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Image interpretation theory > spine > Flashcards

spine Flashcards

1
Q

which muscle attaches to the ASIS

A

sartorius muscle

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2
Q

which muscle attaches to AIIS

A

rectus femoris

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3
Q

what is shenton’s line

A

runs anatomically along the medial edge of the femoral neck and the inferior edge of the superior pubic ramus

interruption of shenton’s line may suggest a NOF fracture in adults or DDH in children

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4
Q

type of stable fractures

A

iliac wing fracture
sacrum fracture
superior and inferior pubic ramus fractures

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5
Q

type of unstable fracture

A

lateral compression fracture with the pelvis pushed inward

anterior-posterior compression fracture

vertical shear fracture with one half of the pelvis shifted upward

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6
Q

normal SI joint anatomy

A

width approx equal

inferior margin of iliac bone lines up with the inferior aspect of sacral part of the joint on both sides

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7
Q

normal SP anatomy

A

no widening (<5mm)
superior margins at about the same level

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8
Q

types of intra-capsular fractures

A

located at the NOF
- subcapital
- transcervical
- basicervical

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9
Q

type of extra capsular fractures

A

located below the intertrochanteric line
- intertrochanteric
- subtrochanteric

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10
Q

cervical spine AP peg view checklist

A
  • alignment of the lateral margins of C1 with the adjacent lateral margins of C2
  • equal spaces on each side of the peg
  • any fracture line across base of the peg
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11
Q

common conditions and injuries of the lumbar spine

A

spondylolisthesis
spondylosis
spondylolysis
ankylosing spondylitis
wedge fracture
burst fracture
chance fracture
spinal metastases

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12
Q

what does the anterior column of spine consist of

A
  • anterior longitudinal ligament
  • anterior annulus fibrosis
  • anterior 2/3 vertebral body
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13
Q

what does the middle column of spine consist of

A
  • posterior longitudinal ligament
  • posterior annulus fibrosus
  • posterior 1/3 vertebral body
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14
Q

what does the posterior column of spine consist of

A

posterior elements
- pedicles, facets
- lamina
- spinous process

posterior ligaments

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15
Q

what is considered stable spinal fracture

A

affects one column only

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16
Q

what is considered unstable fracture

A

affect 2 or more columns

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17
Q

what is spondylolisthesis

A

displacement of vertebra over another
caused by trauma, natural degenerative changes (spondylosis))
grading
- grade I: displacement up to 25%
- grade II: 25-50%
- grade III: 50-75%
- grade IV: 75-100%

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18
Q

what is spondylolysis

A
  • fracture of the pars interarticularis
  • most common in lower lumbar vertebrae
  • may develop spondylolisthesis
19
Q

what is spondylosis

A

osteoarthritis of spine
narrowing of the intervertebral disc space
osteophytes
intervertebral foramina stenosis

20
Q

what is ankylosing spondylitis

A

form of arthritis which causes inflammation of the spine
calcification of anterior and posterior longitudinal ligaments and intervertebral discs
fusion of spine

21
Q

what is spine metastases

A

spread of malignant cancer cells to the spine
lytic or sclerotic lesion
“winking owl sign”
- destruction of the pedicles

22
Q

at what age do ASIS apophysis appear and fuse to skeleton

A

appear: 13-15
fuse: 21-25

23
Q

at what age do AIIS apophysis appear and fuse to skeleton

A

appear: 13-15
fuse: 16-18

24
Q

at what age do iliac crest apophysis appear and fuse to skeleton

A

appear: 13-15
fuse: 21-25

25
Q

at what age do ischial tuberosity apophysis appear and fuse to skeleton

A

appear: 13-15
fuse: 20-25

26
Q

at what age do greater trochanter apophysis appear and fuse to skeleton

A

appear: 2-3
fuse: 16-17

27
Q

at what age do lesser trochanter apophysis appear and fuse to skeleton

A

appear: 11-12
fuse: 16-17

28
Q

difference between male and female pelvis

A

male:
narrower and less flared
oval or heart shaped
angle of pubis arch is <90deg

female:
broader
has round pelvic inlet
angle of pubic arch is >90deg

29
Q

what landmarks can be seen in a judet’s view

A

ilioischial line (posterior column)
anterior acetabular wall
roof of acetabulum
iliac crest

30
Q

what landmarks can be seen in an obturator oblique view

A

iliopectinal line
posterior acetabuluar wall
roof of acetabulum
obturator foramen

31
Q

what are the blood supplies to the capsule of femur

A

deep femoral artery –> medial and lateral circumflex femoral artery

32
Q

risk factors of pelvic injuries

A

osteoporosis
ageing
excessive alcohol consumption
physical inactivity
visual impairment
female

33
Q

causes of fractures of pelvis

A

high energy trauma
bone insufficiency
avulsion fracture

34
Q

how should the assessment of AP pelvis be

A
  1. scrutinise both the inner and outer contours of the main pelvic ring
  2. two small rings forming the obturator foramina
  3. widths of SI joints should be equal
  4. superior surfaces of the body of each pubic bone should align; width should not exceed 5mm
  5. sacral foramina and arcuate lines should have smooth surface
  6. region of acetabulum
  7. check apophyses in adolescents and young adults
35
Q

pitfall of acetabulum

A

Os acetabuli
- small bone ossicle at the superior margin of the acetabular rim is a common finding
- represents either unfused ossification centre or an impingement effect from a longstanding injury

36
Q

how to assess a lateral cervical spine

A
  1. technical quality - include C1-7
    - C1 to C2 articulation
    - superior surface of T1
  2. identify the anterior arch of C1
  3. position of anterior cortex of odontoid and the coffee bean
  4. alignment of
    - anterior cortex of peg with anterior cortex of C2
    - posterior cortex of peg with posterior cortex of C2
  5. normal
    - Harris’ ring
    - posterior arches of C1 and C2
    - C3 to C7
    - 3 main contour lines
    - pre-vertebral soft tissues
37
Q

how to assess AP thoracic and lumbar spines

A
  1. alignment of vertebral bodies and spinous process
  2. check for loss of vertebral height
  3. check the vertebral disc spaces
  4. check the vertebral end plates
  5. trace the posterior elements
    - pedicles
    - laminae
    - spinous processes
  6. ensure the vertebral and spinous processes are intact
  7. no visible paraspinal line
  8. check for fracture of transverse process
38
Q

what is the width of pre-vertebral soft tissue in the cervical

A

C1-4 = 7mm
C5-7 = 22mm

any bulge or local increase in width suggest of haemorrhage

39
Q

what is the normal measurement of the alantodental interval

A

<3mm un adults
<5mm in children

40
Q

how does normal C3 to C7 look like

A
  • fairly uniform in square or rectangle shape
  • anterior and posterior vertebral body should be about the same height
41
Q

how does a normal harris ring look like

A

appears slightly incomplete at its inferior and superior aspects

disruption in anterior or posterior ring is suggestive of either fracture of the base of peg or C2 body fracture

42
Q

how to assess AP cervical spine

A

alignment of lateral margins of C1 with adjacent lateral margins of C2

equal spaces on each side of the peg

check for any fracture line across the base of peg

alignment of spinous process should lie mid-line and have equal amount of space between

the lateral masses of the vertebra should be aligned smoothly

43
Q

how to assess lateral lumbar and thoracic spine

A
  • height of vertebral body
  • check 3 columns
  • fragment of bone detached from the anterior aspect of a vertebral body
  • check for more abnormalities
44
Q

3 main contour lines to assess lateral cervical xray

A

anterior vertebral line
posterior vertebral line
spinolaminar line

(extra: posterior spinous line)

Image interpretation theory (5 decks)

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