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Troxell Intern Notes > Spinography > Flashcards

Spinography Flashcards

1
Q

12 signs of posteriority on the lateral x-ray:

A
  • visual posteriority
  • anterior coccyx
  • posterior S2 tubercle
  • BP sacrum
  • spondylo
  • stair-stepping
  • stacking
  • Schmorls node
  • eburnation
  • exostosis
  • disc degeneration
  • hour glassing
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2
Q

What is true about X-ray distortion?

A

distortion can alter the degree in which the vertebrae appear to be misaligned but does NOT alter the direction

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3
Q

How does C1/C0 misalignment affect the spinal canal?

A

AS–>canal smaller

PS–>canal is larger

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4
Q

For every 5mm of ___ misalignment, the femur head will be 2mm lower

A

PI or EX

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5
Q

For every 5mm of ____the femur head will be 2mm higher

A

AS or IN

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6
Q

For every 5mm of ____ correction, the femur head will be raised 2mm

A

PI or EX

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7
Q

For every 5mm of ____correction, the femur head will be lowered 2mm

A

AS or IN

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8
Q

What is the most important change the AS ilium undergoes, when analyzing the x-ray?

A

decrease innominate measurement compared to the PI side

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9
Q

How does the distance between PSISs change in relation to IN/EX ilium?

A
  • IN–> closer to center of sacrum

- EX–>further to center of sacrum

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10
Q

When is the optimal relationship between 2 vertebrae found?

A
  • when the perimeters of the bodies are in line
  • the vertical distance between opposing surfaces of the bodies are the same at ALL points (parallel discs) allowing for nucleus to act as a pivotal ball bearing joint
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11
Q

Why do vertebra in C spine appear non-parallel

A
  • posterior lipping of subjacent vertebra

- lateral uncinate processes

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12
Q

When the axis/atlas plane lines are not parallel, what can you infer?

A
  • atlas has gone anterior–>lateral film

- side of laterality–>A-P film

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13
Q

How much rotation of the sacrum needs to be present in order to list it?

A

Greater or equal to 7mm

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14
Q

How do you determine a base posterior sacrum?

A

look at lateral x-ray

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15
Q

Compare the Sacrum to L5–>sacrum will be posterior to L5

A

L5 disc wedge open to posterior

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16
Q

How do we measure the degree of an ilium misalignment on the AP x-ray?

A

we measure the differences in mm and write them as subscripts

17
Q

2 contradictions to x-ray:

A
  • pregnancy

- radiation exposure

18
Q

Normal sacral angle:

A

35-40 degrees

19
Q

What are 20 indiations to X-ray?

A
  • Pathology
  • Anomaly
  • Fracture
  • Dislocation
  • Malformation
  • Accurate count
  • Segmental relationship
  • Spinal contour
  • Exact relation of adjacent segments
  • Specific listings
  • Disc condition
  • Disc spatial relationship to level
  • Surrounding tissue
  • Motion studies for biomechanics of disc under stress
  • Prosthesis
  • Posture analysis
  • Progress change
  • Patient education
  • Court cases
  • Because every spine is different
20
Q

3 ways to determine atlas rotation?

A
  • measuring lateral masses
  • measuring radiolucency on medial borders of lateral masses
  • atlas/occiput condyle lines will converge on side of anterior rotation
21
Q

4 reasons why we use/prefer full-spine films:

A
  • Less radiation than sectionals
  • Provide accurate vertebral count
  • Provide full spinal contour for posture analysis w/axial weight-bearing
  • Shows problems other than chief complaint
22
Q

14 reasons to take a full spine x-ray over a sectional x-ray

A
  • 2 films
  • 3 exposures
  • less radiation
  • less film cost
  • time
  • full spine contour
  • exact relation of adjacent segments
  • posture analysis
  • accurate count of segments
  • good for patients that can’t stand long
  • much easier to read
  • much easier to analyze
  • less chance for mistakes
  • better for patient education
23
Q

3 ways to list body rotation in order of reliability:

A
  • width of articular process–> lesser width on side of spinous rotation:: L5 especially
  • Pedicle Shadows:: rest of spine
  • Spinous rotation:: least reliable
24
Q

How do you determine vertebral wedging on AP x-ray?

A
  • vertebral endplates
  • superior junction of TVP and body
  • superior/inferior pedicle borders
25
Q

Which term describes the actual difference in length of the patient’s leg?

A

Actual or anatomical deficiency

26
Q

Which term describes the difference in height of the 2 femur heads as they appear on A-P film?

A

Measured deficiency

27
Q

What measurement is used to determine leg length PRE-adjustment?

A

Measured deficiency

28
Q

What measurement is used to determine leg length POSTadjustment

A

Actual/Anatomical deficiency

29
Q

What is the allowable yearly dose for radiation workers?

A

5 rem

30
Q

How much radiation does one get from full spine x-rays (A-P & lat.)?

A

2mrem

31
Q

3 considerations when the ilia are not equal on the x-ray?

A
  • pathological or congenital condition
  • poor positioning on the x-ray
  • misalignment of the pelvis
32
Q

Tube distance of full spine x-rays:

A
  • Lateral 72’’ FFD

- AP 84’’ FFD

33
Q

Film size of full spine x-rays:

A
  • Lateral- 2 exposures 14’’ X 18” film each

- AP - 1 exposure, 14’’ X 36” film

34
Q

How many mm of deficiency is the body able to adapt to?

A
  • <6mm

- >6mm causes subluxations

35
Q

How often will a thoracic vertebra show inferiority on film?

A
  • Rarely

- because of the ribs and their ligament that bind to the thoracic spine

36
Q

When occiput is subluxated, what do you expect to find with the atlas and axis on A-P film?

A
  • Atlas and axis will be parallel

- Because the principal motion is rotation around the odontoid (not laterally)

37
Q

When C0/C1 are aligned, what is the angle formed on the lateral x-ray between the lines?

A

~5 degrees
AS occiput decreases angle
PS occiput increases angle

38
Q

Should you take a different x-ray if visualization changes on the patient?

A

YES, because now it’s a new patient

39
Q

How do you measure for sacral inferiority?

A
  • roll your parallel to the highest sacral point from the femur head line
  • Strike a line
  • if this coincides with posteriorly rotated side, then you have sacral inferiority

Troxell Intern Notes (12 decks)

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