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23 Cards in this Set
- Front
- Back
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What are the different ways to view parts of the cervical spine? |
Atlanoaxial Joint (c1-c2) AP Mouth open - Dens of C2 and Lateral Masses of C1 Lower Cervical - AP Lower Cervical C3-C7 Alignment of all Cervical Vertebrae - Lateral View Right and Left Obliques- Single Side IVF |
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How to View Right and Left Cervical Obliquess |
Anterior - Same side - face to buckey Posterior - opposite side - back to bucky |
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Normal Alignment Features |
Seen on lateral view bby 3 parallel lines -Ant Border of Vertebral Bodies -Pos border of vertebral bodies -Junction of laminae to spinous process -Not aligned means fracture or dislocation |
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Features of Damage or Dislocation |
Anterior Fracture - little chance of neuro damage Posterior Fracture - Possible neuro damage Middle and Posterior- very likely neuro damage |
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What can you see in Lateral Flex and Exten Views |
Check space between spinous processes for symmetry. if it isnt than infra or supraspinous ligament is torn |
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What are the ABCS of Analysis |
A: Alignment B: Bone C: Cartilage S: Soft Tissue |
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Alignement analysis |
Follow the lines of lateral Xray Front: Ant Long Lig Back: Pos Long Lig Base of Spinous Processes Tips of Spinous Processes |
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Bone Analysis |
Follow each outline for signs of steps or breaks |
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Cartilage analysis |
Examine IV discs and fact joints for displacement -Widened Disc = annulous fibrosis is ruptured - common in degenerative disc disease |
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Soft Tissue Analysis |
Check for widening of soft tissues anterior to the spine on lateral radiograph |
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What can CT Scan Analysis show? |
Use when there is any doubt about cervical spine integrity Increased detaail of bony structures and can show fractures and displacements. Usefull in assesing the cervicothoracic junction, upper Cervical spine and any suspected fracture or misalignement |
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What can MRI Analysis show? |
Info on spinal cord and soft tissues -Compression: bones, prolapsed disc, lig damage, intraspinal hematomas Extent of cord damage and swelling |
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Stable vs Unstable injuries |
-Based on immediate or potential risk to spinal cord or nerve root Stable: Compression fractures, disc herniations, unilateral facet dislocation Unstable: Fracture dislocations, bilateral facet dislocation |
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Viewing Fractures and Trauma |
RGraphs can show fractures in long bones well Can miss fractures in complex skeletal areas like the hand,foot, upper C-spine |
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Differentiation for Bilateral and Unilateral Dislocation |
More than 50% disolcation = bilateral Less than 50% = unilateral |
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Types of spinal fractures |
Avulsion Compression - Top (Tear drop) Bottom (Flexion of diving) Fracture Dislocations - most unstable and life threatening |
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What is a Hangmans fracture? |
Fracture of both Pedicles of the axis (c2) |
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What is a Clay Shovelers Fracture |
Stable fracture through the spinous process of a vertebrae of the lower cervical or upper thoracic. |
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What is a Jefferson's Fracture |
bone fracture of the anterior andposterior arches of the C1 vertebra |
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Where do the different dislocations occur? |
Isolated can occur unilaterally at a facet joint - flexion rotation Bilateral at a pair of facet joints - hyperflexion With anterior translations = unstable |
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Cervical Degeneration Diseases |
Disc (DDD) seen on lateral view by decreased disc space height Joint (DJD) Seen on lateral view by decerased joint space, sclerosis, and osteophytes Foraminal Enchrochment - IVF ara on oblique view Spondylosis: Osteophytes at joint margins of the disk |
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Decreased Disk Height results in |
–Endplateapproximation –Uncovertebraljoint friction –Spondylosis –Schmorl’snodes intravertebral herniation of nucleus –Vacuumphenomenon |
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Diffuse idiopathic Skeletal hyperostosis |
DISH: Ossification of at least 4 contiguous vertebrae. Disk height normal |
