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136 Cards in this Set

  • Front
  • Back
What does the brain stem consist of?
-midbrain
-pons
-medulla
What 3 places in the CNS contain cerebrosinal fluid?
1-ventricles of the brain
2-subarachnoid spaces
3-central canal of the spinal cord
What is the purpose of CSF (cerebrospinal fluid)?
to cushion the brain and spinal cord
4 irregular fluid filled cavities located within the brain
Ventricular System
extends from the medulla thru the foramen magnum to the level of the 1st and 2nd lumbar vertebra
Spinal Cord
How many pairs of spinal nerves are connected to the spinal cord?
31
The spinal nerves are transmitted through what part of the vertebra?
Intervertebral foramina
What position must a patient be in inorder to see the IVF in the T-spine?
lateral
What position must a patient be in inorder to see the IVF in the T-spine?
lateral
What position must a patient be in inorder to see the IVF in the C-spine?
patient must be in a 45 degree obliqued position and if in the AP position the side of would be demonstrated
What position must a patient be in inorder to see the zygopophyseal joints in the T-spine?
patient obliqued 70 degrees and demonstrates side up when in the AP position
What position must a patient be in inorder to see the zygopophyseal joints in the c-spine?
lateral
What position must a patient be in inorder to see the zygopophyseal joints in the l-spine?
patient obliqued 45 degrees and side down in demonstrated in the AP position
CONUS MEDULLARIS
pointed end of the cord
CAUDA EQUINA "horses tail"
large number or nerve roots extending from the conus to the coccyx
acts as a liquid buffer to absorb and distribute external and internal forces endangering the brain and cord
CSF (cerebrospinal fluid)
Where is CSF produced?
within the brain by choroid plexuses (network of capillaries)
circulates freely through the ventricles, the subarachnoid space around the brain, and the spinal cord
CSF
Name the 4 ventricles.
1-lateral ventricle
2-lateral ventricle
3-third ventricle
4-fourth venticle
Where are the 2 lateral venticles located?
located in each cerebral hemisphere
What connects the lateral ventricles to the third ventricle?
the foramen of Monroe
Where is the third ventricle located?
located between the two thalami
What connects the third ventricle to the fourth ventricle?
the cerebral aqueduct of Sylvius
Where is the fourth ventricle located?
located posterior to the pons
What connects the fourth ventricle to the spinal canal?
the foramen of Magendie (medial) and the foramen of Lushka (lateral)
Which ventricle is the largest?
lateral ventrical
Which ventricle is the most superior?
lateral ventricals
Which ventricle is the most medial?
3rd ventricle
Which ventricle is the most inferior?
4th ventricle
Which ventricle is the most posterior?
4th ventricle
b/w the periosteum of the cranium/vertebrae and the dura mater layer
Epidural space
strong, fibrous outermost layer of the meninges
Dura Mater
layers that cover the brain and spinal cord
Meninges
List the meninges layers from outer to inner including the spaces.
OUTER
-epidural space
-dura mater layer
-subdural space
-arachnoid layer
-subarachnoid space
-pia mater layer
INNER
divides the dura mater layer and the arachnoid layer
subdural space
delicate, weblike inner layer of the meninges
Arachnoid layer
divides the arachnoid layer and the pia mater layer
subarachnoid space
Of the meninges layers and spaces where does CSF circulate at?
subarachnoid space
inner, vascular coating; adheres directly to brain and cord
Pia mater layer
During a lumbar puncture where does the doctor stick the needle?
b/w L2/L3 or L3/L4
During a LP or a myelogram where is the contrast injected?
the subarachnoid space
strong fibrocartilaginous structures; provide powerful bonds and elastic buffers;
intervertebral disks
What percentage of the length of the vertebral column does the intervertebral disks account for?
25%
inner pulpy semi-gelatinous layer of the intervertebral disk
Nucleus pulposus
outer fibrous covering of the intervertebral disk
Annulus fibrosus
What are the 2 layers of the intervertebral disk?
1-annulus fibrosus
2-nucleus pulposus
What does HNP stand for?
Herniated nucleus pulposus
What is the most common pathologic finding of myelography?
HNP (herniated nucleus pulposus)
If the HNP bulges posterior what does it hit?
spinal cord and causes numbness
If the HNP bulges right or left what does it hit?
spinal nerves and causes pain
If the HNP bulges anterior what does it hit?
nothing
is performed to study the spinal canal, spinal cord, and nerve roots through the introduction of contrast media via lumbar puncutre
Myelography
Where is the contrast injected during a Myelogram?
into the subarachnoid space
When the contrast is injected into the subarachnoid space during a myelogram what does this allow the radiologist to visualize?
allows visualization of the contours of the canal and cord to distinguish pathology
Name indications for myelography. (14)
1-HNP
2-degenerative disk disease
3-benign or malignant tumors
4-bone fragments from trauma
5-spondylosis
6-spondylolisthesis
7-spinal stenosis
8-failed open back surgery
9-foraminal stenosis
10-radiculitis
11-radiculopathy
12-sciatica
13-bone spurs
14-whiplash
osteoarthritic changes causing spurs to form and compress nerve roots
Spondylosis
breaking down of articular facets causing foward slippage of the vertebra
Spondylolisthesis
narrowing of the lumbar spine that produces pressure on the nerve roots resulting in sciatica
SPINAL STENOSIS
inflammation of the nerve root
Radiculitis
a pathological condition of the nerve roots
Radiculopathy
pain along the course of a sciatic nerve
sciatica
herniation of the pulpy inner layer of the disk into the spinal canal
HNP
What are some causes of HNP?
-pressure from bending or lifting
-trauma resulting in fracture
What is the most common cause of HNP?
trauma resulting in fracture of the annulus fibrosus with a herniation or escape of the inner nucleus pulposus layer
What are 6 symptoms of HNP?
1-numbness
2-pain
3-burning sensation
4-occurs in the extremities
5-may be temporary or intermittent symptoms
6-acute or chronic
short-term
acute
long-term
chronic
What are the 2 treatments for a herniated disc?
-conservative or non-operative
-surgical
What types of medications may be offered to patients with a herniated disc?
-non-steroidal and anti-inflammatory medication (motrin, advil, nuprin)
Name some different surgical procedures that may be used for a surgical herniated disc repair (8)
1-microdiscectomy
2-cervical discectomy
3-lumbar discectomy
4-thoracic discectomy
5-laser spine surgery
6-lasery discectomy
7-laminectomy
8-spinal fusion
surgical removal of herniated disc materical that presses on nerve roots or the spinal cord
discectomy
A surgical procedure in which the posterior arch of a vertebra is removed.
laminectomy
A surgical procedure in which two or more of the vertebrae in the spine are united together so that motion no longer occurs between them.
Spinal fusion
Name some contraindications that may occur during a myelogram? (5)
1-severe contrast allergy
2-taking phenothiazines (lowers seizure threshold
3-blood thinners
4-antibiotics for infection
5-increased intracranial pressure
During a spinal puncture where is the spinal needle placed by the radiologist?
into the subarachnoid space
Where is the common injection site for a spinal puncture?
around L3-L4 interspace
How is the flow of CSF controlled inorder to reach each level of the spine (C/T/L)?
angulation of the table
What must the patient do during a cervical and thoracic myelogram inorder to prevent spillage into the ventricles.
they must hyperextend their neck
What happen if spillage in the ventricles occurs?
It could cause seizures
What are some complications that could occur during a myelogram? (5)
1-headache/nausea
2-subarachnoid bleeding
3-seizures
4-temporary pain due to position
5-CSF leakage through injection site causing headache/dizziness/nausea
What must a patient do if they experience CSF leakage through injection site?
they must undergo a blood patch procedure to stop CSF leakage with patients own blood
How many degrees must the patient keep his/her head for the first 12 hours after a myelogram and then the remaining 12 hours? The next day?
1st 12 hours: elevated 30-45 degrees

2nd 12 hours: flat

following day: bed rest no lifting/bending; increase liquids

*allows slow uptake of contrast into the system*
When can a myelogram patient resume normal activity?
after 48 hours
What do you see when taking plain films of the spine?
1-arthritic changes
2-post operative
3-metastatic disease
What does a CT of the spine show?
CT defines the dimesions of the bony canal (stenosis) and lateral encroachment
What is CTM?
CT after intrathecal contrast injection
What does CTM of the spine show?
size, shape, position of spinal cord and nerve roots
What does a MRI of the spine show?
provides excellent images of the spinal cord, nerve roots, and CSF

(cord compression, HNP, tumors, metastases)
radiologic study of soft tissue structures of synovial joints
arthrography
What are some things that you can view with an arthrogram? (8)
1-menisci
2-ligaments
3-tendons
4-bursa sacs
5-articular cartilage
6-rotator cuff
7-anterior and posterior cruciate ligaments
8-synovial capsules
bone to bone
ligaments
muscle to bone
tendon
cartilage
menisci
What are some things that you take arthrograms of? (5)
1-knee
2-shoulder
3-hip
4-wrist
5-TMJ
What are some things that an arthrogram of the shoulder would show? (3)
1-rotator cuff tears
2-persistant pain or weakness
3-frozen shoulder
What are some things an arthrogram of the knee would show? (5)
1-pain
2-swelling
3-torn menisci
4-ligament damage
5-capsular damage
What are some things an arthrogram of the hip would demonstrate? (3)
1-pain
2-check for infection
3-check for loose prosthesis
What are some things an arthrogram of the TMJs would demonstrate? (2)
1-pain
2-headaches
What are some things an arthrogram of the wrist would demonstrate? (3)
1-limited movement
2-pain
3-trauma
What are some contraindications of an arthrogram study? (3)
1-allergy to contrast
2-allergy to anestheic
3-infection in or near the joint

*always check to see if patient is on blood thinners*
What is the pre-procedural care for an arthrogram study? (6)
1-clincal hx
2-allergy hx
3-check for infection, blood thinners, current medications
4-explain procedure to include risks
5-informed consent signed by MD and patient
6-Verification of procedure form completed and signed by Tech
What are some risks that are involved during a arthrogram? (3)
1-infection
2-bleeding
3-reaction to contrast
What is the general procedure for a arthrogram study? (6)
1-sterile arthrogram tray set-up
2-scout film performed of area
3-radiologist marks joint under fluoro
4-area is cleaned (asceptic technique) and sterile drape applied
5-anesthetic, 22 gauge arthrogram needle inserted and contrast is adminstered
6-routine radiographs are performed
What are the post-procedural care for a arthrogram study?
1-apply bandaid
2-may experience some pain at joint
3-call MD if pain increases
4-keep "pain log" if steroid or anesthetic was injected for pain management
When do you instruct a patient to use a pain log?
when a steroid or an anestheic is injected during an arthrogram for pain management
What are some radiographic findings during a arthrogram study of the knee?
torn menisci and capsular tears
What are some radiographic findings during a arthrogram study of the shoulder?
rotator cuff muscle tears
What are some radiographic findings during a arthrogram study of the wrist?
intrinsic and extrinsic tears in the wrist ligaments
What are some radiographic findings during a arthrogram study of the hip?
prosthesis dislocation or infection
radiographic study of the salivary glands of the mouth?
Sialography
Name the 3 salivary glands
1-parotid
2-submandibular (submaxillary)
3-sublingual
Which salivary gland is the largest?
parotid
Where is contrast injected during a sialogram?
into each duct of the glands
Where are the parotid glands located?
located anterior to each mastoid tip
How many parotid glands are there?
2
What duct is associated with the parotid gland?
stenson duct
What is the most common duct?
stenson duct
How many submandibular glands are there?
2
Where are the submandibular glands located?
located inferior to each mandibular body
What duct is associated with the submandibular gland?
Wharton's duct
How many sublingual glands are there?
1
Where is the sublingual gland located?
located under the tongue
What duct is associated with the sublingual gland?
Duct of Rivinus
What indications might cause a sialogram to be ordered?
1-inflammatory lesions
2-pain and swelling
3-obstruction (Stone or tumor)
4-palpable mass
What might be a contraindication for a sialogram exam?
mumps (parotitis)
What are mumps?
parotitis (inflammation of the parotid gland)
What is a sialogogue?
secretory stimulant such as a lemon
What does biting a lemon do during a sialogram study?
stimulates dilation of the ducts
Where is the small needle or catheter placed during a sialogram study?
into the duct
introduction of a radiopaque contrast media through a uterine cannula or catheter to determine size, shape, and position of the uterus and fallopian tubes
hysterosalpingogram
fluoroscopic study showing patency of uterine tubes
HSG
What are some indications that may cause a doctor to order a HSG? (6)
1-infertiliy
2-habitual abortions (miscarriage)
3-abnormal uterine bleeding
4-absence of menses
5-blockage of uterine tubes
6-to delineate polyps, tumor masses, or fistulous tracts
What are some HSG contraindications?
1-PID (pelvic inflammatory disease)
2-uterine bleeding
3-questionable pregnancy
4-too close to premenstrual or post menstrual phase
5-allergy to contrast or latex
When must an HSG be performed?
within 10 days of the onset of menstruation (day 5-10)
What position is the patient placed in for a HSG?
lithotomy position
What are some HSG findings?
1-congenital abnormalities
2-diverticula
3-dilated tubes
4-adhesions (scar tissue)
5-obstruction
6-fibroid tumors or polyps
7-retroversion or anteversion of the uterus