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230 Cards in this Set
- Front
- Back
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How many cervical bones are found in the adult vertebral column?
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7
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How many thoracic bones are found in the adult vertebral column?
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12
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How many lumbar bones are found in the adult vertebral column?
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5
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How many sacral segments or bones are found in the adult body? How many in the infant body?
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1; 5
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How many coccygeal segments or bones are found in the adult body? How many in the newborn body?
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1; 4 (avg)
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How many total separate bones are found in the adult vertebral column?
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26
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How many total separate bones are found in newborn vertebral column?
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33
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Where are the two primary or posterior convex curves seen in the vertebral column?
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thoracic, sacral
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Where are the two secondary or compensating concave curves in the vertebral column?
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cervical, lumbar
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An abnormal, or exaggerated, "sway back" lumbar curvature.
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lordosis
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An abnormal or exaggerated lateral curvature seen in the thoracolumbar spine.
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scoliosis
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An abnormal or exaggerated thoracic "humpback" curvature.
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kyphosis
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Lordosis of the spine is always abnormal. True/False
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false, only if exaggerated
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The two main parts of a typical vertebra are:
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body, vertebral arch
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The two bony aspects of the vertebral arch that extend posteriorly from each pedicle to join at the midline
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laminae
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What foramina are created by two small notches on the superior and inferior aspects of the pedicles?
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intervertebral
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The opening, or passageway, for the spinal cord.
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vertebral canal
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Where does the spinal cord begin?
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medulla oblongata of the brain
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The downward extension of the spinal cord is located where?
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lower L1 border
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The tapered ending of the spinal cord.
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conus medullaris
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Which structures pass through the intervertebral foramina?
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spinal nerves, blood vessels
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The thick, weight-bearing anterior part of the vertebra.
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body
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Why are the superior and inferior surfaces of the body rough and flat?
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attachment of the intervertebral disks
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What extends posteriorly from the vertebral body?
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a ring or arch
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The circular opening formed by the posterior surface of the body and the vertebral arch.
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vertebral foramen
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What is the tubelike opening formed by the sucession of vertebral formina as a result of stacked vertebrae?
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vertebral canal
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What does the vertebral canal do?
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encloses and protects the spinal cord
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What extends posteriorly from either side of the vertebral body and forms most of the sides of the vertebral arch? (superior perspective)
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pedicles
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What are the two somewhat flat layers of bone that form the posterior part of the vertebral arch? (superior perspective)
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laminae
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What extends posteriorly from each pedicle to unite in the midline? (superior perspective)
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lamina
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The projection that extends laterally from approximately the junction of each pedicle and lamina. (superior perspective)
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transverse process
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The projection that extends posteriorly at the midline junction of the two laminae and most posterior extension of the vertebrae. (superior perspective)
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spinous process
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From a lateral perspective, the posterior extensions directly off the vertebral body and are located on each side.
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pedicle
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From a lateral perspective, where do the pedicles terminate?
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area of the transverse process
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From a lateral perspective, what continues posteriorly from the origin of the transverse process on each side?
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two laminae
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Where does the lamina end, from a lateral perspective?
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at the spinous process
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How many articular processes are there?
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4 (2 superior, 2 inferior)
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What do the articular processes formulate?
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important joints of the vertebral column
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What is the third main part of a typical vertebra?
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joints
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How many joint types are in the vertebral column?
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3
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The joints found between the vertebral bodies.
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intervertebral joints
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What is located within the intervertebral joints and are tightly bound to adjacent vertebral bodies for spinal stability but allow for flexibility and movement of the vertebral column?
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intervertebral disks
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The joints located between the superior and inferior articular processes.
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zygapophyseal joints
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The term used to describe the articulating surface.
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facet
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The joints located along a portion of the vertebral column and articulates with the ribs to the thoracic vertebra.
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costal joints
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The articulation of a facet, located on the body of a thoracic vertebra, with the head of a rib.
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costovertebral joint
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The articulation of a facet, located on a transverse process of the thoracic vertebra, with the tubercle of a rib.
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costotransverse joint
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The half moon-shaped area located along the upper surface of each pedicle. (left/right)
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superior vertebral notch
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The half moon-shaped area located along the lower surface of each pedicle. (left/right)
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inferior vertebral notch
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The opening formed by the alignment of the superior and inferior vertebral notches when the vertebraes are stacked. (4th aspect of vertebral column)
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intervertebral foramen
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Where are the intervertebral foramina located?
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between every two vertebrae
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How many intervertebral foramen (foramina) are located between every two vertebrae?
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2, one on each side
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What passes through the intervertebral foramina?
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important spinal nerves and blood vessels
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Typical adult vertebrae are separated by tough fibrocartilaginous disks between every two vertebra. True/False
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false, not between C1 and C2 as C1 has no body
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What is the purpose of the intervertebral disks?
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provide a resilient cushion between the vertebrae and help absorb shock during movement of the spine
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What is the outer fibrous portion of the intervertebral disk?
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annulus fibrosus
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What is the soft, semigelatinous inner part of the intervertebral disk?
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nucleus pulposus
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What happens when the soft inner portion of the intervertebral disk, nucleus pulposes, protrudes through the outer fibrous layer, annulus fibrosus,of the intervertebral disk?
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it presses on the spinal cord and causes severe pain and numbness that radiates into the lower limbs
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Name the condition when the soft inner portion of the intervertebral disk, nucleus pulposes, protrudes through the outer fibrous layer, annulus fibrosus,of the intervertebral disk.
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slipped disk
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The condition causing a "slipped disk" is correctly referred to what?
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herniated nucleus pulposes (HNP)
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The zygapophyseal joints of all cervical vertebrae are visualized only in a true lateral position. True/False
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false
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What zygapophyseal joints of the cervical spine are visualized on a true AP projection?
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C1-C2
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What zygapophyseal joints of the cervical spine are visualized on a true lateral projection?
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C3-C7
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What is the vertebral column?
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a complex succession of many bones called vertebrae
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Where is the function of the vertebral column?
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provide a flexible supporting column for the trunk and head and also transmit the weight of the trunk and upper body to the lower limbs
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Where is the vertebral column located?
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midsagittal plane, forming the posterior or dorsal asapect of the bony trunk of the body
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As adjacent vertebrae are stacked vertically, openings in each vertebra line up to create what?
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a tubelike vertical spinal canal
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What does the spinal canal contain?
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the spinal cord
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What is the spinal canal filled with?
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cerebrospinal fluid
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What is the most common site for a lumbar puncture into the spinal canal to avoid striking the spinal cord?
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level of L3-L4
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How many divisions are in the vertebral canal?
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5; cervical, thoracic, lumbar, sacral, coccyx
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How many cervical vertebrae are in the vertebral column?
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7
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How many thoracic vertebrae are in the vertebral column?
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12
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What are the unique characteristics of the cervical vertebrae?
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transverse foramina, bifid spinous process tips, overlapping vertebral bodies
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The cervical vertebrae are all the same size. True/False
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false, they continue to get larger progressing down to the seventh cervical vertebra
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Which vertebrae are considered "typical" vertebrae?
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C3-C6
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What is another term used to describe the first vertebra, C1?
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atlas
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Where was the term "atlas" for C1 derived from?
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a Greek god who bore the world upon his shoulders
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What is the distinquishing feature of C1?
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it has no body but a thick arch of bone called the anterior arch which includes a small anterior tubercle
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What replaces the two laminae and spinous process, found in typical vertebrae, on C1?
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posterior arch that includes a small posterior tubercle
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What is another term used to describe the second vertebra, C2?
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axis
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What is the most distinctive feature of C2?
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dens; odontoid process
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What is the dens, or odontoid process?
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a conical process that projects up from the superior surface of the vertebra body of C2
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What is the dens embryologically?
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body of C1; fuses to C2 during development
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What holds the dens in place to C1?
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transverse atlantal ligament
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What is to the left and right of C1?
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superior articular processes
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What is the large depressed surface of the left and right superior articular processes on C1 called?
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superior facet
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What is the purpose of the superior facet on the right and left superior articular processes of C1?
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articulation with the respective right and left occipital condyles of the skull
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What are the articulations/joints between C1 and the occupital condyles of the skull called?
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atlantooccipital articulations
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The segments of bone between the superior and inferior articular processes of a typical vertebra.
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articular pillars
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The segment of bone between the superior and inferior articular process of C1.
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lateral mass
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The lateral mass of C1 is the most bulky and solid part. What is it's purpose?
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support the weight of the head and assist in rotation of the head
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Where does the rotation of the head primarily occur?
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between C1 and C2
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What acts as a pivot for rotation of the head?
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dens
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What assists the dens with rotation of the head?
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superior articular processes that articulate with the skull
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What type of stress might cause fracture of the dens?
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forced flexion-hyperextension "whiplash" type of injury
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Why is the relationship of C1 and C2 and the relationship of C1 to the base of the skull clinically important?
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injury this high in the spinal canal can result in serious paralysis and death
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What does the AP open mouth demonstrate?
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C1 and C2
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Why is the anterior arch of C1, which lies in front of the dens, not clearly visible on an xray image?
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it is a thin piece of bone compared with the larger, more dense den
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The articulations between C2 and C1, the zygapophyseal joints, and the relationship of the dens to C1 must be perfectly symmetric. What would render these areas asymmetric?
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injury and improper positioning
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What is another term used to describe the seventh vertebra, C7?
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vertebra prominens
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What section of the vertebral column does C7 most resemble?
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thoracic, spinous process is extra long and more horizontal than the other cervical vertebrae
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What is the palpable bony landmark of the cervical column, where is it located and what is it's purpose?
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spinous process of C7, base of the neck, used for radiographic positioning
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The transverse processes of the typical cervical vertebrae arise from the pedicle-lamina junction. True/False
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false, from the pedicle and the body
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What is the hole in each transverse process of the cervical vertebra called?
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transverse foramen
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What passes through the cervical transverse foramen?
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vertebral artery and veins, and certain nerves
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How many foramina are found in the cervical vertebrae? Name them.
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3, right and left transverse foramina and the single large vertebral foramen
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The spinous processes of C2-C6 are fairly short and end in what?
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double-pointed or bifid tip
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The cervical superior and inferior articular processes, located over and under the articular pillars, are directly lateral to what?
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the large vertebral foramen
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The zygapophyseal joints for the second through seventh cervicle verebrae are situated at what angle?
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90° or right angles to the midsagittal plane
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How are the zygapophyseal joints of C3-C7 visualized radiographically?
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true lateral projection
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How are the zygapophyseal joints of C1-C2 visualized radiographically?
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true AP projection
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How can the intervertebral foramina of the cervical column be identified?
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by the pedicles
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The pedicles in the cervical column form what bounderies of the intervertebral foramina?
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superior and inferior
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The intevertebral foramina of the cervical vertebrae are situated at what angle?
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45° angle to the midsagittal plane and open anteriorly show T5-T8, least resemble cervical or lumbar vertebrae
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Describe T1-T4 characteristics.
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smaller, share features of the cervical vertebrae
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Describe T9-T12 characteristics.
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larger, share characteristics of the lumbar vertebrae
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What is the unique feature of all thoracic vertebrae that distinguishes them from other vertebrae?
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facets for rib articulation
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How many facets do the thoracic vertebrae have and where are they positioned?
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one full facet or a partial facet on each side
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Another term for two partial facets.
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demifacets
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Each facet or combination of two demifacets located on the thoracic vertebrae accepts the head of a rib to form what joint?
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costovertebral
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The first 10 thoracic vertebrae have an additional set of facets located where?
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on each side of the transverse process
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Each set of facets on the transverse processes of T1-T10 that articulate with the tubercles of ribs 1-10 form what joint?
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costotransverse
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Ribs 11 and 12 articulate only at the costotransverse joints. True/False
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false, costovertebral joint
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How is the spinous process of the thoracic region projected?
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inferiorly
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How is the spinous process of the thoracic region best viewed radiographically? projection
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lateral
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How is the spinous process of the thoracic region projected radiographically on an AP, anteroposterior, projection?
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superimposed on the body of the successive thoracic vertebra
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From a lateral oblique perspective of the thoracic spine, what direction is the superior articular processes facing?
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primarily posterior
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From a lateral oblique perspective of the thoracic spine, what direction is the inferior articular processes facing?
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more anterior
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What is found on each side, between any thoracic vertebrae, which are defined on the superior and inferior margins by the pedicles?
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intervertebral foramina
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In the thoracic vertebrae, what angle do the zygapophyseal joints form?
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70-75° from the midsagittal plane
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What postition would be needed in order to "open up"and radiographically demonstrate the thoracic zygapophyseal joints?
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an oblique 70-75° rotated position with a perpendicular central ray
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The openings of the intervertebral foramina on the thoracic vertebra are located at what angle?
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90° or right angles to the midsagittal plane
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What postition would be needed in order to radiographically demonstrate the thoracic intervertebral foramina?
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true lateral, 90° projection will demonstrate the right and left superimposed on e
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Upper portion of the sternum
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manubrium
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Superior margin of upper section of sternum (landmark)
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Jugular notch (suprasternal notch)
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Main center portion of sternum
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body
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Joint between top and center portions of sternum (landmark)
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Sternal angle
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Most inferior aspect of sternum (landmark)
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xiphoid process
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Xiphoid process (tip) is at the level of
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T10
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Thyroid cartilage is at the level of
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C4-C5
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Jugular notch is at the level of
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T2-T3
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Sternal angle is at the level of
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T4-T5
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Mastoid tip is at the level of
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C1
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Vertebra prominens
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C7-T1
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3 to 4 inches (8 to 10cm) below jugular notch
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T7
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In addition to the gonads, which 3 other radiosensitive organs are of greatest concern during cervical and thoracic spine radiography
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Thyroid gland, para thyroid glands, and female breasts.
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Two advantages of using higher kV exposure factors for spine radiography, especially on an AP thoracic spine radiograph
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Increase in exposure latitude and decrease in patient dose.
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T/F When using digital imaging for spine radiography, it is important to use close collimation, grids, and lead masking.
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True- it is important to use close collimation, grids, and lead masking.
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T/F If close collimation is used during conventional radiography of the spine, the use of lead masking is generally not required.
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False- Lead masking should be used even if close collimation is used.
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T/F To a certain degree, MRI and CT are replacing myelography as the imaging modalities of choice for the diagnosis of a ruptured intervertebral disk.
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True- These modalities are replacing myelography.
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T/F Nuclear Medicine is often performed to diagnose bone tumors of the spine.is used to diagnose bone tumors of the spine.
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True. Nuclear Medicine
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To ensure that the intervertebral joint spaces are open for lateral thoracic spine projections, it is important to :
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Keep the vertebral column parallel to the image receptor.
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For lateral and oblique projections of the cervical spine, it is important to minimize magnification and maximize detail by:
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Using a small focal spot and increasing the source to image receptor distance (SID).
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Fracture through the pedicles and anterior arch of C2 with forward displacement upon C3
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Hangman's fracture
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Inflammation of the vertebrae
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Spondylytis
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Abnormal or exaggerated convex curvature of the thoracic spine
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Kyphosis
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Comminuted fracture of the vertebral body with posterior fragments displaced into the spinal canal
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Teardrop burst fracture
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Avulsion fracture of the spinous process of C7
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Clay shoveler's fracture
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Abnormal lateral curvature of the spine
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Scoliosis
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A form of rheumatoid arthritis
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Ankylosing spondylitis
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Impact fracture from axial loading of the anterior and posterior arch of C1
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Jefferson fracture
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Mild form of scoliosis and kyphosis developing during adolescence
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Scheuermann disease
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Produces the "bow tie" sign
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Unilateral subluxation
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What are the major differences between spondylosis and spondylitis?
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Spondylitis is an inflammatory process of the vertebrae. Spondylosis is a condition of the spine characterized by rigidity of a vertebral joint.
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What is the name of the radiographic procedure that requires the injection of contrast media into the subarachnoid space?
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Myelography
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Which imaging modality is ideal for detecting early signs of osteomyelitis? Medicine
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Nuclear
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T/F Many geriatric patients have a fear of falling off the radiographic table.
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True.
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Which two landmarks must be aligned for an AP "open mouth" projection.
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The lower margin of upper incisors and the base of the skull.
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What is the purpose of the 15 to 20 degree angle for the AP axial projection of the cervical spine?
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To open the intervertebral disk space.
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For an AP axial of the cervical spine, a plane through the tip of the mandible and _______ should be parallel to the angled central ray.
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Base of skull
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What are two important benefits of an SID longer than 40-44 inches for the lateral cervical spine projections?
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Less divergence of x-ray beam to reduce shoulder superimposition of C7, and compensates for increased OID; reducing magnification.
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What central ray angulation must be used with a posterior oblique projection of the cervical spine?
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15 degree cephalad angle.
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Which foramina are demonstrated with a left posterior oblique (LPO) position of the cervical spine?
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The right intervertebral foramina or upside.
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Which foramina are demonstrated witha a left anterior oblique (LAO) position of the cervical spine?
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The left intervertebral foramina or downside.
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In addition to extending the chin, which additional positioning technique can be performed to ensure that the mandible is not superimposed over the upper cervical vertebrae for the oblique projections?
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Rotate the skull into a near lateral position.
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What is the recommended SID for a lateral projection of the cervical spine?
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60" - 72"
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The lateral projection of the cervical spine should be taken during _________.
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Expiration. To maximize shoulder depression.
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Which specific projection must be taken first if trauma to the cervical spine is suspected and the patient is in a supine position on a backboard?
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Lateral, horizontal beam projection.
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The proper name of the method for performing the cervicothoracic (swimmer's lateral) projection is the________.
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Twining method.
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Where should the central ray be placed for a cervicothoracic (swimmer's lateral) projection?
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At T1 1 inch above jugular notch, or at the vertebral prominence (C7)
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Which region of the spine must be demonstrated with a cervicothoracic (swimmer's lateral) projection?
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C4 to T3
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Which one of the following projections is considered a "functional study" of the cervical spine. AP wagging jaw projection, AP open mouth position, Fuchs or Judd method, Hyperextension and flexion lateral positions.
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Hyperextension and flexion lateral positions.
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When should the Judd or Fuchs method be performed?
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If unable to demonstrate the upper portion of the dens with the AP open mouth projection.
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Which AP projection of the cervical spine demonstrates the entire upper cervical spine with one single projection?
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Scoliosis series.
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Which two things can be done to produce equal density along the entire thoracic spine for the AP projection (especially for a patient with a thick chest)?
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correct use of anode-heel effect; use of compensating (wedge) filter. correct use of anode-heel effect; use of compensating (wedge) filter.
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What is the purpose for using a brething technique for a lateral projection of the thoracic spine?
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To blur out rib and lung markings that obscure detail of thoracic vertebrae.
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Which zygopophyseal joints are demonstrated in a right anterior oblique (RAO) projection of the thoracic spine?
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The right downside.
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Which one of the following projections delivers the greatest skin dose to the patient? AP thoracic spine projection, Lateral cervical spine projection, Swimmer's lateral projection, Fuchs or Judd method.
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Swimmer's Lateral
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Which of the following results in the lowest midline and skin doses for the patient? AP T-Spine projection at 90kV@7 mAs, AP T-spine at 80kV @12 mAs, Lateral T-spine at 80kV@50 mAs, Oblique T-spine at 80kV@20 mAs
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AP Thoracic spine at 90kV@7mAs
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T/F The thyroid dose used during a posterior oblique cervical spine projection is more than 10 times greater than the dose used for an anterior oblique projection of the cervical spine.
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True (anterior oblique <5 mrad; posterior oblique <69 mrad)
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Which one of the following structures is best demonstrated with an AP axial vertebral arch projection? Spinous processes-lumbar spine, Articular pillar-(lateral mass)-cervical spine, Zygopophyseal joints-thoracic spine, Cervicothoracic spine region.
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Articular pillar (lateral masses) of cervical spine.
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What central ray angle must be used with the AP axial-vertebral arch projection?
|
20-30 degree caudal angle
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What ancillary device should be placed behind the patient on the table top for a recumbent lateral projection of the thoracic spine when using computed radiography?
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lead mat or masking
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Which skull positioning line is aligned perpendicular to the IR for a PA (Judd) projection for the odontoid process?
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Mentomeatal line (MML)
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Which zygopophyseal joints are best demonstrated with a LPO position of the thoracic spine?
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right (upside)
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How much rotation of the body is required for an oblique position of the thoracic spine from a true lateral position? 20 degrees from lateral
|
pathologic indication of the spine
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A radiograph of an AP "open mouth" projection of the C-spine reveals that the base of the skull is superimposed over the upper odontoid process. Whats the positioning error?
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Excessive extention of the skull
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An AP axial projection of the c-spine requires what angulation?
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15 degree cephalad angle
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What is the SID for the c-spine?
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60"-72"
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What is the name of the AP "wagging jaw" of the c-spine?
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Ottonello method
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The Ottonello method requires a short exposure time. (True/False)
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False. purpose is the blur the mandible.
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What does the breathing technique do on the Lateral T-spine?
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blurs out unwanted rib and lung markings.
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What is the Anode Heel Effect?
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creates a uniform density throughout T-spine. Cathode side is over abdominal end of patient
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Why do you flex the patients knees and hips for an AP T-spine?
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to reduce thoracic curvature
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What does the wedge compensating filter do on an AP T-spine?
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obtains uniform brightness/density. Thicker part of filter is over the upper vertebra of patient.
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What do you do on a Lateral T-spine if the patient has broad shoulders?
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angle the CR 3-5 degrees cephalic
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On a trauma C-spine, what projection should you do first?
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left horizontal lateral
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What pathology may be visualized with a left horizontal lateral projection for a trauma patient?
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clay shoveler's, compression, hangman's, odontoid, and teardrop burst fractures.
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What is subluxation?
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partial dislocation
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What projections would best demonstrate a whiplash injury?
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hyperextension and hyperflexion lateral positions
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The lateral hyperflexion and hyperextension of the c-spine are performed to rule out whiplash and what else?
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follow up after spinal fusion surgery
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What's viewed on a c-spine hyperflextion?
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spinous processes should be well seperated
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What's viewed on a c-spine hyperextension?
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spinous processes should be close in proximity.
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What other projections can be taken to view the odontoid process/dens besides the AP open mouth?
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AP Fuchs; PA Judd
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If technologist cannot obtain C7-T1 on the lateral c-spine, what other projection can be taken?
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Cervicothoracic (Swimmers)
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Whats another name for the Cervicothoracic (Swimmers) projection?
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Twining Method
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To help seperate the shoulders on the Cervicothoracic (Swimmers) projection, what should the technologist do?
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slight caudad angle of 3-5 degrees
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What projection can be taken to demonstrate the lateral masses of C4?
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AP Axial vertebral arch (pillars)
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What are the structures shown on the AP axial vertebral arch(pillars) projection?
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posterior elements of mid and distal cervical and proximal thoracic vertebrae. C4-C7
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What specific projection is taken for a Jefferson fracture? (besides a CT scan)
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AP open mouth
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What procedure is performed if a patient has a history of Scheuermann disease?
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scoliosis series
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Convex curve with (respect to posterior)
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Thorasic spine and sacram
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concave curve(respect to posterior)
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cervical spine and lumbar spine
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secondary curve
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cervical spine and lumbar spine
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Primary curve
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Thorasic spine and sacram
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Developesas child learns to hold head errect
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cervical spine
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An abnormal or exaggerated thoracic "humpback" curvature.
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kyphosis
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Lordosis of the spine is always abnormal. True/False
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false, only if exaggerated
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which specific thoracic verterbra are classified as typical thorasic veterbra
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T5-T8, least resemble cervical or lumbar vertebrae
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