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Flashcards in Radiological Eval of C-Spine Deck (40)
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1

ABCDs of MRI for C-spine: B= Bone density

  • Assess for irregular signal intensities signifying ____ or _____ that may be localized or an extension from adjacent tissue

disease or infection

2

Trauma to the Cervical Spine: Stable or Unstable

  • compression fractures, disc herinations that do not invade central canal or foramen

Stable

3

ABCDs of MRI for C-spine: C = ___

  1. Observe the size of the ___, which is normally widely patent (open)
  2. Contents of the ___ = spinal cord, nerve roots, cerebrospinal fluid => can be assessed
  3. Look for any ____ (indentation from an ajacent structure) of the thecal sac

C = canal space

  1. spinal canal
  2. thecal sac
  3. effacement

4

ABCDs of CT for C-spine

  • Coronal and sagittal reformats are best for assessing normal spinal ____ or deviaations in _____ that signal fracture, dislocation, or bone destruction.

alignment

5

Trauma to the Cervical Spine

  • In an emergent situation, which type of imaging is preferred given potential complexity of anatomy?

CT

  • will screen more
  • relatively cheap, short, and greater access than MRI

6

Two types of fractures charateristic of the cervical spine:

  1. ___ = can see secondary to spinous ligament sprain
  2. ____ = wedge, impacted, or burst

  1. Avulsion
  2. Compression

7

For MRI, which image plane demonstrates the following structures for evaluation:

  • vertebral bodies, endplates
  • disc signal, disc height
  • subarachnoid space
  • spinal canal, spinal cord
  • anterior and posterior longitudinal ligaments
  • interspinous and supraspinous ligaments
  • spinour processes

Sagittal plane

8

Both DDD and DJD can cause degenerative changes in the surrounding structures including ____ and ____.

Foramen and central canal

9

Trauma to the Cervical Spine: Stable or Unstable

  • fracture dislocations, facet dislocations

 

Unstable

10

In a CT sagittal evaluation of the C-spine:

  1. Assess vertebral body alignment via 3 lines drawn connecting ___, ____, and _____
  2. ___ indicate fracture, subluxation, or dislocation

  1. anterior vertebral bodies, posterior bodies, and spinolaminar conjuction
  2. Step-offs

11

DDD can lead to:

  1. vertebral endplate ____
  2. Increased ____ changes at joints
  3. Stenotic changes at ____ and ____

  1. approximation
  2. stenotic
  3. vertebrae and discs

12

In a coronal evaluation of the C-spine:

  • assess normal ____ relationship

craniovertebral

13

Trauma to the Cervical Spine: Stable or Unstable

  • can be treated with bracing and rest => no immediate risk to central canal

Stable

14

What are the 5 types of routine series of radiographs for the C-Spine (which types of views)?

 

  1. AP Open Mouth
  2. AP lower c-spine
  3. lateral
  4. Right Oblique
  5. Left Oblique

15

In a CT C1/C2 axial evaluation:

  1. Position of the dens to the anterior arch of ___ to the lateral masses of __
  2. The ___ interface
  3. Steel's Rule of thirds

  1. atlas, C1
  2. atlantodental
  3. Steel's Rule of thirds
    1. AP diameter ring of atals = 3 cm
    2. dens and spinal cord each = 1 cm, taking up 2/3rds of the ring
    3. remaining 1 cm of free space allows for some ?

16

For MRI, which image plane demonstrates the following structures for evaluation:

  • IV discs
  • nerve roots
  • intervertebral foramina
  • spinal canal, epidural space, thecal sac
  • facet joint
  • ligamentum flavum

Axial Plane

17

Which type of C-spine view assesses the following:

  • ABC's
  • IV foramina are seen individually (IMPORTANT)
  • Both R and L views are made

Oblique View (Right and Left)

On image

  • A = foramina

18

Degeneration of the Cervical Spine

  1. DDD = ___
  2. DJD =____
  3. ____ stenotic changes
  4. ___ ___ stenotic changes

  1. Degenerative Disc Disease
  2. Dengenerative Joint Disease
  3. Foraminal
  4. Central Canal

19

ABCDs of MRI for C-spine

  • Sagittal is best for assessing normal spinal ___ or deviatins that signal  fracture, dislocation, or destruction of bone.

alignment

20

Which type of C-spine view assesses the following:

  • ABC's
  • 3 parallel lines
  • IV disc spaces
  • Atlantodental interspace
  • Retropharyngeal space < 7mm
  • Retrotracheal Space 14 mm kids, 22mm adults

Lateral View

On image

  • 3 parallel lines
    • Lines 1,2,&3 are useful for appreciating alignment
    • abnormal presentations include spondylotisthesis
  • b = IV disc spaces
  • c= atlantodental interspace
  • d= retropharyngeal space
  • e = retrotracheal space

21

For MRI, which imaging view will assess for the following at the C-spine:

  • abnormal soft tissues
  • abnromal vertebral alignment
  • abnormal joint relationships

Lateral View

22

ABCDs of CT for C-spine: D= disc integrity

  1. Evaluate the ___ and ___ margins on axial views for contour and intact bodies.
  2. ___ will alter the posterior contour.

  1. Posterior and posterolateral
  2. Herniated Discs

23

ABCDs of MRI for C-spine: s = soft tissue

  1. examine the paravertebral soft tissues for presence of ____ due to truama, primay neoplasmss, infection, or extension of masses
  2. Inspect the integrity of the ligaments and ____ following truama

  1. edema
  2. spinal cord

24

Stenosis (i.e, spondylosis and osteo.), schmorl's nodes, and vacuum phenonmenon = ______, such as with DDD

stenotic changes

25

Avulsion fractures, compression fracture, and wide spinous process secondary to an MVA are all examples of ____ injury to the cervical spine.

Hyperextension

26

Trauma to the Cervical Spine: Stable or Unstable

  • immediate serious risk to spinal cord or nerve root => will need surgical intervention to repair

Unstable

27

ABCDs of CT for C-spine: B = bone density

  1. Assess for ___ signfying disease or infection
  2. Assess for breaks in the ____ which are fractures
  • Note; cortical bone = most dense and cancelleous bone = less dense

  1. destruction
  2. cortical margins

28

ABCDs of MRI for C-Spine: D = disc

  1. evaluate disc ___ and ____ of the nucleus pulposus
  2. Evaluate the ____ margins on sagittal views and ____ margins on axial views for contour and intact boarders

  1. disc height, hydration of the nucleus pulposus
  2. posterior = sagittal, posterolateral = axial

29

ABCDs of CT for C-spine: C =____

  1. Assess the ____ space on axial views for latency
  2. Look for encroachment on the ____ or lateral recesses that may cause neural impingement
  3. Identify any  ____ that may have migrated to the canal from a fracture or an extruded disc

C= Canal Space

  1. spinal canal space
  2. central canal
  3. free fragments

30

Which type of C-spine view assesses the following:

  • ABC's
  • C1-C2 symmetry
  • Dens Midline between the lateral masses of C1
  • C2 vertebral body
  • C2 spinous process

AP Open Mouth: cervical

on image

  • lateral masses of C1 = a
  • C2 vertebral body = e