Thoracic/ lumbar spine Flashcards
1
Q
AP view:
- pt position
- central beam
- demonstrates
A
- pt position - supine, knees flexed to correct thoracic kyphosis
- central beam - directed vertically about 3 cm above xiphoid process
- demonstrates - vertebral endplates, pedicles, intervertebral disks
- height of vert segments can be determined, changes in paraspinal lines can be evaluated
2
Q
Thoraco-lateral view
- pt position
- central beam
- demonstrates
A
- pt position - standing with arms elevated; advised to breath shallowly during exposure
- central beam - directed horizontally to the level of the T6 vert with about 10 degrees cephalic angulation
- demonstrates - lateral image of vert bodies and IV disc space
3
Q
AP Lspine view:
- pt position
- central beam
- demonstrates
A
- pt position - supine with knees flexed to eliminate lordosis
- central beam - vertically to center of abdomen at the level of the iliac crests
- demonstrates - vert bodies, vert endplates, TVPs, IV disc space, spinous process, pedicles
4
Q
What are the advantages and disadvantages of the AP Lspine view?
A
- advantages = usually is sufficient for evaling traumatic conditions involving vert bodies, TVPs, and IVD space, L3-5 characteristics are observed
- disadvantages, L5-S1 will be obscured
5
Q
characteristic configuration of ed plates of L3-5 vert bodies; demonstrated on inferior aspects of the vert; if not present, possible compression fx
A
Cupid’s bow
- AP view
6
Q
Lateral Lspine view:
- pt position
- central beam
- demonstrates
A
- pt position - sidling with knees and hips flexed to eliminate lordotic curve
- central beam - directed vertically to center of the body of L3 at pts waist
- demonstrates - vert bodies, pedicles, SPs, IV foramina, disc space; vert bodies are seated profile, superior and inferior end plates are going to be well demonstrated
7
Q
oblique (posteroanterior) view:
- pt position
- central beam
- demonstrates
A
- pt position - recumbent on table with right side rotated 45 to demonstrate right sided articular facets
- central beam - directed vertically toward center of L3
- demonstrates - facet joints, superior/ inferior articular process, pedicles, pars interarticularis
8
Q
What shape should you look for with an oblique view?
A
Scotty dog
- superior articular process = dog ear
- pedicle = eye
- neck = pars articularis - possible fx site for spondy (issues with adolescent and spondy’s - should be entertained)
- body = lamina
- hind leg = superior articular process
9
Q
What injuries are seen with AP view?
A
- Fx of vert bodies, vert end plates, pedicles, TVPs
- fracture - dislocations
- abnormalities of the IVD spaces
- Paraspinal bulge
- Inverted napoleon’s hat sign
10
Q
What injuries are seen with lateral view?
A
- Fx of vert bodies, vert end plates, pedicles, SPs, chance fx (seatbelt fx)
- abnormalty of IV foramina, IVD space
- limbus vertebra
- schmorl node
- spndylolisthesis
- SP sign
11
Q
What injuries are seen with oblique view?
A
- abnormalties of articular facets, pars interarticularis
- spondylolysis
- scotty dog configuration
12
Q
what are the groups of thoracolumbar fxs?
A
- compression
- burst
- distraction
- fx-dislocation
- can involve vert body, arch, TVP’s, SP’s
13
Q
What does the anterior column consist of?
A
- Anterior ⅔ of annulus fibrosus and vert body
- anterior longitudinal ligament
14
Q
What does the middle column consist of?
A
- posterior longitudinal ligament
- posterior ⅓ of Fert body and annulus fibrosis
15
Q
What does the posterior column consist of?
A
- posterior ligament complex = supraspinous and infraspinous ligs, IV joint capsule, lig flavum (aka inter laminar lig), and posterior neural arch
