Bontrager Ch.8 Workbook
Name the following parts of the sternum or associated topographic landmarks. Upper portion of sternum:
MANUBRIUM
B. List the inner aspects of the intervertebral disk
Nucleus pulposus
Match the following topographic landmarks to the correct vertebral level. Thyroid cartilage
C4-C6
Which region of the spine must be demonstrated with a cervicothoracic lateral position
C5 to T3
List the number of bones found in each division in the adult vertebral column- Cervical
7 (breakfast)
Which of the following projections delivers the greatest skin dose to the patient
. Cervicothoracic lateral position
List the number of bones found in each division in the adult vertebral column- Coccyx
1
List the number of bones found in each division in the adult vertebral column- Sacrum
1
What central-ray angulation (amount and direction) must be used with a posterior oblique projection of the cervical spine
15 degrees cephalad
List the number of bones found in each division in the adult vertebral column - Thoracic
12 (lunch)
For the central ray to pass through and "open" the intervertebral spaces on a 45-degree posterior oblique projection of the cervical vertebrae, what central-ray angle (if any) is required
15 degrees cephalad
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 position (70 degrees from plane of table or wall bucky)
What central-ray angle must be used with the AP axial-vertebral arch (Pillars) projection
20- to 30-degree caudad
List the number of bones found in each division in the adult vertebral column- Lumbar
5 (dinner)
\What is the recommended SID for the cervicothoracic position of the cervical spine
60 to 72 inches (152 to 183 cm)
the thoracic vertebrae are at a ______ degree angle to the midsagittal plane.
70-75
The zygapophyseal joints for the second through seventh cervical vertebrae are at a ______ degree angle to the midsagittal plane
90
3. Indicate which two portions of the vertebral column are classified as secondary or compensatory curves
A. Cervical B. Lumbar
What are two important benefits of using an SID 60 to 72 inches (152 to 183 cm) for the lateral cervical spine projection
A. Compensates for increased object image receptor distance (OID); reduces magnification B. Less divergence of x-ray beam to reduce shoulder superimposition of C7
List the two advantages of using higher kV exposure factors with high-latitude analog (film-screen) systems imaging for spine radiography, especially on an anteroposterior (AP) thoracic spine radiograph.
A. Increase in exposure latitude (wider range of densities) B. Decrease in patient dose
List the two primary or posterior convex curves seen in the vertebral column
A. Thoracic B. Sacral
List three features that make the cervical vertebrae unique.
A. Transverse foramina B. Bifid spinous process C. Overlapping vertebral bodies
Which AP projection of the cervical spine demonstrates the entire upper cervical spine with one single projection
AP "wagging jaw" projection (Ottonello method)
List the outer and aspects of the intervertebral disk
Annulus fibrosus
A short column of bone found between the superior and articular processes in a typical cervical vertebra is called
Articular pillar
Which of the following structures is best demonstrated with an AP axial vertebral arch projection
Articular pillars (lateral masses) of the cervical spine
What is the name of the joint found between the superior articular processes of C1 and the occipital condyles of the skull
Atlanto-occipital articulation
alternative names C1:
Atlas
alternative names C2:
Axis
Match the following topographic landmarks to the correct vertebral level. Vertebra prominens
C7-T1
Name the following parts of the sternum or associated topographic landmarks. Center portion of sternum:
BODY
The two main parts of a typical vertebra are the ______________ and the
BODY ; VERTEBRAL ARCH
For an AP axial of the cervical spine, a plane through the tip of the mandible and the __________________________ should be parallel to the angled central ray.
Base of skull
Match the following topographic landmarks to the correct vertebral level. Mastoid tip
C1
Match the following topographic landmarks to the correct vertebral level. Gonion
C3
Match the correct aspect(s) of the vertebral column with the following characteristics. Develops as child learns to hold head erect
Cervical Spine
Match the correct aspect(s) of the vertebral column with the following characteristics. Concave curve (with respect to posterior)
Cervical/Lumbar
Match the correct aspect(s) of the vertebral column with the following characteristics. Secondary curve
Cervical/Lumbar
Which two things can be done to produce equal density along the entire thoracic spine for an AP projection (especially for a patient with a thick chest)
Correct use of anode-heel effect and use of compensating (wedge) filter
The modified body of C2 is called the
Dens or odontoid process
The lateral projection of the cervical spine should be taken during __________(inspiration, expiration, or suspended respiration). Why
EXPIRATION ; MAXIMUM SHOULDER DEPRESSION
True/False: The zygapophyseal joints of all cervical vertebrae are visualized only in a true lateral position.
FALSE (between C1 and C2 visualized on a frontal or AP projection)
True/False: Only T11 and T12 have full facets for articulation with ribs.
FALSE (T1, T10 to T-12 have full facets)
True/False: If close collimation is used during conventional (analog) radiography of the spine, the use of lead masking (blockers) is generally not required.
FALSE (Lead masking should be used even if close collimation is used.)
True/False: 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.
False. The entire dens or odontoid process must be demonstrated. If trauma or injury is ruled out, the technologist could perform the AP or PA projection for the odontoid process to demonstrate the tip.
The condition involving a "slipped disk" is correctly referred to as
Herniated nucleus pulposus (HNP)
Which of the following projections is considered a "functional study" of the cervical spine
Hyperextension and hyperflexion lateral positions
Two small notches on the superior and inferior aspects of the pedicles create the
INTERVERTEBRAL foramina.
An abnormal, or exaggerated, "sway back" lumbar curvature is called
LORDOSIS
When should the Judd or Fuchs method be performed
If unable to demonstrate the upper portion of the odontoid process (dens) with the AP "open mouth" projection
Name the following parts of the sternum or associated topographic landmarks. Superior margin of this upper section (landmark):
JUGULAR (SUPRASTERNAL) NOTCH
To ensure that the intervertebral joint spaces are open for lateral thoracic spine projections, it is important to:
Keep the vertebral column parallel to the image receptor (IR)
The _______ are two bony aspects of the vertebral arch that extend posteriorly from each pedicle to join at the midline.
LAMINA
Which foramina are demonstrated with a left anterior oblique (LAO) position of the cervical spine
LT Intervertebral foramina(DOWNSIDE)
What is the term for the same structure, identified in the previous question, for the C1 vertebra
Lateral mass
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
Lateral, horizontal beam projection
What ancillary device should be placed behind the patient on the tabletop for a recumbent lateral projection of the thoracic spine
Lead mat or masking
Which two landmarks must be aligned for an AP "open mouth" projection
Lower margin of upper incisors and base of skull
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) __________
MEDULLA OBLONGATA ; LOWER BORDEROF L1; CONUS MEDULLARIS
What is the name of the radiographic procedure that requires the injection of contrast media into the subarachnoid space
MYELOGRAPHY
Which skull positioning line is aligned perpendicular to the IR for a PA (Judd) projection for the odontoid process
Mentomeatal line (MML)
Which imaging modality is ideal for detecting early signs of osteomyelitis
NUC MED
What is the unique feature of all thoracic vertebrae that distinguishes them from other vertebrae
Presence of facets for articulation with ribs
Which zygapophyseal joints are best demonstrated with an LPO position of the thoracic spine
Right
Which zygapophyseal joints are demonstrated in a right anterior oblique (RAO) projection of the thoracic spine
Right (downside)
Which foramina are demonstrated with a left posterior oblique (LPO) position of the cervical spine
Right intervertebral foramina (upside)
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 oblique projections
Rotate the skull into a near lateral position
A lack of symmetry of the zygapophyseal joints between C1 and C2 may be caused by injury or may be associated with
Rotation of the skull
An abnormal lateral curvature seen in the thoracolumbar spine is called
SCOILIOSIS
Which structures pass through the intervertebral foramina
SPINAL NERVES & BLOOD VESSELS
Name the following parts of the sternum or associated topographic landmarks. Joint between top and center portions (landmark):
STERNAL ANGLE
What are the major differences between spondylosis and spondylitis
Spondylitis is an inflammatory process of the vertebrae characterized by bony bridges between vertebrae (advanced stages). Spondylosis is a condition of the spine characterized by decreased vertebral joint space and arthritic changes of the zygapophyseal joints.
The common name of the method for the cervicothoracic lateral position is the
Swimmer's method
Match the following topographic landmarks to the correct vertebral level. Jugular notch
T2-T3
Match the following topographic landmarks to the correct vertebral level. . Sternal angle
T4-T5
Which specific thoracic vertebrae are classified as typical thoracic vertebrae (i.e., they least resemble cervical or lumbar vertebrae)
T5 to T8
Match the following topographic landmarks to the correct vertebral level. 3 to 4 inches (8 to 10 cm) below jugular notch
T7
Match the following topographic landmarks to the correct vertebral level. Xiphoid process (tip)
T9-T10
True/False: Many geriatric patients have a fear of falling off the radiographic table.
TRUE
True/False: Nuclear medicine is often performed to diagnose bone tumors of the spine.
TRUE
True/False: To a certain degree, magnetic resonance imaging (MRI) and computed tomography (CT) are replacing myelography as the imaging modalities of choice for the diagnosis of a ruptured intervertebral disk.
TRUE
True/False: When using digital imaging for spine radiography, it is important to use close collimation, grids, and lead masking.
TRUE
Match the correct aspect(s) of the vertebral column with the following characteristics. Convex curve (with respect to posterior)
Thoracic/Sacrum
Match the correct aspect(s) of the vertebral column with the following characteristics. Primary curve
Thoracic/Sacrum
In addition to the gonads, which other radiosensitive organs are of greatest concern during cervical and thoracic spine radiography
Thyroid, parathyroid glands, and breasts
Where should the central ray be placed for a cervicothoracic lateral position
To T1; 1 inch (2.5 cm) above the jugular notch anteriorly and level of vertebra prominens posteriorly
What is the purpose of using an orthostatic (breathing) technique for a lateral projection of the thoracic spine
To blur out rib and lung markings that obscure detail of thoracic vertebrae
What is the purpose of the 15- to 20-degree cephalad angle for the AP axial projection of the cervical spine
To open up the intervertebral disk spaces
True/False: Performing the cervicothoracic projection is often required to demonstrate the C7/T1 region for the obese patient.
True
True/False: The thyroid dose delivered during a posterior oblique cervical spine (LPO or RPO) projection is greater than the thyroid dose for an anterior oblique (RAO or LAO) projection of the cervical spine.
True
For lateral and oblique projections of the cervical spine, it is important to minimize magnification and maximize detail. This can be done by (more than one answer may be used):
Using a small focal spot Increasing the source image receptor distance (SID)
The opening, or passageway, for the spinal cord is the
VERTEBRAL (SPINAL) CORD
alternative names C7:
Vertebra prominens
Name the following parts of the sternum or associated topographic landmarks.Most inferior aspect of sternum (landmark):
XIPHOID PROCESS
Which of the following is found between the superior and inferior articular processes
Zygapophyseal joints
True/False: Less CR angle is required for the AP axial projection of the cervical spine if the examination is performed supine rather than erect.
true