Imaging the spine - 24/10/18 Flashcards

1
Q

What do X-rays show?

A

Bone Outlines

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2
Q

What do CT scans show?

A

Bone outlines in more detail and some soft tissue structures e.g. lumbar disc

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3
Q

What do MRI scans show?

A

Bone outlines in less detail but shows bone marrow, discs, ligaments and the spinal cord and nerves

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4
Q

What are the 3 curves of the spine?

A

Cervical lordosis
Thoracic kyphosis
Lumbar Lordosis

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5
Q

Which vertebraes all have the same anatomy?

A

C3-C7
all 12th thoracic
5 lumbar

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6
Q

What is the anatomy of most of the vertebrae?

A
A vertebral body
Posterior arch
2 pedicles
2 Laminae
1 spinous process
2 transverse processes
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7
Q

Where does the neural foramen lie?

A

Inferior to the pedicle

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8
Q

How do the articular processes project?

A

Superiorly and inferiorly between the pedicles and laminae

Forming the facet joints

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9
Q

How are normal anatomincal features depicted?

A

Lateral view

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10
Q

Which vertebrae has no vertebral body?

A

C1`

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11
Q

What forms c1?

A

Anterior and posterior arches united by two large lateral masses, articulate with the occipital bone and C2`

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12
Q

What does C2 have?

A

An odontoid process which projects superiorly into C1 forming a joint with its anterior arch

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13
Q

When is CT used to image spinal trauma?

A

X-ray shows break but more detail is required

When X-ray is normal but there is a high clinical suspicion of break

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14
Q

What do ligaments do?

A

Tether vertebrae together and are responsible for spinal stability

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15
Q

How are ligaments assessed?

A

Not seen on x-ray or CT
Seeing normal vertebral alignment on these tests implies intact ligaments and stable spine
Abnormal alignment on x-ray implies ligament damage

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16
Q

How are ligaments seen directly?

A

MRI
Normal ligaments are black
Damaged ligaments are light

17
Q

Why is MRI used to image spinal trauma?

A

Provide detail of the spinal ligaments

Show soft tissue abnormality

18
Q

What kinds of soft tissue abnormality can be seen on MRI?

A

Acute prolapsed intervertebral disc
Epidural Haematoma
Spinal cord damage

19
Q

What X-ray and CT features suggest tumour?

A

Bone destruction
vertebral collapse
Bone sclerosis

20
Q

What is seen on MRI with tumours?

A

Early - bone marrow infiltration

Late - extradural mass and spinal cord compression

21
Q

What do the intervrtebral discs do?

A

Cushion body from spinal stress

22
Q

What are healthy discs filled with?

A

Water

23
Q

What can happen when discs dehydrate?

A

Herniation through disc lining into the spinal canal

24
Q

What can a herniated disc cause?

A

Spinal nerve compression

Sciatica

25
Q

Can intervertebral discs be seen on X-ray?

A

No

26
Q

What do CT and mRI show in discs?

A

Disc prolapse

27
Q

Which imaging shows the spinal cord?

A

MRI