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Cranial and Vertebral Imaging
Clinical Skills, Module 3
84
Medical
Graduate
07/01/2009

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Cards

Term
What diagnostic imaging techniques were available for anatomical structure examination prior to 1974?
Definition
plain radiographs
Term
What unit is the focus of nuclear imaging?
Definition
atoms
Term
In nuclear medicine, what converts ingested or injected radioactive material into a light pulse? What do computers do with this image?
Definition
gamma cameras in 2-D. reconstitute the atoms into an image
Term
What refers to the isolated radioactive particles that are used to perform the nuclear medicine study?
Definition
nuclear "activity"
Term
In nuclear medicine, particles absorb or locate where?
Definition
tissue, fluid, blood, bone, etc
Term
In nuclear medicine, in what views are images taken?
Definition
planar views
Term
What is defined as the time it takes for half of a nuclear substance to decay?
Definition
half life
Term
What is defined as the the time an organism takes to eliminate one half of a compound or chemical on a strictly biological basis?
Definition
biological half life
Term
What is defined as the time required fro the amount of a radioactive element deposited in a living organism to b diminished 50% as a result of the combined action of radioactive decay and biological elimination?
Definition
effective half life
Term
What are some ways concentration within the body can occur with nuclear medicine isotopes?
Definition
blood pool or component, physiologic, capillary blockage, phagocytosis, cell sequestration
Term
On what does the amount of isotope depend in nuclear medicine?
Definition
the test and the material used. care must also be given in considering the following: pediatric dosing according to weight, pregnancy (acog stds), allergies to contrast studies before
Term
What are some psychiatric issues to be considered in nuclear medicine safety?
Definition
psychiatric issues- claustrophobia (premedicate and open ct and mri's).
Term
What is most important in nuclear medicine safety?
Definition
protect yourself!
Term
What nuclear imaging modality is good for bone disease not detected on plain films but suspected? This musculoskeletal modality is also good for detection of metastasis of known malignancy.
Definition
Technetium- 99spect bone scan
Term
What musculoskeletal imaging modality is useful for fx and congenital anomalies?
Definition
ct
Term
What musculoskeletal imaging modality is useful for staging of tumors, inflammatory processes (i.e. osteomyelitis), occult fx, and avascular necrosis?
Definition
mri
Term
What imaging technique involves the ability to detect defects in lung fields based on decreased absorbtion isotope? Pt. inhales xenon-133 isotope (ventilation) and then technetium-99 is injected (perfusion). Images are taken looking for defects.
Definition
v/q
Term
How are v/q read?
Definition
read as negative, low, intermediate or high probability
Term
In what scan are wbc's labeled on leukocytes, injected, and then studied in 24-48 hrs?
Definition
gallium-67 citrate scan
Term
What is useful in detecting inflammation of lung (sarcoidosis, pulmonary fibrosis, radiant pneumonitis) and malignancy (multiple myeloma)?
Definition
gallium-67 citrate scan
Term
What imaging technique involves pts' own blood, which is drawn, spun down, and extracted, labeled, and reinjected?
Definition
indium-iii labeled wbc scan
Term
What imaging technique is useful for detection of infection (pneumonia, lung abscesses, or no infection)?
Definition
indium-iii labeled wbc scan
Term
What imaging technique involves absorption of radio labeled rbc's?
Definition
technetium-99m spect
Term
What is widely used in detection of tumors (bone, lung, organ), fx, and cardiology (myocardial perfusion)?
Definition
technetium-99 spect
Term
What diagnostic technique is radiolabeled and injected, and is an excellent test for detection of thyroid disorders?
Definition
iodine-123 spect
Term
What imaging technique allows a view of tissue in a 3-d mode and is used with technetium and iodine radio labeled isotopes?
Definition
spectroscopy
Term
What imaging technique creates a tomography by detecting gamma rays which are produced when the emitted positrons interact with electrons?
Definition
pet (positron emission tomography)
Term
What imaging technique is useful for functional evaluations and is also able to distinguish neoplasm and normal tissue?
Definition
pet (positron emission tomography)
Term
What imaging technique is widely used and accessible, inexpensive, and is able to detect a majority of bony abnormalities and soft tissue defects?
Definition
plain radiographs
Term
What imaging technique is limited b/c it is only in one plane? Therefore, multiple views need to be taken and positioning of the pt. is key. Pt must remain still. This imaging technique cannot show any internal views or structures?
Definition
plain radiographs
Term
Which older test is accessible by many facilities and is good for detecting any spinal cord lesion and/or disc herniations? This can be used to view in more than one plane.
Definition
myelography
Term
What is an invasive procedure that requires an LP to get the csf and to inject the contrast medium for study?
Definition
myelography
Term
What testing modality involves the following disadvantages: pt may not tolerate procedure and must remain still during the test. May be technically difficult based on pt size and anatomy. Can increase risk of infection, spinal headaches and pain related to procedure?
Definition
myelography
Term
What imaging technique is painless, involves multiple planes (windows), allows detection of lesions and tumors, and offers newer open scanners?
Definition
ct
Term
What imaging modality involves the following disadvantages: expensive, size limits on table, claustrophobia, and access to ct's in smaller rural areas?
Definition
ct
Term
What imaging technique is more sensitive to detect spinal cord lesions, is able to detect disc herniations, tumors, and involves contrast which can "light up" the cauda equina?
Definition
ct myelography
Term
Can CT "light up" the cauda equina?
Definition
no. use ct myelography.
Term
In what diagnostic study mus you perform an lp and inject contrast directlly into subarachnoid space? This techniques involves risks for infection, spinal ha, and pain.
Definition
ct myelography
Term
What imaging technique is becoming the std for evaluating several tissue structures of the spine, involves multiple views to achieve a 3-d view and is painless?
Definition
mri
Term
What imaging technique is expensive, involves large structure, a small tube (anxiety, claustrophobia), is loud and uncomfortable, and not easily accessible?
Definition
mri
Term
What can affect multiple parts of the spine, and can involve osteophytes?
Definition
degenerative osteoarthropathy
Term
What can form and push into neural foramen and spinal canal and compress it, resulting in disc herniation?
Definition
osteophytes
Term
What is caused by a defect in the pars interarticularis, usually by a stress fx?
Definition
spondylolysis
Term
Is spondylolysis usually unilateral or bilateral, congential or acute? Where is it commonly seen?
Definition
bilateral, either congenital or acute. l5-s1 joint
Term
Lysis means fx of the vertibrae. however, it didn't go anywhere. It's still in it's position. What is the risk of spondylolysis?
Definition
can lead to "slipping" of the jt space. It can result in impaired neural function. However this is a secondary effect, caused by spondylolysis.
Term
Does spondylolysis require surgery?
Definition
maybe, depending on grade of slippage
Term
What involves disconnection from the posterior elements of the spine?
Definition
spondylolisthesis
Term
What lysis on plain oblique films has the appearance of a broken neck of the "scottie dog"?
Definition
spondylolisthesis
Term
Regarding spondylolisthesis in the elderly, what will the defect of degenerating pars cause?
Definition
will lead to slipping
Term
What would be described as subluxation of l4 on l5?
Definition
spondylolisthesis
Term
How common are disc herniations?
Definition
very common
Term
What are the imaging modalities for disc herniations?
Definition
ct or mri, but myelography still used in some areas
Term
What is the usual appearance of disc herniations?
Definition
herniated nucleus pulposus
Term
To what can disc herniations lead?
Definition
radiculopathy
Term
What are surgical options for disc herniations?
Definition
fusion, discectomy and laminectomy
Term
What can cause nn root compression?
Definition
either severe herniation, tumors or fluid pushing up against the nn root
Term
What does nn root compression cause?
Definition
severe pain, radiculopathy
Term
What is the most serious condition involved with nn root compression?
Definition
cauda equina syndrome
Term
What involves urinary and/or bowel incontinence w/numbness to extremity or both? It is the most serious condition with what problem?
Definition
cauda equina most serious condition w/nn root compression
Term
How serious is cauda equina syndrome? What imaging modality is best to detect this?
Definition
surgical emergency! mri best test to detect
Term
What is an infection of the bone causing a destructive breakdown of the bony structure?
Definition
osteomyelitis
Term
What organisms can cause osteomyelitis?
Definition
bacteria (sometimes mycobacteria) or fungi. most common organism *staph aureus*
Term
Pt presents w/back pain. What 2 questions do you ask?
Definition
any bowel or bladder incontinence?
Term
What is the most common cause of osteomyelitis?
Definition
*staph aureus*
Term
What are the most common places for osteomyelitis in children?
Definition
long bones, particularly near the end plate
Term
What adult populations are susceptible to osteomyelitis?
Definition
diabetics-very common in the feet, peripheral vascular disease
Term
What are tx options for osteomyelitis?
Definition
long course of abx (6 weeks or more), possible sx debridement, amputation if not improved
Term
What are the most common neoplasms of the spine?
Definition
astrocytomas or ependymomas
Term
How easy is it to tx neoplasms in the spine?
Definition
very difficult to tx
Term
What is the tx of choice for purely staph osteomyelitis?
Definition
naf for staph- nacillin
Term
Which are more difficult to tx: astrocytomas or ependymomas?
Definition
astrocytomas are more malignant and are more difficult. Ependymomas are less infiltrative and can be resected.
Term
What is the most common type of tumor of the spine?
Definition
malignancies, the lung and breast are the most common primary sites
Term
What are 2 things that really light up a bone?
Definition
really bad infection, tumor
Term
What are some types of injury to spine?
Definition
spine fx and trauma: multiple types of injury including: fx, subluxation, compression, external trauma (gsw, knife wounds)
Term
Where can degenerative osteoarthropathy occur?
Definition
multiple parts of the spine
Term
What is caused by spondylolysis?
Definition
caused by defect in pars interarticularis, usually caused by a stress fx
Term
What is a fx that breaks the spinous process of c2?
Definition
hangman's fx
Term
What fx breaks the dens of c2?
Definition
odontoid fx
Term
What fx causes widening of c1 w/lateral displacement bilaterally around dens?
Definition
jefferson's fx
Term
What fx involves a tear drop fx of the body and a broken spinous process?
Definition
flexion fx
Term
What fx involves distal spinous process fx?
Definition
clay shoveler's fx
Term
Pt falls down the steps on their butt- what type of fx might they sustain?
Definition
compression fx
Term
What fx involves entire vertebra, with separation of vertebra from native position?
Definition
burst fx
Term
What "is a minimally invasive treatment in which orthopaedic balloons are used to gently elevate the bone fragments in an attempt to return them to the correct position?"
Definition
balloon kyphoplasty
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