Chapter 8- C And T Spine

Front 1

How many bones make up the Cervical Spine?

Back 1

7

Front 2

How many bones make up the Thoracic Spine?

Back 2

12

Front 3

How many bones make up the Lumbar Spine?

Back 3

5

Front 4

How many bones make up the Sacrum?

Back 4

1

Front 5

How many bones make up the Coccyx?

Back 5

1

Front 6

How may bones make up the spine in total?

Back 6

26

Front 7

What are the two primary convex curvatures seen in the vertebral column?

Back 7

1. Thoracic

2. Sacral

Front 8

Which two portions of the vertebral column are classified as secondary or compensatory curves?

Back 8

1.Cervical

2. Lumbar

Front 9

C-Spine, T-Spine, L-Spine, or Sacrum?

Convex Curve (with respect to posterior)

Back 9

Thoracic and Sacrum

Front 10

C-Spine, T-Spine, L-Spine, or Sacrum?

Concave Curve (with respect to posterior)

Back 10

Cervical and Lumbar

Front 11

C-Spine, T-Spine, L-Spine, or Sacrum?

Secondary Curve

Back 11

Cervical and Lumbar

Front 12

C-Spine, T-Spine, L-Spine, or Sacrum?

Primary Curve

Back 12

Thoracic and Sacral

Front 13

C-Spine, T-Spine, L-Spine, or Sacrum?

Develops as child learns to hold head erect

Back 13

Cervical

Front 14

An abnormal, or exaggerated, "sway back" lumbar curvature is called: __________

Back 14

Lordosis

Front 15

An abnormal lateral curvature sen in the thoracolumbar spine is called _______

Back 15

Scoliosis

Front 16

The two main parts of a typical vertebra are the ____ and the _____

Back 16

Body; vertebral arch

Front 17

The _________ are two bony aspects of the vertebral arch that extend posteriorly from each pedicle to join at the midline.

Back 17

Lamina

Front 18

The ___ foramina are created by two small notches on the superior and inferior aspects of the pedicles.

Back 18

Intervertebral

Front 19

The opening, or passageway, for the spinal cord is the ______.

Back 19

Vertebral canal

Front 20

The spinal cord begins with the (a) _________ of the brain and extends down to the (b)__________ vertebra, where it tapers and ends. This tapered ending is called the (c)_______.

Back 20

(a) Medulla Oblongata (b) lower boarder of L1 (c) Conus Medullaris

Front 21

Which structures pass through the intervertebral foramina?

Back 21

Spinal Nerves and Blood Vessels

Front 22

Label A-F

Back 22

A. Spinous Process

B. Lamina

C. Transverse Process

D. Facets of Superior Articular Process

E. Pedicle

F. Vertebral Foramen

Front 23

Label G-K

Back 23

G. Spinous Process

H. Facet of Superior Articular Process

I. Pedicle

J. Body

K. Inferior Articular Process

Front 24

Label L-P
Q. The joints between the ribs and vertebrae at N are called: _______
R. The joints between the ribs and vertebrae at P are called:______

Back 24

L. Superior Articular Process
M. Zygapophyseal Joint
N. Facet for Head of Rib Articulation
O. Intervertebral Foramen
P. Facet for rib articulation

Q Costovertebral Joints
R. Costotransverse Joints

Front 25

Which of the following is found between the superior and inferior articular process?

A. Intervertebral Joints

B. Articular Joints

C. Zygapophyseal Joints

D. Intervertebral Facets

Back 25

C. Zygapophyseal Joints

Front 26

T/F: Only T1, T11, and T12 have full facets for articulation with ribs

Back 26

True

Front 27

T/F: The zygapophyseal joints of all cervical vertebrae are visualized only in a true lateral position

Back 27

False

Front 28

List the inner and outer aspects of the intervertebral disk

Back 28

Outer: Annulus Fibrosus

Inner: Nucleus Pulposus

Front 29

The condition involving a "slipped disk" is correctly referred to as:

Back 29

Herniated Nucleus Pulposus (HNP)

Front 30

List the alternative names for:

(a): C1

(b): C2

(c): C7

Back 30

a. atlas

b. Axis

c. vertebrae prominens

Front 31

List 3 features that make the Cervical Vertebrae unique:

Back 31

1. Transverse Foramina

2. Bifid Spinous process

3.Overlapping vertebral bodies

Front 32

A short column of bone found between the superior and articular processes in a typical cervical vertebrae is called:

Back 32

Articular Pillar

Front 33

What is the term for the articular process for the C1 vertebra?

Back 33

Lateral Mass

Front 34

The zygapophyseal joints for the 2nd-7th cervical vertebrae are at a ____ to the midsagittal plane; the thoracic vertebrae are at a ______ to the midsagittal plane.

Back 34

90 degree angle; 70-75 degree angle

Front 35

What is the name of the joint found between the superior articular processes of C1 and the occipital condyles of the skull?

Back 35

Occipitoatlantal articulations

Front 36

The modified body of C2 is called the ____ or the ______

Back 36

dens; odontoid process

Front 37

A lack of symmetry of the zygapophsyeal joints between C1 and C2 may be caused by injury or may be associated with _____.

Back 37

Rotation of the skull

Front 38

What is the unique feature of all thoracic vertebrae that distinguishes them from other vertebrae?

Back 38

Presence of facets for rib articulation

Front 39

Which specific thoracic vertebra are classified as typical thoracic vertebrae (i.e they lease resemble cervical or lumbar vertebrae?

Back 39

T5-T8

Front 40

Label A-E and what vertebrae it belongs to

Back 40

A. Body, C4

B. Dens, C2

C. Posterior Arch and Tubercle, C1

D. Zygapophyseal Joint, C5-C6

E. Vertebra Prominens, C7

Front 41

Label F-H and what vertebrae it belongs to

Back 41

F. Posterior Arch and Tubercle, C1

G. Pedicle, C4

H. Intervertebral Foramen, C4-C5

Front 42

For the CR to pass throughand "open" the intervertebral spaces on a 45 degree posterior oblique projection of the cervical vertebrae, what CR angle (if any) is required?

Back 42

15 degree cephalad

Front 43

What part of the sternum is this:

Upper portion of the sternum

Back 43

Manubrium

Front 44

What part of the sternum is this:

Superior margin of this upper section (landmark)

Back 44

Jugular Notch

Front 45

What part of the sternum is this:

Center portion of the sternum

Back 45

Body

Front 46

What part of the sternum is this:

Joint between top and center portions (landmark)

Back 46

Sternal Angle

Front 47

What part of the sternum is this:

Most inferior aspect of sternum (landmark)

Back 47

Xiphoid Process

Front 48

Match the topographic landmark to the correct vertebral level:

Gonion

Back 48

C3

Front 49

Match the topographic landmark to the correct vertebral level:

Xiphoid Process (Tip)

Back 49

T9-T10

Front 50

Match the topographic landmark to the correct vertebral level:

Thyroid Cartilage

Back 50

C4-C6

Front 51

Match the topographic landmark to the correct vertebral level:

Jugular Notch

Back 51

T2-T3

Front 52

Match the topographic landmark to the correct vertebral level:

Sternal Angle

Back 52

T4-T5

Front 53

Match the topographic landmark to the correct vertebral level:

Mastoid Tip

Back 53

C1

Front 54

Match the topographic landmark to the correct vertebral level:

Vertebra Prominens

Back 54

C7-T1

Front 55

Match the topographic landmark to the correct vertebral level:

3-4 inches below jugular notch

Back 55

T7

Front 56

In addition to the gonads, which other radiosensitive organs are of greatest concern during C-Spine and T-Spine radiography?

Back 56

Thyroid, Parathyroid, Breasts

Front 57

List the 2 advantages of using higher kV exposure factors (analog imaging) for spine radiography, especially on an AP thoracic spine radiograph?

Back 57

1. Increase in Exposure latitude

2. Decrease in patient dose

Front 58

T/F: When using digital imaging for spine radiography, it is important to use close collimation, grids, and lead masking

Back 58

True

Front 59

T/F: If close collimation is used during conventional (analog) radiography of the spine, the use of lead masking (blockers) is generally not required.

Back 59

False

Front 60

To ensure that the intervertebral joint spaces are open for lateral thoracic spine projections, it is important to:

A. Keep the vertebral column parallel to the IR

B. Use a small focal spot

C. Use a breathing technique

D. Angle the CR caudad

Back 60

A. Keep the vertebral column parallel to the IR

Front 61

For lateral and oblique projections of the cervical spine, it is important to minimize magnification and maximize detail by:

Back 61

1.Using a small focal spot 2. Increasing SID

Front 62

T/F: Many geriatric patients have a fear of falling off the radiographic table.

Back 62

True

Front 63

Which two landmarks must be aligned for an AP open mout projection?

Back 63

Lower margin of upper incisors and base of skull

Front 64

T/F: The tip of the odontoid process does not have to be demonstrated on the AP open mouth projection because it is best seen on the lateral projection

Back 64

False

Front 65

What is the purpose of the 15-20 degree angle for the AP axial projection of the C-Spine?

Back 65

To open up the intervertebral disk spaces

Front 66

For an AP axial of the C-Spine, a plane through the tip of the mandible and _______ should be parallel to the angle of the CR.

Back 66

Base of Skull

Front 67

T/F: Less CR angle is required for the AP axial projection of the C-Spine if the examination is performed supine rather than erect

Back 67

True

Front 68

What are 2 important benefits of an SID longer than 40-44inches for the lateral C-Spine projection?

Back 68

1.Compensates for increased OID

2. Less divergence of X-Ray beam to reduce shoulder imposition

Front 69

What CR angulation must be used with a posterior oblique projection of the C-Spine

Back 69

15 degree Cephalad

Front 70

Which formina are demonstrated with a left posterior oblique (LPO) position for the C-spine?

Back 70

Right Intervertebral Foramina (Upside)

Front 71

Which formina are demonstrated with a left Anterior oblique (LAO) position for the C-spine?

Back 71

Left Intervertebral Foramina (downside)

Front 72

In addition to extending the chin, which additional positioning technique can be performed to ensure that the mandible is not superimposed over the cervical vertebrae for the oblique projections?

Back 72

Rotate skull into a near lateral position

Front 73

What is the recommended SID for a lateral projection of the C-Spine?

Back 73

60-72 inches

Front 74

The lateral projection of the C-Spine should be taken on ______, why?

Back 74

Expiration, for maximum shoulder depression so shoulders aren't superimposed over c7-t1

Front 75

Which specific projection must be taken first if trauma to the C-Spine is suspected and the patient is in a supine position on a backboard?

Back 75

X-Table Lateral, Horizontal Beam

Front 76

The proper name for the cervicothoracic lateral (Swimmer's) position is:

Back 76

Twinning Method

Front 77

Where should the CR be placed for ta cervicothoracic lateral (swimmer's) position?

Back 77

To T1; 1 inch above Jugular notch anteriorly, to level of vertebra prominens posteriorly

Front 78

Which region of the spine must be demonstrated with a cervicothoracic lateral (swimmer's) position?

Back 78

C5-T3

Front 79

Which one of the following projections is considered a "functional study" of the C-Spine?

A. AP "wagging jaw" projection

B. AP "open mouth" position

C. Fuchs or Judd method

D. Hyperextensiton and hyperflexion lateral

Back 79

D. Hyperextensiton and hyperflexion lateral

Front 80

When should the Judd or Fuchs method be performed?

Back 80

If unable to demonstrate dens of axis w/ AP open mouth

Front 81

Which AP projection of the C-Spine demonstrates the entire upper C-Spine with one single projection?

Back 81

AP Wagging Jaw Projectio (Ottonello Method)

Front 82

Which 2 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?)

Back 82

Correct use of anode heel affect; use of compensating wedge filter

Front 83

What is the purpose of using orthostatic (breathing) technique for a lateral projectionof the T-Spine?

Back 83

Blur out rib and lung markings that obscure detail of the thoracic vertebrae

Front 84

Which zygapophyseal joints are demonstrated in a RAO projection of the T-Spine?

Back 84

Right (downside)

Front 85

Which of the following projections delivers the greatest skin dose to the patient?

A. AP thoracic spine projection

B. Lateral Cervical Spine Projecton

C. Cervicothoracic lateral position

D. Fuchs or Judd method

Back 85

C. Cervicothoracic lateral position

Front 86

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 C-Spine

Back 86

True

Front 87

Which of the following structures is best demonstrated with an AP axial vertebral arch projection?

A. Spinous Processes of Lumbar Spine

B. Articular Pillars (lateral masses) of C-Spine

C. Zygapophyseal joints of T-Spine

D. Cervicothoracic Spine Region

Back 87

B. Articular Pillars (lateral masses) of C-Spine

Front 88

What CR angle must be used with the AP Axial- vertebral arch projection?

Back 88

20-30 degrees caudad

Front 89

What ancillary device should be placed behind the patient on the tabletop for a recumbant lateral projection of the T-Spine?`

Back 89

Lead mat or masking

Front 90

Which skull positioning line is aligned perpendicular to the IR for a PA (Judd) projection for the odontoid process?

Back 90

Mentomeatal Line (MML)

Front 91

Which zygapophyseal joints are best demonstrated with an LPO position of the T-Spine?

Back 91

Right

Front 92

How much rotation of the body is required for an oblique position of the T-Spine from a true lateral position?

Back 92

20 degrees from a lateral position

Front 93

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. Which specific positioning error is present on this radiograph?

Back 93

Excessive extension of skull

Front 94

A radiograph of an AP axial projection of the C-Spine reveals that the intervertebral disk spaces are not open. The following positioning factors were used: extension of the skull, CR angled 10 degrees cephalad, CR centered to the thyroid cartilage, and no rotation or tilt of the spine. Which of these factors must be modified to produce a more diagnostic image?

Back 94

Increase CR angle to 15 degrees

Front 95

A radiograph of a RPO cervical spine projection reveals that the lower intervertebral foramina are not open. The upper intervertebral foramina are well visualized. What positioning error most likely led to this radiographic outcome?

Back 95

Underrotation of upper body, body must be rotated 45 degrees

Front 96

A radiograph on a lateral projectionof the C-Spine reveals that C7 is not clearly demonstrated. The following factors were used; erect position, 44inches SID, arms down by the patient's side, and exposure made during inspiration. Which two of these factors should be changed to produce a more diagnositc image during the repeat exposure?

Back 96

72 SID, expose on suspended expiration

Front 97

A radiograph of an AP "wagging jaw" (Ottonello Method) projection taken at 75 kV, 20 mAs, and .5 second demonstrates that part of the image of the mandible is still visible and obscuring the upper C-Spine. Which modification needs to be made to produce a more diagnostic image during the repeat exposure?

Back 97

Reduce mAs and increase exposure time to produce more blur of mandible

Front 98

A radiograph of a lateral thoracic spine reveals that lung markings and ribs make it difficult to visualize the vertebral bodies. The following factors were used; recumbant position, 40inch SID, short exposure time, and exposure made during full expiration. Which one of these factors must be modified to produce a more diagnostic image during the repeat exposure?

Back 98

Use of orthostatic breathing technique

Front 99

A radiograph of an AP projection of the thoracic spine is greatly overexposed but the lower vertebrae are well visualized. The head of the patient was placed at the anode end of the table. What can be modified during the repeat exposure to produce a more diagnostic image

Back 99

Use a compensating filter over upper thoracic spine to equalize density

Front 100

A radiograph of a cervicothoracic lateral position demonstrates superimposition of the humeral heads over the upper T-Spine. Because of an arthritic condition, the patient is unable to rotate the shoulders any farther apart. What can the technologist do to further separate the shoulders during the repeat exposure?

Back 100

Angle CR 3 degrees to 5 degrees

Front 101

A patient with a possible C-Spine injury enters the ER. the patient is on a backboard. Which projection of the C-Spine should be taken first?

Back 101

Horizontal beam lateral projection

Front 102

A patient who has been in a MVA enters the emergency room. The basic projections of the C-Spine reveal no subluxation (partial dislocation) or fracture. The physician wants the spine evaluated for whiplash injury. Which additional projections would best demonstrate this type of injury?

Back 102

Hyperextension and Hyperflexion lateral projection

Front 103

A patient comes to the Radiology department for a C-Spine series. An AP open mouth radiograph indicates that the base of the skull and lower edge of the front incisors are superimposed, but the top of the dens is not clearly demonstrated. What should the technologist do to demonstrate the upper portion of the dens? ( A horizontal beam lateral projection has ruled out a C-Spine fracture or sublaxation).

Back 103

Perform either AP Fuchs or PA Judd method

Front 104

A patient comes to the radiology department for a routine C-Spne series. the lateral projection demonstrates only the C1 to C6 region. The radiologist wants to see C7-T1. What additional projection can be taken to demonstrate this region of the spine?

Back 104

Swimmers Lateral

Front 105

A patient enters the ER with a possible C-Spine fracture, but the initial projections do not demonstrate any gross fracture or sublaxation. After reviewing the initial radiographs, the ER physician suspects either a congenital defect or fracture of the articular pillars of C4. He wants an additional projection taken to better see this aspect of the vertebrae. What additional projection can be taken to demonstrate the articular pillars of C4?

Back 105

AP Axial- Vertebral Arch (Pillar) Projection