Positioning 8&9

Front 1

How many cervical vertebrae is there?

Back 1

Seven

Front 2

How many thoracic vertebrae Is there?

Back 2

Twelve

Front 3

How many lumbar vertebrae is there?

Back 3

Five

Front 4

A new born baby has how many sacral segments?

Back 4

Five

Front 5

How many coccygeal segments are there for newborns?

Back 5

3 to 4 average 4

Front 6

How many separate bones does an adult have for the vertebral column?

Back 6

26

Front 7

How many bones consist of the vertebral column for a child?

Back 7

33

Front 8

What are intervertebral disks?

Back 8

Cushion like disks for spinal stability and allow flexibility and movement

Front 9

What protects the spinal cord?

Back 9

The spinal canal

Front 10

What is kyphosis?

Back 10

Abnormal condition characterized by increased convexity of the thoracic spine

Front 11

What is scoliosis?

Back 11

An exaggerated lateral curvature of the spine

Front 12

What is lordosis?

Back 12

Abnormal anterior concavity of the lumbar spine

Front 13

What is the largest individual vertebrae?

Back 13

The 5 lumbar vertebrae

Front 14

Where does the spinal canal start and end?

Back 14

Begins at the base of the skull and ends at into the sacrum

Front 15

What are the two main parts of the vertebra?

Back 15

The body and vertebral arch

Front 16

What is laminae?

Back 16

Two flat layers of bone that form the Posterior part of the vertebral arch

Front 17

What movement type is skull-c1?

Back 17

Synovial diarthrodial -ellipsoid

Front 18

What movement type is C1-C2?

Back 18

Synovial diarthrodial -plane (gliding)

Front 19

What type of movement is medial atlantoaxial?

Back 19

Synovial diarthrodial- trochoid (pivot)

Front 20

What type of movement is C2-T12?

Back 20

Cartilaginous amphiarthrodial (slightly movable)

Front 21

What type of movement is the zygapophyseal?

Back 21

Synovial diarthrodial -plane (gliding)

Front 22

What movement type is T1-T12?

Back 22

Synovial diarthrodial -plane (gliding)

Front 23

What movement type is T1-T10?

Back 23

Synovial diarthrodial -plane (gliding)

Front 24

What cervical landmark corresponds to the level of C1?

Back 24

Mastoid process (tip) and 1 inch below level of EAM

Front 25

What cervical landmark corresponds to C5?

Back 25

Adam’s apple (thyroid cartilage)

Front 26

What landmark is the same level as C7/T1?

Back 26

Vertebra prominence

Front 27

What landmark is at the level of T2/T3?

Back 27

Jugular notch

Front 28

T1 is how many inches above the jugular notch?

Back 28

1.5 inches

Front 29

Where is the vertebra prominens?

Back 29

Posteriorly at the base of the neck

Front 30

What is the central portion of the sternum called?

Back 30

The body

Front 31

What is the name for the upper section of the sternum?

Back 31

Manubrium

Front 32

Name the most inferior end of the sternum.

Back 32

Xiphoid process, xiphoid tip, ensiform process

Front 33

What landmark is at the level of T9/T10?

Back 33

Xiphoid tip

Front 34

What makes up the sternal angle and where is it located at?

Back 34

The manubrium and body connected at a slight angle located 2 inches below the manubrial notch

Front 35

What is AP open mouth projection for and what does it demonstrate?

Back 35

C1 and C2 fractures and demonstrates Odontoid and Jefferson fracture

Front 36

Where do you center for open mouth projection?

Back 36

Direct CR through center of open mouth

Front 37

What is the clinical indication for lateral C spine?

Back 37

Pathology involving the cervical spine including spondylosis and osteoarthritis

Front 38

Where should you center for a lateral C spine?

Back 38

Center IR to CR—-Top of IR 1 to 2 inches above the EAM

Front 39

How should you position the patients head for a lateral C spine?

Back 39

Elevate chin to place acanthiomeatal line (AML) parallel with floor

Front 40

What is the clinical indication for lateral trauma c spine?

Back 40

Pathology involving the C spine like clays shoveler’s fracture, compression fracture, hangman’s fracture, odontoid fracture, teardrop burst fracture and subluxation

Front 41

Where do you center for lateral trauma C spine?

Back 41

Horizontally to C4 (level of upper margin of thyroid cartilage)

Front 42

If AP axial projection doesn’t get a good view of C7 , what’s an alternative position?

Back 42

Swimmers (cervicothoracic)

Front 43

What is the SID for swimmers C spine?

Back 43

40 inches

Front 44

What is the clinical indication for swimmers C spine?

Back 44

Pathology involving the inferior cervical spine, superior thoracic spine and adjacent soft tissue fractures

Front 45

Where do you center for swimmers C spine?

Back 45

At T1, 1 inch above the jugular notch anteriorly and at the level of the vertebra prominens posteriorly

Front 46

What is the hyperflexion and hyperextension c spine usually done for?

Back 46

Demonstrate anteroposterior vertebral mobility and to rule out whip lash and follow up after spinal fusion surgery

Front 47

What projection shows C3 to C7?

Back 47

AP axial projection

Front 48

How do you position for hyperflexion c spine?

Back 48

Depress chin until it touches the chest or as much as the patient can tolerate

Front 49

How do you position for hyperextension?

Back 49

Raise chin and tilt head backwards as much as possible

Front 50

Where do you center for hyper extension and Flexion c spine?

Back 50

Direct CR horizontally to C4

Front 51

What does the AP axial projection demonstrate?

Back 51

Clays shovelers fracture, compression fractures and herniated nucleus pulposus (HNP)

Front 52

How many degrees does the CR angle have to be for AP axial?

Back 52

15 to 20 cephalic

Front 53

Where do you center for AP Axial?

Back 53

At the level of the lower margin of thyroid cartilage to pass through C4

Front 54

What is the clinical indication for oblique cervical spine?

Back 54

Stenosis involving the intervertebral foramen

Front 55

Is anterior or posterior oblique better for C-spine and why?

Back 55

Anterior oblique positions because of reduced thyroid doses

Front 56

What is the CR angle for RAO & LAO?

Back 56

15 to 20 caudal

Front 57

What is the CR angle for posterior oblique?

Back 57

15 to 20 cephalic

Front 58

Where do you center for the anterior and posterior oblique?

Back 58

To C4 level of upper margin of thyroid cartilage

Front 59

What projection would be a second option if you couldn’t visualize C1-C2 on AP mouth projection?

Back 59

Fuchs method (AP)

Front 60

What is the angle and center for CR for pillars position?

Back 60

Angle CR 20 to 30 caudal

And center at lower margin of the thyroid cartilage

Front 61

How do you position the patients neck for the pillar position?

Back 61

Hyperextend the neck if patient is able to

Front 62

Name the alternative name for AP or PA projection for C1-C2?

Back 62

(Odontoid process-dens)

Fuchs method (AP) and Judd method (PA)

Front 63

What is demonstrated on AP/PA projection for C1-C2?

Back 63

Pathology involving the dens and surrounding bony structures of the C1 ring

Front 64

How do you position and center for the Fuchs method?

Back 64

Elevate chin as needed to bring mentomeatal line (MML) near perpendicular to table top

Adjust CR angle as needed to be parallel to MML

Center to inferior tip of mandible

Front 65

How do you position and center for the Judd method?

Back 65

Prone position with chin resting on table top and is extended to bring MML near perpendicular to table

Center CR parallel to MML, 1 inch inferoposterior to mastoid tips and angles of mandible

Front 66

What the projection name for ottonello method?

Back 66

AP “wagging jaw”

Front 67

What is demonstrated on the AP wagging jaw?

Back 67

Pathology involving the odontoid process and surrounding bony structures of the C1 ring as well as the entire cervical column

Front 68

Where do you center for the ottonello method?

Back 68

Direct CR to C4

Front 69

What is the angle and center for pillars position?

Back 69

Angle CR 20 to 30 caudal

And center at lower margin of the thyroid cartilage

Front 70

What is the clinical indication for vertebral arch (pillars)?

Back 70

pathology or trauma involving the posterior vertebral arch of C4 to C7 and spinous processes of cervicothoracic vertebrae with whiplash type injuries

Front 71

How many positions are available including trauma for C spine?

Back 71

10

Front 72

What is the clinical indication for AP thoracic spine?

Back 72

Pathology involving the thoracic spine such as compression fractures, subluxation, or kyphosis

Front 73

Where do you center for AP thoracic spine?

Back 73

At T7, 3 to 4 inches below jugular notch or 1 to 2 inches below sternal angle

Front 74

Where should the anode and cathode be placed for the AP thoracic spine?

Back 74

The anode heel effect will create more uniform density throughout the thoracic spine. Place patient so the more intense aspect of the beam (cathode side) is over the thoracolumbar region of the spine

Front 75

Where do you center for lateral thoracic spine?

Back 75

T7, 3 to 4 inches below jugular notch or 7 to 8 inches below the vertebra prominens

Front 76

What is the clinical indication for anterior or posterior obliques?

Back 76

Pathology involving the zygapophyseal joints of the thoracic spine —both right and left oblique projections are taken for comparison

Front 77

Where do you center for anterior or posterior oblique thoracic spine?

Back 77

At T7

Front 78

Which oblique for thoracic spine is recommended?

Back 78

Anterior obliques because of significantly lower breast dose

Front 79

How should the body be rotated in a recumbent oblique position for a thoracic spine?

Back 79

Rotate the body 20 degrees from true lateral to create a 70 degree oblique from plane of table

Front 80

What is the largest individual vertebrae?

Back 80

The five lumbar vertebrae

Front 81

What is a common site for injury and pathologic processes on the lumbar vertebra?

Back 81

The cartilaginous disks between the inferior L spine

Front 82

Which body is the largest on the L spine?

Back 82

L5

Front 83

What is the clinical indication for AP L spine?

Back 83

Fractures, scoliosis, and neoplasticism processes

Front 84

Where do you center for L spine AP?

Back 84

Level of the iliac crest (L4-L5)

If using a small IR 1.5 inch above iliac crest

Front 85

What is the clinical indication for oblique L-spine?

Back 85

Defects of the pars interarticularis (spondylolsis)

Front 86

Where do you center for oblique L-spine?

Back 86

To L3 at the level of the lower costal margin , 1 to 2 inches above iliac crest and 2 inches medial upside to ASIS

Front 87

What is the clinical indication for lateral L-spine?

Back 87

Lumbar vertebrae fractures, spondylolisthesis, neoplastic processes, and osteoporosis

Front 88

Where do you center for lateral L-spine?

Back 88

Center to the level of the iliac crest (L4-L5)

Front 89

What is the clinical indication for L5-S1 lateral?

Back 89

Spondylolisthesis invoking L4-L5 or L5-S1 and other pathologies

Front 90

Where do you center and what’s the angle for the L5-S1 lateral?

Back 90

5 to 8 Caudal and center 1.5 inches below the iliac crest and 2 inches posterior to the ASIS

Front 91

What is the clinical indication for L5-S1 (AP) axial?

Back 91

L5-S1 and the SI Joints

Front 92

What is the alternative name for lateral spinal fusion series and why is it done?

Back 92

Hyperextension and hyper flexion , assessment of mobility at a spinal fusion site

Front 93

What is the SID for lateral spinal fusion?

Back 93

40

Front 94

How do you position for hyperflexion and hyperextension spinal fusion?

Back 94

Hyperflexion-put patient in fetal position

Hyperextension- tell patient to move torso and legs posteriorly as far as possible

Front 95

Where do you center for spinal fusion?

Back 95

Site of fusion if known or center of IR

Front 96

What is the SID and CR angle for AP sacrum?

Back 96

40 SID, 15 cephalic

Front 97

Where do you center AP sacrum?

Back 97

2 inches above the pubic symphysis

Front 98

What is the SID and CR angle for Coccyx?

Back 98

40 SID & 10 caudad

Front 99

Where do you center for AP coccyx?

Back 99

2 inches above the symphysis pubis

Front 100

Where do you center for the lateral sacrum and coccyx?

Back 100

3 to 4 inches posterior to ASIS

Front 101

Why is the lateral sacrum coccyx recommended over individual laterals?

Back 101

To decrease gonadal doses

Front 102

Where do you center and angle for the AP axial L5-S1?

Back 102

Levels of the ASIS at midline of the body , angle 30 male and 35 females cephalic

Front 103

What kind of filter would be used on a lateral sacrum/coccyx ?

Back 103

Boomerang to ensure optimal density

Front 104

What should be placed behind patient for lateral sacrum/coccyx and why?

Back 104

Lead masking on table behind patient to reduce scatter to IR

Front 105

What is the clinical indication for AP axial SI joints?

Back 105

Pathology of the SI joint, including fracture and joint dislocation or subluxation

Front 106

What is the SID and center for AP SI joints?

Back 106

40 sid and 2 inches below ASIS

Front 107

What is the angle of AP SI joints?

Back 107

30 for males and 35 females cephalic

Front 108

How do you position the patient for oblique SI joints?

Back 108

25 to 30 posterior oblique with side of interest elevated

Front 109

Where do you center for oblique SI joints?

Back 109

1 inch medial to upside ASIS

Front 110

What does the Ferguson method for scoliosis do?

Back 110

Assists in differentiating deforming (primary curve) from compensatory curve

Front 111

What is the method name for PA projection scoliosis series?

Back 111

Ferguson method

Front 112

What is the SID for scoliosis?

Back 112

72

Front 113

Where do you place the IR on Ferguson method scoliosis series?

Back 113

Place IR to include a minimum 1 to 2 inches below iliac crest.

Front 114

How do you position the patient in the scoliosis Ferguson method?

Back 114

One standard erect and one with the foot or hip on the convex side of the curve elevated

Front 115

What is the right/left bending scoliosis done for?

Back 115

Assessment of the range of motion of the vertebral column

Front 116

How do you position the patient for left/right scoliosis?

Back 116

Have patient bend laterally (lateral flexion) either side, erect or recumbent

Front 117

Where do you center for Left/right bending scoliosis?

Back 117

Place bottom edge of IR 1 to 2 inches below iliac crest