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22 Cards in this Set
- Front
- Back
Thoracic Spine Views |
AP: All 12 vertebrae Lateral: all vertebrae except the T1-T3 because the shoulder obscures them Oblique View Thoracolumbar or other coned views Swimmer's View |
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Sternum views |
Posterior Oblique; Sternum without the spine superimposed? Lateral: shows the entire sternum in profile |
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Rib Sections |
Anterior/Posterior/Axillary Subdivided into right and left sides/above diaphragm (1-9) below diaphragm (8-12) |
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Rib Views |
AP: shows posterior ribs PA: shows Anterior Ribs (hemothorax ot pneumothorax) AO or PO shows Axillary ribs May need 2 week follow up for callus formation |
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Thoracic Alignment and Trauma |
Shown by three lines - anterior body, posterior body and spinolaminar junction Sings: Step defect, wedge deformity, impaction, displaced endplates, loss of disc heights, spinal edema. Stable unless supra or infra is torn. |
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Thoracic Spinal Injuries |
Highest occurence in T11-T12,L1,L2 Compression Fracture and disolcations commmon with 15-20% neurological injuries |
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Anterior Vertebral Body Compression factors |
Most common spinal injury detectable on radiograph. Flexion 90% and Exteension 10% Younger: Falls, MVA Oldeer: Osteoporosis with minimal forces |
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What is a Chance Fracture |
Flexess the spine and distracts the spine injuring the ligaments and spinal cord. aka Seat Belt Fracture |
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Age related compression fractures |
Younger:disks are thicker andabsorbforces readily resultingindisk herniation,endplate fractures,and shearingforces Older:Dehydrated disks and demineralized bone results inwedge deformity |
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How to asses Compression Fracturess |
Stepdefect // Wedgedeformity // Linearzoneof impaction // Displacedendplates // Decreaseddiskheight // Paraspinaledema Abdominalileus: the edema affects the abdominal ANS and there is increased gas in thebowel. |
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Thoracic Spine Conditions |
Osteoporosis // Scoliosis // Tuberculous Osteomuuelitis // Scheuermann's Disease |
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Radiographic Signs of Osteoporosis |
Increased Radiolucency // Cortex thinning // wedge deformity // schmorl's nodess |
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Typical Scoliosis Views |
Erect AP Supine AP - asses flexibilitly of the curve Erect Lateral Sidebending R and L - Structural vs NonStructural curves PA view L hand; Compared to Standardized views |
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What is the Cobb Method |
Used to assess the deviation of the spine from the midline. Uses the erect(weight bearing) AP. ID upper and Lower end Vertebrae // Draw lines extending along the vertebral column // Measure cobb angle |
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How is Skeletal maturity assessed |
–CompareL hand and wrist compared to the population (Greulich & Pyle Atlas is used) –Apophysisossification to the vertebral body –Risser’ssign(iliac apophysis fusion to the ilia) |
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Scoliosis Rotation |
0 = No rotation +1 = pedicle toward midline +2 = Pedicle 2/3 to midline +3 = Pedicle in Midline +4 = Pedicle beyond midline |
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Risser sign and Mesasurement |
After Risser of 5 scoliosis should not progress |
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What is Tuberculous Osteomyelitis |
"Pott's Disease" is always a lesion to TB somewhere else in the body RG shows destructio nof the vertebral bodies MRI detects spinal cord compression and to evaluate disk space infection and disease in soft tissue |
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What is Mycobacterium tuberculosis |
Organism that causes TB Osteomyelitis and involves mostly thoracic and lumbar vertebrae. Extensive necrosis and bony desetruction with compressed fractures and extension to soft tissues including psoas abscess |
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What is Scheuermanns Disease |
-Backacheand thoracic kyphosis are the result of secondary ossification centerosteochondrosis -irregular ossification of the anterior portions of theepiphysis on at least 3 contiguous bodies -indentations through the epiphyseal plates (Schmorl’s Nodes). -MRIdirectly shows the disc herniations |
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Secondary effects of Scheuermann's Disease |
Thoracic outlet syndrome and Brachial Plexopathy |
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Scheuermann's Patholgenesis |
Unknown Etiology Schmorls nodes are consistently found. Disk herniation narrows disk space and can interfere with 2ndary ossification centers --> Osteochondritis of the end plates and deficient growth of the anterior body and normal growth of the posterior body produces the wedge shaped vertebrae |