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Diagnostic Imaging I Exam Two > Disc Herniations > Flashcards

Disc Herniations Flashcards

1
Q

What is the true definition of a disc herniation?

A

Projection of nuclear material through the annulus into the canal

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2
Q

Are disc herniations common?

A

NO; only 5% of back pain patients suffer from disc herniation

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3
Q

What is the gold standard imaging procedure to diagnosis a disc herniation?

A

MRI

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4
Q

How does the pain typically present with a disc herniation?

A

IMMEDIATELY

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5
Q

What is the most common complaint of patients with a disc herniation?

A

Back pain

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6
Q

What kinds of activities make the pain of a disc herniation work?

A

Sneezing, flexion, sitting, bowel movement

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7
Q

What is one of the most serious complications of a disc herniation?

A

Cauda Equina syndrome (1-16%)

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8
Q

What is cauda equina syndrome?

A

Compression of multiple nerve roots leading to altered bowel and bladder function, saddle paresthesia, muscle atrophy, and impotence

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9
Q

What neurological test can be used to assess for myelopathy?

A

Lhermitte’s

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10
Q

What kind of canal can lead to asymptomatic herniations?

A

Increased canal size

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11
Q

What is the most common treatment for a herniated disc?

A

Discectomy

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12
Q

What is the most common age range for a disc herniation?

A

25-40 (which discs are juicy)

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13
Q

A C5/C6 disc herniation would compress which nerve root?

A

C6

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14
Q

What kinds of symptoms arise from a midline disc herniation in the cervicals?

A

Myelopathies

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15
Q

What kind of directional disc herniation causes nerve route compression below in the cervicals?

A

Lateral

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16
Q

What type of disc herniation in the lumbars will compress the nerve root BELOW? The nerve root at the same level?

A

BELOW = midline/paracentral

SAME LEVEL = foraminal

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17
Q

A L5/S1 foraminal disc herniation will compress what nerve root?

A

L5 nerve root

18
Q

A L5/S1 midline disc herniation will compress what nerve root?

A

S1

19
Q

Which types of disc herniations in the cervicals is most significant due to the compressive of the nerve root below? Lumbars?

A 
Cervicals = lateral
Lumbars = midline/paracentral
20
Q

What is the function of the IVD?

A

Dampen forces

21
Q

What three things must be intact and functional for the IVD to successful work to dampen forces?

A

1 stability of annulus
2 hydration of nucleus
3 separation offed by endplates

22
Q

What is the technique used by injecting a water-based or oil-based contrast into subarachnoid space to asses for disc herniations?

A

Myelography

23
Q

What is the technique used by injected radiopaque contrast into the nucleus pulpous to image morphology?

A

Discography

24
Q

How does discography show a present disc herniation?

A

Contrast will leak into spinal canal

25
Q

Why are discography and myelography considered inferior to CT or MRI?

A

Invasive due to injection

26
Q

If a disc herniation is visible on CT, what would be the FINDING?

A

Paracentral protrusion

27
Q

What are the contents of the spinal canal?

A 
1 thecal sac 
2 epidural fat
3 internal vertebral plexus
4 ligamentum flavus
5 PLL
28
Q

What are the MRI findings of a disc herniation?

A 
1 focal bulge
2 obliterated epidural fat
3 deformed theca
4 displaced nerve roots
5 decreased MRI signal
29
Q

What are the four steps of classification for a disc herniation?

A

1 bulge
2 protrusion
3 extrusion
4 sequestration

30
Q

Which step of a disc herniation involves more than 25% of the disc diameter?

A

Bulge

31
Q

Which step of a disc herniation involves a free fragment of disc material with no connection to the disc?

A

Sequestration

32
Q

Which step of a disc herniation involves less than 25% of the disc diameter and the base is wider than the herniation?

A

Protrusion

33
Q

Which step of a disc herniation involves less than 25% of the disc diameter and the base is narrower than the herniation?

A

Extrusion

34
Q

Which step of a disc herniation is a true focal lesion and a complete disruption of the annulus?

A

Extrusion

35
Q

An area of high signal intensity on T2-weighted MRIs of a disc can indicate what?

A

Fissure or tear of the annulus

36
Q

Which congenital condition can lead to spinal stenosis?

A

Achondroplasia

37
Q

Spinal stenosis of the cervical spine is seen at what measurement? Lumbar spine?

A 
Cervicals = less then 12 mm
Lumbars = less than 15 mm
38
Q

How is the spinal canal measurement obtained?

A

Anterior line (through posterior aspect of vertebrae) to posterior line (through spinolaminar line)

39
Q

What imaging system is best used to determine spinal stenosis?

A

CT or MRI (X-rays are prone to distortion and only 2D)

40
Q

What are the three types of spinal stenosis?

A

1 central
2 neuroforaminal
3 lateral recess

41
Q

What are the general symptoms of spinal stenosis?

A

Radicular in nature

Diagnostic Imaging I Exam Two (7 decks)

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