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Radiology > Spine > Flashcards

Spine Flashcards

1
Q

Modalities for spine imaging.

A

Plain films
CT
MRI
Myelography

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2
Q

What is when contrast is put in the spinal canal?

A

CT myelogram

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3
Q

what can happen with neck chiropractic manipulation?

A

Dissection of vertebral arteries

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4
Q

how many views should you get for trauma?

A

At least 2 views

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5
Q

For a cervical spine, what spinal levels should you get imaging done to at least

A

T1

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6
Q

What is the views for cervical spine usually?

A

cross table lateral to top of T1
AP
open mouth odontoid (C1 and C2)

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7
Q

If you cant see T1 what should you do?

A 
Pull down the shoulder (gently) 
Swimmers view (have pts arm up so you can see C1 and C2)
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8
Q

A cross tabel lateral x-ray will show how much of cervical spine injuries?

A

85-90%

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9
Q

In alignment of cervical spine, where does the first line merge?

A

With the anterior aspect of the peg

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10
Q

In alignment of cervical spine, where does the second line merge?

A

With the posterior aspect of the peg

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11
Q

What should the distance b/w the anterior arch of C1 and the odontoid peg be in adults?

A

3 mm in adults

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12
Q

What should the distance b/w the anterior arch of C1 and the odontoid peg be in children?

A

5 mm in children

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13
Q

What is the name for the ring of C1?

A

Harris ring

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14
Q

Distances between spinous processes should be what?

A

Roughly equal

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15
Q

What can mimic a fracture on the base of the peg? (Mach effect)

A

Incisors
Occiput
Soft tissues

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16
Q

When should you use the swimmer’s view?

A

when the shoulders limit evaluation of the lower C spine and it’s relationship with T1

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17
Q

What type movement causes a odontoid fracture?

A

Hyperflexion

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18
Q

What are the 5 unstable fractures?**

A 
Jefferson fracture
Hangman’s fracture
Flexion teardrop
Extension teardrop
Bilateral locked facets.
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19
Q

What is an avulsion fracture of spinous process of C6 or C7 called?

A

Clay Shoveler’s Fracture

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20
Q

How does a clay shoveler’s fracture occur?

A

Results of rotation of trunk relative to neck

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21
Q

What causes a Jefferson fracture?

A

Axial loading force on occiput of the head
Ex- diving into a shallow pool
usually not associated w/ neurologic defect

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22
Q

What is a hyperextension injury most common at C2. Not associated w/ neurologic deficit.

A

Hangmans fracture

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23
Q

What type of liagmentous injury is an unstable fracture?

A

Locked facets (50% subluxation)

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24
Q

What is a visual sign of a unilateral locked facet?

A

Spinous processes do not line up on a frontal film

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25
Q

What are the three types of odontoid fractures?

A

Type 1- Tip
Type 2- waist
Type 3- base
(Type 2 and 3 are unstable)

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26
Q

What causes a flexion teardrop fracture?

A

Combination of flexion and compression

fragment comes from the anteroinferior aspect of the body

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27
Q

What causes an extension tear drop fracture?

A

Hyperextension causes a triangular fragment to be avulsed off the antero-inferior corner of the vertebral body

28
Q

Which teardrop fracture is associated with neurological damage?

A

flexion- teardrop fracture

29
Q

When is an injury to the thoracic spine considered unstable?

A

An injury to the thoracic spine is unstable if two of the three columns are disrupted.
If middle is involved, anterior or posterior often is too

30
Q

What is a wedge fracture?

A

Vertebral body that is compressed and looks like a wedge

31
Q

Where do most wedge fracture occur?

A

T11, T12, L2

although verbally he said it is more likely L1 and L2

32
Q

In what type fracture are there Vertebral body explodes outward
Loss of concavity of the posterior vertebral cortex

A

burst fracture

33
Q

Is there neurological deficit with a burst fracture?

A

yes, high probability

34
Q

What causes chance fracture?

A

Seat belts w/o shoulder aspect

Horizontal fracture though vertebral body, laminae, pedicles, and spinous process

35
Q

if you find a fracture in one part of the cervical spine is there a possibility that you could have a second fracture?

A

yes

36
Q

These are all things you should look for after what?

Loss of height or wedging
Fragments of bone detached from the anterior Aspect of a vertebral body
More than one abnormality
Posterior cortex should be slightly concave

A

MVA

37
Q

What is a procedure that supports a compressed vertebral body?

A

Vertebroplasty (super glue)

kyphoplasty (balloon)

38
Q

What is this type of pain: sharp, shooting and confined pain confined to a narrow band. Originates from a irritation of the spinal nerve or its roots.

A

Radicular

39
Q

What is a conduction block associated with numbness or weakness in the nerve roots distribution?

A

randiculopathy

40
Q

What is this- “deeper and broader with an aching quality. Difficult to localize. Different senory neurons are involved for what ever reason. Use pain diagram?”

A

referred pain

41
Q

What is a good imaging place to start with degenerative changes?

A

X-rays

42
Q

What is myelography mostly used for now?

A

Individuals who can’t undergo an MRI

43
Q

bony things are better seen with what type of imaging technique?

A

CT

44
Q

What is your imaging of choice for degenerative changes?

A

MRI

45
Q

what is when a “marshmallow is squeezed and pushed out” Annular fibers have gotten lax and the marshmallows expands

A

Disc bulge

46
Q

What is when there is a focal part of a disc bulge?

A

Disc protrusion

47
Q

What is where the length of the disc material extending beyond its margin is greater than the waist?

A

Disc extrusion

48
Q

Do nerve roots like to be touched?

A

No

49
Q

What is the name of this syndrome; Bilateral lower extremity symptoms
Pain and/or weakness
Saddle anethesis
Urinary incontinence

A

Cauda equina syndrome

50
Q

What may cause cauda equina syndrome?

A

Disc herniations

51
Q

What do you do for cauda equina syndrome?

A

Immediate imaging and treatment!!

52
Q

Fracture than maybe acute or chronic that extends from the inferior facet across the pars interarticularis to the superior facet

A

Spondolysis

53
Q

Forward displacement of the vertebra upon one another.

A

Spondolisthesis

54
Q

What improves spinal stenosis?

A

Flexion, sitting, riding a bike, walking up hill

55
Q

When is spinal stenosis worse?

A

Extension

56
Q

What is the clinical presentation of spinal stenosis?

A

Back pain and sciatica

57
Q

Why do you often image a post operative spine?

A

no relief of symptoms
patient didn’t get the results they expected (not operated at on right level)
Lawsuits

58
Q

What 4 problems are associated with neurological deficit?

A

flexion teardrop fracture
locked facets (85% neurologic deficits)
Unilateral locked facets (30% neurologic deficits)
Burst Fracture

59
Q

What are 2 key things in identifying whiplash?

A

sprain or intervertebral disk injury WITHOUT fracture/dislocation

Normal curvature reduced/reversed

60
Q

Is a posterior neural arch fracture more likely to occur bilaterally or unilaterally?

A

bilaterally

61
Q

What don’t you do an oblique view for the cervical spine trauma?

A

because the patient has to turn their head

62
Q

Whats the main difference between flexion teardrop and extension teardrop?

A

flexion is associated with neurological deficit (70%) and extension is not

63
Q

What can a burst fracture sometimes be mistaken for?

A

anterior wedge fracture

64
Q

In plain films, what are oblique radiographs good for evaluating?

A

foraminal stenosis

65
Q

What imaging technique is good for spinal canal stenosis?

A

myelography

66
Q

What are some causes of disc degeneration?

A

disk space narrowing, dehydration, annular fissures, subchondral marrow changes, osteophyte formation

67
Q

T/F: Spondolysis never leads to spondylolisthesis.

A

False: spondolysis may lead to spondylolisthesis

Radiology (11 decks)

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