Laminar line
Posterior Spinous Process line

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10
Q

What may strongly indicate disruption of the PLL, capsular and interspinous ligaments?

A

Posterior disc space widening and fanning of the spinous processes

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11
Q

At what levels of the spine may disruption of the PLL, capsular and interspinous ligaments typically occur?

A

C3-C6

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12
Q

Where does the odontoid process lean in order for you suspect an odontoid fracture?

A

Anteriorly

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13
Q

What classification system indicates if a spinal fracture is stable or unstable?

A

3-column Denis classification system

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14
Q

If only 1-column is injured, is the fracture stable or unstable?

A

Stable

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15
Q

If 2 or more columns are injured, is the fracture stable or unstable?

A

Unstable

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16
Q

T/F: the more mobile the cervical spine is, the less stable it is

A

True

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17
Q

What is the most common fracture of the Atlas?

A

Bilateral fracture of the posterior arch of C1

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18
Q

How does a bilateral fracture of the posterior arch of C1 come about?

A

extension/compression of the C1 arch by the occiput

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19
Q

What is a burst fracture of C1 and represents an osseous ring that ossifies between 3-6 years of age?

A

Jefferson Fracture

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20
Q

How does a Jefferson fracture come about?

A

“diving head first” compression of occipital condyles into lateral masses of C1

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21
Q

What does an APOM view of a Jefferson Fracture indicate?

A

C1 overhanging masses

22
Q

How much overhanging of the masses of C1 need to happen in order to suspect transverse ligament damage and marked instability of a Jefferson Fracture?

A

> 6mm

23
Q

What type of odontoid process fracture involves avulsion of the tip?

A

Type 1

24
Q

What type of odontoid process fracture is the most common and most unstable through the base of the odontoid process?

A

Type 2

25
Q

What ligament may be affected with a Type 2 odontoid process fracture?

A

Cruciate ligament

26
Q

What type of odontoid process fracture is through the base into the body and lateral masses and carries best healing potential due to greater fracture surface
and vascularization?

A

Type 3

27
Q

What type of fracture is a traumatic spondylolisthesis of C2 and is 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

28
Q

In a Hangman’s fracture, what is an extension teardrop fracture caused by?

A

Avulsion of ALL

29
Q

What kind of fracture is due to hyperextension of the Cervical spine which may cause avulsion of the inferior-anterior corner of the vertebral body (ALL)?

A

Extension teardrop fracture

30
Q

Is an extension teardrop fracture stable or unstable in flexion?

A

Stable

31
Q

Is an extension teardrop fracture stable or unstable in extension?

A

Unstable

32
Q

What type of fracture typically occurs from severe flexion and compression with anterior cord damage that may develop due to posterior displacement of vertebral body fragments?

A

Flexion teardrop fracture

33
Q

How many people would be paralyzed at the time of a flexion teardrop fracture?

A

> 80%

34
Q

What vertebral levels are the most common with flexion teardrop fracture?

A

C5-C6

35
Q

Where on the vertebral body do wedge compression fractures most commonly occur?

A

anterior body aspect

36
Q

What kind of fracture are wedge fractures considered to be?

A

Single-column fracture

37
Q

What part of spine do you typically see wedge compression fractures?

A

Thoracic and T/L region

38
Q

What type of fractures are a 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

39
Q

When it involves the thoracolumbar level, what vertebral levels do burst fractures typically involve?

A

T9-L5

40
Q

How does a burst fracture come about?

A

High energy axial loading

41
Q

What results from hyperflexion and traction and also reported buckling force to be involved and is a flexion/distraction type of injury?

A

Bilateral cervical Facet dislocations

42
Q

How does a unilateral facet dislocation occur?

A

Flexion/distraction with cervical rotation

43
Q

On a lateral cervical view, what appearance do overriding facets produce with facet dislocation due to sudden facet rotation with a unilateral facet dislocation?

A

Bow tie appearance

44
Q

What is a vertebral facet joint whose inferior articular process appears to sit on the ipsilateral superior articular process of the vertebra below?

A

Perched facet joint

45
Q

What is a fracture of the spinous process of a lower cervical vertebra (usually C7), and are usually an avulsion-pull fracture?

A

Clay-shoveler fracture

46
Q

What type of fracture is a flexion-distraction type injury of the spine that extends through to involve all three spinal columns and has a high association with intra-abdominal trauma?

A

Chance fracture

47
Q

What is the most common history presented with a Chance fracture?

A

Back seat passenger restrained by a lap seatbelt

48
Q

What spinal level does a Chance fracture come up in 50% of the cases?

A

Thoracolumbar junction (T12-L1)

49
Q

What type of imaging would you order for a Chance fracture?

A

CT

50
Q

T/F: radiographically, a chance fracture is an anterior wedge fracture of the vertebral body with horizontal fracture through posterior elements or distraction of facet joints, disc and spinous processes

A

True

51
Q

T/F: Radiographic evaluation of “whiplash injury” is often unrewarding

A

True

Fundamentals of Imaging (16 decks)

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