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Radiology > spine and skull > Flashcards

spine and skull Flashcards

1
Q
A

1st rib

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2
Q
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ankylosing spondytis

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3
Q
A

ankylosing spondytis

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4
Q
A

ankylosing spondytis

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5
Q
A

ankylosing spondytis

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6
Q
A

anterior arch of the atlas

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7
Q
A

atlanto-occipital dislocation

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8
Q
A

atlanto-occipital joint

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9
Q
A

atlas

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10
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axis

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11
Q
A

body of cervical vertebra

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12
Q
A

body of th axis

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13
Q
A

burst fracture

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14
Q
A

burst fracture

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15
Q
A

burst fracture

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16
Q
A

C7

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17
Q
A

cervical facets

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18
Q
A

A) vocal cord

B) intervertebral space

C) trachea

D) transverse process

E) spinous process

F) pedicle

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19
Q
A

cervical transverse processes

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20
Q
A

chance fracture

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21
Q
A

clay shovelers

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22
Q
A

compression fracture

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23
Q
A

compression fracture

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24
Q
A

compression fracture

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25
Q
A

dens

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26
Q
A

first rib

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27
Q
A

hangmans fracture

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28
Q
A

hangmans fracture

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29
Q
A

heart shadow

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30
Q
A

jefferson fracture

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31
Q
A

jefferson fracture

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32
Q
A

red: clay shovelers
blue: burst fracture with associated swelling

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33
Q
A

red: lipping
blue: calcification
green: spondlylolithesis

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34
Q
A

spondylolisthesis C4-5

lipping C5-6

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35
Q
A

abnormal lines in the cervical vertebral body and lamina

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36
Q
A

body, lamina, spinous process lines

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37
Q
A

latearl cervical MRI

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38
Q
A

soft tissue edema

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39
Q
A

A) atlanto-occipital joint

B) dens

C) posterior arch of the atlas

D) inferior facet of C2

E) transverse process

F) superior facet of C3

G) lamina of C5

H) intervertebral disc space

I) pedicle

J) spinous process of C6

K) C7

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40
Q
A

A) C1

B) body of the axis

C) posterior arch of the atlas

D) spinous process

E) transverse process

F) C7

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41
Q
A

lateral lumbar

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42
Q
A

thoracic body

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43
Q
A

thoracic pedicle

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44
Q
A

transverse process

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45
Q
A

spinous process

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46
Q
A

lumbar oblique

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47
Q
A

Left: thoracic scoliosis

right: lumbar scoliosis

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48
Q
A

pedicle

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49
Q
A

S1

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50
Q
A

spinous process

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51
Q
A

transverse process

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52
Q
A

lumbar body

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53
Q
A

lumbar burst fracture

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54
Q
A

CT

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55
Q
A

CT

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56
Q
A

lamina

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57
Q
A

body

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58
Q
A

pedicle

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59
Q
A

spinous process

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60
Q
A

metastatic disease

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61
Q
A

metastatic disease

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62
Q
A

metastatic disease

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63
Q
A

metastatic disease

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64
Q
A

metastatic disease

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65
Q
A

oblique C Spine

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66
Q
A

A) pedicles
B) intervertebral foramen
C) superior articulating facets
D) spinous processes
E) inferior articulating facets
F) 1st rib

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67
Q
A

odontoid fracture

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68
Q
A

open mouth CT

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69
Q
A

A) odontoid process
B) inferior facet of C1
C) atlanto-axial joint
D) superior facet of C2
E) spinous process

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70
Q
A

pagets disease

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71
Q
A

posterior arch of the atlas

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72
Q
A

scheurmans kyphosis

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73
Q
A

scottie dog

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74
Q
A

spondylolisthesis

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75
Q
A

spondylosis

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76
Q
A

swimmers

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77
Q
A

swimmers

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78
Q
A

C7

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79
Q
A

pedicle

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80
Q
A

thoracic scoliosis

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81
Q
A

C7 to T12

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82
Q
A

spinous process

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83
Q
A

transverse process

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84
Q

what views are used in the cervical spine

A
  1. AP
  2. lateral
  3. swimmers
  4. oblique
  5. flexion
  6. extension
85
Q

what three views are used in cervical trauma

A
  1. AP
  2. cross table lateral
  3. odontoid
86
Q

how should vertebrae look on x ray

A

stacked marshmellows

87
Q

what three alignments should be checked on an AP or lateral

A
  1. body alignment
  2. lamina alignment
  3. spinous process alignment
88
Q

how should the lateral edges of the spine look on edge

A

smooth rolling lines

89
Q

what are seven features to look for on a cervical xray

A
  1. size and symmetry of bodies
  2. normal alignments x3
  3. smooth lateral edges
  4. no fractures
  5. normal axis and atlas
  6. no large soft tissue mass
  7. normal disc spaces
90
Q

what three vertebrae must be included on a cervical X ray

A

C1, C7, T1

91
Q

soft tissue at C2 should be no thicker than _____

soft tissue at C6 should no thicker than _____

A

6mm

2cm

92
Q

when should a swimmers view be done

A

when the shoulder doesn;t allow a clear picture of C7-T1

93
Q

when would someone do a cervical oblique

A

when there is a suspected facet issue

94
Q

when would someone use an open mouth view

A

to see the dens

95
Q

what are some issues to look for in an open mouth xray

A

is the dens a normal size

are there equal and normal spaces around the dens

96
Q

what are two reasons someone might do a lateral flexion/extension view

A
  1. checking for rheumatological disease
  2. checking to see if the patient can be intubated
97
Q

what two view are normally done in the thoracic spine

A

AP and lateral

98
Q

when examining a thoracic x ray what are five issue to look for

A
  1. step deformity
  2. midline spinous processes
  3. spinous processes eqidistant from both pedicles
  4. evenly space sternoclavicular joints
  5. equal disc spaces
99
Q

what structures should be included in a thoracic xray

A

C7-L1, all transverse process, at least part of all the ribs

100
Q

what is a lateral thoracic useful for

A

looking for scoliosis and compression fractures

101
Q

what five views are used in the lumbar spine

A
  1. AP
  2. lateral
  3. oblique
  4. flexion
  5. extension
102
Q

what structures should be included in a lumbar xray

A

L1-S1

103
Q

what is the oblique lumbar view used for

A

to look for spondylolysis

104
Q

par interarticularis

A

the portion of the lamina between the superior and inferior articular processes

105
Q

what is CT used for in the spine

A
  1. look for bony abnormalities
  2. rule out C spine fracture
  3. when MRI is not an option
106
Q

what is MRI useful for in the spine

A
  1. look for soft tissue deformity
  2. no radiation
107
Q

T/F contrast should be used on an MRI if the patient has undergone surgery or there is a history of cancer/chemotherapy

A

true

108
Q

what are some metallic implants that would not permit MRI

A
  1. aneurysm clips
  2. pace makers
  3. ocular foreign bodies
  4. metal cardiac valves
109
Q

what are seven unstable cervical spine fractures

A
  1. atlanto-occipital dislocation
  2. facet joint dislocation
  3. hangmans
  4. hyperextension fracture
  5. burst
  6. jeffersons
  7. odontoid
110
Q

what are the stable fractures of the cervical spine

A
  1. clay shovelers
  2. wedge
111
Q

what are the unstable fractures of the lumbar and thoracic spine

A
  1. chance fracture
  2. burst fracture
112
Q

what are the stable fractures of the lumbar and thoracic spine

A
  1. wdge
  2. spinous process fracture
  3. spondylolysis
  4. spondylolisthesis
113
Q

three types of facet joint dislocation

A
  1. subluxed
  2. perched
  3. locked
114
Q

what is the difference between subluxed, perched, locked facets

A

subluxed is just some slippage

perched means complete subluxation but not jumped

locked means the superior facet has slid anterior over the inferior facet

115
Q

what happens in a hangmans fracture

A

there is bilateral pedicle fracture at C2 which pushes C2 anteriorly

116
Q

what will a hangmans fracture feel like on palpation

A

a step off at C1-2

117
Q

what happens in a jeffersons fracture

A

the atlas “smooshes” due to an axial force applied to the top of the head

118
Q

what will a jefferson fracture look like on imaging

A

a C1 with splayed out lateral masses and too much space around the odontoid

119
Q

what are the three grades of an odontoid fracture

A
  1. just the tip
  2. through the odontoid
  3. fracture through the base of the odontoid into the body of C2
120
Q

what kind of odontoid fracture is most unstable

A

grade two

121
Q

what is a clay shovelers fracture? how is it caused

A

a spinous process fracture at C6 or 7

commonly found secondary to a flexion injury

122
Q

what is the key indication of a burst fracture

A

parts of the body will be pushed back

123
Q

T/F an xray is all that is needed to assess burst fracture

A

false, if a burst fracture is suspected a CT should be done

124
Q

what two fractures are common with a patient who jumped from a height and landed on their feet

A

lumbar burst fracture and calcaneus fracture

125
Q

how can a compression fracture be differentiated from a burst fracture

A

they are less traumatic and the defect doesnt push the body back

126
Q

what are four possible conditions that wold lead to a compression fracture

A
  1. osteoporosis
  2. osteomalacia
  3. pagets disease
  4. multiple myeloma
127
Q

osteomalacia

A

inadequate phosphorus, calcium, and vitamin D in blood that leads to softening of bone

128
Q

pagets disease

A

a nonmetabolic bone disease that is characterized by excessive bone destruction and repair

129
Q

what will pagets disease look like on xray

A

vertebrae with white streaks of hypertrophied bone next to areas of decreased bone density

130
Q

multiple myeloma

A

malignant neoplasm of the bone marrow, usually looks like a punched out lesion in bone

131
Q

T/F multiple myeloma often present with compression fracture

A

true

132
Q

chance fracture

A

a fracture through the spinous process into the vertebrae

133
Q

how do chance fractures hapen

A

hyperflexion with the leg immobilzed (child with a lap belt)

134
Q

how will a chance fracture look on a lumbar AP

A

a missing spinous process

135
Q

spondylolysis

A

a defect in the pars interarticularis that can cause sponylolisthesis

136
Q

spondylolisthesis

A

a movement of one vertebrae in relation to the inferior vertebrae common in L5-S1

137
Q

what sign is indicative of spondylolysis

A

a “scottie dog” with a collar or broken neck

138
Q

how many grades of spondylolisthesis are there? what are they indicative of

A

4

  1. grade 1: 1/4 slippage
  2. grade 2: 1/2
  3. grade 3: 3/4
  4. grade 4: completely slipped off
139
Q

sclerotic change to a disc

A

hardening and osteophyte formation

140
Q

how will a calcified disc look on xray

A

hazy white instead of dark gray

141
Q

lipping

A

osteophyte formation that forms a narrow disc space with lips

142
Q

ankylosing spondylytis

A

a chronic inflammatory condition that results in the vertebrae growing together around disc spaces

143
Q

what is the difference between ankylosing spondylitis on xray

A

lipping is osteophyte formation, AS will cause syndesmophyte formation with smooth edges

144
Q

what sign is indicative of ankylosing spondylitis on xray

A

bamboo spine, squared vertbrea with smoothed disc spaces

145
Q

scheurmans kyphosis

A

anterior wedging of the thoracic vertbrae, common in adolescent boys

146
Q

what is the diagnostic criteria for scheurmans kyphosis

A

3 consecutive vertbrae with +5deg of wedging

147
Q

what is the main factors determining what type of treatment is best for scheurmans kyphosis

A

how much time there is availible for bracing based on the patients age

148
Q

how will metastatic disease present itself on xray

A

can be moth eaten or ivory vertbrae

149
Q

what types of cancer metastases are common with ivory vertbrae

A

prostate and breast cancer

150
Q

what types of metastases present with a moth eaten or punched out vertebrae

A

breast, multiple myeloma

151
Q
  1. what is this?
  2. what is it indicative of?
  3. what view is this in?
A
  1. air fluid interface in the left maxillary sinus
  2. fluid or tumor in the right sinus
  3. waters
152
Q
  1. what is this?
  2. what is happening?
A
  1. basilar skull fracture with hemotympanum
  2. blood from the skull fracture is collecting behind the ear
153
Q
A

basilar skull fracture

154
Q

what is this? what might cause this

A

battle sign

basilar skull fracture

155
Q
  1. what is this?
  2. what might cause this?
  3. what bones are fractured to cause this
A
  1. a blowout fracture
  2. a blow to the orbit
  3. the zygomatic/maxillary bone
156
Q
  1. what is this
  2. name a two likely causes
A
  1. a blowout fracture
  2. a racquet ball to the face, MVA
157
Q

what would make this happen?

A

a blowout fracture that traps the inferior rectus so it can’t contract to move the eye up

158
Q

what is happening here? how can you tell?

A

bony destruction caused by infection or neoplasm

because the septum and nasal concha are gone

159
Q

what view is this

A

caldwell/AP

160
Q
A

coronal suture

161
Q
A

coronoid process

162
Q
A

crista galli

163
Q

what is this? what complications come from this?

A

depressed skull fracture

increased intracranial pressure and hemorrhage

164
Q

what is this? how can you tell

A

epidural hematoma, because it is more lens shaped than flat

165
Q
A

epidural hematoma

166
Q
A

ethmoid

167
Q
  1. what are the arrow indicating?
  2. why would this be abnormal?
  3. what is causing this?
A
  1. falx cerebri
  2. they are deviating to the left
  3. increased intracranial pressure
168
Q
A

floor of the sella turcica

169
Q
A

frontal sinus

170
Q
A

greater wing of the sphenoid

171
Q

what is this?

what would cause this?

A

hemotympanum

basilar skull fracture

172
Q
A

inferior nasal concha

173
Q
A

inferior nasal concha

174
Q
A

lacrimal bone

175
Q
A

lambdoidal suture

176
Q
A

maxilary sinus

177
Q
A

frontal sinus

178
Q
A

right and left ventral horns

179
Q
A

linear skull fracture

180
Q
A

mandibular condyle

181
Q
A

maxillary sinus

182
Q
  1. what are these?
  2. what do they represent?
  3. what is a common cause?
A
  1. oil droplets
  2. areas of bone destruction
  3. multiple myeloma
183
Q
A

optic sulcus

184
Q
A

orbital roof

185
Q

what view is this

A

panorex

186
Q

what is this called? what might you suspect if you see this?

A

raccoons sign

basillar skull fracture

187
Q
A

ramus of the mandible

188
Q
A

sinusitis

189
Q
A

scalp hematoma

190
Q
A

sinusitis

191
Q
A

sphenoid sinus

192
Q
A

sphenoid sinus

193
Q

what is this?

what is happening?

A

subdural hematoma

blood is collecting in the subdural space

194
Q

what view is this? what is it used for?

A

townes

looking at the back of the skull

195
Q

what view is this? what is it used for

A

waters

getting better look at the frontal and maxillary sinuses and the orbital floor

196
Q
A

zygomatic bone

197
Q

what are the maxillary sinuses hard to evaluated on an AP/caldwell?

A

because the beam has to pass through the skull and brain

198
Q

what is a lateral skull xray best for?

A

looking for fracture lines

199
Q

when taking a townes view, how is the head positioned

A

the head stay neutral but the beam is directed at an angle

200
Q

how are the teeth numbered in a panorex view

A

top row, left to right, 1-16

bottom row, right to left, 16-32

201
Q

what is the most common skull fracture? is it considered serious

A

linear

no, other than there may be a bleed associated with it

202
Q

why are depressed skull fractures serious?

A

they are more likely to involved injury to the brain

203
Q

what is the most serious type of skull fracture

A

basillar

204
Q

what physical exam findings might indicate a basilar skull fracture

A
  1. CSF leak from the nose or ears
  2. hemotympanum
  3. raccoon sign
  4. battle sign
205
Q

what should be in the maxillary sinus?

if there is an interface, what might you suspect is the cause

A

mostly air, no fluid interface

blood in the sinus, sinusitis, or tumor

206
Q

what is the primary indication of sinusitis

A

thickened nasal concha

207
Q

what are two possible causes of bony destruction of the septum or sinuses?

A
  1. funal infection
  2. cancer
208
Q

how can you typically tell the difference between a epidural and subdural hematoma

A

epidurals are more of a lens shape

subdural is more of a crescent shape

209
Q

what percent of epidural hematomas are associated with skull fractures? where are they most common?

A

95%

unilateral temporoparietal region

Radiology (14 decks)

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