Block 1 - Anatomy - Intro to Spinal Imaging Flashcards Preview

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Flashcards in Block 1 - Anatomy - Intro to Spinal Imaging Deck (40)
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1
Q

What is a PA CXR?

A

A chest X-ray taken from behind (posterior - anterior)

2
Q

What is an AP CXR?

A

A chest X-ray taken from the front (anterior - posterior)

3
Q

Which is better for imaging the heart, an AP CXR or PA CXR?

A

PA CXR

4
Q

How is a CAT scan image oriented?

A

Viewed as if looking up from the patient’s feet;

patient facing up (patient right side is on the viewer’s left side)

5
Q

What joint between the atlas and axis allows for head shaking (head rotation: shaking head for ‘no’)

A

Atlanto-axial joint

6
Q

What joint between the atlas and occiput allows for head nodding (head rotation: nodding head for ‘yes’)

A

Atlanto-occipital joint

7
Q

When checking an X-ray for cervical alignment, what four alignments should be checked?

A

Anterior vertebral line;

posterior vertebral line;

spino-laminar line;

posterior spinous line

8
Q

What can form on the edge of the vertebral cortical bone as a result of osteoarthritis?

A

Osteophytes (bone spurs)

9
Q

What color is air on an X-ray? What color is metal and water?

A

Black; white or gray (depending on density)

10
Q

Why are the vessels and GI tract so bright in this CAT scan? Why is the vertebra so bright?

A

Contrast dye;

dense calcium salts

11
Q

What two structures make up the occipito-atlanto-axial complex?

A

The atlanto-occipital joint;

the atlanto-axial joint

12
Q

The atlanto-axial and atlanto-occipital joints make up what complex?

A

The occipito-atlanto-axial complex

13
Q

What vessels are most at-risk for disruption during dislocation of the atlanto-occipital joint?

A

The posterior inferior cerebellar arteries

(and the vertebral arteries themselves)

14
Q

Disrupting what articulation can inhibit blood flow through the posterior inferior cerebellar arteries and vertebral arteries?

A

The atlanto-occipital joint

15
Q

What type of fracture is especially likely to damage the atlanto-occipital joint?

A

A fracture of the C1 ring

16
Q

What cranial nerves may be damaged by inhibited blood flow through the posterior inferior cerebellar arteries?

A

V, IX, X, XI

17
Q

What type of joint are the atlanto-occipital and atlanto-axial joints?

A

Condyloid

18
Q

What membranes support the atlanto-axial and atlanto-occipital joints?

A

Anterior and posterior atlanto-occipital membranes

19
Q

What ligaments support the alanto-occipital and atlanto-axial joints?

A

The alar, cruciform, and transverse ligaments (as well as the tectorial membrane)

20
Q

How should the patient be positioned to get a lateral X-ray of the thorax as shown here?

A
21
Q

What might be some reasons that patients are only able to get AP X-rays?

A

They are too sick to get comfortably to the imaging suite

22
Q

What is a double-contrast CAT?

A

Oral contrast is administered so the small intestine and colon can be checked in the CAT scan;

IV contrast is administered so that the vessels of the body can be seen

23
Q

Which joints make up the atlanto-axial joints?

A

The inferior articular facets of C1 interacting with the superior articular facets of C2

24
Q

Which joints make up the atlanto-occipital joint?

A

The superior articular facets of C1 interacting with the occipital condyles

25
Q

What is proper spinal protocol in assessing a potential C-spine injury?

A

You must be able to see all 7 vertebrae and the thoracic 1

26
Q

What should you never do with a potentially injured C-spine?

A

Flex, extend, or rotate it

(use a C-collar to stabilize and protect the neck)

27
Q

What is a FAST scan?

A

A rapid, bedside ultrasound in the ED

(Focused Assessment with Sonography for Trauma)

28
Q

For what is a FAST scan especially useful?

A

Checking for bleeding intro the mediastinum or other cavities

29
Q

What is the most common type of odontoid fracture?

A

A type II

30
Q

What type of insult can lead to a type II odontoid fracture?

A

Hyperextension or hyperflexion

31
Q

What is another name for the hangman’s fracture?

A

Pars interarticularis fracture

32
Q

What is lordosis in terms of tilt of the pelvis?

A

Anterior tilt of the pelvis

(with compensating swayback)

33
Q

Which nerve exits at the L4-L5 intervertebral foramen?

Which nerve will be impinged if the L4-L5 intervertebral disk is herniated?

A

L4;

L5

(although L4 leaves at the the L4-L5 foramen, it leaves just above the disk while L5 passes down in front of it)

(remember, this is below the cona medullaris; there are plenty of free nerves around)

34
Q

Which nerve exits at the L3-L4 intervertebral foramen?

Which nerve will be impinged if the L3-L4 intervertebral disk is herniated?

A

L3;

L4

35
Q

What are the two principal internal ligaments of the dens?

A

The alar ligaments and the cruciform ligament

36
Q

Why is the cruciform (or cruciate) ligament called the cruciform ligament?

A

It is cross-shaped, with a transverse portion and a superior and inferior longitudinal portion

37
Q

The transverse ligament of the atlas is a portion of what larger ligament?

A

The cruciate ligament of the atlas

38
Q

The superior and inferior longitudinal bonds of the atlas are portions of what larger ligament?

A

The cruciate ligament of the atlas

39
Q

What X-ray angle is ideal for visualizing a pars interarticularis fracture?

A

Oblique

40
Q

What is the arterial phase of an IV contrast dye?

What is the venous phase of an IV contrast dye?

A

The initial phase in which the dye is highlighting arterial structures;

the secondary phase when the dye moves from the arteries to highlight venous structures