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Test 2 - Cervical XRay
Cervical X-rays
55
Health Care
Graduate
03/09/2014

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Cards

Term
XRay film composition (inside to outside)
Definition
cellulose acetate base
silver bromide gel

calcium tungstate
Term
Chemical activity >> xray film change
Definition
silver bromide >> silver halide
Term
XRay film exposed to radiation >> ...(color)
Definition
black (radiolucent)
Term
Body tissues, etc: "Very Radiolucent"
Definition
gas
Term
Body tissues, etc: "Moderately Radiolucent"
Definition
fatty tissue
Term
Body tissues, etc: "Intermediate" radiolucency
Definition
connective tissue
muscle
blood
cartilage
epithelium

cholesterol stones
uric acid stones
Term
Body tissues, etc: "Moderately Radiopaque"
Definition
bone
calcium salts
Term
Body tissues, etc: "Very Radiopaque"
Definition
heavy metals
Term
Importance of Xray positioning
Definition
prevent superimposition
prevent magnification (focal-object and object-film distances)
Term
Types of C-Spine films typically taken (3)
Definition
neutral (cross-table) lateral
AP
AP open mouth
Term
Types of C-spine films taken in addition to 3 typical films (5)
Definition
L/R oblique
Lateral, in flexion
Lateral, in extension
Pillar View (Wier)
Swimmer's Lateral/Flying Angel
Term
Reason for "Swimmer's Lateral" Xray positioning
Definition
visualize C7 without imposition of shoulders
Term
Normal soft tissue shadow: ant to C2
Definition
≤7mm
Term
Normal soft tissue shadow: ant to C3-4
Definition
≤4mm
Term
Normal soft tissue shadow: ant to C5-7
Definition
≤20mm (1 vertebral body width)
Term
Normal ADI (adults)
Definition
≤3mm
Term
ABCDs of Xray exam
Definition
Alignment/Anatomy
Bony integrity
Cartilage/Disc space
Soft tissue
Term
Xray exam: Alignment/Anatomy (7)
Definition
A/P vertebral body lines
Spinolaminar line
Jumped/locked facets
Rotation of SpPr
Loss of superimposition of lateral columns
Loss of lordosis
Kyphotic angulation
Term
Xray exam: Bony integrity (2)
Definition
Cortices & medullary portions of bones
"Fat" C2 (C2 should be same size as C3 body)
Term
Xray exam: Cartilage/Disc space (4)
Definition
Widened predental space
Abnormal IVD space
Widened/naked facets
Widened interspinous/inerlaminar distance
Term
Xray exam: Soft tisue (5)
Definition
widening of retropharyngeal space
widening of retrotracheal space
displacement of prevertebral fat stripe
soft tissue mass in craniocervical junction
tracheal/laryngeal deviation
Term
"Structure of the spine has been maintained after trauma such that further controlled motion has a low probability of causing or aggravating existing cord or nerve damage"
Definition
spinal stability
Term
3-column model of the spine: Instability
Definition
≥2/3 columns damaged
Term
3-column model of spine: Columns
Definition
Anterior: ant vertebral body, ALL, ant annulus
Middle: post vertebral body, PLL, post annulus
Posterior: vetebral arch, SS/IS ligts, capsule, ligt. flavum
Term
Vertebral injuries: Most often caused by forces that cause...
Definition
violent motion of head/trunk
Term
Factors affecting vertebral injury (4)
Definition
direction of forces
magnitude/rate/duration of forces
point of application of force
position of head/neck/trunk at injury
Term
Damage to C spine has __% incidence of associated spinal cord damage
Definition
40%
Term
__% of all SCI occur in C spine
Definition
52%
Term
Reasons most cervical SCI survivors have lower C spine injury (2)
Definition
Vertebral canal is large at craniovertebral jxn (cord only takes up 50% of space)
Complete C1-2 SCI >> diaphragm loss >> asphyxiate
Term
Most common cause of neurological injury =
Definition
hyperflexion injury (e.g. head-on MVA)
Term
Types of hyperflexion injury
Definition
Wedge/compression fx
Flexion Teardrop fx
Sublux/Dislocation of facets
Clay Shoveler's fx
Term
Wedge fx: stable v. unstable
Definition
Stable
Term
Flexion Teardrop fx >>
Definition
anterior cord syndrome (saggital fx >> post displacement of vertebral body fragments into cord)
Term
Sublux/Dislocation of facets: stable v. unstable
Definition
Bilat: highly unstable
Unilat: typically stable (unless significant ligt damage)
Term
Unilat sublux/dislocation of facets: __% cord damage
Definition
30% incidence of cord damage (primarily Brown-Sequard or nerve root)
Term
Types of vertical compression injury (2)
Definition
Burst fx
Jefferson fx of atlas
Term
Burst fx >>
Definition
anterior cord syndrome
Term
Jefferson fx of atlas =
Definition
bilat fx of ant/post arches

disruption of transverse ligt (>>incr ADI)
Term
Types of extension injuries (3)
Definition
Dislocation
Hangman's fx
"Sprain" of cervical spinal column
Term
Extension dislocation injury >>
Definition
posterior cord syndrome,
with motor & deep sensory impairments

(cord impinged between superior vertebra [displaced backward] and adjacent vertebra's posterior arch
Term
Hangman's fx =
Definition
bilat fx of C2 pedicles, with dislocation of C2-3
Term
"Sprain" of cervical spinal column =
Definition
cord damage occurring without bony/ligt damage in presence of OSTEOPHYTES and/or narrowed canal
Term
Stable v. Unstable: anterior subluxation
Definition
stable
Term
Stable v. Unstable: unilat facetal dislocation
Definition
stable
Term
Stable v. Unstable: simple wedge fx
Definition
stable
Term
Stable v. Unstable: burst fx of lower C spine
Definition
stable
Term
Stable v. Unstable: post neural arch fx, atlas
Definition
stable
Term
Stable v. Unstable: pillar fx
Definition
stable
Term
Stable v. Unstable: clay-shoveler's fx
Definition
stable
Term
Stable v. Unstable: bilat facetal dislocation
Definition
unstable
Term
Stable v. Unstable: flexion tear-drop fx
Definition
unstable
Term
Stable v. Unstable: extension tear-drop fx
Definition
unstable
Term
Stable v. Unstable: hangman's fx
Definition
unstable
Term
Stable v. Unstable: Jefferson fx
Definition
unstable
Term
Stable v. Unstable: hyperextension fx dislocation
Definition
unstable
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